International Midwife day: Maternal Health Expert Advocates for Comprehensive Care

In commemoration of this year’s International Midwife Day, we share the experience and expertise of a seasoned maternal health expert who has had the privilege to contribute to positive pregnancy outcomes in both the developed and developing worlds. With Nigeria’s staggering maternal health challenges, Khadijat Adeleye, an esteemed maternal child expert with a career spanning […]

In commemoration of this year’s International Midwife Day, we share the experience and expertise of a seasoned maternal health expert who has had the privilege to contribute to positive pregnancy outcomes in both the developed and developing worlds.

With Nigeria’s staggering maternal health challenges, Khadijat Adeleye, an esteemed maternal child expert with a career spanning more than a decade across Nigeria, the United Kingdom, and the United States, brings a beacon of hope. In a recent interview with Daily Trust, Adeleye emphasized the pressing need for comprehensive strategies to address maternal health challenges in Nigeria, a country accounting for a substantial proportion of global maternal deaths. Adeleye, throughout her career, has focused on enhancing structured content for antenatal education for pregnant women and emphasizing the need for balanced information to enhance positive pregnancy outcomes.

Can we meet you?

 I am a Registered Nurse recognized by the Nigeria Nursing and Midwifery Council, the Massachusetts Board of Nursing in the USA, and the Nursing and Midwifery Council in the UK. My professional journey has taken me through clinical nursing roles in Nigeria and the United Kingdom. Beyond direct patient care, I am passionate about sharing knowledge and expertise, which has led me to train and educate nurses across Nigeria. With my extensive nursing practice and educational background, I bring a unique perspective to addressing maternal and child health challenges. My focus is on researching and implementing strategies to tackle inequalities in maternal healthcare, ultimately striving to reduce maternal morbidity and mortality rates.

THE UN recently reported that most Maternal Mortality happened in Nigeria. What is the implication of this new report on maternal health care in Nigeria?

The UN’s recent report highlighting Nigeria’s significant share of maternal mortality is deeply concerning. Nigeria has an estimated maternal mortality ratio of over 800 maternal deaths per 100,000 live births, signifying the urgent need for effective strategies to address this issue. This sobering statistic underscores the dire state of maternal healthcare in our country and the imperative for immediate, comprehensive reforms.

The UN report has several profound implications for maternal health in Nigeria. First and foremost, it sheds light on the monumental challenges we face in ensuring the safety and well-being of Nigerian women during pregnancy, childbirth, and the postpartum period. The report’s finding that a Nigerian woman has a 1 in 19-lifetime risk of maternal mortality, compared to 1 in 4,900 in developed countries, is a stark reminder of the gaping disparities we must address.

Additionally, the report underscores the need for increased investment in maternal healthcare infrastructure, resources, and training programs for healthcare professionals. Equally concerning is the report’s emphasis on the disproportionate impact of the maternal health crisis on specific regions, particularly the conflict-affected Northeast, where insecurity and displacement have further exacerbated the challenges in accessing quality care. This highlights the critical need for targeted, context-specific interventions to reach the most vulnerable population.

The UN report is a sobering wake-up call but also an opportunity to catalyze meaningful change. By harnessing all stakeholders’ collective will and expertise, we can forge a future where every Nigerian woman can access the high-quality, respectful maternal care she deserves. This is a moral imperative and a critical step towards achieving the Sustainable Development Goals and building a healthier, more equitable Nigeria.

Can you describe maternal health care?

Maternal health care comprises several essential components to ensure pregnant women’s well-being before, during, and after childbirth. These components include antenatal care (ANC), skilled birth attendance (SBA), emergency obstetric care (EmOC), and postnatal care (PNC). ANC provides health screenings, counseling, and interventions during pregnancy, while SBA ensures safe delivery practices and management of complications. EmOC offers life-saving interventions for obstetric emergencies, and PNC provides follow-up care for mothers and newborns after childbirth. Together, these components help reduce maternal and neonatal morbidity and mortality and promote healthy outcomes for mothers and infants.

How can Nigeria’s midwives help in reducing maternal morbidity and mortality?

I firmly believe that Nigeria’s midwives play a pivotal role in reducing maternal morbidity and mortality rates. Midwives are crucial in addressing these challenges due to their strategic position in the continuum of care for women and newborns. They are trained to provide skilled, knowledgeable, and compassionate care directly associated with better maternal and newborn health outcomes. Midwives can deliver essential services that reduce the need for unnecessary interventions, thereby being cost-effective and improving the overall quality of care.

Implementing strategies such as the Midwives Service Scheme (MSS) has improved maternal and newborn health. The MSS ensures continuous provision of skilled birth attendance by deploying midwives to nationwide health facilities. Additionally, partnerships with community midwifery and the provision of Emergency Obstetric and Newborn Care (EmONC) have demonstrated a commitment to comprehensive maternal health services. Additionally, Interventions such as the Abiye program can serve as a model for how focused maternal and neonatal health initiatives can substantially improve outcomes. Incorporating lessons from international models like UK midwifery-led programs could provide strategic approaches to addressing Nigeria’s challenges in maternal health.

What must Nigeria do more drastically to change its position?

Drawing from my clinical experience in Nigeria and the United Kingdom, I stress the urgent need for Nigeria to take decisive action to enhance its maternal health outcomes. This demands a multifaceted strategy that bolsters healthcare infrastructure, expands skilled birth attendance, improves emergency obstetric care, and fosters health education and awareness.

A prime example from the United Kingdom’s maternal health services that Nigeria could adopt is the implementation of midwifery-led care. In the UK, midwives are pivotal in supporting pregnant women throughout their maternal journey, delivering tailored, woman-centered care that attends to their physical, emotional, and social needs.

Nigeria can emulate this model by integrating midwifery-led care, where trained midwives provide expectant mothers antenatal, intrapartum, and postnatal care. This approach holds the potential to enhance access to skilled birth attendance, advocate for everyday birth practices, and reduce unnecessary medical interventions like cesarean sections. By empowering midwives to offer holistic care, Nigeria stands to significantly improve maternal health outcomes and ensure that every woman receives the comprehensive support she requires during pregnancy and childbirth.

What are your concluding thoughts?

Consistent with the International midwifery celebration’s theme, it is time to reduce maternal mortality and morbidity. We must go beyond the rhetoric and demonstrate political will through commitment to investments, innovations, and implementing bold maternal health initiatives. We need stronger partnerships, multisectoral collaboration, private sector engagements, and strengthening of the health system.