It is an auspicious season. A new era of renewed hope for pregnant women in Nigeria as the federal government’s nationwide Comprehensive Emergency Obstetrics and Neonatal Care (CEmONC) Programme, designed to provide vulnerable and economically disadvantaged pregnant women with free access to emergency Caesarean Section (C-Section) and other crucial maternal and neonatal healthcare services, advances in several states across the nation.
An important element of the programme, which is claims management, has also progressed significantly, with independent verification of 706 out of 887 claims submitted by participating facilities, representing an 80% verification rate. Payment efficiency is evident, with 663 verified claims already paid and 169 payments currently being processed. The programme operates in four pilot facilities and has expanded to seven additional healthcare institutions across multiple states, while over 31 tertiary facilities have expressed interest. The initiative has also reduced obstetric barriers by facilitating life-saving interventions, particularly in underserved regions, ensuring that critical maternal health services are now more accessible.
Despite the success of the intervention, inclusive of the vesicovaginal fistula (VVF) surgical repair initiative, which has covered about 50% of the 172 priority LGAs contributing to high maternal death rates in the country, there have been some attempts at contorting facts as regards the programme.
The CEmONC nationwide free C-Section programme was launched in August 2024 to reduce maternal mortality and address disparities in access to life-saving obstetric care among women. Since its inception, the programme has demonstrated remarkable achievements. Independent verification of claims has reached 80%, underscoring the programme’s accountability. With over 87 million naira already paid to settle 663 claims and others being processed, the initiative ensures timely reimbursement to participating facilities via the National Health Insurance Agency, fostering trust among stakeholders.
From its launch in four facilities in Kano and Akwa Ibom, the programme has expanded to seven more in Bauchi, Sokoto, Kebbi, and Borno. These facilities cater to high-burden regions, directly addressing maternal health inequities. The programme’s transparent claims management system has set a benchmark for efficiency, with payment being processed for 169 claims, illustrating the government’s commitment to sustaining momentum. Additionally, 31 out of 69 eligible tertiary facilities have formalised their interest in a tripartite MoU, lending credence to the programme’s scalability and appeal to stakeholders nationwide.
The CEmONC interventions are targeted at the health-related top causes of maternal mortality and poor health outcomes among child-bearing women: postpartum haemorrhage, VVF, sepsis, and obstructed labour. Life-saving surgical and medical interventions are now within the reach of vulnerable pregnant women and newborns, especially in high-burden regions.
Apart from the free C-Section initiative, there are several other interventions under Presidential Initiative to unlock the Healthcare Value Chain, a strategic framework targeting systemic healthcare improvements due to be implemented this year, 2025. By the end of 2025, 40% of Level 1 Primary Health facilities will be upgraded to Level 2. This will enable these facilities to offer integrated sexual and reproductive health services, including family planning and post-abortion care, across all states.
The federal government’s commitment to facility enhancement will bridge service delivery gaps, especially in rural and underserved areas. Over 60,000 frontline health workers are being trained in comprehensive SRH service delivery. This capacity-building initiative will improve the quality of FP and PAC services, directly impacting maternal and child health outcomes.
The free C-Section programme is complemented by a fistula repair initiative targeting 50% of the 172 priority local government areas contributing to maternal mortality. These targeted interventions underscore the government’s resolve to address the root causes of maternal deaths.
Dedicated National Health Fellows will be trained in programme implementation, performance, and financial management and deployed to oversee programme activities and support primary health centres across all 774 LGAs. This includes annual statutory audits at national, state, and local levels, ensuring compliance and enhancing credibility.
The Federal Ministry of Health and Social Welfare, under the leadership of Professor Muhammad Ali Pate, is working hard to ensure that every Nigerian family, especially our women and children, enjoys access to quality healthcare. Within months of President Bola Tinubu’s appointment of Dr Abdul Mukhtar, laudable projects have been set in motion, including but not limited to the establishment of the Beta Lactam antibiotics manufacturing plant by Jawa Pharmaceuticals, employing over 700 Nigerians directly contributing to household income. Local manufacturing of critical diagnostics kits for malaria, HIV, and blood sugar by firms like Colexa Biosensor has been achieved, while WHO prequalification of some local pharma manufacturing companies has been facilitated with the support of NAFDAC and the Pharmacy Council of Nigeria. Additionally, modalities for vaccine production are being put in place.
All these are direct consequences of the Executive Order signed by President Tinubu to unlock the value chain in the healthcare industry and stimulate local manufacturing of drugs, vaccines, medical textiles, and consumables with the objective of boosting the availability of drugs, reducing import dependence, and lowering costs of medications for vulnerable people.
The nationwide free Caesarean Section programme is a cornerstone of the government’s broader healthcare agenda. It represents significant progress towards achieving universal health coverage, reducing maternal mortality, and fostering equity in healthcare access. The federal government’s proactive approach, underpinned by CEmONC and PVAC’s comprehensive framework, ensures that no woman is left behind, irrespective of geographic or socioeconomic barriers. The public is encouraged to support and celebrate these milestones, recognising their profound impact on Nigeria’s health landscape.
~ Opeyemi Akindele is an independent consultant at the intersection of health systems, strategy, and business development with over 15 years of work and academic experience in Nigeria and England. He is based in Ibadan and may be reached via [email protected]
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