I write in response to a feature story by Nkechi Onyedika-Ugoeze published in The Guardian on January 9, 2025, which painted an inaccurate and unnecessarily dismal picture of the Comprehensive Emergency Obstetrics and Neonatal Care programme. The article described the initiative designed to make Caesarean sections free for eligible pregnant women as a “gargantuan failure.” It misrepresented facts and smeared the ambitious effort towards reducing Nigeria’s high rate of maternal mortality.
The report claimed that delays in awareness campaigns and in the rollout of the programme had spurred doubts about the viability of the initiative and also alleged that the programme was yet to take off three months after its announcement. Although large-scale health programmes often have bumpy starts in their implementation, branding CEmONC as a failed initiative will completely discount tangible evidence of progress made since its inception and the different phases the initiative has undergone. The Guardian needs to do some robust research and correct such inaccuracies by setting the record straight. It will surely uncover the serious efforts made and milestones achieved if the respected newspaper lends itself to the rigour of fact-checking.
The launch of CEmONC was in August 2024 in four health facilities spread between Kano and Akwa Ibom. For Kano, the kick-off took place at Aminu Kano Teaching Hospital, Murtala Mohammed Specialist Hospital, and Mohammed Abdullahi Wase Specialist Hospital, while in Akwa Ibom, the University of Uyo Teaching Hospital was the flagship centre. The programme expanded to seven more facilities in Bauchi, Sokoto, Kebbi, and Borno States by December 2024― thus far from a stagnating programme.
Others include the Federal Teaching Hospital Birnin Kebbi; Sir Yahaya Memorial Hospital, Kebbi; Maryam Abacha Women and Children Hospital; and Usman Danfodio University Teaching Hospital, Sokoto; Abubakar Tafawa Balewa University Teaching Hospital and the Federal University of Health Sciences Teaching Hospital Azare, Bauchi; and the University of Maiduguri Teaching Hospital, Borno. Of these newly added facilities, five have already started reporting and making active strides towards the objectives of the programme.
In its first four months, CEmONC achieved several measurable results that contradict this bleak description of The Guardian report: between September to December 2024, 887 claims were facilitated through the programme, out of which 706 were independently verified and 663 paid. As of now, more than ₦87 million has been disbursed to participating facilities to support the cost of treatment for life-threatening complications arising during childbirth. More importantly, more than 2,600 women have accessed life-saving obstetric care in the pilot facilities, with 887 of them receiving comprehensive support that covered all associated costs. My perusal of verifiable documents from the Federal Ministry of Health and engagements with some of the hospital leadership prove that they have received support from the government and have started deploying some of these crucial services.
Therefore, this is not the story of a failed initiative; rather, it is one of progress and dedication. The CEmONC program stands out as proof of the commitment by the government to stem the uncontrollable maternal mortality rate in Nigeria, estimated by the World Health Organization in 2023 to be 1,047 deaths per 100,000 live births, second in the world. This no doubt forms a call for targeted interventions, especially in the most economically deprived families who often do not have access to health facilities.
Worth noting is that CEmONC is not an impromptu programme but rather one that was done with great planning and consideration of its sustainability. As early as December 2023, all 36 states and the FCT had already been engaged by letters to the State Commissioners for Health to provide data on eligible healthcare facilities. This engagement allowed for the prioritisation of facilities in terms of need and capacity, ensuring that resources go where they are most needed. As of the end of 2024, MOUs had been signed by 42 referral facilities across all six geopolitical zones, with ongoing efforts geared at onboarding all 69 eligible tertiary health institutions.
Financial support for Caesarean sections is not the only impact that the programme has deployed.
A key component of CEmONC is upgrading healthcare infrastructure to ensure better service delivery. 40 percent of Level 1 primary health facilities are being upgraded to Level 2, enabling them to provide integrated sexual and reproductive health services, including family planning and post-abortion care. Furthermore, in 2024, more than 60,000 frontline health workers were trained for full-scale SRH services, and another 60,000 will be trained in 2025. All these activities represent comprehensive work regarding maternal health, striking at the very roots of maternal mortality and strengthening the general healthcare system.
With these achievements, it is astounding how The Guardian went out of its way to selectively expound the delays in behavioural change campaigns and the initial glitch in implementation to make a point of failure. Such challenges are not new and are expectant in the case of most large-scale intervention initiatives that take multiple stakeholders’ coordination. Rather, the huge strides taken in such a short time and the fact that this could save millions of lives if supported properly should be what people should focus on rather than dwelling on some temporary setbacks.
Unfortunately, it is sad to think that The Guardian, a newspaper with a history and reputation for balanced and fact-based reporting, would publish an article seemingly without proper research and nuance. Journalism is important to hold institutions accountable and spur public debate, but even then, it needs to be pegged on truth and fairness. Misleading narratives of such an important initiative as CEmONC risk undermining public confidence and preventing potential beneficiaries from seeking life-saving care. This is dire, in that misinformation moves fast in the country and spreads with real-life consequences among the most vulnerable populations.
The most important focus of the CEmONC programme is on the five causes of maternal deaths in Nigeria: haemorrhage, preeclampsia, sepsis, post-abortion complications, and obstructed labour. It offers a lifeline to poor women who cannot afford to pay for the full cost of treatment. This is, in all honesty, a bold and highly commendable decision on the part of the federal government—a step that should be collectively supported by stakeholders, including the media, civil society, and health professionals.
Crucially, the programme requires more awareness among the public for successful implementation. More families should be made aware that financial constraints need not stand in the way of life-saving obstetric care. Similarly, health workers and administrators should be properly informed and equipped with the necessary knowledge and skills to implement the programme. Constructive criticism by the media may prove extremely useful in pointing out deficiencies that need to be attended to, but this should be done responsibly, factually, and without sensationalism.
Moreover, a tighter policy should be established to constrict the spread of misinformation through any conventional media or digital platforms. The damage caused by such incorrect reporting does not lie only in making wrong perceptions among the masses, but it can also hamper the efforts of the policymakers and healthcare providers who relentlessly work on programmes like CEmONC. At a time when Nigeria is striving to join the comity of nations in attaining the Sustainable Development Goal of reducing maternal mortality to less than 70 deaths per 100,000 live births by 2030, the media should be a partner in progress and not a promoter of undue cynicism.
The CEmONC programme, therefore, marks a major milestone in Nigeria’s quest to stem the tide of maternal mortality and harness quality healthcare for its citizens. It is anything but the “gargantuan failure” as described by the Guardian report. Rather, it is a work in progress that has indeed started yielding fruits and holds so much promise for the future. I, therefore, call on all Nigerians, particularly the media, to give this initiative all the support it deserves to succeed.
~ Tony Ademiluyi, a health journalist and columnist, wrote from Lagos
