Proud to be on the frontlines of the fight to crash maternal mortality in Nigeria

As a midwife, Fauzziya Abubakar Abare helps women in her community deliver their babies safely and provides pregnancy care and family planning advice. Inspired by the midwives who took good care of her and her daughter, she is proud to be making a positive impact in the lives of other women. In this story, she shares her experience, concerns and hopes for the future. 

The birth of my first daughter was joyful and fortunate: a skilled team of midwives helped deliver my baby girl into the world, guiding me through a difficult delivery and making sure I had the care I needed. I often think about what could have happened had I given birth at home, like many women in my community do. My gratitude for the midwives that were monitoring my baby and I only multiplied when through their vigilant care, they were able to identify an early disorder that affected my daughter’s mobility and speech. She was able to begin treatment early, helping to improve her quality of life.

Inspired by the midwives who had been so influential in my own life, just a few years after my daughter was born, I became a midwife myself. I was determined to ensure that other women in my community would have a good pregnancy journey and safe births. In our area, many women have historically given birth at home, either because of social norms or no access to care—either because health centers lacked staff and equipment or because services were too expensive. This meant too many women and children dying preventable deaths, devastating families and communities across the state.

After earning my certification, I joined Gombe State’s Primary Health Care Development Agency which handled the implementation of the Basic Health Care Provision Fund, a government-led initiative to improve access to primary health care and help Nigeria move closer to universal health coverage. Supported by partners such as the World Bank and the Global Financing Facility (GFF) through an investment project, this initiative has significantly transformed healthcare access, not only in Gombe but also in another five states in the North East of the country, reaching vulnerable and conflict-affected communities.

The impact was profound. Resources flowed steadily to primary health care centers, allowing them to hire more community health workers and procure essential medicines, including free antenatal medications for pregnant women. For women in the community, word began to spread that the center was well prepared to meet their needs, and this translated into more visits. Just to give you an idea, when the program operated in our region, there were a 30% more antenatal care visits and 56% more assisted deliveries.

Community health workers and midwives were trained and there were significant improvements in staff retention and morale. Many of us forged personal connections with community members. This is especially important for women and adolescents seeking sexual and reproductive health services, including family planning. Our work to debunk common misconceptions has empowered women and girls to seek more information and make informed decisions.

But of course, access is not the only trigger: services also became more affordable and in many cases medications, tests and deliveries were even free of charge. This was a lifeline for the most vulnerable community members because it meant not having to make impossible trade-offs between health and other basic needs. Some health centers would also cover transportation costs for health workers and midwives to reach remote areas, so the most isolated communities have access to essential services.

Even with these gains, we are far from where we need to be.

Too many women still give birth at home and lack access to family planning and safe spaces; too many children are missing out on critical vaccinations and nutritional supplements, threatening their health and development. With the economic downturn, it’s increasingly more difficult to keep prices down. Once we had a woman come in for antenatal care only to notice that she was in labor. We sent her to the labor room but before we realized it, she had left the facility for fear of an expensive bill.

My journey from a mother facing uncertainty to a midwife dedicated to improving maternal and child health in my community has been both challenging and deeply rewarding. I am proud to be on the frontlines of this fight to crash maternal mortality in Nigeria. I’m optimistic we can do it. But we won’t do it alone and it will take fully resourced and concerted efforts. My daughter, my work and my community as well as Nigeria’s commitment to better health give me hope that we can all work together to ensure a brighter future for all.