Supply-side barriers and health system concerns in five high maternal mortality settings in Africa

Background: Chad, Central African Republic (CAR), Sierra Leone, Liberia and Nigeria are among the seven African countries with the highest rates of maternal mortality globally due in the main limited facility deliveries and basic emergency obstetric care. Data Source and Methods: The study sought to contextualize supply-side barriers that encroach on maternal mortality by examining some health system concerns confronting selected African countries. The study makes use of data from the World Bank and adopts a descriptive-analytic approach. Current Health Expenditure of less than 10% in four countries and Domestic General Government Health Expenditure of less than 2% in all five countries evinced underfunding of health. Results: In all five countries, the proportion of skilled health workers fell well short of the WHO requirements for density of doctors and nurses. Conclusion: The onus on individuals to pay for health care was formidable in Nigeria. CAR had the lowest proportion of births attended by skilled health personnel. CAR and Sierra Leone relied heavily on External resources for funding health.