Islamic perspectives of reproductive and maternal health: what role can Nigerian Muslim religious leaders play in the prevention of maternal mortality? –With Particular Reference to Zamfara State NorthWest Nigeria

Reproductive and Maternal health are an important components of public health and medicine which are concerned with the complete state of physical, mental and social wellbeing in all matters regarding reproductive system and health of mother especially during pregnancy.It implies ensuring that all women receive the care they need to be safe and healthy throughout pregnancy, childbirth and beyond. However, according to World Health Organization, millions of women all over the world do not have access to good quality health services during pregnancy and childbirth resulting in mortalities. Islam is a complete way of life. The Qur’an and Hadith consider pregnancy and child bearing as signs among other signs of the divine existence of Allah.The importance of maternal and reproductive is thus not unexplained in the Islamic perspectives. The study look at what role Muslim religious leaders can play in the prevention of maternal deaths and morbidities in developing countries. A qualitative study was conducted through in-depth interviews and focus groups discussion with a purposive sample of some Muslim religious leaders from Gusau local government area of Zamfara state northwest Nigeria in order to elicit information about the Islamic perspectives of reproductive and maternal health and the roles they can play in the prevention of maternal deaths among the Muslim communities. Muslim Religious leaders have a crucial role and contribution for the attainment and maintenance of good heath of women and children among Muslim communities through public enlightenment in the context of ‘ilm’, providing guidance through ‘Fatwah’ and community mobilization in the spirit brotherhood ‘ukhuwah’.Islam does not accept the “preventable death of a woman” due to childbirth or pregnancy. Thus, Islam encourages attendance of antenatal care visits and health care seeking

ANALYSIS OF THE IMPACT OF INSECURITY, EXCHANGE RATE AND ENERGY PRICES ON INFLATION IN NIGERIA

The study investigates the impact of insecurity, exchange rate, and energy prices on inflation rate in Nigeria. To document this study, time series data were used from 1985 to 2022. Major variables used include insecurity, which was proxied by security expenditure, exchange rate, premium motor spirit prices, crude oil prices, and inflation. Descriptive and inferential statistics was employed specifically the autoregressive distributive lag (ARDL) model. Findings revealed that LCRPR, LPMS and LINSEC are stationary at first difference whereas LINFL and LEXCH achieved stationarity at levels and a long run relationship exists among the series. However, in the short run, insecurity and premium motor spirit have a positive relationship to inflation whereas exchange rate is on the contrary. Also, crude oil prices and premium motor spirit possesses an inverse relationship while exchange rate and insecurity are on the contrary in the long run. The study further reveals that insecurity, exchange rate and premium motor spirit has a unidirectional relationship to inflation. Consequently, the study concluded that all the variables insecurity, exchange rate, crude oil prices and premium motor spirit have significant impact with varying magnitude on inflation under the period considered. Therefore, the study suggested that government should aggressively diversify her economy towards the non-oil sector with emphasis on the critical sectors and also a Marshallian action plan need to be instituted by all stakeholders within the value chain on how to bring the insecurity condition to its knees as this will revive and spur economic activities

Intervention programmes and policies for maternal mortality reduction in Zanfara State, Northwest, Nigeria: a review 2005-2015

Estimates indicate that Nigeria has more than 50,000 maternal deaths annually, while many key maternal health indicators have remained stagnant or have worsened over the last decade, and coverage and utilization of key interventions are correspondingly low. The maternal mortality in Nigeria is 576 per 100,000 live births according to Nigeria demographic health survey 2013.This study used both quantitative and qualitative methods as well as secondary data to review the interventions program and policies for the reduction of maternal mortality in Zamfara state. The results indicated that socio-cultural issues, non-utilization of health facilities and preference for home deliveries by mothers remain some of the major reasons for the high maternal deaths. Other institutional factors include insufficient manpower and frontline health care workers. There are obvious gaps in policies, funding and political commitment, poverty, weakened capacity of public institutions, low literacy levels and other entrenched negative health seeking behaviours

The health MDGs in Zanfara state with emphasis on maternal mortality 2010-2015: perspectives and challenges

The Nigerian government has demonstrated commitments for the attainment of the Millennium Development Goals particularly the Health MDGs with an emphasis on reducing maternal mortality. Yet Nigeria along with other developing countries especially in Sub-Saharan Africa could not achieve most the health related targets. Maternal mortality is still unacceptably high with Nigeria contributing to about more than 10% of the global burden of maternal deaths at 576/100.000 live births. Nothern Nigeria continued to have the highest maternal mortality ratio compared to the south states of the country. Zamfara State has one of the highest rates in the northwest second next to Kano State. This study aims to examine some of the challenges of achieving the health MDGs targets in Zamfara State with a particular reference to maternal deaths in the states. Data for this study were collected through qualitative method facilities based approached and review of secondary data. The results of the study showed high maternal deaths at the health facilities and low hospital utilization and health facility deliveries. The causes for high maternal deaths are both direct medical and indirect causes. Some of the medical causes include Hemorrhage, eclampsia sepsis and malaria, while the indirect and non medical causes include socio-cultural and economic factors. These are some of the challenges faced in achieving the MDG target of reducing maternal deaths in Zamfara State. With the new UN Sustainable Development Goal (SDGs). States in the north like Zamfara needs to re-strategize efforts to improve on the health SDGs especially the maternal health

Knowledge, attitude and perception of Islamic religious leaders on maternal health issues in Zamfara state, Northwest, Nigeria: a qualitative study

The objective of this study was to evaluate the knowledge, attitude and perception of the Islamic religious leaders (IRLs) on maternal health issues in Zamfara States, Nigeria, as well as the roles they can play in reducing maternal deaths in the state with a view to improve the maternal. A qualitative study, in the forms of in-depth interview and focus group discussion was conducted in eliciting information from the IRLs regarding their knowledge, attitude and perception on maternal health issues and maternal deaths among women of reproductive age in Zamfara State. A total of sixty four (64) IRLs were purposively sampled for this reason. The results show that all of the IRLs interviewed have a positive perception on maternal health issues and programs implemented by partners and donor agencies in maternal health services in the state, especially those with some knowledge about the activities of these implementing agencies. Their knowledge and understanding of the maternal health issues was high especially on maternal health issues from the Islamic perspectives and viewpoint. IRLs served as health educators on maternal health through delivering sermons at Friday congregational prayers (jummaat), Islamic gatherings and schools. In conclusion, the IRLs can become an important medium for information, education and communication in improving maternal health services uptake. Programmers, implementing agencies and donor partners in maternal health services need to collaborate and work with the IRLs in achieving the set targets of maternal mortality reduction and improving uptake of maternal health services in Zamfara

Maternal mortality and the implementation of maternal health policies in Zamfara state: challenges and issues

The Nigerian health system operates within the federal design of its political system. The 1988 National Health Policy revised in 1996 and 2004 lays out the different functions within the system. The Federal Ministry of Health is responsible for defining the overall policy framework for the health system of the whole country. There is a wide geographical variation on maternal mortality in Nigeria, with the north having a far higher rate compared to the south. The North-west zone has one of the highest figures of 1,549/100,000 almost ten times that of the south-western zone (165/100,000). The rural area, where most of Nigerians live, has a higher maternal mortality ratio (828 deaths per 100,000 live births) compared to the urban areas (351 maternal deaths per 100,000 live births). The leading causes of maternal mortality were eclampsia, sepsis, postpartum haemorrhage, antepartum haemorrhage, unsafe abortion, obstructed labour and heart failure. Also several intermediate social and cultural factors account for many of these deaths. In the face of these challenges, there have been efforts on the part of the Government of Nigeria and states to improve the health status of women and children. Data for this study were collected through review of secondary data; facilities based approached and questionnaire administration. The results of the study showed that there are several maternal health policies launched in Zamfara State and Nigeria but are faced with several challenges and issues of implementation. Zamfara State has put in place several interventions policies and programmes in order to improve the maternal health situation in the state and reduce maternal mortality. Many of the respondents interviewed are aware of some of the policies or their implementation. However, respondents are of the opinion that there are inadequate staff and equipment to cater for the maternal health services in the state. It is concluded that maternal mortality in Zamfara State still remain high and even higher than the national average of 576 according to the Nigeria Demographic and Health Survey of 2013 despite the implementation of some of these policies

Health care seeking behavior of pregnant women in Gusau Metropolis of Zamfara State, Northern Nigeria

Purpose: The objectives of the study were to determine the health care seeking behavior and the barriers to hospital delivery of pregnant women in Gusau metropolis of Zamfara State, Northwest Nigeria. Also the study was to identify those factors that prevent women from delivering at the hospital and access care. Methods: The study used both survey and qualitative technique. In the survey a descriptive cross sectional survey involving with patients based on a structured questionnaire format with answer sets was used to ask about (N=826) pregnant women attending antenatal care at some clinics in Gusau metropolis about how, why, where and when they seek care and how they perceive certain illness during pregnancy. While about 6 focus group discussions (FGDs) were conducted at the health facilities targeting the pregnant women in order to understand their illness behavior and perception to facility delivery. During the FGDs notes were taken and answers recorded using a tape recorder and video. Results: 87.9% of the respondents said they attend Antenatal care clinics (ANC) regularly and many of the respondents have some knowledge of complications during pregnancy, N=177 reported having headache, N=221 and N=227 reported having fever and swelling of legs respectively.87.1% of those attending ANC indicated that they will seek care at hospital or clinic. Though, responses in the FGDs, many of the respondents indicated that they seek care at health facility but will however not want to deliver at the hospital. Conclusion: There is a remarkable improvement in attendance of ANC by pregnant women but yet the hospital delivery is very low and not exciting as many women wished to deliver at home rather than in the hospital. Also many of the women’s perception about their health or illness during pregnancy are that they think it is normal to be sick and therefore not necessary to visit the clinic. There is still high preference for home delivery among the pregnant women in Zamfara State, with a consequent increased in maternal deaths unreported

Selenium supplementation in patients with peripartum cardiomyopathy : a proof-of-concept trial

Background: We studied the efficacy and safety of selenium supplementation in patients who had peripartum cardiomyopathy (PPCM) and selenium deficiency. Methods: We randomly assigned 100 PPCM patients with left ventricular ejection fraction (LVEF) &lt; 45% and selenium deficiency (&lt; 70 mu g/L) to receive either oral Selenium (L-selenomethionine) 200 mu g/day for 3 months or nothing, in addition to recommended therapy, in an open-label randomised trial. The primary outcome was a composite of persistence of heart failure (HF) symptoms, unrecovered LV systolic function (LVEF &lt; 55%) or death from any cause. Results: Over a median of 19 months, the primary outcome occurred in 36 of 46 patients (78.3%) in the selenium group and in 43 of 54 patients (79.6%) in the control group (hazard ratio [HR] 0.69; 95% confidence interval [CI] 0.43-1.09; p = 0.113). Persistence of HF symptoms occurred in 18 patients (39.1%) in the selenium group and in 37 patients (68.5%) in the control group (HR 0.53; 95% CI 0.30-0.93; p = 0.006). LVEF &lt; 55% occurred in 33 patients (71.7%) in the selenium group and in 38 patients (70.4%) in the control group (HR 0.91; 95% CI 0.57-1.45; p = 0.944). Death from any cause occurred in 3 patients (6.5%) in the selenium group and in 9 patients (16.7%) in the control group (HR 0.37; 95% CI 0.10-1.37; p = 0.137). Conclusions: In this study, selenium supplementation did not reduce the risk of the primary outcome, but it significantly reduced HF symptoms, and there was a trend towards a reduction of all-cause mortality.Errata: Karaye, K.M., Sa’idu, H., Balarabe, S.A. et al. Correction to: Selenium supplementation in patients with peripartum cardiomyopathy: a proof‑of‑concept trial. BMC Cardiovasc Disord 21, 4 (2021). DOI: 10.1186/s12872-020-01782-w </p