Closing the Gap: Linking Fistula Surgery to Health Coverage in Nigeria

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.

A pair of doctors are working to make healthcare more accessible and affordable by training area hospitals to use new technology, like ultrasound devices, to detect non-communicable diseases. Through their newly established non-communicable disease clinic staffed with personnel trained to provide more precise medical care, about 1,100 patients have been cared for.

The RECOVERY Rehabilitation Center provides rehabilitation care for wounded soldiers. Providers at the center provide patients with specialized care and help to create individual action plans for when patients leave the center to ensure they have the means to adapt to their new way of life.

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.

The Safer Hands Health Initiative (SHI) aims to reduce maternal mortality across the country by educating and empowering birth attendants, healthcare centers and pregnant women to use safe delivery practices. SHI partners with medical boards and area hospitals to provide free training for birth attendants and also provides sterile birthing kits to expectant mothers. So far, SHI has trained over 200 birth attendants and has distributed more than 10,000 birthing kits.

Instead of letting a rural Kansas hospital perish, one CEO found a way to recruit young physicians, and get grants for the hospital. His methods helped the hospital avoid the common fate many rural hospitals face, which are often forced to shut down. It “now serves about 20,000 patients annually, up from roughly 10,000 patients in 2012, and generated $23.4 million in revenue last year.”

Hospitals in New York improve healthcare quality and reduce medical costs by staying in frequent contact with patients requiring frequent or long-term care. Montefiore's Accountable Care Organization pulls in care providers from across the medical and social spectrum to improve patient health while curbing expenses.

Worker-owned home-care cooperatives are emerging as an alternative to the for-profit agencies that dominate America's direct-care sector. In these cooperatives, professional caregivers earn an average of $2 more per hour than the industry standard, share in business decision-making, and stay on the job at nearly double the rate of workers at traditional agencies. Patients also stay with co-op agencies twice as long, suggesting higher satisfaction and quality of care.

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.

Helpster Charity operates a tech-enabled emergency financing model that connects families facing urgent medical bills with donors through a website and app. The nonprofit uses volunteers stationed at partner health facilities to identify patients who can’t afford critical care for conditions like malaria, sickle cell anemia, and kidney problems. The organization has helped provide treatment for over 2,000 families across Nigeria, Kenya and Bangladesh.