Maternal health remains one of the most pressing global health challenges, marked by stark disparities between high-income and low- to middle-income countries. While advancements have been made, maternal mortality remains unacceptably high in many regions, particularly in sub-Saharan Africa and South Asia. Globally, over 800 women die every day from preventable causes related to pregnancy and childbirth, with 94% of these deaths occurring in low-resource settings. The majority of maternal deaths could be averted with access to quality healthcare, making the case for urgent global reforms aimed at ensuring equitable access to maternal healthcare.
Drawing from global health practices and evidence-based interventions, this article examines strategies to strengthen healthcare systems worldwide to improve maternal health outcomes. It leverages the insights of public health experts like Jaiyeola Abiose Ayanbadejo, whose work in resource-constrained environments, such as Nigeria, demonstrates effective models for making maternal health services more accessible and equitable worldwide.
Since the early 2000s, maternal mortality rates have decreased by almost 38% globally, primarily due to international initiatives and the expansion of healthcare services. However, this progress has been uneven, and significant disparities persist between high-income countries and their low- and middle-income counterparts. Maternal mortality ratios (MMRs) in sub-Saharan Africa and South Asia remain alarmingly high, with figures reaching 462 deaths per 100,000 live births in sub-Saharan Africa compared to just 11 per 100,000 in high-income countries. This disparity underscores the failure to provide consistent and equitable maternal healthcare globally.
The primary causes of maternal deaths are often preventable and include severe bleeding (mostly after childbirth), infections, high blood pressure during pregnancy (pre-eclampsia and eclampsia), complications from delivery, and unsafe abortion practices. For every woman who dies from pregnancy-related complications, many more suffer long-term severe consequences such as fistulas, infertility, and psychological trauma. These outcomes are particularly prevalent in regions where women lack access to quality prenatal care, skilled birth attendants, and emergency obstetric services.
The root causes of maternal health disparities are complex and multifaceted. Socioeconomic inequities, including poverty and limited access to education, profoundly impact maternal health outcomes, while systemic issues in healthcare delivery, such as the lack of trained healthcare professionals, inadequate infrastructure, and supply chain problems, exacerbate these challenges. Furthermore, in many cultures, gender inequalities limit women’s access to healthcare services, often depriving them of the agency to seek the care they need.To address these challenges, global health leaders must learn from successful interventions that significantly improve maternal health outcomes in resource-constrained settings. Those of Jaiyeola Abiose Ayanbadejo, with the United Nations Population Fund (UNFPA) in Nigeria, is an exemplary maternal healthcare reform model in low-resource environments. Jaiyeola’s focus on capacity building, community engagement, and data-driven evaluations offers critical insights into how maternal health services can be sustainably improved, even in the most under-served regions.
In Nigeria, where maternal mortality remains among the highest in the world, Jaiyeola spearheaded efforts to strengthen maternal and reproductive healthcare by building local capacity for monitoring and evaluating health programs. Her approach centered on integrating maternal healthcare into community-based health services, ensuring that even women in the most remote areas had access to essential maternal care services. By working directly with local communities, healthcare workers, and policymakers, her efforts led to better-designed programs that addressed the population’s specific needs.
One of the key lessons from Jaiyeola’s work is the importance of data in driving sustainable improvements in healthcare. By collecting and analyzing health data, Jaiyeola was able to identify critical gaps in healthcare delivery, optimize resource allocation, and tailor interventions to the specific needs of different communities. This evidence-based approach is essential in ensuring that healthcare programs are both effective and efficient, particularly in resource-constrained settings where every dollar must be carefully spent.
Moreover, Jaiyeola’s emphasis on capacity building ensures sustainable healthcare improvements. By training local healthcare workers and building the infrastructure needed to deliver quality care, her programs not only improved maternal health outcomes in the short term but also equipped communities to maintain these improvements over the long term. This model of healthcare reform — focusing on community-based care, data-driven interventions, and sustainable capacity building — can be applied across countries facing similar challenges in maternal healthcare.
The provision of culturally competent care is critical to improving maternal health outcomes, particularly in ethnically diverse and low-resource settings. Cultural norms and practices around childbirth can vary widely, and healthcare programs that fail to consider these differences often struggle to gain the trust of the communities they aim to serve.
Jaiyeola Abiose Ayanbadejo’s work illustrates the importance of engaging communities directly and understanding their specific cultural needs.
In Nigeria, Jaiyeola worked closely with community leaders and local healthcare providers to ensure that maternal health services were culturally sensitive and adapted to the local context. For example, in some communities, women were reluctant to seek care from male healthcare providers due to cultural or religious norms. By training female healthcare workers and involving local leaders in health program design, Jaiyeola helped overcome these barriers and ensure that women felt comfortable accessing maternal health services.
Another critical aspect of culturally competent care is providing women with accurate, accessible information about maternal health in ways that resonate with their cultural values and beliefs. Jaiyeola’s programs included developing culturally appropriate educational materials that were disseminated through community outreach programs, ensuring that women were empowered with the knowledge they needed to make informed decisions about their health. This approach improved maternal health outcomes and fostered greater community involvement and ownership of health programs, making these interventions more sustainable.
Conclusion
Investing in equitable access to maternal healthcare is both a moral and economic necessity. Healthier mothers lead to healthier families, stronger communities and more robust economies. Every year countries lose billions of dollars due to the social and economic costs of poor maternal health outcomes. These costs, which include lost productivity, long-term disability, and the burden on healthcare systems, can be mitigated by investing in maternal healthcare services that are accessible, affordable, and culturally competent.
SOURCE: Vanguard Nigeria, by Jaiyeola Abiose Ayanbadejo, 28 October 2024