Health
Raise BHCPF funding to 5% to curb maternal deaths, don urges N’Assembly
Raphael Ede
A Professor of Obstetrics and Gynaecology at the University of Nigeria, Nsukka, George Ugwu, has called for a critical shift from clinical evidence to decisive state action to address the alarming maternal and child mortality rates across Nigeria.
The gynaecologist urged the National Assembly to increase the Basic Health Care Provision Fund allocation from the current one per cent to five per cent.
Delivering the 251st Inaugural Lecture of the university on Thursday at the UNN Business School Auditorium, Enugu Campus, titled “The Mother, the Child, and the State: My Triumphant Journey from Evidence to Action,” Ugwu outlined how decades of medical practice, research, and public governance must align to build resilient health systems that protect vulnerable lives.
Recounting a poignant tragedy early in his medical career—the loss of an unbooked pregnant woman to severe hemorrhaging in a labor ward—the don explained how the experience sparked his lifelong commitment to identifying systemic failures in maternal care.
Analyzing national and global health statistics, Ugwu expressed deep concern over Nigeria’s disproportionate contribution to global maternal deaths, noting that while the country accounts for roughly 2.8 per cent of the global population, it contributes nearly 29 per cent of maternal deaths worldwide.
Highlighting findings from his participation in the Nigerian Near-Miss Maternal Death Surveillance Network across 42 public tertiary health institutions, the don revealed that out of 91,702 live births studied, researchers recorded 2,449 severe maternal outcomes, 1,451 near-misses, and 998 maternal deaths.
He noted that the study, captioned “When getting there is not enough,” exposed how physical arrival at a tertiary hospital fails to assure survival due to delays, unbooked status of patients, and lack of immediate equipment readiness.
“We found that competencies in a system-dependent diagnosis fail when blood, theater, equipment, or staff readiness fails. Correct diagnosis won’t work if proper things are not put in your hands to work with,” Ugwu stated. “Physical arrival at the tertiary hospital does not mean survival is assured.”
To tackle these systemic gaps, the don advocated the adoption of the United Nations’ AAAQ framework—Availability, Accessibility, Acceptability, and Quality—arguing that healthcare must be physically reachable, financially affordable, and delivered with fundamental human dignity.
He emphasized the significance of studying “maternal near-misses”—instances where women narrowly survive life-threatening complications—as a vital research tool to identify delays in decision-making, transportation, and hospital care before fatal outcomes occur.
To curb preventable deaths from unrecognized ectopic pregnancies, Ugwu advocated the immediate establishment of early pregnancy assessment units equipped with dedicated gynecologists and ultrasound machines across public hospitals.
“Before you finish review, admit in casualty, and move to the other side, things can degenerate from bad to worse quickly, and some women have died through that process,” he warned.
Addressing the mass brain drain of medical personnel from the country, the fertility expert revealed that research showed 79.8 per cent of healthcare workers are fleeing Nigeria due to worsening insecurity, while others are pushed out by poor remuneration and inadequate working tools.
“These push factors act in isolation or in combination to push our physicians and health workers out of this country. To retain skilled workers, the conditions required to practice effectively must be put in place,” he said.
Calling on state governments and health administrators to move beyond routine procedures, Ugwu urged clinicians to exercise dynamic judgment, improve health system financing, and provide coordinated, respectful care that protects maternal autonomy and improves neonatal survival.
The professor, who also serves as the Enugu State Commissioner for Health, detailed how research findings are being deployed into actionable policies through a comprehensive four-tier healthcare strategy across the state.
He revealed that Enugu State has established standard Type-2 Smart Primary Healthcare Centers in every political ward, complete with solar power installations, digital health information tools, and modern clinical equipment. Secondary and tertiary facilities, including the ESUT Teaching Hospital Parklane and the newly operational State University of Medical and Applied Sciences (SUMAS) Teaching Hospital, are undergoing major infrastructure expansions to accommodate growing healthcare needs.
Ugwu highlighted the upcoming Enugu International Hospital as a transformational project designed to halt medical tourism in southern Nigeria through ultra-modern maternal, child, and specialized clinical care units. He disclosed that institutions across Enugu State are collectively expanding training infrastructure to produce over 1,000 medical doctors annually to mitigate the brain drain.
The health commissioner shared notable outcomes of targeted interventions, including a drop in malaria prevalence in Enugu State from 24.5 per cent to 9.9 per cent following a year-long free testing and treatment program across public facilities.
He added that proactive public health initiatives shielded the state from recording a single case during recent regional outbreaks of Lassa fever and cholera reported across neighboring states.
Among his key policy recommendations, Ugwu urged the National Assembly to increase the BHCPF allocation from the statutory one per cent to five per cent to buffer shrinking international donor funding.
He further advocated linking university academia directly to Planning, Research, and Statistics departments within government ministries, while proposing an “Adopt-a-Health-Facility” framework to encourage community leaders and alumni to support local primary healthcare centers.
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