Only about 22 percent of hospitals in Nigeria have access to clean running water according to Kwara State former first lady, Toyin Saraki.

Saraki, founder-president of the Wellbeing Foundation Africa, disclosed this during an interview at a senior leadership meeting of Ferring Pharmaceuticals, where she highlighted structural weaknesses in Nigeria’s healthcare system and their impact on childbirth outcomes.

Citing a World Bank survey on healthcare facilities in Nigeria, Saraki said while 69 percent of facilities reported that they conduct deliveries, only about 29 percent of labour rooms have access to running water.

This, she noted, means that most deliveries are carried out in environments where basic hygiene cannot be guaranteed.

She warned that the lack of water, sanitation and hygiene infrastructure exposes mothers and newborns to life-threatening infections, particularly sepsis, which accounts for about 17 percent of maternal deaths in Nigeria.

“In Nigeria, a woman has a one-in-13 lifetime risk of dying from pregnancy or childbirth-related causes,” Saraki said.

Nigeria is home to nearly 20 percent of global maternal deaths, despite advances in medical knowledge and technology that make most of these deaths preventable.

Saraki said the persistence of avoidable deaths points to systemic failures rather than medical limitations.

Through the Wellbeing Foundation Africa, Saraki said efforts to tackle maternal mortality are built around what she described as a “MamaCare 360” approach, combining community education, skilled healthcare delivery and basic infrastructure such as clean water.

Under the foundation’s MamaCare programme, more than 230,000 women have received antenatal and postnatal education delivered by trained midwives across several Nigerian states and the Federal Capital Territory.

Saraki said participants in the programme now meet the World Health Organization’s recommendation of at least eight antenatal visits, with no recorded maternal deaths among enrolled mothers during childbirth.

However, she stressed that education and access to midwives alone are not enough if healthcare facilities are unable to manage complications.

This led to the launch of the Emergency Obstetric and Newborn Care (EmONC) programme, which focuses on practical training for doctors, nurses and midwives using anatomical models.

According to Saraki, the foundation has trained 600 master trainers across 16 local government areas in Kwara State, who have in turn trained more than 62,800 frontline health workers. The programme has also established 10 EmONC skills laboratories in selected medical facilities.

Despite these interventions, Saraki said preventable deaths would continue unless urgent attention is given to water and sanitation in health facilities.

She said many health workers are forced to conduct deliveries without access to clean water, increasing the risk of infection for both mothers and newborns.

To address this, the foundation launched a WASH programme that combines advocacy for increased public funding with frontline training for health workers and cleaners on hygiene practices.

The initiative also extends to schools, where students are taught basic hygiene skills such as proper handwashing.

Saraki said improving maternal health requires sustained investment in three critical areas: quality training for health workers, functional water and sanitation infrastructure, and reliable personal health records to guide emergency care.

She added that without addressing these fundamentals, Nigeria would continue to record preventable maternal and infant deaths, despite having the knowledge, medicines and technology to save lives.