CHAPTER ONE
INTRODUCTION
1.1     Background of the study
The growing concern on improving reproductive health at the global level  has created a demand for  research  especially in the area of maternal health. Maternal health, which is the physical well being of a woman during pregnancy, childbirth, and postpartum period (WHO, 2011; Fadeyi, 2007), has been a major concern of several international summits and conferences since the late 1980s, which culminated to the Millennium Summit in 2000 (WHO, 2007).
It is obvious that maternal mortality is a key constituent of maternal health. The World Health Organization in the international statistical classification of diseases and related health problems (ICD), has defined maternal mortality as the death of a woman while pregnant or within 42 days of a termination of a pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental and incidental causes (WHO 2007; Ogunjuyigbe and Liasu, 2007; Khama, 2006).  It is within this conceptual framework that the Millennium Development Goal Target 5A, calls for a reduction in maternal mortality ratio by three-quarters by 2015. At its present rate, however, the world will fall short of the target for maternal mortality reduction because the data so far collated suggest that to reach the target, the global Maternal Mortality Rate (MMR) would have had to be reduced by an average of 5.5% a year between 1990 and 2015.
Nigerian constitutes only two percent of the world‟s population, but Nigeria accounts for over 10% of the world maternal deaths, and ranks second globally only to India (Okonofua, 2007; Abdul‟Aziz, 2008). The status of maternal health is poor in Nigeria, defined by maternal mortality of 59,000 per annum due to pregnancy-related causes. This has been identified as the leading cause or determinant of death among women of reproductive age in Nigeria (Idris, 2010).
Although opinion differ on the determinants of maternal mortality, Herfon, (2006), noted  that the cause of maternal mortality is an outcome of nexus interaction of a variety of factors namely: the distant factors (socio-economic, cultural) which include; occupation, income level and illiteracy act through the proximate or intermediate factors (health and reproductive behavior, access to health services) and in turn influence outcome (pregnancy complication mortality).Idris, (2010) further identified other factors responsible for maternal  mortality as sociology-cultural factors which include; traditional practices, norms, believes, education and religion.