A Nation’s Maternal Health Crisis

They are saying childbirth is the start of life. However for one pregnant Nigerian girl, it marked the top—she died in agony and determined want for medical consideration whereas her husband live-streamed the complete ordeal on-line. There was no emergency intervention. No ambulance. No midwife or expert start attendant in sight. Only a telephone, a digital camera, and a crowd of on-line spectators watching one other Nigerian girl die.

In February 2025 within the Lekki/Ibeju space of Lagos State, Kemi Akinbobola’s tragic demise was a devastating reflection of the intersection between Nigeria’s damaged well being system, the disempowerment of ladies, and a digital tradition that turns human struggling into leisure. Additionally it is a name to motion—to deal with the deep gaps in our healthcare system and the pressing want for complete medical health insurance and gender-responsive well being insurance policies that empower ladies to take management of their our bodies and lives.

Kemi, in line with on-line studies had been in labour for hours and was not registered for antenatal care. Her husband Folajimi took her to a non-public hospital the place she was allegedly refused care as a result of they may not pay the deposit. Sadly, she died on the way in which to the general public hospital they’d been referred to. They’d 9 months to plan for at the present time, however she died because of ignorance, negligence, and poor well being infrastructure.

She died, not solely from labour problems however from systemic failure. Not in a hospital. Not surrounded by skilled professionals however on a smartphone display screen, on social media, the place her husband live-streamed her labour as she struggled, pleaded, and finally died. Not from a uncommon illness or sophisticated prognosis, however from one thing tragically frequent in Nigeria: the absence of well timed, reasonably priced, high quality care.

A Maternal Well being Disaster

Nigeria stays probably the most harmful locations on the planet to provide start and ranks among the many nations with the best maternal mortality charges at over 20% of the world’s maternal deaths. In line with knowledge from the Nationwide Demographic and Well being Survey (NDHS) and the World Financial institution, roughly 1,000 ladies die for each 100,000 stay births—and in some rural areas, the figures are much more dire. Behind these numbers lie actual folks, actual households, and tales like this one—the place the dearth of entry to high quality maternal healthcare turns into a demise sentence.

Let’s name it what it’s, she was failed by a rustic that has not prioritized maternal well being. Failed by a system the place entry to care shouldn’t be common, the place ladies typically want permission or cash to see a physician, and the place silence and disgrace too typically encompass reproductive well being.

The contributing elements are clear: restricted entry to main healthcare amenities, cultural practices that forestall ladies from making well being selections independently, and, critically, lack of ability to afford care when problems come up. Many households keep away from hospitals not as a result of they need to, however as a result of the prices are merely out of attain. When over 90% of well being expenditures are out-of-pocket, a go to to the hospital might be financially catastrophic.

That is the place common, reasonably priced and gender-sensitive medical health insurance should are available—not as a privilege for the few, however as a nationwide precedence for all. Think about if Kemi had entry to a medical health insurance plan that assured emergency obstetric care. Think about if her husband knew that assist was only a name away, with out the worry of an unaffordable hospital invoice. That livestream might have been a start announcement, not a demise chronicle.

Complete Well being Insurance coverage

Nigeria has made strides with the Nationwide Well being Insurance coverage Authority (NHIA) Act, which now mandates well being protection for all. Nevertheless, implementation stays sluggish, particularly on the grassroots degree. Consciousness is low. Enrolment is uneven. Many ladies—particularly in rural communities—are unaware of their entitlements beneath the scheme. Others are excluded totally because of poverty, lack of documentation, or bureaucratic delays.

What we want is a sturdy, accessible, and accountable medical health insurance system that centres the wants of ladies, significantly throughout being pregnant, childbirth, and postpartum care. This contains free antenatal and postnatal take care of all ladies, protection for emergency obstetric providers and caesarean sections, community-based schooling about well being rights and entitlements, and insurance policies that take away monetary and logistical limitations to enrolment

The federal government should broaden and absolutely implement the NHIA, guaranteeing maternal well being is central to all packages, educate communities, particularly males, concerning the significance of ladies’s well being and rights, fund women-led well being advocacy teams that work on the grassroots to bridge the hole between coverage and follow, maintain digital platforms accountable for enabling the exploitation of susceptible folks on-line and create emergency response methods that may be accessed even in rural or casual settings.

Too typically, ladies are excluded from decision-making about their very own well being. In lots of houses, they have to search permission to go to the clinic, take treatment, and even relaxation throughout being pregnant. Many are taught to endure relatively than communicate up, to submit relatively than resist.

Neighborhood-based options are important. Girls’s teams, midwives, conventional start attendants, and grassroots well being employees have to be supported and built-in into the formal well being system. Native leaders—non secular, conventional and political—have to be engaged to problem the norms that perpetuate ladies’s disempowerment.

Probably the most pressing classes from this tragedy is the crucial want for complete, accessible medical health insurance. Girls shouldn’t be pressured to decide on between enduring ache at dwelling or going through payments they can not afford on the hospital.

Medical health insurance shouldn’t be a privilege. It ought to be a lifeline. A pregnant girl ought to by no means hesitate to go to the hospital as a result of she’s apprehensive about prices. She shouldn’t be depending on a husband or relative who could delay, deny, or refuse her the care she wants.

Past Insurance coverage: Voice, Energy and Company.

Medical health insurance alone shouldn’t be sufficient. The deeper drawback is the systemic disempowerment of Nigerian ladies with regards to well being selections. Too many ladies nonetheless want permission from their husbands or household elders to hunt medical consideration. Too many are conditioned to endure ache quietly. Too many are afraid to talk up—even when their lives are in danger.

We should reframe maternal well being not as a charity problem however as a human rights problem. Nigerian ladies have to be given the instruments to train voice, energy, and company over their well being. This implies complete reproductive and maternal well being schooling in faculties, communities, and thru media and enforcement of ladies’s rights to well being, security, and bodily autonomy.

It additionally means supporting ladies to be financially unbiased and in a position to entry care with out relying solely on spouses and a cultural transformation that includes partaking males, non secular leaders, and conventional rulers in shifting dangerous norms and selling shared decision-making in households.

We have to ask ourselves arduous questions on how we worth ladies’s lives, particularly when they’re poor, pregnant, and powerless. Our digital areas have to be held accountable, and we should construct moral norms round using expertise in intimate or traumatic conditions.

What occurred to Kemi Akinbobola is not only a private or household tragedy. It’s a collective and systemic indictment. It exposes the brutal price of our damaged healthcare system, the damaging energy imbalances that also outline many ladies’s lives, and the yawning hole between Nigeria’s well being insurance policies and the realities in houses throughout the nation.