The case of postpartum hemorrhage (PPH) in Nigeria can no longer be treated as a routine Maternal Health challenge, it demands urgent, wide-reaching intervention. PPH, the excessive bleeding that occurs after childbirth, is the leading cause of maternal deaths in the country, claiming thousands of lives each year—often within minutes of delivery. Despite advances in healthcare and knowledge of lifesaving practices, PPH continues to take a heavy toll, especially in underserved and rural communities. The need to act decisively has never been more critical.
Studies indicate that it accounts for a significant proportion of maternal deaths in Nigeria, highlighting a glaring gap between available medical solutions and their implementation. The tragedy of PPH lies not only in its prevalence but also in the speed at which it can turn a moment of life into one of death. Certain risk factors, such as advanced maternal age, previous preterm births, cesarean sections, and babies with higher birth weights, increase the likelihood of this condition. Even without these factors, women remain at risk in settings where early detection and timely intervention are lacking.
Strengthening existing preventive care in the country.
As such, there is a high need for the country to strengthen its existing preventive initiatives such as antenatal care, ensuring skilled birth attendants, actively managing the third stage of labor, and improving access to timely and effective treatment, including blood transfusion and uterotonics. Additionally, the country also needs to explore the E-MOTIVE strategy, one of the most promising global interventions currently available introduced by the World Health Organization (WHO). Designed as a practical and evidence-based approach, E-MOTIVE emphasizes the importance of early detection and rapid response in managing PPH.
At the heart of the strategy is a calibrated blood-collection drape, which allows for precise measurement of blood loss—an essential step, as visual estimations often underestimate the severity of bleeding. The effectiveness of the E-MOTIVE strategy is backed by strong clinical evidence. Trials conducted in Nigeria, Kenya, South Africa, and Tanzania demonstrated that the approach could reduce the occurrence of severe PPH by as much as 60 percent. These results are not only impressive but offer hope for transforming maternal healthcare outcomes in Nigeria if scaled up effectively.
Systemic barriers continue to hinder the widespread use of E-MOTIVE.
However, despite the success of these trials and the proven potential of E-MOTIVE, its implementation across Nigeria remains fragmented and limited. Several challenges hinder its nationwide adoption. These include inadequate training for healthcare providers, insufficient supply of essential medicines and equipment, poor infrastructure, and inconsistent referral systems. Moreover, disparities between urban and rural healthcare facilities continue to widen the gap in access to life-saving maternal care. To close this gap, the country must act swiftly and decisively.
Most importantly, the federal and state governments should adopt E-MOTIVE as a standard part of maternal healthcare policy and ensure its integration into medical and midwifery training programs. Existing healthcare workers must also receive ongoing training to build capacity across all tiers of the health system. Equally important is ensuring that health facilities are equipped with the necessary tools and medications. This requires strengthening the national supply chain, securing consistent funding, and forming partnerships with global health organizations to support procurement and distribution.
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Beyond the facility walls, community-level Education and engagement are also essential in preventing PPH- related deaths. Women and families must be made aware of the risks of childbirth complications and the importance of delivering in health facilities with skilled care providers. Removing financial, geographical, and cultural barriers to accessing timely maternal care will be crucial in improving outcomes. Nigeria has the opportunity—and the responsibility—to prevent avoidable maternal deaths caused by postpartum hemorrhage. The tools, strategies, and evidence already exist. What remains is the will to scale up interventions like E-MOTIVE, invest in health systems, and ensure that no woman dies while giving life.