New research has shown that Nigeria contributes the highest number of global maternal deaths from postpartum haemorrhage (PPH), a preventable complication that affects millions of women each year.
The data was presented at the inauguration of the Accelerating the Implementation of Maternal, Newborn, Child Nutrition and Health Innovations (AIM-MNCH) Regional Think Tank in Abuja on Wednesday.
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The Think Tank will serve as a high-level advisory and technical body to promote evidence-based interventions and strengthen policy implementation for maternal and child health across Africa.
Presenting the data from the E-MOTIVE Trial, during her keynote address on “Accelerating the Scale-up of PPH Prevention and Management in the Nigerian context,” Hadiza Galadanchi, a professor and obstetrician, said about 14 million women globally experience postpartum haemorrhage yearly, but most deaths occur in sub-Saharan Africa, with Nigeria contributing the largest share.
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Ms Galadanchi explained that while PPH occurs in every region, the differences in survival are linked to health system weaknesses, including slow emergency response, shortages of essential medicines, and lack of readiness at the facility level.
“We were hoping to really see a reduction in maternal mortality. But unfortunately, it is still high, about 260,000 women died in 2023, and Nigeria alone accounted for almost 75,000 of those deaths,” she said.
Citing a global study released earlier this year, she said haemorrhage has remained the leading cause of maternal death for over 50 years, followed by hypertensive disorders, sepsis, anaemia, and obstructed labour.
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“Those causes have not changed for half a century. 50 years later, we still have the same five killers of women during childbirth,” she noted.
She stressed that sub-Saharan Africa accounts for 70 per cent of all maternal deaths globally, with Nigeria among the top five contributors worldwide.
From research to policy
Ms Galadanchi highlighted the E-MOTIVE project, a global trial focused on preventing and managing PPH, as a model of how evidence can drive policy and scale-up in Nigeria.
She explained that while many health innovations are piloted in Africa, few are implemented widely enough to make an impact.
The E-MOTIVE study, conducted in several countries including Nigeria, Kenya, and Tanzania, demonstrated how early detection and bundled care for PPH can significantly reduce maternal deaths.
“We talk about how to move research to policy. E-MOTIVE showed that when we act early, when bleeding is measured objectively, not guessed, women survive.”
Following the trial’s success, she said Nigeria was among the first countries in the world to adopt the E-MOTIVE approach into its national guidelines for obstetric care.
She added that this model of rapid translation, from evidence to guideline to frontline implementation, should serve as a template for scaling up other maternal and newborn health innovations across sub-Saharan Africa.
Citing findings from the E-MOTIVE research, Ms Galadanchi said using the WHO ‘first-response bundle’, which includes uterine massage, oxytocin, tranexamic acid, intravenous fluids, and rapid escalation, reduced severe bleeding cases by more than 60 per cent compared to standard care.
She added that the results have informed new WHO recommendations and Nigeria’s own national guideline on PPH, developed to standardise treatment across all levels of care.
Scaling up national response
Following the WHO endorsement, Nigeria developed and began implementing its first National PPH Guideline, training over 75 master trainers and more than 800 healthcare workers nationwide to support early detection and treatment.
“For the first time, all partners including government, WHO, and civil society are coordinated. That’s how we make real change,” she said.
ALSO READ: PT Health Watch: What to know about postpartum haemorrhage, leading cause of maternal deaths
The AIM-MNCH consortium, supported by the Gates Foundation, is currently active in 16 Nigerian states, implementing the E-MOTIVE approach across hundreds of facilities.
Policy coordination and local production
Representing the Federal Ministry of Health and Social Welfare, Samuel Oyeniyi, Director and Head of Reproductive Health, said the government is committed to institutionalising innovations that improve maternal outcomes, especially those backed by strong local and international evidence.
Mr Oyeniyi said, “The Ministry is aligning its strategies with WHO recommendations and local realities. Our goal is to ensure every mother, regardless of where she lives, has access to skilled care and essential supplies.”
He noted that the Ministry, in collaboration with partners, had recently adopted new national guidelines for the prevention and management of PPH, a move influenced by the E-MOTIVE trial and WHO’s updated recommendations.
He also highlighted the need for consistent supply of life-saving commodities, improved data systems, and local production of health technologies to address recurring shortages.
In her goodwill message, Director Department of Community Health Services at the National Primary Health Care Development Agency (NPHCDA), Nana Sanda, reaffirmed the agency’s support for the Think Tank, describing it as a crucial step in strengthening coordination and evidence-based decision-making in maternal and child health.
Ms Sanda who was represented by Olah Owobi, Assistant Director of the Community Health Services Department at the NPHCDA said most Nigerian women give birth at primary healthcare centres and the agency is committed to ensuring that the facilities have the right commodities and skilled workers to prevent avoidable deaths.
She added that the agency had strengthened supply chains and integrated preventive tools such as uterotonic drugs into its maternal care packages.
“Our work is to make sure frontline workers have the right training, commodities, and supervision to save lives,” she said.
Ms Galadanchi highlighted that despite training and innovation, many facilities still face shortages of basic commodities and consumables needed for PPH response.
She urged states to include maternal health supplies in their annual budgets, noting that “training without tools cannot save lives.”
She also revealed that Nigeria has begun local production of intravenous fluids (drips), a move aimed at reducing supply bottlenecks and costs.
“We developed a standard operating procedure for local production. That’s what sustainability looks like, when countries start owning and driving solutions,” she said.
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