From 10% to 100% Coverage for Institutional Deliveries in Nigeria: The Case of Mayo-Ine Health Center

Mayo-Ine Health Center lies in Fufore district in Adamawa State in North-East Nigeria. One year ago it was a typical health center in rural Nigeria. Years of neglect had left their mark. The fence was damaged, the roof caving in places, windows broken, and equipment gone. Medical waste was scattered in the backyard, some of it half burnt. Goats were searching the waste, nibbling on edible bits of carton.  The center had no running water. Its latrines were defunct. Essential drugs were out of stock and vaccines were rarely available. There had not been supervision from the district for a long time and staff were demoralized and on strike.

The population had gotten used to the situation and was rarely using the facility. In December 2011, just four women delivered at Mayo-Ine, and on average it saw 4 patients per day. The few patients that came were prescribed expensive treatments with drugs which the health workers had bought and sold against a hefty mark-up, making any treatment very expensive. People preferred the local drug vendor who would sell drugs cheaply by the tablet – which fitted their budget better - and consulted with traditional healers.

The situation at Mayo-Ine health center reflected what happens at a larger scale in the North-Eastern region of Nigeria, and to a lesser extent in the rest of Nigeria. Adamawa state is especially dire and its health indicators are at par with South-Sudan which had been at war for 40 years. Nigeria, which contains one- fifth of the entire African population but only 2% of the global population, contributes 14% to the burden of all maternal deaths globally. For a lower-middle income country which is forecasted to be the fastest growing economy in the world over the next forty years, having such poor basic social services would mean unequal growth, social unrest and eventually: the inability to match social development with its economic growth.