No fewer than 4,000 pregnant women across Nigeria have received free caesarean sections under the National Health Insurance programme, marking one of the most remarkable gains recorded through the Maternal and Neonatal Mortality Reduction Innovation Initiative.

This is according to the 2025 health statistics report released by the Federal Ministry of Health and Social Welfare.

The surgeries, fully subsidised and conducted in designated facilities, form part of a broader national push to reduce preventable maternal and newborn deaths and strengthen frontline health systems.

Launched in November 2024, MAMII is designed to reduce maternal deaths by 30 per cent and neonatal deaths by 20 per cent in 172 high-burden local government areas across the country.

The initiative deploys a suite of targeted, context-specific measures that focus on governance, accountability, community demand creation, skilled service delivery, and improved financing and performance management.

Since commencement, the programme has identified the major drivers of mortality in these LGAs and has begun implementing tailored solutions to address them.

“MAMII has achieved significant progress in strengthening Nigeria’s health system response to maternal and neonatal mortality. One hundred and eighty-six LGAs have developed context-specific costed work plans using the national comprehensive implementation guide to improve antenatal care attendance; over 400,000 pregnant women have been line-listed, with the number of referrals on the National Emergency Medical Services and Ambulance System increased from 86 to 32,711, with 4,000 caesarean sections done at no cost to the pregnant women enrolled under the National Health Insurance programme.

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“Lifesaving maternal, newborn and child health commodities have been distributed to over 500 facilities, and emergency transport systems have been activated in LGAs in 12 states. Early data trends show increased facility and antenatal attendance as well as skilled birth attendance.

“The gains made so far can be attributed to significant efforts by LGAs, states, and the Federal teams,” the report read partly.

The report noted that across the 172 LGAs, progress has been significant, as a total of 435 health facilities have been revitalised, while 729,724 women booked their first ANC visit before 20 weeks of pregnancy, and 794,205 women completed their fourth ANC visit.

Between the first and third quarters of 2025, the report showed that the LGAs recorded 731,559 deliveries, 21,172 stillbirths, 841 maternal deaths, and 1,245 neonatal deaths.

The health system indicators also show notable improvement. More than half (52 per cent) of the LGAs now have at least two Level-2 facilities, while 78 per cent have a Primary Health Centre in every ward under the Basic Health Care Provision Fund.

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It added that there has been a 17 per cent reduction in maternal deaths and a 12 per cent reduction in newborn deaths in the intervention areas.

According to the report, 25 per cent of BHCPF facilities are linked to the SEMSAS/NEMSAS referral system, which has already processed 7,451 completed referrals.

The report also revealed that only 12 per cent of BHCPF facilities have at least two midwives, even as 47 per cent of LGAs have been equipped with heat-stable carbectocin, a key drug for preventing postpartum haemorrhage.

Meanwhile, 20 per cent of BHCPF facilities have at least one laboratory technician. To support community-level interventions, 411,296 women have been line-listed across the 172 LGAs for closer follow-up.

Despite the gains, the report stated that significant gaps remain.

“The key gaps identified include that many LGAs lack sufficient community health workers for household-level tracking and demand creation, and inadequate numbers of functional designated Basic and Comprehensive Emergency Obstetric and Newborn Care facilities.

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“Emergency transport services are still limited in coverage, with delayed driver payments and weak digital systems. Similarly, Maternal and Perinatal Death Surveillance and Response implementation remains weak across facilities in the 172 LGAs, and delays in the release of funds under the annual Operational Plans threaten continuity,” it stated.

To consolidate progress and sustain reductions in maternal and newborn mortality, experts recommend prioritising community health system strengthening and fully scaling functional BEmONC and CEmONC facilities.

“To sustain the continuous reduction in maternal and newborn deaths, stakeholders must prioritise strengthening community health systems, scaling BEmONC and CEmONC facilities, ensuring full functionality of emergency transport services, and institutionalising MPDSR in a timely manner, as these are critical to sustaining impact.

“With continued high-level coordination and the expansion of global best practices, MAMII can catalyse Nigeria’s progress toward reducing preventable maternal and neonatal deaths,” it added.