The World Health Organisation (WHO) has called for Nigeria to scale up efforts to address systemic fragmentation and accelerate maternal health progress in the country.
WHO’s representative in Nigeria, Dr. Walter Mulombo emphasised this on Thursday in Abuja at the 2024 Maternal Health Policy Dialogue, themed “Scaling Maternal Health Innovations in Nigeria,” organised by Nigeria Health Watch.
Science Nigeria reports that maternal mortality remains a critical issue in Nigeria, which ranks second globally in maternal deaths according to a 2023 WHO report. This alarming statistic underscores the gap between Nigeria’s current health outcomes and the Sustainable Development Goals (SDG) target of fewer than 70 maternal deaths per 100,000 live births.
Systemic barriers such as poor access to healthcare services, financial constraints and inadequate transportation infrastructure contribute to delays in seeking maternal healthcare, exacerbating the crisis. However, innovative approaches in digital health, telehealth, and evidence-based interventions like E-MOTIVE, a post-partum haemorrhage management bundle, offer promising solutions.
Mulombo highlighted that one of the fundamental challenges is the fragmentation of healthcare interventions across various departments and sectors. “Addressing these gaps, particularly in family planning services, exclusive breastfeeding, and treatment for childhood illnesses, is critical. Enhancing coordination and ensuring universal coverage for these interventions are essential steps towards achieving the SDG targets in Nigeria,” he said.
He stressed the need for aggressive, deliberate actions and strong governance. “Nigeria’s commitment to reducing maternal, newborn and child mortality aligns strongly with the WHO World Health Assembly (WHA) resolution aimed at accelerating progress towards health-related SDGs, particularly SDG 3. The resolution focuses on ensuring healthy lives and promoting well-being for all at all ages,” he noted.
Since the adoption of the SDGs in 2015, Nigeria has shown consistent commitment to improving maternal and child health outcomes. “Key targets in the WHA resolution include reducing the maternal mortality ratio to below 70 per 100,000 live births by 2030 and significantly reducing child mortality rates. These targets are crucial benchmarks for assessing progress and guiding national health strategies,” Mulombo said.
He disclosed that Nigeria’s proactive stance in sponsoring the resolution underscores its dedication to advocating for innovative approaches and the effective implementation of national health plans. The WHO representative called for a shift towards comprehensive, scalable solutions over pilot studies to drive significant improvements in health outcomes.
Mulombo highlighted the importance of investing in primary care and addressing health and care workforce shortages to build resilient health systems capable of providing quality care for all, especially in underserved and fragile regions. “Strategic initiatives such as the Nigeria Health-Sector Renewal Investment Initiative are crucial components of Nigeria’s strategy to improve primary healthcare. By promoting a primary care-centric model and enhancing governance, Nigeria aims to effectively reduce preventable maternal and child deaths,” he stated.
According to him, special attention is needed for healthcare systems in fragile and conflict-affected regions, such as northeast Nigeria. “Strategies to overcome barriers in these areas include establishing a robust healthcare network with strong referral mechanisms and supporting pre-hospital services, laboratories, and blood banks. These efforts are essential to ensure that all regions, including those experiencing humanitarian crises, receive adequate healthcare support,” he added.
Mulombo stressed that urgent action is needed to move beyond repetitive commitments and focus on implementing effective strategies. “With Nigeria’s visible efforts to implement the WHA resolution, the emphasis is now on turning discussions into concrete actions to achieve the SDG targets by 2030,” he said. He emphasised that maternal health impacts everyone and preventing maternal deaths is a collective responsibility.
Director of the Africa Centre of Excellence for Population Health and Policy at Bayero University Kano, Prof. Hadiza Galadanci highlighted that early detection and treatment of postpartum haemorrhage using the WHO MOTIVE “First Response” Bundle is key to reducing the thousands of women dying from excessive bleeding. In 2020, an estimated 287,000 women globally died from maternal causes, amounting to almost 800 maternal deaths daily. “Globally, haemorrhage accounts for more than 25 percent of maternal mortality. Postpartum haemorrhage (PPH) remains a leading cause of maternal deaths in Nigeria due to delays in care,” she explained. Galadanci stressed the need to move from identifying problems to implementing solutions.
Director of family health at the Ministry of Health and Social Welfare, Dr. Binyerem Ukaire noted that the ministry is implementing the E-MOTIVE strategy as part of the Safe Motherhood Project. “For these strategies and policies to be effective, Nigerians must unite to drive initiatives that mitigate maternal mortality,” she noted.
Consultant for nutrition (ANRIN) and the adolescent health project at the Society for Family Health (SFH), Mrs. Fatima Muhammad highlighted the effectiveness of the E-MOTIVE approach. However, she noted the need to ensure its adaptability in rural communities and sustainability at primary healthcare centres before nationwide implementation.
Former president of the Society of Gynaecology and Obstetrics of Nigeria (SOGON), Dr. Habib Sadauki highlighted cultural challenges as a significant threat to the successful implementation of the E-MOTIVE strategy. Sadauki advocated for grassroots education to change perceptions and behaviours, thereby improving hospital-based maternity care.
Managing director of Nigeria Health Watch, Mrs. Vivianne Ihekweazu concluded that the discussions at the maternal health policy dialogue demonstrated that scaling maternal health innovations and implementing effective policies and strategies were crucial for improving maternal health outcomes. According to Ihekweazu, ensuring safe and equitable healthcare for every woman giving birth in Nigeria is essential. She emphasised that this timely policy dialogue brought together key stakeholders to discuss the benefits, challenges, and strategies for implementing and scaling up maternal health innovations within the Nigerian healthcare system. “Access to quality maternal healthcare should not be a privilege; it is a right, and every woman should have this access, irrespective of where she is,” she said.
