Nigeria cannot reduce its staggering maternal mortality rates without removing the chaos in health data management. Fragmented records, outdated methods of collecting and keeping records, delayed reporting, and incomplete tracking sabotage every effort to spot risks early. This leaves preventable maternal death unchecked.

The country is bedevilled by an unending maternal health crisis, with estimates putting the maternal mortality ratio between about 1,016 and 1,047 deaths per 100,000 live births as of 2022, one of the highest burdens globally. Simply put, Nigeria is a major contributor to worldwide maternal deaths.

While limited access to healthcare services and poor infrastructure are key drivers of this tragedy, a medical record system that cannot track risks, follow patients across different healthcare facilities and evaluate outcomes is also contributing to the problem.

Audits in northern Nigerian tertiary hospitals show 89.7% of maternal deaths are caused by late referrals from peripheral centres, with 79.3% of women dying within 24 hours of arrival because no shared patient histories exist to guide care. Poor data handling turns primary-to-tertiary reference into a deadly practice.

Antenatal care is strained the hardest under these data deficits. Women often begin prenatal visits too late, evading detection of dangers like hypertension or anaemia that antenatal logs should flag. An analysis highlighted critical gaps in focused antenatal care, where inconsistent recording misses signals in high-risk cases, fueling deaths from haemorrhage (31%) and eclampsia (27.6%). Without reliable, real-time data entry at the community level, risks stay invisible until emergencies overwhelm unprepared hospitals.

Even post-death scrutiny crumbles due to shoddy data. Nigeria’s Maternal and Perinatal Death Surveillance and Response (MPDSR) system, meant to dissect causes, limps along with incomplete inputs. Facility audits reveal retrospective reviews crippled by absent civil registration—59% of births occur outside tracked sites—and staff fears of blame deter honest reporting. These unreliable tallies mock progress claims, like a reported 17% drop, while hiding true patterns.

Contrast this with the United States, where robust data systems transform maternal health outcomes. Maternal Mortality Review Committees (MMRCs), powered by the CDC’s Maternal Mortality Review Information Application (MMRIA), standardise documentation across states. They link vital records, hospital discharges, and autopsy data for automated analysis, enabling committees to pinpoint preventable factors swiftly. Real-time dashboards from Perinatal Quality Collaboratives (PQCs) further empower action—visualising trends in elective deliveries or antenatal steroid use to slash complications before they escalate.

Public dashboards, over 80 strong and mostly state-run, now track severe maternal morbidity rates nationwide, though gaps persist in some metrics. Providers access patient histories instantly across facilities, averting the referral disasters plaguing Nigeria. Early risk identification thrives; one state collaborative reduced preterm birth risks by integrating birth certificate data with clinical alerts.​

Nigeria needs not reinvent the wheel—simplified versions beckon. Digitise MPDSR via MMRIA-inspired apps to anonymise reports and classify causes automatically, bypassing blame barriers. Build interoperable platforms linking primary and tertiary records, as glimpsed in Lagos pilots, to end referral letter chases like the Abuja twins’ fate. Rural clinics could upload basic antenatal data to shared dashboards, flagging twins or high blood pressure via mobile tools for instant triage.

High-burden states like Lagos offer perfect testing grounds, tying into National Health Insurance Authority streams for sustainability. Such data fixes demand investment but promise outsized gains: reliable tracking could halve deaths from known risks without awaiting perfect infrastructure. Until Nigeria masters health data, maternal mortality will persist as a grim statistic—and more mothers, like the one in Mpape, will pay the ultimate price.

Dr Adewumi is a US-based health informatics professional and researcher combining frontline implementation experience with quantitative methods to measure impact at scale.