Health
EmONC Assessment Exposes Gaps In Maternal, Newborn Care
By Folasade Akpan
The Emergency Obstetric and Newborn Care (EmONC) Assessment has identified significant gaps in the availability, quality and utilisation of life-saving maternal and newborn services across Adamawa, Kwara and Sokoto states, hindering mortality reduction efforts nationwide.
The report was presented on Friday in Abuja during the national dissemination of the EmONC Assessment and Improvement Plan of Action for the three states, highlighting persistent challenges affecting maternal and newborn healthcare delivery.
The assessment revealed shortages of skilled health workers, inadequate infrastructure, weak referral systems, irregular medical supplies and limited functional facilities, all of which continue undermining efforts to reduce maternal and newborn mortality significantly.
Researchers examined the availability, accessibility, quality and utilisation of EmONC services in public primary, secondary and tertiary facilities, while mapping health facilities using Geographic Information System technology to identify service delivery gaps.
The report stated that researchers adopted a cross-sectional, health facility-based design covering public facilities that recorded at least one delivery within the 12 months preceding the assessment across the three participating states.
Data collection employed assessment tools adapted from the World Health Organisation (WHO), United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF) and Columbia University’s Averting Maternal Death and Disability framework for analysis.
The assessment covered 913 public EmONC facilities, comprising 479 in Adamawa, 202 in Kwara and 232 in Sokoto, using descriptive statistical and geospatial analyses to evaluate service availability, quality and access comprehensively.
Findings showed that only 3.5 per cent of Basic Emergency Obstetric and Newborn Care (BEmONC) facilities and 30.1 per cent of Comprehensive Emergency Obstetric and Newborn Care (CEmONC) facilities performed all WHO signal functions.
It noted that no BEmONC facility in Kwara met the required standards for full signal function coverage, while the number of fully functional facilities remained limited across all three assessed states.
According to the assessment, maternity wards experienced severe shortages of electricity, water, sanitation facilities and essential equipment, while one-third of facilities reported frequent stock-outs of medicines and critical medical supplies.
The report added that only two per cent of BEmONC facilities reported regular oxygen supplies, compared with 50 per cent of CEmONC facilities, highlighting major disparities in emergency obstetric service readiness.
It noted that although many referral journeys lasted between 30 and 59 minutes, some women, particularly those requiring obstetric surgery, travelled for more than two hours before receiving appropriate care.
The assessment found that most women lived relatively close to EmONC facilities, with Geographic Information System analysis showing high population coverage within 30-minute and 60-minute travel thresholds in Adamawa and Sokoto.
However, Kwara recorded comparatively lower geographic coverage across assessed thresholds, with many women living beyond the recommended one-hour access window and a substantial proportion residing over two hours away.
The report stated that although nearly half of women received EmONC services free of charge, some women accessing CEmONC facilities paid as much as N200,000 for emergency obstetric healthcare services.
The assessment also found low utilisation of EmONC services, with only 17 per cent of births occurring in assessed facilities in Kwara and 35.9 per cent in Sokoto state.
It recommended expanding functional BEmONC facilities, strengthening infrastructure, recruiting and retaining more health workers and providing continuous capacity building to improve service delivery and maternal and newborn health outcomes.
The report also urged governments to improve referral systems, guarantee uninterrupted supplies of medicines, blood, oxygen and equipment, institutionalise free emergency obstetric services and strengthen community engagement mechanisms.
Other recommendations included adopting digital health records, establishing dedicated supply chain systems, promoting respectful maternity care, assigning EmONC monitoring officers within local governments and increasing funding through comprehensive policy frameworks.
Speaking at the dissemination, Chairman of the National Population Commission, Dr Aminu Yusuf, described maternal and newborn mortality as one of Nigeria’s most pressing public health challenges requiring urgent intervention.
“The EmONC assessment that is being disseminated today was designed precisely to give us a clear, honest picture of where we stand: which facilities are functioning, where skilled personnel and equipment are available.
“Also, to know whether women in rural and remote communities can actually reach life-saving care when they need it most,” he said.
Yusuf said the reports provided practical guidance on facility readiness, quality of care and geographic accessibility, urging federal and state governments to integrate the findings into annual plans and budgets.
Also speaking, UNFPA Resident Representative, Ms Muriel Mafico, said the assessment represented a major milestone in advancing evidence-based policymaking for maternal and newborn health and strengthening healthcare planning nationwide.
She said the findings would support implementation of Nigeria’s reproductive, maternal, newborn, child, adolescent health and nutrition strategy by providing facility-level data for planning and resource allocation purposes nationwide.
“The dissemination of these findings is not the conclusion of our efforts, but the beginning of a vital accountability cycle.
“The recommendations before you must be swiftly implemented and institutionalised to save lives,” she said.
Mafico reaffirmed UNFPA’s commitment to supporting the Federal Government and participating states in translating the assessment findings into improved maternal and newborn health outcomes across the country.(NAN)(www.nannews.ng)
Edited by Abiemwense Moru
