LEGAL FRAMEWORK FOR TRADITIONAL AND FAITH-BASED MATERNAL HEALTHCARE PRACTICES IN NIGERIA

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 iii 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.