Nigeria has promising solutions to prevent maternal deaths. From digital health solutions and innovative financing models to quality improvement initiatives and community-based care, evidence-based interventions are emerging to address gaps in maternal healthcare.

Yet the challenge remains that these solutions struggle to extend beyond individual projects into the health system, where women can access them consistently, even after individual projects end.

This was the question at the heart of the conversation at the maternal health side event at the 11th Future of Health conference convened by Nigeria Health Watch in collaboration with ACIOE Foundation, with funding from MSD for Mothers.

The urgency of this challenge was underscored by Iyadunni Olubode, Nigeria and Kenya Director, MSD for Mothers, who pointed out in her opening remarks the staggering gap of Nigeria’s maternal mortality ratio from the SDG target of less than 70 by 2030 and challenged stakeholders to confront the disconnect between the availability of proven solutions and the limited integration into the health system.

“We have evidence and data that support that these are good innovations. The question is, why have we struggled with getting these into the health system?”

Since 2015, MSD for Mothers has invested in solutions to address maternal mortality in Nigeria, supporting initiatives that demonstrate how innovation can improve access to quality, affordable and sustainable maternal healthcare.

Building on a maternal health roundtable convened by Nigeria Health Watch in collaboration with the Maternal and Neonatal Mortality Reduction Innovation Initiative (MAMII) in July, stakeholders examined what it would take to bridge the gap between promising innovations and sustainable, system-wide maternal healthcare.

Financing care that delivers better outcomes

Financial barriers remain a significant obstacle to accessing maternal healthcare and emerged as a critical factor for scale.

Speaking during a panel session at the side event titled ‘Advancing Maternal Health: Connecting Innovation, Evidence and Systems for Sustainable Impact’, Dr Jennifer Anyanti, Vice President of the Healthcare Federation of Nigeria, called for financing models that reward quality, continuity and cost-effective care throughout the pregnancy journey.

She emphasised the need for greater investment in private providers and community-level services, noting that the private sector must be recognised as an integral part of the health system. “The challenges we have in Nigeria are not innovations. The innovations are everywhere,” she said. “The problem that we have is being able to scale those interventions.”

Drawing on an example from a successful government- private sector partnership in the Delta State Contributory Health Commission (DSCHC), where a government-private partnership demonstrated how financing and private sector expertise can strengthen primary healthcare delivery, she highlighted the potential of partnerships that align provider incentives with measurable improvements in care.

Through an access-to-finance model, private health providers obtained concessionary loans to rehabilitate and manage 15 previously underperforming primary health care facilities across 12 LGAs, thereby expanding access and improving health care delivery. She advocated for the availability of patient capital, financing that will provide health care providers with resources while allowing time to improve quality without passing unsustainable costs to patients.

Initiatives like the Maternal Health Fund (MHF), building on the FOR Mom programme, demonstrate how sustainable financing and digital tools can strengthen maternal healthcare delivery. Similarly. MomCare by PharmAccess, through its partnership with Lagos State Health Management Authority (LASHMA), demonstrates how innovative purchasing and payment approaches can improve access and accountability. Together, these models highlight the need to move beyond short-term project funding towards financing arrangements that incentivise quality and make services more affordable.

Strengthening community-level care and referral systems

Patent and proprietary medicine vendors (PPMVs) and community pharmacists are often the first point of contact for women seeking healthcare. The Promoting Accreditation for Community Health Services (PACS) programme is improving the quality of care provided by PPMVs and Community Pharmacists through a tiered accreditation system, training and links to financing. However, stronger institutional ownership and integration into formal referral pathways are necessary to sustain these gains.

Digital Mom Project, which evolved from the RICOM3 project, has demonstrated success in supporting women throughout their pregnancy by providing self-care information, mental health support, nutrition guidance, and referrals to help them navigate their pregnancy journey. Project Aisha shows how structured quality improvement approaches, practical tools for health workers and community participation can strengthen maternal healthcare delivery.

Similarly, Smiles for Mothers promotes a comprehensive postpartum haemorrhage (PPH) care bundle (EMOTIVE) to improve the prevention, early detection and management of excessive bleeding after childbirth. With a focus on postpartum haemorrhage prevention and response, it emphasises the importance of trained health workers, reliable supply of quality uterotonics and coordinated implementation.

For these initiatives to deliver lasting impact, they must be incorporated into routine health service delivery, supported by government ownership, adequate resources and continuous monitoring.

Moving from fragmented interventions to coordinated action

While individual innovations are addressing important gaps, their collective impact depends on how effectively they are coordinated and integrated into the health system. Speaking on the panel, Dr Murtala Mohamed Bagana, Commissioner for Health in Niger State, identified coordination as a critical missing link.

He noted that maternal, newborn and child health interventions can become fragmented across government departments and implementing partners, making it difficult to align resources and implementation efforts.

“There is no excuse for a woman to die giving birth,” he said, calling for stronger governance and coordination to bring interventions together.

He also described efforts to establish a state-level coordinating platform and align programmes within the Department of Family Health in Niger State. Such mechanisms can help government institutions take greater ownership of interventions, reduce duplication and ensure that resources are directed towards shared priorities.

Similarly, MAMII, through the sector-wide approach, represented on the panel by Dr Abraham Ahmadu is strengthening alignment across government, development partners and implementing organisations, bringing interventions together around shared maternal health priorities.

On digital health, Dr Funmi Adewara, founder and CEO of Mobihealth International, highlighted the validation of Nigeria’s National Telemedicine Guideline and the development of a five-year implementation framework as important steps towards improving access and accountability.

“The biggest barrier for telehealth adoption… has been the lack of policy framework,” she said. She emphasised that digital tools must connect with primary healthcare facilities, health information systems and referral pathways rather than operate as standalone platforms.

What needs to happen next

Promising innovations alone will not address Nigeria’s maternal health crisis. They must be backed by strong government ownership and policy decisions. More importantly, these policies must be sustainably financed to ensure that effective interventions become part of routine healthcare delivery.

Bringing these priorities together, Adenike Badiora, Advocacy Lead at ACIOE Foundation, outlined six advocacy asks emerging from the six maternal health innovations discussed at the side event;

1. Integrating digital health solutions: Incorporate AI-enabled healthcare into national and state digital health policies and implementation frameworks.

2. Mobilising sustainable financing: Increase public and private investment through co-funding, concessional capital, credit enhancement, and performance-based grants.

3. Linking payment to quality: Use service delivery data to connect provider payments and incentives to quality, continuity, and cost-effective care throughout pregnancy.

4. Strengthening community-level referral pathways: Endorse the three-tier PPMV accreditation programme and connect accredited vendors to maternal health referrals and, where appropriate, health insurance enrolment.

5. Institutionalising quality improvement: Adopt and scale Project Aisha’s Quality improvement model and toolkit, placing client voices and community engagement at the centre of improvement efforts.

6. Sustaining lifesaving care: Adopt the comprehensive postpartum haemorrhage care bundle and finance pharmacovigilance and maternal and perinatal death surveillance

The panel discussion reinforced that maternal deaths are preventable and that proven innovations must reach more women. Panellists highlighted the role of government leadership, collaboration with the private sector and the need for policy and operational frameworks that support digital solutions across the continuum of care.

Nigeria’s maternal health innovations will matter only when women can rely on them beyond project timelines. Federal and state governments must translate these advocacy asks into funded commitments, with institutions responsible for delivery and public reporting on results.

Partners and private providers must align investment with those priorities. Success means women can consistently obtain timely, affordable, quality care wherever they live, without their survival depending on whether a donor-funded project operates in their community.