Experts Demand Urgent Need For Nigeria Maternal Health Reform As Pathfinder Trains Journalists

… Grim Statistics Spur Outcry For Family Planning, Maternal Health Investment

BY CHIDINMA ONUOHA, Lagos

Nigeria’s maternal health crisis has reached a boiling point. With a staggering 517 deaths per 100,000 live births, as reported by the 2018 Nigeria Demographic and Health Survey (NDHS), experts and media professionals are sounding the alarm for immediate and sweeping reforms. Even more horrifying is the revelation that 70 percent of these deaths occur among girls under the age of 18, a statistic that has ignited outrage and a renewed call for action.

At the centre of this advocacy is Pathfinder International Nigeria, a Non-Governmental Organisation committed to advancing reproductive health. Through its Smart Advocacy for Strategic Action (SASA) project, Pathfinder convened a two-day workshop in Abuja, training 35 journalists and social media influencers from Kaduna, Kano, Lagos, and the Federal Capital Territory (FCT). The initiative, supported by PPDARO and Jhpiego Kenya, aims to equip media professionals with the tools to champion Family Planning (FP) and Maternal, Newborn and Child Health (MNCH) across Nigeria.

90 Percent of Maternal Deaths Are Preventable,Yet They Persist

Participants at the workshop did not mince words. The sheer scale of maternal deaths is appalling, but the fact that nearly 90 percent are preventable makes the crisis even more tragic. Unsafe abortions, haemorrhage, premature births, and malnutrition were cited as leading causes, conditions that could be mitigated with proper healthcare infrastructure and access.

“It is quite unfortunate that maternal mortality deaths in the country are on the high side,” one participant lamented. “But the truth of the matter is that most of these deaths are avoidable. They are caused by poor abortion practices and other conditions like haemorrhage, premature birth, and malnutrition.”

Chronic Underfunding, Cultural Barriers Deepening Crisis

Reports from across Nigerian states paint a bleak picture. Chronic underfunding, delayed release of allocated funds, inadequate medical facilities, poor remuneration of healthcare workers, widespread illiteracy, poverty, and entrenched cultural and religious practices have created a deep distrust of medical services. This lack of trust translates into limited access to treatment and ultimately, preventable death.

Using the FCT, Kaduna, Kano, and Lagos States as case studies, the workshop exposed stark disparities in access to family planning services. While urban residents in the FCT enjoy relatively easy access, rural communities across its six council areas remain underserved.

Kaduna State exemplifies the funding crisis. Despite budgeting N70 million for family planning programmes in 2025, the funds remain unreleased, just three months shy of year-end. Kano State, which bears the highest maternal mortality rate in Nigeria, has seen its contraceptive prevalence rate rise from 0.5 percent in 2013 to 11.1 percent in 2023. However, unmet needs have surged from 11.1 percent to 26.0 percent over the same period, driven by persistent myths, cultural resistance, and frequent stock-outs of contraceptive supplies.

Kano’s Legislative Efforts Show Promise But Fall Short

In response to these challenges, Kano State launched a strategic plan for Child Birth Spacing (FP) in December 2024, aiming to provide reproductive health services to over 756 health facilities. The state also passed the Free Maternal and Child Health Care Law in May 2023, becoming the first in Nigeria to guarantee free prenatal, maternal, and child healthcare services.

Despite these commendable steps, experts argue that much more must be done to significantly reduce maternal mortality. The gap between policy and implementation remains wide, and without sustained funding and community engagement, progress will stall.

Lagos Leads With Innovation, But Faces Resource Constraints

Lagos State, with a population of 17.2 million according to UN World Urbanisation Prospects, stands out for its proactive approach to FP and MNCH services. The state targets a high Contraceptive Prevalence Rate across its 57 local administrative units, comprising 20 Local Government Areas (LGAs) and 37 Local Council Development Areas.

Current data shows that 59.7 percent of women in a sample use some form of contraceptive, although only 38.5 percent utilise modern methods such as male condoms, implants, and injectables. The state’s total fertility rate is estimated at 3.807, with a maternal mortality ratio of 430 per 100,000 live births.

Lagos offers free family planning services through public health facilities and special health weeks, supported by partners including the Bill & Melinda Gates Foundation. The government’s slogan, “Childbirth is not a death sentence: Safe childbirth is a fundamental human right,” underscores its commitment to maternal health. Free antenatal care and delivery services, including caesarean sections, are available at all public hospitals.

Women access family planning information through health centres, word-of-mouth, and both traditional and social media. The state ensures timely budget approvals and releases, and operates a robust health insurance scheme known as Ilere-Eko, which has proven highly beneficial to women.

The Sector-Wide Approach (SWAp) to healthcare in Lagos aligns all stakeholders under a unified strategic plan, ensuring integrated and evidence-based healthcare delivery. Yet, despite these achievements, insufficient resources continue to hinder comprehensive service delivery, especially given the state’s rapidly growing population.

Experts Demand Accountability, Strategic Investment

During the workshop, Bayo Ewuola of Pathfinder International Nigeria and Dr Ejike Oji, Chair of Nigeria CSO Focal Point FP 2030, issued a clarion call to government authorities. Dr Oji, who also chairs the management committee of the Association for the Advancement of Family Planning (AAFP) Nigeria, stressed the urgent need for both federal and state governments to prioritise family planning commodities.

He revealed that out of a total of $4 million approved by the government at the beginning of 2025, only N60 million was released. However, he commended the Minister of Health for approving $60 million for procurement of family planning commodities through the National Primary Health Agency, a historic move in Nigeria’s reproductive health landscape.

“Apart from this, the Presidential Initiative For Value Chain also allocated N5.77 billion for the purchase of FP commodities,” Dr Oji noted. “In the third trench, the President approved $200 million to cover counterpart funding for USAID’s HIV, malaria, and tuberculosis programmes.”

Dr Oji, who also convenes the Five Million Women Data Base, emphasised that purchasing commodities through USAID would be more cost-effective and ensure accountability. “USAID uses an economy of scale model for 53 countries, allowing them to buy commodities at reduced prices. Nigeria must channel funds through USAID to benefit from this subsidy.”

He explained that purchasing commodities worth $357,000 unlocks a matching grant of $2 million. “If the Federal Government contributes $100,000 and all states contribute the balance, Nigeria will still unlock the $2 million grant. This process also enables proper quantification exercises, which are essential for determining how much commodity to buy.”

Dr Oji warned that despite the large sums approved, accountability remains a concern. “People should be asking whether these commodities will be purchased through USAID or by individuals. Transparency is key.”

Media’s Role In Driving Change

The workshop concluded with a powerful challenge to the media: intensify FP/MNCH advocacy through agenda-setting, narrative shaping, and accountability-driven journalism.

“The media has a critical role to play,” Dr Oji asserted. “They should mount aggressive and strategic media engagement and campaigns using various multimedia platforms, traditional and new media, to lead awareness campaigns in their communities.”

He urged media practitioners to engage local primary healthcare leaders and gather grassroots data for well-researched stories that could inform policy shifts. He also called on the media to demand the release of the 2023 data report to facilitate proper funding of FP/MNCH programmes.

A National Emergency Demands National Action

Nigeria’s maternal health crisis is not just a statistic, it is a national emergency. The deaths of thousands of women and girls each year are preventable, and the solutions are within reach. What is lacking is political will, strategic investment, and accountability.

Pathfinder International Nigeria’s training of journalists is a step in the right direction, but it must be matched by bold government action and sustained media pressure. The time for half-measures is over. Nigeria must act, decisively, urgently, and transparently, to save lives and secure the future of its women and children.