Nigeria remains one of the unsafe places for pregnant women.
According to a 2023 WHO report, the country ranks second globally in maternal deaths, recording 512 maternal deaths per 100,000 live births—a staggering contrast to the UN’s target of 70 by 2030.
In 2020 alone, 82,000 women lost their lives to pregnancy-related complications, while 40 million women of childbearing age continue to face severe maternal health risks.
Severe haemorrhage, high blood pressure (pre-eclampsia and eclampsia), unsafe abortions, and obstructed labour remain the leading causes of maternal deaths in Nigeria.
However, beyond medical complications, a weak healthcare system, financial hardship, and lack of political will remain the biggest barriers to improving maternal health outcomes.
The Cost of Antenatal Care: A price too high for many
Antenatal care is crucial in reducing maternal mortality, yet many Nigerian women cannot afford it. The cost varies widely; public hospitals charge between N10,000 and N50,000, Private hospitals charge even higher fees unless covered by a health insurance plan.
For Omosefe, a 27-year-old pregnant with twins in Benin City, the cost of antenatal care was beyond reach. She relied solely on prayers from her church, unable to afford medical checkups.
When labour began, complications arose—ones the church couldn’t handle. By the time she reached a hospital, she had given birth, but both babies were stillborn.
Omosefe’s case is not isolated—countless Nigerian women lose their babies or their own lives simply because they cannot afford basic maternity care.
Nigeria’s underfunded healthcare system is at the heart of the maternal mortality crisis. Despite being Africa’s largest economy, only 3% of GDP and 5.03% of the national budget is allocated to health, far below the African Union’s recommended 15% and 75% of healthcare spending is out-of-pocket, leaving millions uninsured and unable to access quality medical care.
Government Interventions: A step in the right direction?
In response to the ongoing maternal health crisis, the Nigerian government has secured a loan under the World Bank’s $570 million primary healthcare project, with $15 million specifically allocated for maternal and child health innovations. The funding aims to improve access to quality care and reduce maternal deaths, particularly in underserved regions.
- In November 2024, the government launched several initiatives, including the Maternal and Maternal Mortality Intervention (MAMMI) Project, led by the Federal Ministry of Health to strengthen healthcare access and outcomes for pregnant women.
- Prof. Muhammad Ali Pate, the Coordinating Minister of Health and Social Welfare, emphasized that these initiatives will prioritize regions where over 50% of maternal deaths occur.
“Many women in these areas face barriers such as financial constraints, lack of awareness, and even spousal consent before seeking medical help. This is not just a short-term intervention but a long-term commitment to maternal and neonatal health,” Pate said.
- He noted that the MAMMI project will pilot critical interventions in 17 states, focusing on local governments where maternal mortality exceeds 1,000 deaths per 100,000 live births.
Despite ongoing efforts to improve maternal health in Nigeria, experts caution that funding alone is not enough. Addressing key barriers—including infrastructure gaps, affordability, and human resource constraints—remains crucial to tackling the crisis.
- Dr. Ojo Sikiru, a Lagos-based medical practitioner, highlights socio-cultural and systemic challenges as persistent hurdles to maternal health improvement.
“Beyond infrastructure and funding, cultural beliefs and practices continue to prevent many women from seeking medical care early,” he states. In some communities, even within Lagos, women need their husband’s or family’s approval before going to the hospital. By the time they get permission, it is often too late.”
- He also points out that misconceptions about healthcare services discourage women from accessing essential maternal care.
“Some women believe that cesarean sections are a sign of weakness and would rather risk home delivery. Others think hospitals are only for emergencies, leading to late presentations with severe complications.”
Bridging the Gap: Awareness and strengthening primary healthcare
Dr. Sikiru stresses the need for public awareness campaigns to educate communities on the importance of maternal healthcare.
“We need more community engagement programs that promote the benefits of antenatal care, skilled birth attendance, and emergency obstetric services. Health education must start from the grassroots.”
He adds that strengthening Nigeria’s primary healthcare system is essential to improving access to maternal healthcare.
“If well-equipped primary health centres are available in every community, more women will receive the care they need early, reducing delays and complications.”
- Similarly, Dr. Uzoma Onu, a Consultant Obstetrician and Gynecologist based in Keffi, warns that antenatal care remains critical, yet Nigeria is facing a severe shortage of skilled birth attendants, particularly in rural areas.
“Nigeria has a severe shortage of trained healthcare workers. Many expectant mothers are left in the hands of traditional birth attendants who lack the skills to manage complications such as excessive bleeding or prolonged labor. This significantly increases the risk of maternal deaths.”
- Dr. Onu also emphasizes that financial barriers limit access to antenatal and emergency obstetric care.
“Even in urban centers where hospitals are more available, the cost of maternal healthcare is out of reach for many families. A single delivery, especially if complications arise, can cost a family months’ worth of income,” he explains.
- He further notes that out-of-pocket payments account for 75% of healthcare spending in Nigeria, leaving many expectant mothers unable to afford even basic services.
“Without universal health insurance coverage, pregnant women will continue to face financial barriers to care. Nigeria must enforce policies that ensure free or subsidized maternal healthcare, particularly for low-income families.”
- Dr. Onu emphasizes the need for better awareness of health insurance options, noting that many women do not realize they can enroll in schemes that cover maternal services.
He urges the government to intensify awareness campaigns to encourage more women to register and take advantage of these programs.
