Nigeria launched an initiative in 2024 offering free emergency caesarean sections to combat high maternal mortality rates, which are the third highest globally. Despite recognizing that systemic issues hinder healthcare access, the program aims to significantly reduce maternal deaths by implementing community-based interventions and addressing financial barriers to care. However, enrollment in national health insurance remains a critical challenge for the poorest women. Drawing lessons from similar initiatives in other countries may enhance its success.
In 2024, Nigeria’s government introduced an initiative providing free emergency caesarean sections for poor and vulnerable women, addressing the alarming maternal mortality rates within the country. Researchers Aduragbemi Banke-Thomas and Itohan Osayande analyze this initiative, aiming to highlight its potential in reducing maternal deaths during childbirth.
Maternal mortality remains a critical issue in Nigeria, with approximately 87,000 pregnant women dying in 2020, representing nearly one-third of global maternal deaths. The country faces a staggering maternal mortality rate of 1,047 deaths per 100,000 live births, ranking behind only South Sudan and Chad. Major mortality contributors include severe bleeding, infections, high blood pressure, and unsafe abortion practices; however, these fatalities can often be prevented with timely emergency obstetric care.
Multiple factors contribute to Nigeria’s high maternal mortality. Women often delay seeking care due to cost concerns and a lack of awareness regarding danger signs. Cultural norms may also hinder acceptance of necessary procedures like caesarean sections. The healthcare system presents significant challenges, including insufficient services at facilities where women seek help and a shortage of skilled professionals, exacerbated by increasing migration of healthcare workers.
Financial constraints frequently deter women from seeking care in established healthcare settings, compelling them to rely on traditional birth attendants, which can elevate risks of complications and mortality. Furthermore, poor transportation infrastructure and ongoing conflict disrupt access to maternal healthcare, particularly for women in rural territories.
The initiative seeks to enhance utilization of health facilities and increase skilled birth attendance by 60%, aiming for a 30% reduction in maternal mortality within three years. Addressing Nigeria’s multifaceted maternal mortality issue necessitates a comprehensive approach at various administrative levels. The program involves targeted community interventions, including empowering local leaders, advocating safe delivery practices, collaborations with traditional birth attendants, revitalizing emergency services, and ensuring free caesarean access for the vulnerable.
However, access to the free caesarean service is contingent upon enrollment in Nigeria’s national health insurance scheme, which poses challenges for the indigent who may not be covered. Prior to the 2022 National Health Insurance Authority Act, health insurance enrollment was less than 3%, limiting the scheme’s sustainability and reach.
Several African nations have successfully adopted similar measures to enhance maternal healthcare access, such as Benin, Ghana, and Senegal, which have seen improvements in caesarean rates among lower-income and rural populations. Notably, Ghana and Burkina Faso’s policies have significantly reduced neonatal and infant mortality rates, suggesting broader benefits beyond childbirth.
To ensure the success of Nigeria’s policy, lessons can be drawn from similar past initiatives. Making both caesarean and vaginal delivery freely available can reduce the tendency to categorize more women as needing surgical intervention. To prevent unnecessary surgeries, guidelines must be established and followed by healthcare personnel, with audits in place to monitor usage patterns.
Furthermore, addressing the emigration of skilled healthcare workers is crucial to maintain service availability. The Nigerian government may also need to implement innovative financing models to maintain the initiative amid external funding cuts. Additionally, incentives for private sector participation and expansion of the scheme to community-based health insurance providers could enhance its reach and effectiveness.
In conclusion, Nigeria’s initiative to provide free caesarean sections for vulnerable women aims to tackle the severe maternal mortality crisis. While the program holds promise, the success hinges on addressing systemic issues within the healthcare system, ensuring that the service is truly accessible to all women. Learning from other countries’ experiences and adapting the initiative to be inclusive and comprehensive will be vital in reducing maternal deaths and improving women’s health outcomes in Nigeria.
Original Source: theconversation.com
