By Sylvester Ojenagbon

April 7 is World Health Day 2025. The annual event is marked around the world on the anniversary of the World Health Organisation’s (WHO’s) founding in 1948. It presents an opportunity for the global community to reflect on pressing health challenges. The theme this year is “Healthy beginnings, hopeful futures” and the focus is maternal and newborn health and survival. The goal is to end preventable maternal and newborn deaths and prioritise women’s longer-term health and well-being.

Now, childbearing often comes with its unique joys. However, the process sometimes ends in an undesired outcome—maternal mortality, which is the death of a woman during pregnancy, childbirth, or within a short time after childbirth, due to complications related to the pregnancy or delivery. According to WHO, almost 800 women died from preventable causes related to pregnancy and childbirth every day in 2020. That means a maternal death occurred almost every two minutes that year. And nearly 95% of all maternal deaths occurred in low and lower middle-income countries.

It is therefore no wonder that countries have queued up behind the target to accelerate the decline of maternal mortality by 2030—in the context of the Sustainable Development Goals (SDG). SDG 3 specifically includes an ambitious target to reduce the global maternal mortality rate to less than 70 per 100,000 births, with no country having a maternal mortality rate of more than twice the global average.

Unfortunately, Sub-Saharan Africa contributed the highest maternal mortality rate of about 531 deaths per 100,000 live births in 2020, with countries like South Sudan, Chad, and Nigeria (in that order) having extremely high rates. Countries like Algeria and Mauritius are however closer to the Sustainable Development Goal (SDG) target of 70 maternal deaths per 100,000 live births.

An estimated maternal mortality of 1,047 deaths per 100,000 live births was recorded in Nigeria in 2020. A Nigerian woman is said to face a lifetime risk of 1 in 19 of dying during pregnancy or childbirth, compared to 1 in 4,900 in developed countries.

The truth is that the leading causes of maternal deaths in Nigeria are mainly preventable. Studies show that hypertension accounts for 27% of cases, followed by sepsis (20.6%), haemorrhage (17%), and anaemia (3.2%). Systemic delays worsen these issues. Women often face three life-threatening delays: deciding to seek care, reaching healthcare facilities due to poor infrastructure, and receiving adequate treatment on arrival. These delays are compounded by sociocultural factors such as poverty, early marriage, and gender inequality.

Thankfully, the Nigerian government has developed strategic plans to guide health sector development, with a focus on improving maternal and child health. The government aims to improve access to primary healthcare facilities, with a goal of having at least one facility in each of the country’s 10,000 administrative wards.

States are also implementing various strategies, including strengthening primary healthcare, deploying more skilled birth attendants, and improving access to quality maternal health services. Programmes like the Ondo State’s “Abiye” initiative and the Midwives Service Scheme have shown promise in improving access to skilled care. However, many other programmes suffer from poor implementation and lack of accountability. Funding gaps, inadequate health infrastructure, and shortages of skilled personnel remain significant barriers.

Additionally, perceptions of poor-quality care continue to discourage women from utilising available services. Even when facilities are upgraded, utilisation rates will not improve if trust in the healthcare system is lacking.

Reversing the troubling trends in maternal mortality rates in Nigeria therefore requires a multidimensional approach. The government needs to, as a matter of urgency, strengthen the healthcare systems and improve access to quality antenatal care, ensuring that all pregnant women have access to regular antenatal checkups to detect and manage potential complications.

There is also a need to increase the number of trained midwives and other skilled birth attendants, especially in rural areas, and equip healthcare facilities with the necessary resources for safe deliveries.

In addition, more investments in infrastructure, including well-equipped healthcare facilities, reliable electricity, and clean water, need to be made. Primary health care centres should be made fully functional and well stocked so that they can provide adequate care for women.

Adequate resources also need to be allocated to maternal health programmes and improvements to the efficiency and transparency of healthcare spending ensured.

There is also a need to look more critically at the issue of promoting women’s education and economic empowerment to improve their decision-making power regarding their health and address gender inequality and harmful cultural practices that limit women’s access to healthcare.

There should equally be more engagement at the community level in maternal health initiatives to raise awareness and promote positive behavioural changes. It is essential to work more closely with traditional leaders and community members to address cultural barriers.

Poverty is a huge factor in maternal health, so urgent efforts should be made to address the problem of poverty in every part of the country.

Furthermore, collaborations between government agencies, international organisations, and NGOs should be strengthened, and expertise and resources of various stakeholders leveraged.

The maternal health crisis in Nigeria is not just a public health issue but a reflection of broader systemic inequities. Addressing it requires political will, sustained investment, and community engagement. With concerted efforts, the country can turn the tide on maternal mortality and ensure that every woman has access to safe and dignified childbirth.

Ojenagbon, a health communication expert, lives in Lagos.