CHAPTER ONE
INTRODUCTION
1.1   BACKGROUND OF THE STUDY
Maternal and child health has emerged as the most important issue that determined global and national wellbeing.  This is because every individual, family and community is at some point intimately involved in pregnancy and the success of childbirth (WHO, 2006).  Despite the honour bestowed on womanhood and the
appreciation of the birth of a new born baby, pregnancy and childbirth is still considered a perilous journey. The situation of maternal and child health in Nigeria is among the worst in Africa and has not improved substantially and in some areas of the country, has worsened over the past decade (Ladipo, 2009).  The maternal mortality ratio ranges between 800-15000 per 100,000 live births (Nigeria Demographic and Health Survey, 2003), with marked variation between geo-political zones – 165 in South West compared with 1,549 in the North-East and between urban and rural areas (Ladipo,
2009).  Total fertility rate is 5.7 births per woman and it is estimated that approximately 59,000 of maternal deaths take place annually in Nigeria as a result of pregnancy, delivery and post-delivery complications (WHO, UNICEF, UNFPA, 2007).
Research (Ladipo, 2009) indicated close link between the health of the new born with the health of their mothers.  About 30-40% of neonatal and infant deaths result from poor maternal health and inadequate care during pregnancy, delivery and the critical immediate postpartum period (Ladipo, 2009).  In Nigeria 340,000 infants die every year during delivery and shortly afterwards especially if the mother dies in childbirth (WHO, UNICEF, UNFPA, 2007). The under-five mortality ratio is 200 per 1000 live births (WHO, 2006).  These deaths are not unconnected with the poor maternal health services in the country and could be avoided through provision of quality and effective maternal and child health services.
Nigeria is one of the African countries with a rapidly growing population.  As a nation with a growing economy, one of the major health challenges facing the country today is the capacity to sustain the increasing infant and maternal health.  The most common recorded cause of perinatal deaths are similar to those of other less developed countries, and the common denominators are early childbearing poor maternal health and above all, the lack of appropriate and quality services (Okereke, Kanu, Nwachukwu, Anyanwu, Ehiri & Merick, 2005).  Although life-saving practices for most infants have been known for decades, currently one third of the mothers still have no access to health care services during pregnancy and almost half do not have access to health care services during childbirth (Okereke, et al., 2005). In the light of rapid population growth and increased risks of adverse environmental health exposures, maternal and child health prospects could be a serious national public health problem due to factors such as ignorance, apathy, poverty, lack of commitment, illiteracy and corruption (Opara & Ellah, 2007).