ABSTRACT
Nigeria was first identified as a country with one of the highest rates of maternal mortality in the world in the mid-1980s. The groundbreaking paper by Kelsey Harrison (1985) that reported the determinants of maternal deaths among nearly 23,000 deliveries in northern Nigeria was what the world needed in order to understand the enormity of the problem in low-income countries. The paper described the association between social inequity, economic deprivations, and illiteracy and the high rate of maternal mortality in the region, and highlighted the importance of focusing on broad-based development and governance issues in efforts to prevent maternal mortality. The worldwide dissemination of the paper’s results was followed by the convening of the International Conference on Safe Motherhood in Nairobi, Kenya (Cohen 1987). The conference galvanized global commitment to reduce maternal mortality by half by 2000. The increased recognition of the influence of socioeconomic determinants, cultural experiences, and the low status of women led to a paradigm shift from the hitherto narrow focus on family planning as the main weapon to fight overpopulation to a more broad-based agenda focusing on human development and the empowerment of women.
