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This is to certify that the research work, "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" by ---, Reg. No. --/H2007/01430 submitted in partial fulfillment of the requirement award of a Higher National Diploma on --- has been approved.

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This project is dedicated to Almighty God for his protection, kindness, strength over my life throughout the period and also to my --- for his financial support and moral care towards me.Also to my mentor --- for her academic advice she often gives to me. May Almighty God shield them from the peril of this world and bless their entire endeavour Amen.

ACKNOWLEDGEMENT

The successful completion of this project work could not have been a reality without the encouragement of my --- and other people. My immensely appreciation goes to my humble and able supervisor mr. --- for his kindness in supervising this project.
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Maternal mortality has been describe as the death of women while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy. Iguomo community in Ovia North-East Local Government Area of Edo State is not an exemption to the effect of maternal mortality as research shown that most of the pregnant women suffer from issues related to maternal mortality due to the lack of awareness and high level of illiteracy or exposure to the effect of maternal mortality. Some of the most peculiar problems facing the women in Iguomo which is located in Edo State are ignorance, poverty, home delivery and inadequate maternal centres which are some of the factors that contribute to maternal death in Iguomocommunity. However, there is urgent intervention and need for the government to organize sensitization programmes on awareness of the effect of maternal mortality and also to rehabilitate the existing health facility like provision of electricity, deployment of more medical personnel to the community, provision of ambulance for emergency situations. Therefore the further researcher should collectively expand the knowledge on how to minimize the maternal mortality rate not only through this state but also to the nation and worldwide in general.

TABLE OF CONTENTS
COVER PAGE
TITLE PAGE
APPROVAL PAGE
DEDICATION
ACKNOWLEDGEMENT
ABSTRACT
CHAPTER ONE
INTRODUCTION

1. BACKGROUND OF STUDY
2. PROBLEM STATEMENT
3. RESEARCH OBJECTIVES
4. SIGNIFICANCE OF THE STUDY
5. RESEARCH QUESTIONS
6. SCOPE AND LIMITATIONS OF THE STUDY
7. DEFINITION OF TERMS

CHAPTER TWO
LITERATURE REVIEW

1. REVIEW OF THE STUDY
2. CONCEPTUAL REVIEW OF THE STUDY
3. THEORETICAL FRAMEWORK
4. THEORETICAL IMPERATIVES AND THE STATE OF MATERNAL HEALTHCARE IN NIGERIA
5. CAUSES OF MATERNAL MORTALITY IN NIGERIA
6. REDUCING MATERNAL MORTALITY IN NIGERIA
7. CARE ETHICS AS A HEALTH CARE PRACTICE IN NIGERIA
8. MATERNAL HEALTH CARE IN NIGERIA
9. CULTURAL FACTORS INFLUENCING MATERNAL MORTALITY
10. SOCIOECONOMIC FACTORS INFLUENCING MATERNAL MORTALITY
11. EFFECTS OF MATERNAL MORTALITY ON SOCIOECONOMIC DEVELOPMENT
12. INTERVENTIONS TO REDUCE MATERNAL MORTALITY

CHAPTER THREE
METHODOLOGY

1. STUDY AREA
2. THESTUDYPOPULATION
3. STUDY DESIGN
4. SAMPLING METHOD
5. RESEARCHINSTRUMENTS
6. DATACOLLECTIONMETHODS
7. STUDYVARIABLES
8. ETHICALAPPROVAL
9. DATAANALYSIS

CHAPTER FOUR

1. RESULTSANDDISCUSSION
2. RESULTS
3. DISCUSSION

CHAPTER FIVE

1. CONCLUSION
2. RECOMMENDATION
3. REFERENCES

ABBREVIATIONS
CPD:Cephalo-PelvicDisproportion;
EOC:EmergencyObstetricsCare;
FANC:FocusedAntenatalCare;
HCW:HealthCareWorkers;
iMMR:InstitutionalMaternalMortalityRatio;
LGA:LocalGovernmentArea;
MDG:MillenniumDevelopmentGoals;
MDR:MaternalDeathReview;
MMR:MaternalMortalityRate;
MPDSR:Maternal,PerinatalDeathsSurveillanceandResponse;
NDHS:NationalDemographicandHealthSurvey;
TBAs:TraditionalBirthsAttendants;
WHO:WorldHealthOrganization;
WRA:WomenofReproductiveAge

CHAPTER ONE
1.0                                          INTRODUCTION
1.1                                           BACKGROUND OF THE STUDY
Maternal mortality, also known a maternal death, continues to be the major cause of death among women of reproductive age in many countries and remains a serious public health issue especially in developing countries (WHO 2007). As explained in Shah and Say (2007), a maternal death is defined as the death of a women while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. Globally, the estimated number of maternal deaths worldwide in 2005 was 536,000 up from 529,000 in 2000. According to the WHO factsheet (2008) 1500 women die from pregnancy or pregnancy related complication every day. Most of these deaths occur in developing countries and most are avoidable of all the health statistics compiled by the WHO, the largest discrepancy between developed and developing countries occurred in maternal mortality. Ujahet al. (2005) noted that while 25 percent females of reproductive age lived in developed countries. The contributed only 1 percent of maternal deaths worldwide.
Nigeria has been mentioned by the United Nations as having one of the highest rates the top medical causes of maternal mortality in the world. Reducing high maternal mortality ration is not just a technical and medical challenge but largely a political one which requires the attention and commitment of political leaders. Mothers are the key to the provision of health services for children, she has been neglected and exploited by health service, traditionally to serve infants. As Nigeria is till passing through various stages of development many women still deliver at home without attending antenatal clinics Edo State being part of Nigeria also many cases maternal mortality rate. This study is aimed at finding mortality rate occur due to obstetric hemorrhage. Other include infections following childbirth, unsafe abortion, eclampsia and obstructed labor. Experts agree that these causes are largely treatable and preventable. The root causes of high maternal mortality in Nigeria include weak development planning, poverty, illiteracy and low utilization of formal maternal health care services.
In recent years the international safe motherhood conference convened in Kenya raised global awareness of the devastating maternal mortality rates in developing nations and formally established the safe motherhood initiative. The goal was to reduce maternal mortality 50% unity the plight of the pregnant woman. Initially, donors, United Nation (UN) agencies and government focused of on 2 strategies to reduced maternal mortality: increasing antenatal care and training for traditional birth attendants.
Improving the health care system overall is undoubtedly a critical component to reducing maternal mortality and improving the general health of a nation. The current implementation of free health care to pregnant women and under five children seem to be yielding some positive results but Nigeria’s Maternal Mortality Rate (MMR) however, is yet to reach the reduction rates as recommended.
1.2                                           PROBLEMSTATEMENT
In spite of all the policies, declarations and other efforts aimed at reducing maternal death across the globe, only modest gains in maternal mortality reduction appear to have been achieved in many countries in the past 20 years (Shah and Say, 2007).
In Nigerian, The Federal Ministry of Health had set year 2006 as the target year that maternal mortality would have been reduced by 50 percent. However, not only were these targets not achieved but also the maternal health situation in Nigeria is now which worse than in previous years (Ujah et al., 2005).
Past efforts to reduce maternal mortality ratio in Nigeria were concentrated on making direct improvements to the health systems. These efforts have not involved enough resources to successfully reduce maternal mortality in the country.
1.3                                           AIMS AND OBJECTIVE OF THE STUDY
The objective of this study is to:
Bring together some of the risk factors mentioned in the past as responsible for high maternal mortality in Nigeria. These include whether the woman received antenatal care, whether delivery was assisted by a health professional, whether delivery took place in a health facility and the educational attainment of the woman, and income disturbing. The objectives of the study are:

1.  Identify the factors that seem to have more effect than the others on maternal mortality in Nigeria.
2.  To ascertain the causes of maternal mortality.
3. To identify possible solution to reducing maternal mortality.
4. To identify the poor attitude relation to general public, community in relation to maternal mortality have to be investigated.

1.4                                           SIGNFICANCE OF THE STUDY
The importance of this research work is exclusively to emphasized on the attention of women of child bearing age through these means and also to let the work know that women are reproductive to our society in world and at large population.
1.5                                 SCOPES AND LIMITATION OF THE STUDY
The study cover all the precautionary measures towards the effect of maternal mortality rate in Iguomo community in Ovia North-East Local Government Area of Edo State, with the aims and objectives governing the research work to the effective undertaken by the researcher. The study will be delimited to the effect of maternal mortality rate of women of child bearing age between the age of 20 – 40 years in Iguomo community in Ovia North-East Local Government Area of Edo State Nigeria.
1.6                                 RESEARCH QUESTION
i. What are the possible ways in the prevention of maternal mortality rate among women of child bearing age?
ii. What are the causes of maternal mortality?
iii. How do you educate the female and community about the effect of maternal mortality?
iv. How do you identify the effect of maternal mortality?
1.7                                                  DEFINITION OF TERMS
Poverty: The absence of those needs necessary for human survival. The new encyclopedia Britannica volume 9, Chicago: Encyclopedia Britannica 2003. It is also a major barrier to human development. Poverty can also defined as the situation of people whose “resources (material, social and cultural) are so limited as to exclude them from the minimum acceptable way of life in the countries where they live. (Defining poverty, http://www.anglicare.com)
Maternal: Maternal means a mother, related through the mother’s side of the family. (Advanced Learners Dictionary).
Mortality: Means death and dying, the irreversible caesarian of life and the imminent approach of death. (Encarta – Encyclopedia 2002).

CHAPTER FIVE
5.1                                                         CONCLUSION

We concluded that the majority of causes and contributory factors to reported maternal deaths are preventable through combined safe motherhood strategies of focused antenatal care, prompt referral, active management of labour and immediate post-partum period and access to family planning. However, the pattern of the causes is gradually changing with deaths due to cephalopelvic disproportion on the decline due to availability of caesarean section services. MPDSR provides a platform for critical evidence of where the main problems lie. MPDSR also provides evidence-based recommendations to maternal health stakeholders on strategies that could significantly reduce maternal mortality. The implementation and institutionalization  of MPDSR programmes is on course in Edo State. MPDSR is feasible and should be institutionalized in all states of Nigeria. A commitment to act upon the findings of MPDSR is a key pre- requisite for success.

5.2      RECOMMENDATIONS

Based on the conclusions arrived at in this study, the authors recommend that efforts should be made by relevant stakeholders such as individuals, families, communities, health care providers and the government towards:

1. Curbing maternal and child mortality, by tracking down the escalating figure in the world, Africa and Nigeria in particular.
2. The Christian nurse as a major stake holder must do everything possible to offer her expertise towards the reduction of these death tolls.
3. Emulating positive steps already taken by some countries of the world who have recorded positive outcome in this direction.

CHAPTER TWO: The chapter one of this work has been displayed above. The complete chapter two of "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" is also available. Order full work to download. Chapter two of "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" consists of the literature review. In this chapter all the related work on "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" was reviewed.

CHAPTER THREE: The complete chapter three of "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" is available. Order full work to download. Chapter three of "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" consists of the methodology. In this chapter all the method used in carrying out this work was discussed.

CHAPTER FOUR: The complete chapter four of "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" is available. Order full work to download. Chapter four of "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" consists of all the test conducted during the work and the result gotten after the whole work

CHAPTER FIVE: The complete chapter five of "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" is available. Order full work to download. Chapter five of "the effect of maternal mortality rate among female between the age of 15 to 40yrs in iguomo community, ovia north-east local government area, edo state, nigeria" consist of conclusion, recommendation and references.

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