Stakeholders have called for improved maternal health financing, better budget implementation, increased investment in the health workforce and stronger coordination among governments and development partners to reduce maternal deaths in Nigeria.

They stressed that reducing maternal mortality requires more than increased funding, saying it demands stronger health systems, smarter investments, greater accountability, effective partnerships and sustained political commitment.

They also called for greater use of data to drive advocacy and evidence-based policy decisions.

The call was made at a maternal health roundtable organised by Nigeria Health Watch in Abuja with the theme: ‘Investing in Mothers: Aligning Finance, Policy and Innovation for Improved Maternal Outcomes’.

Participants decried persistent financing gaps and inefficiencies in the health sector, urging governments to strengthen domestic resource mobilisation, adopt innovative financing models, and develop strategies to sustain proven maternal health interventions beyond donor funding.

National Lead of the Maternal and Neonatal Mortality Reduction Innovation Initiative (MAMII), Dr Dayo Adeyanju, said Nigeria continues to bear one of the world’s highest maternal and neonatal mortality burdens, recording more than 572 maternal deaths per 100,000 live births and 41 neonatal deaths per 1,000 live births.

He said sustained domestic resource mobilisation would be critical to achieving the country’s targets of reducing maternal mortality by 30 per cent and neonatal mortality by 20 per cent by 2027.

According to Adeyanju, Nigeria’s 2025 National Annual Operational Plan for the health sector is estimated at N3.68 trillion, comprising N1.70 trillion from government funding and N1.25 trillion from development partners, leaving a financing gap of N720 billion, representing 19.5 per cent of the total funding requirement.

He added that N3.09 trillion, representing 87.9 per cent of the planned expenditure, has been allocated to strengthening efficient, equitable and quality health systems, reflecting the government’s commitment to improving healthcare delivery.

Adeyanju explained that MAMII, launched in 2024, aims to reduce maternal mortality by 30 per cent, neonatal mortality by 20 per cent by 2027 and increase health facility utilisation by 60 per cent by 2030.

He observed that out-of-pocket payments account for between 69 and 77 per cent of healthcare spending in Nigeria, making maternal healthcare unaffordable for many families.

He further disclosed that less than five per cent of the estimated seven million women who give birth annually in the country are covered by health insurance. According to him, the MAMII programme is being implemented in 172 priority local government areas across 33 states, covering about 55 per cent of Nigeria’s maternal mortality burden.

Strengthening Health Systems Lead at the BudgIT Foundation, Biobele Davidson, said Nigeria accounts for nearly one-fifth of global maternal deaths despite representing only about two per cent of the world’s population.

He cited estimates showing that the country’s maternal mortality ratio stands at about 993 deaths per 100,000 live births, while about 82,000 women die annually from pregnancy-related complications, many of which are preventable through adequate financing and a functional primary healthcare system.

Davidson argued that Nigeria’s maternal health crisis extends beyond policy commitments, noting that inadequate financing and weak budget implementation remain major obstacles to reducing preventable maternal deaths.

He lamented that public investment in health remains far below the Abuja Declaration target of allocating 15 per cent of national budgets to the sector.

“The 2026 Federal Government health budget stands at N2.51 trillion, representing only 3.67 per cent of the national budget. At the same time, between 69 and 77 per cent of health financing comes directly from patients through out-of-pocket spending, creating major barriers to maternal healthcare.

“Budget implementation remains poor across many states, with actual health expenditure often falling between 30 and 50 per cent below approved allocations.

As a result, funds meant for emergency obstetric care, skilled birth attendance, and referral services frequently do not reach frontline health facilities,” he said.

Davidson also referenced BudgIT’s recent assessment of 5,099 primary healthcare centres, which revealed that only 13.89 per cent have ambulances, nearly half lack nurses or midwives.

40 per cent have no laboratory facilities and more than half are not adequately secured to provide round-the-clock emergency services.

He identified poor budget implementation, diversion of local government health funds, weak enforcement of accountability mechanisms under the Basic Health Care Provision Fund and inadequate use of digital budget-tracking tools as major barriers to improving maternal health outcomes.

Davidson urged governments at all levels to increase health sector allocations to meet the Abuja Declaration benchmark, expand health insurance coverage for women in the informal sector, improve financing for essential obstetric medicines and emergency transport, strengthen implementation of the Basic Health Care Provision Fund and institutionalise transparent budget reporting.

In her remarks, the United Nations Population Fund (UNFPA) Resident Representative in Nigeria, Muriel Mafico, reaffirmed the organisation’s commitment to improving maternal health outcomes in the country.

She said UNFPA would continue to support Nigeria’s maternal health agenda through matched financing for states, investments in local manufacturing of reproductive health commodities, and the strengthening of the midwifery workforce through training and the deployment of digital tools.