Stakeholders warn N720bn gap threatens maternal, newborn health goals

Nigeria requires an additional N720bn to adequately fund interventions aimed at reducing maternal and newborn deaths, the National Lead of the Maternal and Neonatal Mortality Reduction Innovation Initiative, Dr Dayo Adeyanju, has said.

He stated this during a maternal health roundtable organised by Nigeria Health Watch in Abuja, with the theme, “Investing in Mothers: Aligning Finance, Policy and Innovation for Improved Maternal Outcomes,” according to presentation slides made available to our correspondent on Monday.

This comes as stakeholders in Nigeria’s health sector called for increased domestic investment in maternal and newborn healthcare, warning that inadequate financing, poor budget implementation and weak accountability continue to fuel the country’s high maternal and neonatal mortality rates.

Speaking at the event, Adeyanju said Nigeria’s 2025 National Annual Operational Plan for the health sector was estimated at N3.68tn, comprising N1.7tn in government funding and N1.25tn from development partners, leaving a N720bn financing gap.

According to him, the largest share of the health budget, about 87.9 per cent, was dedicated to strengthening efficient, equitable and quality health systems, reflecting the government’s commitment to improving healthcare delivery.

He said sustained domestic resource mobilisation was critical to achieving Nigeria’s targets of reducing maternal mortality by 30 per cent and neonatal mortality by 20 per cent by 2027.

According to him, Nigeria continued to face one of the world’s highest maternal and neonatal mortality burdens, recording more than 572 maternal deaths per 100,000 live births and 41 neonatal deaths per 1,000 live births.

“To reverse this trend, the Maternal and Neonatal Mortality Reduction Innovation Initiative was launched during the 2024 Joint Annual Review with clear targets to reduce maternal mortality by 30 per cent, reduce neonatal mortality by 20 per cent by 2027, and increase health facility utilisation by 60 per cent by 2030,” Adeyanju said.

He explained that the initiative identified 172 priority Local Government Areas responsible for about half of Nigeria’s maternal mortality burden, noting that interventions were focused on communities where the need was greatest.

Adeyanju identified delays in seeking healthcare, reaching health facilities, receiving quality care, taking timely decisions and poor coordination among stakeholders as the major factors contributing to maternal and newborn deaths.

“Our strategy focuses on strengthening data systems, improving coordination, expanding health financing, ensuring facilities are adequately equipped, improving physical and financial access to care, and mobilising communities to identify pregnant women early and support them to access skilled care,” he said.

Also speaking, the Strategic Health Systems Lead at BudgIT Foundation, Dr Biobele Davidson, said Nigeria’s maternal health financing landscape remained inadequate despite policy commitments and ongoing reforms.

“Nigeria accounts for about 19 to 20 per cent of global maternal deaths despite having only about two per cent of the world’s population.

“Approximately 82,000 Nigerian women die every year from pregnancy-related complications, many of which are preventable,” he said.

Davidson noted that although African leaders committed under the Abuja Declaration to allocate 15 per cent of national budgets to health, Nigeria’s health allocation had remained between 3.5 and 6 per cent, with the 2026 Federal Government health budget of N2.51tn representing only 3.67 per cent of the national budget.

He further observed that between 69 and 77 per cent of healthcare spending in Nigeria came from out-of-pocket payments, making maternal healthcare unaffordable for many families.

“Of the approximately seven million women who give birth annually in Nigeria, fewer than five per cent have health insurance coverage,” he said.

Highlighting progress under the MAMII programme, Davidson said interventions had reached 172 priority local government areas across 33 states, covering about 55 per cent of Nigeria’s maternal mortality burden.

He added that more than 500,000 pregnant women had been registered and tracked, over 3,000 primary healthcare centres had been upgraded to provide emergency obstetric and newborn care, while digital platforms had been deployed to monitor high-risk pregnancies and coordinate emergency transportation.

However, he warned that poor budget execution continued to undermine service delivery.

“Even where health budgets are approved, actual expenditure is often between 30 and 50 per cent below approved allocations, meaning resources intended for emergency obstetric care and other essential maternal health services do not reach frontline facilities,” Davidson said.

He also cited BudgIT’s assessment of 5,099 primary healthcare centres, which found that only 13.89 per cent had ambulances, 49.6 per cent lacked nurses or midwives, 40 per cent had no laboratory facilities, while more than half were not sufficiently secure to provide round-the-clock emergency services.

Davidson urged governments to increase health allocations towards the 15 per cent Abuja Declaration benchmark, strengthen implementation of the Basic Health Care Provision Fund, expand health insurance coverage for women, invest in emergency transport systems and improve funding for essential maternal medicines.

He also called on lawmakers to strengthen oversight of health financing, development partners to align support with domestic priorities, and civil society organisations to sustain budget tracking and public accountability.

Nigeria has one of the highest maternal mortality burdens globally.

In response, the Federal Ministry of Health and Social Welfare launched the Maternal and Neonatal Mortality Reduction Innovation Initiative in 2024 as part of its Sector-Wide Approach to accelerate reductions in preventable maternal and newborn deaths.

The initiative targets the country’s highest-burden local government areas through improved financing, strengthened primary healthcare services, digital innovation, emergency referral systems and community engagement, with the goal of significantly reducing maternal and neonatal mortality by 2027.