Nigeria faces a disproportionately high burden of maternal and child mortality despite significant global and national efforts. In 2023, the country accounted for nearly 29% of all maternal deaths globally, with over 75,000 maternal deaths recorded.[1] Neonatal and under-five mortality rates also remain far above global targets, pointing to persistent gaps in the coverage, quality, and financing of essential maternal, newborn, and child health (MNCH) services. Neonatal and under-five mortality rates also remain far above global targets, pointing to persistent gaps in the coverage, quality, and financing of essential maternal, newborn, and child health (MNCH) services. While several policies have been implemented to reverse this trend, challenges such as fragmented financing, low government investment, and inefficient resource utilization continue to limit progress.

As the government of Nigeria unveiled its strategy for crashing the unacceptably high maternal child death rates in the country through the Maternal Mortality Reduction Innovation and Initiatives (MAMII), DGI Consult organized a webinar themed ‘’Financing Maternal and Child Death-Crashing Interventions: Achieving Scale, Scope and Sustainability for Impact’’ to examine the intervention’s financing approaches for achieving scale, needed scope, and sustainability for impact.

Moderated by Dr. Gafar Alawode, CEO of DGI Consult, the webinar brought together local and international health system experts to share proven strategies for financing high-impact maternal and child health interventions, aimed at reducing preventable deaths, while ensuring scale, scope, and sustainability.

“In the last two decades, Nigeria has stagnated in its efforts to reduce maternal deaths, remaining trapped in the very high mortality phase while other countries recorded progress.”

The webinar was heralded with a keynote presentation by Professor Charles Ameh, Professor of Global Health at the Liverpool School of Tropical Medicine, drawing on global evidence and the WHO mortality transition model to highlight how countries have reduced maternal and child deaths through higher health spending, reduced out-of-pocket expenditure, high health workforce density, and the right skill mix. Professor Ameh noted Nigeria’s stagnation in the highest mortality phase for two decades, linked to weak health systems, low health budgets, inequitable access, and poor data systems. He urged actions including expanding and equitably distributing midwives and nurses, improving budget efficiency, boosting per capita health spending, and ensuring effective coverage of quality care. Professor Ameh also emphasized the role of digital solutions in promoting accountability, integrating health information systems, managing supply chains, strengthening referral networks, enabling remote training, and using real-time data to assess performance and scale effective interventions.

For 20 years, Nigeria’s efforts towards reducing maternal mortality have been siloed, addressing pieces of the problem instead of the whole, which is what the MAMII initiative seeks to address.”

Dr. Dayo Adeyanju, Lead of the MAMII Initiative at the SWAp Office outlined the MAMII initiative’s strategy to curbing maternal, newborn, and child deaths, which is distinct from strategies deployed in the past that were fragmented by emphasizing the identification of the 172 LGAs across 33 states that account for 55% of maternal mortality in Nigeria while also identifying other barriers affecting access to services and addressing them through community-based health workers, enrolment of pregnant women into health insurance, declaration of free making caesarean sections, and upgrade of Basic Emergency Obstetric Care (BEmONC) and Comprehensive Emergency Obstetric Care (CEmONC) facilities. Through the initiative, active and functional emergency transport systems have also been provided in 15 states, supported with a digital platform that connects at-risk women to the nearest functional facility, while maternal death surveillance ensures every case is recorded, reviewed, and acted upon. Dr. Adeyanju noted implementation challenges such as inadequate funding, over-reliance on donors, competition from traditional birth attendants, socio-cultural barriers, weak data systems, and low family planning uptake. These challenges are being addressed through targeted resource mobilization, integration of Traditional Birth Attendants (TBAs) into referral systems, community and religious leader engagement, real-time performance tracking, and integration of family planning into all interventions to ensure scale, sustainability, and impact.

“Ekiti state’s improvements in maternal and child health are results of a coordinated strategy anchored on governance reforms, financing innovations, and supply chain strengthening.”

Highlighting the strategies deployed in Ekiti state to reduce neonatal and under-five mortality, Dr Oyebanji Filani, Chair of the Forum of Commissioners of Health and Hon. Commissioner for Health, Ekiti State emphasized the recognition of health systems inputs through training of existing health workforce in BEmONC, establishment of a Drug Management Agency to ensure availability of affordable, high-quality medicines. Investment in the “Ulerawa” health insurance scheme to expand access to PHC services covering about 73% of common health needs. The state also uses weekly data reviews to track progress, identify challenges, and make timely course corrections. Dr. Filani also highlighted the use of peer-learning and inter-state collaboration to replicate the successes of Ekiti State nationally through the Forum of Health Commissioners, supported by initiatives such as the Vision Alignment Programme, the nationwide “Know Your Number, Control Your Number” NCD screening campaign, and the expansion of Drug Management Agencies (now in 29 states) to facilitate bulk procurement and improve affordability.

A comprehensive and integrated approach is needed to tackle maternal mortality by using data to identify key drivers across different regions.

Dr. Olufunke Fasawe, Vice President for Integration at the Clinton Health Access Initiative (CHAI), shared scalable lessons from CHAI’s work in high-burden maternal and child mortality states, including Kano, Kaduna, and Katsina, covering over 10 million people. Dr Fasawe stressed the need for the use of an integrated and comprehensive approach for tackling maternal and child mortality that combines training of skilled birth attendants, consistent supply and access to life-saving commodities, and strong referral pathways to yield better results. She also emphasized the need to track every pregnancy to identify region-specific mortality drivers and tailor solutions while building the management capacity of the health workforce to use data to improve the quality of care. Dr. Fasawe also called for stronger coordination between partners and the government to avoid duplication, alignment with national priorities, and greater transparency in data use. Further urged the health sector to leverage digital tools and artificial intelligence (AI) to expand outreach, support overburdened frontline health workers and reach underserved communities.

Strengthening the capacity of government agencies to budget, execute, and track expenditure efficiently is crucial to promoting ownership and sustainability of public financing for child health interventions.

Dr. Sachin Bhokare, Health Finance Specialist at UNICEF, outlined the key components of UNICEF’s approach to advancing sustainable financing for child health. These include technical support to track public expenditure to ensure child health is visible in health budgets, identifying underfunded priorities, and improving resource allocation and efficiency in spending. Secondly, UNICEF supports the development and costing of primary healthcare service packages to guide investment planning, integration of immunization and other child health costs into national and subnational budgets for long-term funding. Through the state health insurance schemes, UNICEF also supports the adoption of poor and vulnerable populations to improve access to healthcare services, targeting the zero-dose children. Drawing from UNICEF’s work in Nigeria and other contexts, Dr Bhokare emphasized that meaningful reform is most successful when government capacity is strengthened to lead and co-own initiatives for predictable and sustained financing for child health services.

“Through the Nigeria UHC Forum, the CSOs have been empowering citizens to make informed demands and amplify their voices in shaping maternal and child health policies.”

Chief (Mrs.) Moji Makanjuola, Chair of the Nigeria Universal Health Coverage (UHC) Forum, described the efforts of the Nigeria Universal Health Coverage (UHC) Forum as a strategic partner in tackling maternal and child health challenges in Nigeria through the current health reform. She highlighted the forum’s journey so far in positioning health as a political priority by interfacing with the government to shape maternal and child health policies, as well as the citizens, to help people understand their rights and responsibilities and make informed health demands. The forum also tracks government policy commitments while ensuring transparency, accountability, and leveraging the media to amplify community voices. She highlighted the shift from being seen as critics to being valued as solution-oriented partners, with ongoing efforts to close knowledge gaps and promote community ownership of health financing.

Looking Ahead

The webinar concluded with a collective call to action. Speakers identified key strategies to curb Nigeria’s high maternal and child mortality, drawing from successful programs and innovations to demonstrate measurable impact, while exploring sustainable financing approaches through the current reforms of the health sector. As the Government of Nigeria implements its strategy for crashing the high maternal and child deaths, it is imperative to invest in approaches that work, while using effective governance, data for accountability and course correction, and appropriate technologies to achieve better health outcomes for women and children.

Watch the full recording of the webinar here

[1] Trends in maternal mortality estimates 2000 to 2023: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.