In Nigeria, screening pregnant women for hepatitis B is no longer the hard part. Sustaining it is. Test kits arrive, programmes launch, and women are tested — until the funding cycle ends. Dr. Elohor Oborevwori, a physician and public-health specialist, focused on the second problem: how to make universal antenatal screening permanent rather than temporary.

Her answer was not a new clinical guideline. It was a financing and delivery mechanism. While serving as a Public Health Physician in the Delta State Ministry of Health, Oborevwori proposed integrating hepatitis B and C screening into two systems the state already ran: routine antenatal care for delivery, and the Delta State Contributory Health Scheme for payment. The proposal arrived complete — clinical rationale, operational pathway and sustainable financing presented together.

On 2 November 2023 the Delta State Contributory Health Commission directed medical directors of all accredited facilities to begin screening every pregnant woman covered by the scheme and adjusted the scheme’s service tariff so the cost would be reimbursed like any other covered service. No new programme was created and no external grant was required. Commission records show 2,886,555 residents enrolled as of April 2026.

Health officials familiar with the process note that most proposals for expanded services arrive as requests for stand-alone programmes with separate budgets and outside funding — arrangements that often collapse when the money runs out. Oborevwori’s proposal did the opposite. That completeness, they say, was decisive.

The same financing logic is now visible well beyond Delta. In the South West, Lagos State offers free hepatitis B and C screening across general hospitals, its teaching hospital and designated primary health centres, while Ekiti ranks among the stronger performers nationally for antenatal testing access. In the North West, Kano’s triple-elimination strategy folds hepatitis B screening into routine antenatal care alongside HIV and syphilis. In the South East, Enugu maintains screening in secondary and tertiary facilities. In the North East, Adamawa operates frameworks at the same levels. In the North Central zone, federal secondary and tertiary facilities across the Federal Capital Territory do likewise. Together with Delta in the South South, these jurisdictions span all six geopolitical zones.

None of these governments is subordinate to Delta State or to Oborevwori. Where screening is delivered inside existing maternal-health services and paid for through domestic structures rather than donor cycles, the programmes reflect the core principle first demonstrated in Delta: that universal antenatal screening can be financed through a state’s own health-insurance mechanism.

Dr. Ejiro Orhewere, a public-health specialist focused on implementation, said the distinction is important. “Most professionals publish, run programmes or improve care inside their own institutions. Far fewer design a mechanism that a government adopts as policy. Rarer still is seeing that underlying approach appear, independently, in other jurisdictions that had no obligation to follow it.” That pattern of independent governmental reliance, Orhewere noted, is what typically places an implementation contribution in the small percentage of work that shapes practice beyond its original setting.

Oborevwori did not discover hepatitis screening. The clinical recommendation belonged to the field. Her contribution was showing how one Nigerian state could turn that recommendation into routine, domestically financed care — and how the same principle could travel.