‘Reaching hospital no longer enough to save pregnant woman’

A Professor of Obstetrics and Gynaecology, George Ugwu, has said the belief that reaching a tertiary hospital by women giving birth is the ultimate safety net when childbirth complications arise is no longer true in Nigeria.

He noted that new medical research reveals a troubling reality: Timely physical arrival at a high-level health facility no longer assures survival.

He pointed out that systemic failures, acute equipment deficits, severe brain drain, and institutional delays within public tertiary hospitals continue to claim the lives of pregnant women who made it to the hospital alive.

Speaking at the 251st Inaugural Lecture of the University of Nigeria held at the UNN Business School Auditorium, Enugu Campus, Ugwu, raised the alarm over the institutional bottlenecks crippling emergency maternal care across the country.

Ugwu, who is also the Enugu State Commissioner for Health, delivered a paper titled, ‘The Mother, The Child and The State: My Triumphant Journey from Evidence to Action.’

Presenting key findings from the Nigerian Near-Miss Maternal Death Surveillance Network across 42 public tertiary health institutions nationwide, Ugwu revealed that out of 91,702 live births monitored, researchers recorded 2,449 severe maternal outcomes, comprising 1,451 near-misses and 998 maternal deaths.

Captioned ‘When getting there is not enough,” the study exposed how arrival at a tertiary health centre often fails to save lives due to internal delays, un-booked patient statuses, and lack of immediate equipment readiness.

“We found that competencies in a system-dependent diagnosis fail when blood, theatre, equipment, or staff readiness fails. Correct diagnosis won’t work if proper things are not put in your hands to work with. Physical arrival at the tertiary hospital does not mean survival is assured,” Ugwu stated.

Recounting a tragic encounter early in his career – where an un-booked pregnant woman bled to death in a labour ward – the fertility expert noted that Nigeria bears a disproportionate share of global maternal mortality. Although the country accounts for roughly 2.8 per cent of the global population, it contributes nearly 29 per cent of maternal deaths worldwide.

To avert these preventable deaths, he advocated the immediate establishment of dedicated early pregnancy assessment units equipped with resident gynaecologists and functional ultrasound machines across public health institutions.

Compounding these infrastructural deficits is the massive exodus of trained healthcare professionals.

Research cited by the don indicates that 79.8 per cent of Nigerian healthcare workers are actively seeking to leave the country due to worsening insecurity, 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 stressed.

Addressing policy solutions, Ugwu urged state governments and health administrators to move beyond routine clinical procedures by adopting the United Nations’ AAAQ framework – Availability, Accessibility, Acceptability, and Quality – to ensure care is affordable and dignified.

He also called on the National Assembly to increase the Basic Healthcare Provision Fund allocation from the current 1 per cent to 5 per cent of the Consolidated Revenue Fund.

This, he noted, would cushion the impact of dwindling international donor support and ensure sustainable funding for maternal and child healthcare.

“Judge service expansion by readiness, quality, and respectful care,” Ugwu advised.

He emphasised that every priority maternal and child health indicator must be assigned a named owner, a continuous feedback cycle, and an auditable response.