Improving Access to Care to Advance Maternal Health Outcomes in Nigeria

Speeches Shim

Cynthia John and her triplets.
Cynthia John and her triplets.
Photo Credit: Pathfinder International

In partnership with Merck for Mothers, USAID helped reduce institutional maternal deaths by 66 percent and perinatal deaths by 47 percent across U.S. Government-supported health facilities in the Cross River State by improving women’s access to care before, during, and after labor and delivery.

Cynthia John is a young woman living in the Ugboro community in Ogoja, Nigeria. The Ugboro community is far from the nearest health facility, so when she found out she was pregnant with triplets, she was concerned about being able to reach the facility in time to deliver her children safely.

Nigeria has one of the world’s highest maternal mortality rates1 and women are less likely to deliver in health facilities because of the distance and cost.2 To address gaps in maternal service provision, USAID employs a whole-of-system approach that engages individuals and communities from the household to the health facility by empowering women to seek care and increasing access to vital resources and services. In partnership with Merck for Mothers, USAID supports antenatal counseling and emergency transportation to health centers for women in labor in Cross River State, where Cynthia lives.

When Cynthia learned that her pregnancy was considered high risk, she sought care at a USAID-supported community health center and was informed about the need to deliver at a health facility. During her antenatal visits, health workers provided her with information on a health facility where she could deliver as well as a voucher and the phone number to call for emergency transportation. When she went into labor, Cynthia was able to reach the primary health facility using USAID-supported emergency transport services and was able to safely deliver her three children.

“I am so happy that I am alive and my triplets are alive and healthy too,” says Cynthia. “I want to thank the nurses in our health facility, and I am advising other pregnant women in the community to always visit our health center so that their lives and that of their babies can be saved."

The Power of Partnerships

Out of a population of 3.7 million people in Cross River State, Nigeria, more than 90 percent of women now have timely access to quality emergency obstetric care if complications arise, thanks to our partnership with Merck for Mothers. This demonstrates the power of partnering with the private sector to design and deliver health solutions to improve the health and well-being of mothers and children. By partnering with Merck for Mothers, USAID is empowering women to seek care and increasing access to essential maternal health services to support Nigeria on its Journey to Self-Reliance.


Download the PDF version of this story. [PDF, 1.1MB]

1 WHO, Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank Group and the UN Population Division (Geneva: WHO, 2015).

2 National Population Commission (NPC) [Nigeria] and ICF International. 2019. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International.