NIGERIA – Smiles for Mothers Playbook

Uterine atony is responsible for 63.6% of post-partum haemorrhage cases in Nigeria. This is preventable by active management of the third stage of labour using oxytocin. However, the quality of oxytocin is often compromised by cold storage problems, erratic power supply, weak refrigeration infrastructure, and knowledge gaps among health workers on storage conditions. In 2018, WHO updated its guidelines on uterotonics to include heat-stable carbetocin for PPH prevention, addressing the fragile cold chain infrastructure in health systems like Nigeria’s. In 2020, the Smiles for Mothers programme, with funding from MSD for Mothers supported the Federal Ministry of Health to roll out these recommendations and drive HSC adoption in Lagos, Niger, and Kano states. These experiences are now detailed in the Smiles for Mothers Playbook, designed to guide healthcare stakeholders to improve maternal health initiatives.