and 512 maternal deaths with every 100,000 live births. Within the country, regional disparities exist and reveal high maternal mortality ratios of up to 1,625 and 1,463 deaths per 100,000 live births in northern states such as Kano and Niger respectively; and a MMR of 555 in southern states such as Lagos.
The most recent World Health Organisation recommendations on uterotonics for the prevention of postpartum haemorrhage include seven uterotonics, including new options, notably, carbetocin and misoprostol plus oxytocin combination. To ensure a user-driven approach to designing long-term solutions for tackling PPH, the Smiles for Mothers consortium has concluded plans to partner with government at federal level and in three states: Kano, Niger, and Lagos, to incorporate human-centered design in their response to PPH prevention and management.
Project Manager, CHAI, Olajumoke Adekeye, said: “In addition to working directly with Federal and State ministries of health and their agencies, the program will also collaborate closely with professional associations in the medical field in Nigeria.”SCIDaR, an indigenous Nigerian organisation, brings extensive cold chain logistics, health systems design, and implementation experience in Nigeria, as well as the capability to manage large grants from various donor organisations.
McKinsey and Company, a global consulting firm will serve as the lead design partner for the first innovation in the program, seeking to implement the WHO recommendations. Although Oxytocin remains the first line uterotonic for PPH prevention in Nigeria, evidence shows that the quality of oxytocin is often compromised due to improper cold chain storage from erratic power supply, weak refrigeration infrastructure, and general knowledge gaps of health workers on the appropriate storage condition for the drug. Also, in remote hard-to-reach areas, a large number of deliveries occur at the community level in the absence of a skilled health worker.