Hope you’re doing very well.
Something that’s been on my mind
As you may know, I’ve been part of a research team documenting maternal health interventions in Nigeria over the last 30 years. We’re developing a database that will be available to the public (but primarily built for journalists working on the health beat) quite soon - more on that another time.
Every few years, the World Health Organization publishes their Trends in Maternal Mortality report. It’s a document that tells the estimated Maternal Mortality Ratio (MMR) of all their member countries over a period of time. The worst countries are usually India and Nigeria who account for about a third of the maternal deaths in the world.
Before we go too deep, let me explain what the Maternal Mortality Ratio means. It is the number of maternal deaths that occur in a location divided by 100,000 live births. A maternal death (has a technical definition that’s heavily debated) but is simply the death of a woman while pregnant or within 42 days of termination of pregnancy.
On the surface, there seems to be nothing wrong with WHO’s estimates. But below is a graph of WHO’s MMR estimates for Nigeria from the last three reports: 2014 (for the years 1990 to 2013), 2015 (for the years 1990 to 2015) and 2019 (for the years 2000 to 2017).
Figures are from the reports. Graph is by me.
Basically, these estimates change at such a frequency that decisions based on those figures could be quickly irrelevant. You might say that’s the nature of estimates, but maternal mortality is such a pandemic in the country that estimates that volatile are not good. And what’s worse, estimates from one report to the other are often outside of the margin of error of each other for the same year.
The estimates vary frequently because they are based on estimates themselves. WHO’s model relies on covariates like the country’s general fertility rate, GDP and percentage of births performed with skilled birth attendance. And because Nigeria does not have it’s own civic registration and vital statistics (CRVS) database, there is nothing to correct WHO’s one-size-fits-all-countries model. To be fair, CRVS databases can be difficult to implement; the United States only started republishing their official MMR figures in January after 11 years.
In the US case, the issue was something as simple as getting states to adopt a new checkbox on death certificates.
You might wonder if WHO knows that their estimates might be off, and yes they do. In fact, in a WHO bulletin 5 years ago, two researchers pointed out this same discrepancy for South Africa. Frankly, the ball lies in Nigeria’s (and South Africa’s, and other countries who don’t have a CRVS database) court. Until then, different data sources continue to give different figures.
If you want to learn more about Nigeria’s maternal health or our work at Maternal Figures, just reply!
Things I Enjoyed Reading
Cameroon’s government has launched a Small and Medium Enterprises Prototyping Fund (PDF) directed at hardware startups who need funding to develop their first prototype. Interestingly, only entrepreneurs under 35 may apply and its 20 recipients have to commit to a three-year horizon to go to market. It will be interesting to see how this grows in the near future.
Food security remains a big issue on the continent. And unlike many other investors, Fledge has made a lot of investments in startups in the food space. Last month, 27 of those startups across 10 countries were ‘bundled’ into a holding company: Africa Eats. Combined, these startups earned $7 million in 2019. The holding company is registered in Mauritius and has an aggressive plan to be publicly listed before the end of the decade.
In The Conversation, Alex Mashilo writes about how organized labour can shape the direction of new technology and its impact on workers. He gives an interesting case study of Volkswagen introducing robots in their Uitenhage plant in South Africa, but also highlighted an interesting statistic: from 1995 to 2017, automobile manufacturers in South Africa doubled the capacity of output per worker.
Zafree: making paper from agricultural waste. Ethiopia
CityTaps: prepaid water meters for rural communities. Niger/France
AsaDuru: stabilized rammed earth for construction. South Africa
Riding a motorbike is a thrilling experience, but a good number of people worry about the safety of the rider and emergency communications in case of an accident.
Casky, a Morrocan startup, is building a connected device to be attached behind a motorcycle helmet. The device is activated by braking or turning, has a visible red light to amplify your braking signal, offers proximity information of gas stations, and sends a call to the local helpline in emergencies.
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