Abstract:
Reproductive health and reduction of maternal mortality are major components of the
Sustainable Development Goals. Nigeria‘s Maternal Mortality Rate (MMR) estimate from
2000 to 2015 is 814 deaths per 100,000 live births. Traditional Birth Attendants (TBAs)
and Faith-Based Birth Attendants (FBAs) play a significant role in the provision of
maternal health care services, particularly where orthodox maternal healthcare services are
inaccessible in Nigeria. Previous studies have attributed the causes and high incidence of
MMR mortality in Nigeria to the frequent patronage of TBAs and FBAs by pregnant
women with little focus on the legal framework guiding their practices. This study was,
therefore conducted in order to examine the laws regulating traditional and faith-based
maternal healthcare practices with a view majorly directed at ensuring the standardization
of its practice.
Historical and Sociological theories of law were adopted. Qualitative research method was
adopted. Study location was two urban (Abadina and Agbowo) and two rural (Akufo and
Ologuneru) communities in Ibadan. In-depth interviews were conducted with 48 pregnant
women ages 18 to 29, key informant interviews with 12 TBAs, 12 FBAs and 24 orthodox
maternal healthcare practitioners including doctors, midwives and nurses; four focus group
discussions were held with 32 couples ages 30 and above over a period of six months.
Primary sources of law included the Constitution of the Federal Republic of Nigeria, 1999
(as amended), Traditional Medicine Policy 2007, National Health Policy 2016 and National
Reproductive Health Policy 2017. Legislations from Tanzania, South Africa and Malaysia
were examined for comparative purposes. Secondary sources included books, journal
articles and internet materials. Data gathered were subjected to jurisprudential and
comparative discourse.
Maternal healthcare practices of TBAs and FBAs were inadequately regulated under a
specific national law to address the incidence of maternal mortality in Nigeria. There was a
proliferation of unregulated maternity homes by both TBAs and FBAs. Women patronising
TBAs and FBAs were exposed to risks and subjected to unorthodox practices in the hands
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of quacks and incompetent personnel. The existing policies on health and traditional
medicine lacked provisions regulating TBAs and FBAs. The Traditional Medicine Council
Bill fell short of provisions stipulating standards, training, professionalism, referral and
other practice guidelines in comparison with Malaysia, Tanzania and South Africa that
have lower incidence of maternal mortality. Tanzania‘s Traditional and Alternative
Medicines Act 2002, South Africa‘s Traditional Health Practitioners Act 2007 and
Malaysia‘s Traditional and Complementary Medicine Act 2016 had provisions on
professionalism and specialisation of traditional and complementary medicine practices,
apprenticeship, training and the duty to refer patients.
Nigeria‘s current legal framework for addressing traditional and faith based maternal
practices is weak and requires a review. There is a need for an all-embracing legislation to
ensure more effective maternal health care services in Nigeria.