Price on survival: Kemi’s death and cost of care

The preventable death of Kemi Akinbobola, a pregnant woman who was said to have been denied medical treatment at a Lagos private hospital due to her husband’s inability to pay N500,000 immediately, is a sorrowful and humiliating reminder of the fragility—and inhumanity—that is prevalent in much of Nigeria’s health system. Kemi was not just another […]

The preventable death of Kemi Akinbobola, a pregnant woman who was said to have been denied medical treatment at a Lagos private hospital due to her husband’s inability to pay N500,000 immediately, is a sorrowful and humiliating reminder of the fragility—and inhumanity—that is prevalent in much of Nigeria’s health system. Kemi was not just another maternal mortality statistic; she was a mother who had a family, a child in her womb, and every right to expect that the healthcare system of her country would preserve her life at the moment when she needed it most. And yet, instead of an ambulance, she was presented with a price list. Instead of help, she found a gatekeeper who assessed her in naira. She died, purportedly turned away, untreated, simply because the hospital claimed it couldn’t treat a woman in labour without a down payment—regardless of the obvious emergency that was being presented to them.

There is no justification—ethical, medical, or legal—to refuse an expectant mother in labour basic emergency care. The medical field is one that is bound by an oath that places emphasis on the value of life. Emergencies, particularly obstetric emergencies, can’t be postponed for ATM withdrawals. Labour is not an affair that you can put off with a “Come back later when you have money” message. It is an emergent high-risk state that necessitates urgent attention and compassion. A hospital that fails to respond to such a demand has failed at its fundamental role.

We cannot speak of the death of Kemi without condemning the system under which this occurred. Nigeria’s healthcare system is at times broken and at others exhausted, avoided, and in some way, commodified to brutality. There are countless families like Kemi’s—ordinary people, working hard, surviving each day—who cannot afford sudden medical bills of hundreds of thousands of naira. These are not careless or unserious families. They are simply victims of a system that continues to place healthcare beyond the reach of the poor. Indeed, poverty in Nigeria shouldn’t be a fatal consequence.

Now, let us be clear: there is a law in Nigeria. The National Health Act of 2014, Section 20, states that all health professionals must administer emergency care without demanding any sort of advance payment. To deny anyone such care is not only immoral—it is against the law. That law exists to prevent just this kind of tragedy. If it had been obeyed, Kemi might be alive today. This hospital, therefore, if culpable, must be held fully accountable under Nigerian law.

Aside from this, the Medical and Dental Council of Nigeria (MDCN), a regulatory agency for medical practice, cannot remain silent. An appropriate investigation should be instituted, and if the facts are proven, suspension or revocation of license should be considered. Anything less would be complicity.

Moreover, the Medical and Dental Council of Nigeria (MDCN), being the regulatory agency for medical practice, cannot remain silent. A full investigation must be launched and if facts are found, sanctions ranging from suspension to license revocation should be considered. Anything less than this would constitute complicity.

But while calling for accountability, we also have to contend with the structural problems that allow such tragedies to be repeated. Nigeria already has a universal health coverage scheme, under the National Health Insurance Authority (NHIA), saddled with the responsibility of ensuring all citizens have access to needed healthcare. But what is the point of a system that can’t even protect someone like Kemi? Universal health coverage should mean that no woman dies during childbirth because of cost. It should mean that hospitals are empowered to treat emergencies first and ask questions later. Yet, Kemi’s story exposes a troubling gap between policy and practice—one that continues to claim innocent lives.

While it is clear that the Federal Ministry of Health has made maternal mortality a priority and is trying as hard as it can within the constraints of Nigeria’s healthcare system, more targeted interventions are still urgently needed. We understand that there is no magic wand to wave away decades of systemic issues overnight and that it takes time to make progress. However, cases like that of Kemi remind us that time is a luxury most women cannot afford. Streamlining emergency response systems, implementing the laws that are already in place to protect patients in critical conditions, and increasing access to quality maternal care need to remain at the centre of continued reforms. Only through concentrated and sustained efforts can we expect to prevent such.

Systemic change is necessary, but personal preparation must play its key role. As much as we put institutions on alert, families themselves must be aware and take the lead. Therefore, parents-to-be are encouraged to save early for delivery expenses because planning and saving beforehand can significantly reduce financial burdens once the time comes. Regular antenatal visits (ANC) are also important as they provide valuable information about the course of the pregnancy and detect potential risks early on, allowing better planning and decision-making. In addition, exploring health insurance is advisable, as enrolling in a suitable plan can offer financial support and ensure access to necessary medical care without the stress of initial out-of-pocket costs.

Men need to understand that being supportive of their pregnant wives is not just emotional support—it is financial planning. Giving birth, especially in our current health scenario, can be unforeseen. Having a buffer fund, pre-planning health insurance, and knowing good and cheap facilities beforehand can be the difference between life and death. It is a responsibility that needs to be taken seriously.

Finally, the government and all professional organisations involved must ensure that this matter is not closed with condolence messages and press releases. I read that the Lagos State Ministry of Health has launched an investigation into the matter, and I look forward to its findings and actions. We cannot have a system where pregnant women are allowed to die simply because they cannot afford treatment. If we hold one hospital accountable, perhaps 10 others will change their position. If we punish one doctor or midwife, then other doctors and midwives will be reminded of the oath they took. We have to send a message that life comes before everything else—always.

Kemi’s death was avoidable. If there was the will of God, there was also negligence of man. Negligence of a hospital. A negligence of oversight. A failure of a system that provides such injustice. But let it not be in vain. Let her death ignite something greater in us—a rage that demands justice, a transformation that demands accountability, and an empathy that demands no other woman, no other family, must go through this again. Kemi deserved better. Every Nigerian deserves better.

Let this be the last time we mourn in this way. Let this be a turning point.