The Medical Director of General Hospital, Gusau, Zamfara state, Dr. Amina Mohammed Hassan speaks on how Traditional and Cultural Beliefs Driving Maternal Mortality in Northern Nigeria .
By Bilkis Abdulraheem Lawal
Deeply rooted traditional and cultural practices in Northern Nigeria are fueling alarmingly high rates of maternal mortality, particularly in states such as Zamfara, Katsina, Sokoto, and Kano.
The Medical Director of General Hospital, Gusau, Zamfara state, Dr. Amina Mohammed Hassan, disclosed this in an exclusive interview with BAL-News. She explained that while religion is often blamed, many harmful practices are largely cultural, though they have become intertwined with faith, making them difficult to challenge.
“Many women in the North are conditioned to depend entirely on their husbands for money, permission, and even decision-making about their health. This lack of autonomy delays or prevents them from seeking skilled care during pregnancy and childbirth,” she said.
Harmful Practices and Delays in Care
One major issue, Dr. Hassan noted, is the widespread belief that pregnancy and childbirth are natural processes requiring no medical intervention. Women who choose hospital deliveries are often mocked as “lazy” or “weak.” Instead, families turn first to traditional healers, herbalists, or religious clerics for remedies before seeking professional care, often too late.
She recounted a harrowing case of a woman in labour attended to by an unqualified environmental health worker. The woman presented with a breech birth, but in the process of mishandling, the baby’s body was separated from the head before she was rushed to the hospital. “Even then, the family defended the attendant, saying he was only trying to help,” Dr. Hassan said.
Traditional birth attendants (TBAs), who inherit the practice through family lines, also play a significant role in maternal and neonatal deaths. Practices such as the dangerous “Gishiri cut”, an unskilled episiotomy performed to address obstructed labor, often result in life-threatening injuries, obstetric fistula, and even death.
Traditional Birth Attendant trying to resuscitate a new mother (Photo Credit: Meta AI)
Although training programs supported by organisations like Maternal, Newborn, and Child Health 2, have reduced some of these harmful practices by teaching TBAs to refer women to health facilities, the legacy of mistrust in modern healthcare persists.
Polygamy, Poverty, and Contraception
Dr. Hassan further highlighted the role of polygamy and cultural perceptions of fertility in worsening the crisis. Many women see having multiple children as a form of competition among co-wives, often without regard for their health.
Even when advised on contraception for medical reasons, husbands frequently resist. “I once counseled a woman with pregnancy-induced hypertension who already had 10 children. Her husband refused contraception, insisting his mother bore 12 and looked younger than his wife,” Dr. Hassan recalled.
Though economic hardship is now gradually shifting perceptions, with more women independently seeking family planning services, cultural barriers remain significant.
The Statistics Behind the Crisis
Globally, about 700 women die daily from preventable causes related to pregnancy and childbirth, translating to one death every two minutes. Nigeria contributes a disproportionate share of this tragedy.
According to the World Health Organization (2023), Nigeria’s maternal mortality ratio stands at 1,047 deaths per 100,000 live births, with northern states like Zamfara consistently recording 1,100 per 100,000 live births according to MNCH2.
This stands in stark contrast to the Sustainable Development Goal (SDG) target of reducing global maternal mortality to fewer than 70 deaths per 100,000 live births by 2030.
The Role of Men, Leaders and Media
Dr. Hassan stressed that patriarchal norms are central to the problem. In many communities, even when women recognise danger signs during pregnancy, they cannot seek care without their husband’s or mother-in-law’s consent. Some families believe women who go to hospitals without permission will be punished by “angels,” she noted.
However, progress is being made through male engagement and advocacy by traditional and religious leaders. “When village heads and imams encourage facility-based deliveries and lead by example, communities are more likely to follow,” she said.
She also emphasised the media’s critical role, particularly radio, in raising awareness in hard-to-reach communities plagued by insecurity. “Radio is still the most powerful tool for sensitisation here. It can save lives where insecurity prevents physical outreach,” she added.
A Call for Action
Dr. Hassan urged stronger investments in universal health coverage, community midwifery, and culturally sensitive advocacy to dismantle harmful traditions. She also called for collaboration between government, civil society, and the media to shift attitudes and empower women with both knowledge and autonomy.
“Maternal deaths in Nigeria are preventable. Culture and tradition should never be reasons why women lose their lives giving birth,” she concluded.
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