Access to quality maternal healthcare is influenced by how a society values women's health and rights, impacting the care they receive during pregnancy and childbirth Maternal health has long been shaped by disparities in access to care, with equitable healthcare often out of reach for many women, particularly in underserved communities. According to a study, social and cultural factors have significantly influenced maternal outcomes. These factors include women's participation in family decision-making, particularly regarding healthcare and treatment choices, as well as educational attainment, age at marriage, and family structure.
In Nigeria, women face a 1-in-18 lifetime risk of dying during pregnancy, childbirth or in the postpartum period. This underscores that maternal health is not just a medical concern but also a reflection of the broader inequalities women face. When women lack access to quality care or denied autonomy to make decisions about their health and bodies, the consequences are both preventable and tragic. Financial barriers also prevent many from receiving, quality-live saving care.
As the world marks International Women's Day (IWD) 2025, with the theme #AccelerateAction, there is no better time to confront the systemic inequalities that continue to put women's lives at risk and demand urgent reforms that ensure every woman, regardless of her socio-economic status, survives and thrives in motherhood.
During International Women's Day in 2024, the theme was to #EmbraceEquity, prompting discussions on why advocating for equal opportunities alone is insufficient. In line with accelerating action for gender equality, in healthcare, the Nigerian government has taken steps to improve access to quality healthcare for its women through various policies and programmes. One notable example is the Maternal and Neonatal Mortality Reduction Innovation and Initiative (MAMII) programme, launched by the Federal Ministry of Health and Social Welfare as part of its Sector Wide Approach (SWAp) to tackle Nigeria's high maternal and neonatal mortality rates.
While this initiative represents a key advancement, more must be done to achieve genuine gender equality in maternal health. Efforts must also focus on addressing the root causes of maternal mortality, including improving access to family planning services, tackling gender-based violence, and ensuring that every woman, regardless of socioeconomic status, has the right to make informed decisions about her reproductive health.
Addressing the low representation of women in leadership
One of the challenges in improving maternal health is the low representation of women in leadership positions in Nigeria, which impacts policymaking and advocacy for women's rights. As of 2023, in the 10th Assembly, women hold only 3 out of 109 seats (2.7%) in the Senate and 17 out of 360 seats (4.7%) in the House of Representatives, amounting to just 4.2% of the entire 469-member Assembly. In the previous 9th Assembly, there were 8 female Senators (7.3%) and 13 female members of the House of Representatives (3.6%), representing 4.5% of the total Assembly. These numbers highlight the slow progress in increasing women's political representation.
Closing this gap and accelerating gender equality, especially in healthcare, requires greater inclusion of women in leadership roles. Women in leadership can champion policies that address the unique challenges they face, particularly in healthcare. This aligns with the call at our annual Future of Health Conference, themed 'Breaking Glass Ceilings,' which emphasised the need to increase women's leadership in health governance, particularly in Nigeria.
Maternal health as a gender issue
Pregnancy and childbirth remain a perilous journey for too many Nigerian women. Despite the many medical advancements recorded, thousands of women lose their lives each year due to preventable complications.
For millions of women, the main concerns include access to quality healthcare and addressing biases in the healthcare system. Women, particularly those living with disabilities or from low-income or marginalised backgrounds, often face discrimination or mistreatment in health facilities. Reports of disrespect, neglect, and even abuse deter many from seeking health care and institutional deliveries. Ensuring respectful maternity care, training healthcare providers on gender sensitivity, and holding institutions accountable for patient mistreatment are critical to improving maternal health outcomes.
To support this, Nigeria has created policies and programmes such as the Nigeria National Reproductive Health Policy and Strategy, where equitable and inclusive healthcare coverage, particularly for women and girls with disabilities. The implementation of policies like the National Policy on Sexual and Reproductive Health and the Rights of Persons with Disabilities has been slow as individuals with disabilities continue to face challenges in accessing services.
Unfortunately, in many parts of Nigeria, it is still common for a woman's husband or family members to make key healthcare decisions on their behalf, even with the provision of the National Health Act (2014), which guarantees every citizen a right to access healthcare services and provides legal backing for patient autonomy. This has contributed to the three delays in maternal mortality, which lead to life-threatening complications.
In Nigeria, true gender equality lies in empowering women with the ability to make informed choices about their health, from family planning to seeking skilled maternal care. the Violence Against Persons (Prohibition) Act (VAPP) 2015 also protects women's rights to bodily autonomy and reproductive health decisions, signalling progress in this regard.
Financial barriers play a major obstacle to quality maternal care in Nigeria, particularly for women in rural areas. According to a 2022 study by Enhancing Financial Innovation and Access (EFInA) with DRPC, only 45% of women in Nigeria have access to financial services compared to 56% of men, which limits their ability to afford essential healthcare. Expanding financial inclusion through women-targeted loans and savings programs, alongside gender-responsive budgeting, can significantly improve access to maternal healthcare and reduce maternal mortality. Addressing economic dependency and gender pay gaps is also crucial in ensuring that all women can afford the care they need.
In November 2024, while announcing the MAMII Initiative, Nigeria unveiled a plan to reduce maternal mortality by providing free emergency Caesarean Sections (C-Section) for poor and vulnerable women. Professor Mohammed Ali Pate, Nigeria's Coordinating Minister for Health and Social Welfare noted that
"by removing financial barriers to this life-saving procedure, we ensure that no woman in need is denied critical care due to cost."
#AcceleratingAction for gender-equitable healthcare
The Nigerian government's recent launch of the MAMII programme is an important step in addressing maternal health disparities. Other policies, such as the Abiyamo Maternal and Child Health Insurance Scheme (AMCHIS) in Ondo State aim to expand and improve women's access to quality healthcare by establishing equitable access to healthcare services, with a focus on marginalised groups, especially women.
These policies and initiatives align with the call to #AccelerateAction for women's health by ensuring financial protection, providing free C-Sections, and strengthening primary healthcare systems. However, sustained investment, strong political will, and community engagement are necessary to ensure long-term impact.
As we celebrate International Women's Day, let us remember that no woman should lose her life, giving birth. Maternal health is a fundamental human right and a key pillar of gender equality. By prioritising women's access to quality care, we are not only saving lives but also empowering women, strengthening families, and building a healthier, more equitable society.