Solving Cleveland's infant mortality crisis: Saving the Smallest

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.”

In South Carolina, a Medicaid program is offering long-acting contraceptives during a new mother’s hospital stay, while she is still eligible for the benefit. Other states are following suit.

Kenya has an alarmingly high rate of maternal mortality rate and many women are afraid to give birth at the hospital for fear of being treated violently. OparanyaCare uses financial incentives to get women to seek prenatal, childbirth, and antenatal care at the hospital with trained healthcare workers.

Reducing cases of early birth deliveries shouldn’t have been hard — at least, they should have been easier to change than many other harmful practices. But it was - until hospitals started introducing models for change, creating accountability and changing payment systems. This article looks at a range of solutions happening across the country that serve as a model for other healthcare providers.

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.

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.

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.

A formerly closed hospital reopened as a pop-up health care facility in Los Angeles County to help provide health services for a predominantly Latino community during the coronavirus pandemic. Although it was only open for just over a month and operating costs were high, the facility was a unique opportunity for the healthcare providers involved to "create their own healthcare system and practice medicine unconstrained by medical corporations and insurance companies."

To combat pregnancy-related deaths, a coalition of "doctors, nurses, public health leaders and others" have created a Maternal Mortality Review Committee to act as a statewide task force and investigate the reasoning behind such deaths. This type of committee has proven to work in other states, including in California where the review committee was able to identify hemorrhage and pregnancy-induced high blood pressure as two leading causes of maternal mortality.