Chatham Maternity Care Center bucks trend of rural maternity closures

Enugu State is addressing healthcare access gaps and high maternal mortality by establishing 260 Type 2 Primary Healthcare Centers, with 100 already completed. These fully-equipped facilities provide 24-hour care with essential medications and reliable utilities. As part of the initiative, the Centers are also recruiting 2,200 healthcare workers, training over 1,800 staff members in safe delivery and contraceptive methods, introducing AI-assisted ultrasound screening and implementing affordable health insurance. Since opening in March 2025, one center alone has served over 690 people.

The Anambra state government’s Antenatal and Delivery Program mandates government-owned hospitals and Primary Healthcare Centers (PHCs) to offer free antenatal care and delivery services, to close the gap in care and curb maternal mortality rates. The program has helped strengthen the maternal care capacity at 329 PHCs throughout the state and has served over 60,000 women.

To address gaps in healthcare access, the local government partnered with organizations like Plan International, German Cooperation and the World Bank’s Saving One Million Lives Project to build, refurbish and equip primary healthcare centers across the state to provide better care. As of May 2023, 138 centers have been built or upgraded, offering maternity care services, child healthcare, vaccinations and family planning among other services.

The Health and Social Development Foundation (HESED) aims to increase access to healthcare, specifically among pregnant women and children. HESED works to bring doctors closer to communities that struggle to get care and has also created designated spaces for important care that was previously inaccessible, like OBGYN checkups. Over the last three years, more than 400 people have received checkups from the center, regardless of their insurance status.

In 2020, Nigeria's Rural Electrification Agency installed a 50-kilowatt solar-hybrid system at Gombe State Specialist Hospital, providing uninterrupted electricity to critical units, including the ICU and emergency departments. Since its installation, maternal mortality dropped from 15-20 deaths monthly to 1-2 per month, and neonatal deaths also decreased from 50 to 20-25 monthly. The system has also helped healthcare workers perform life-saving surgeries without interruption, as these surgeries were often delayed or impossible due to power outages.

In 2017, residents of Kabuga Aisami in Kano built their own maternal and child health hospital to address maternal mortality rates and improve access to care. Led by the Kabuga Aisami Community Initiative (KACI), community members pooled resources to construct the facility, which includes two labor rooms, three wards with 40 beds, four laboratories, a pharmacy, 25 toilets, and three self-contained flats for doctors to enable 24-hour care. Patient volume has since increased by over 250%, and the hospital has expanded to serve 10 surrounding communities, as well.

Jacquelyn Alvarado, a certified nurse midwife with the Texas A&M Rural and Community Health Institute, travels across Texas to teach rural hospital staff how to deliver babies. Using a mannequin, she runs simulations covering both routine and complicated deliveries for ER nurses, paramedics, and other non-obstetrical staff who may be the only help available when a rural patient goes into labor.

The Abiye Project registered over 20,000 pregnant women using a community-based model to ensure they receive proper healthcare. The program connected women with trained health rangers who served as liaisons with traditional birth attendants (TBAs). When TBAs’ resistance stalled the program, the government introduced financial incentives, paying them for each patient referral, leading to more hospital births and a reduced child and maternal mortality rate.

Reachout Center Trust is addressing gaps in maternal healthcare with mobile outreach to connect pregnant women with clinics for full-service care up to delivery. The program has served over 200 women since forming and research shows its intervention has led to healthier babies and reduced stigma in seeking hospital care.

The Saving Mothers, Giving Life project aims to improve access to and the quality of maternal and infant healthcare to reduce maternal and newborn deaths. The project established a Maternal and Perinatal Death Surveillance and Response team and launched an interactive digital chat solution on WhatsApp to get important health information to pregnant women. Through these efforts, maternal and perinatal deaths in 25 private health facilities decreased by 60% and 16%, respectively.