The recent decision by the federal government to provide free caesarean section (CS) for all pregnant Nigerian women who need it could not have come at a better time. Nigeria’s Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, made the announcement on November 7, 2024 at the three-day Nigeria Health Sector-Wide Joint Annual Review meeting in Abuja, where the Maternal Mortality Reduction Innovation Initiative (MAMII) was also launched.
The initiative, according to Pate, represents a commitment that aims at reducing maternal and new-born mortality across Nigeria. The minister was quoted as saying, “No woman should lose her life simply because she can’t afford a caesarean section”. He disclosed that a pivotal feature of the initiative is the provision of free caesarean sections for poor and vulnerable women who meet eligibility criteria, covering services provided through both public and private facilities empanelled by the National Health Insurance Authority (NHIA).
Pate further noted that, “By removing financial barriers to this life-saving procedure, we ensure that no woman in need is denied critical care due to cost. Maternal mortality remains unacceptably high, with 172 local governments contributing to over 50 per cent of maternal deaths.” He also said the NHIA in collaboration with the National Primary Health Care Development Agency (NPHCDA) and state health insurance agencies will manage the reimbursement process; ensuring that providers across both sectors can deliver these essential services sustainably.
Speaking on the role of community health workers in ensuring the success of the initiative, the minister announced the federal government’s plan to on-board 120,000 additional health workers to support primary care across Nigeria.
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To further ease access, the minister explained that the National Emergency Medical Service and Ambulance System of the Federal Ministry of Health has been revitalised to provide timely transport for emergencies; bridging a key gap in both maternal and new-born care by bringing emergency services closer to those who need them most.
Available statistics show that Nigeria currently contributes 10 per cent of global deaths for pregnant mothers. Latest figures show a maternal mortality rate of 576 per 100,000 live births in Nigeria, the fourth highest globally. Each year, approximately 262,000 babies die at birth; the world’s second highest national total.
Given the huge benefits of the free-CS initiative, which seeks to tackle Nigeria’s maternal and new-born health challenges, we encourage the government to remain committed to every aspect of this humanitarian investment. Procedures for accessing the offer should be devoid of administrative bottlenecks, and should be accessible to pregnant women in all parts of the country; urban and rural. The healthcare facilities that would be used for the free-CS should properly be equipped with adequate human and material resources. More importantly, the policy should not be turned into another sinkhole for misappropriating funds meant to remove financial barriers in maternal healthcare.
In spite of the common goodwill inherent in this laudable investment by the government, it is yet prompting several questions concerning the modalities for its implementation. Nigerians are asking, among other questions, whether or not there are adequate budgetary provisions for it. It is not clear if statistics are available on the number of prospective beneficiaries, the cost implications for providing the services, and the medical personnel needed to successfully implement the initiative? With many of Nigeria’s women in their reproductive age residing in the country’s rural communities, the healthcare facilities from which the free-CS can be accessed is another matter to be clarified.
Given the huge annual budgetary allocations which over decades failed to improve the maternal healthcare delivery system in Nigeria, the government needs to expressly establish its political will to implement the free-CS policy; at least, to allay the fears of Nigerians who believe that the policy is a mere political statement. This insinuation essentially sprouts from the government’s inability to, for instance, provide free minimal antenatal services to pregnant women. The promise of free-CS in a country where pregnant women cannot access low-cost drugs for free, including folic acid and vitamin tablets, further justifies public allusions. Pregnant women pay for nearly every medical service they enjoy in public health facilities, including folders and hand cards.
As Nigerians await the roll-out of the free-CS initiative, Daily Trust urges the 774 local government areas in Nigeria to increase and improve upon their existing emergency facilities for maternal healthcare, especially in the rural areas. The LGAs could do more to further the policy thrusts of the free-CS by training and supporting traditional birth attendants. To make the free-CS for pregnant women a reality is a task that should be done by the government with the full commitment it deserves.
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