By Isaac Atunlute
Nigeria continues to record one of the highest maternal mortality rates in the world–512 deaths per 100,000 live births–according to the 2018 Nigeria demographic and health survey.
The contributing factors remain familiar: limited access to skilled birth attendants, poverty, long distance to health facilities, and delayed intervention during obstetric emergencies.
Recent reports by the World Bank highlight a disturbing trend – more women, especially in rural areas, are giving birth at home, often without the presence of a skilled health worker. The result? Preventable complications like haemorrhage, eclampsia, or obstructed labour which often turn fatal.
“While proactive care like antenatal services is essential, many pregnant women still die due to delayed or inadequate response during emergencies; that is where trained nurses can make a difference,” noted Idara Umoette, a practising medical doctor and founder of Birth Safe Nigeria
To address this, Birth Safe Nigeria launched the Train One to Reach Many (TORM) initiative, aimed at training 1,000 frontline nurses and midwives in obstetric emergency management across five states – Lagos, Kano, Oyo, Rivers, and FCT.
The programme is designed to help nurses identify and treat complications in the first five minutes, a critical window that can be the difference between life and death.
The initiative will begin in Lagos, training 200 nurses and midwives. The state’s existing healthcare structures and innovations provide a solid foundation to enhance the programme before it expands to other regions.
Umoette noted that empowering the frontline health workers with advanced skills for rapid identification and management of obstetric emergencies would improve pregnancy outcomes for over 250,000 pregnant women.
The nurses are educated to recognise eclampsia, sepsis, obstructed labour, and excessive bleeding as complications and are instructed to administer the first line of intervention before referring the patient. Where home delivery still prevails, this type of decentralised emergency capability might save lives.
The first training sessions are scheduled to take place in Lagos on July 2 and 3, with rollout to other states planned in the following months.
Innovative tools are also playing a role. One such tool is the Jidem breast pump, developed in Nigeria.
Besides supporting newborn nutrition, breast stimulation through the pump can help manage postpartum bleeding by enabling uterine contraction, a simple yet vital intervention.
Partnerships with healthcare firms like Accentcare have also helped supply digital simulation tools and training kits, especially in remote areas where access to large hospitals is limited.
Indeed, the programme is not without challenges. Nigeria’s health system continues to struggle with funding gaps, shortages of trainers, and cultural resistance to care by nurses in some communities.
However, local governments are beginning to show support. In Kano and Oyo states, there are ongoing discussions to include the TORM training into nurses’ continuing professional development programme.
The broader hope is scale this model across Nigeria, and adapt it to other African countries facing similar maternal-health challenges.
Nigeria has one of the highest maternal mortality rates globally, with a figure of 512 deaths per 100,000 live births. Factors contributing to this include limited access to skilled birth attendants, poverty, and delayed emergency interventions. A troubling increase in home births without skilled health workers, particularly in rural areas, has led to preventable complications such as haemorrhage and eclampsia turning fatal.
To combat this, Birth Safe Nigeria launched the Train One to Reach Many (TORM) initiative to train 1,000 nurses and midwives in obstetric emergency management across five states. The training focuses on rapid complication identification and management during the critical first five minutes post-delivery. The program hopes to improve pregnancy outcomes for over 250,000 women, starting in Lagos and expanding to other regions subsequently. The initiative also introduces innovative tools like the Jidem breast pump for postpartum bleeding management and relies on partnerships to supply digital training kits in remote areas.
Despite facing challenges like funding gaps and cultural resistance, the program is garnering local government support in states like Kano and Oyo, which are considering incorporating TORM into nurses' continuing professional development. The broader objective is to scale the model throughout Nigeria and adapt it for other African countries facing similar maternal health challenges.
