Nigeria’s Maternal Health Crisis: Why Most Women Still Lack Insurance
By DIANA CHUKWUKA
ON paper, Nigeria has the laws and resources to guarantee healthcare for every citizen. In reality, more than 90 per cent of Nigerian women remain outside the health insurance net—exposed to risks that turn childbirth into a life-or-death experience.
A new study by the Maternal and Reproductive Health (MRH) Collective paints a stark picture of the gap between policy and lived reality. Conducted under the three-year Iyaloju Initiative across 18 local councils in Lagos State, the research shows that while more women are moving away from traditional birth attendants toward hospitals, affordability remains a decisive factor in maternal health choices.
The Numbers Behind the Crisis
From 2023 to 2025, deliveries assisted by traditional birth attendants declined from 30.1 per cent to 24.6 per cent. Public hospital births rose slightly to 40.7 per cent, and private facilities recorded modest growth to 34.7 per cent. But behind these shifts lies a troubling reality: only 7.6 per cent of women surveyed had any form of health insurance.
The result, researchers say, is that many families delay seeking professional care during emergencies or fall back on unsafe practices. “The insurance gap reflects a deeper national crisis,” said Dr. Olajumoke Oke, Executive Director of MRH Collective, at the initiative’s dissemination forum in Lagos.
Beyond the Numbers: A Human Struggle
Cost was cited as the primary reason for using traditional attendants by more than two-thirds of respondents. Yet the research also offered glimpses of progress: more women reported receiving respectful maternity care, being asked for consent during procedures, and being allowed a companion during delivery.
Still, campaigners argue that incremental improvements mean little without systemic reforms. “We must deliberately make health insurance affordable and accessible, especially for low-income women,” said Funmi Owosho, Chief Operating Officer of MRH Collective.
The Legal Mandate and the Gaps
Nigeria already has a legal framework for universal coverage. The National Health Insurance Authority (NHIA) Act of 2022 mandates compulsory health insurance and provides for a vulnerable group fund to subsidise care for pregnant women, children under five, the elderly, and the poor.
Human rights lawyer Femi Falana (SAN) insists that governments have no excuse for failure. He noted that President Bola Tinubu recently ordered all Ministries, Departments, and Agencies to enrol their employees under the NHIA scheme, with compliance tied to procurement requirements.
“Despite these reforms, over 90 per cent of Nigerians remain uninsured,” Falana said. “This undermines our constitutional and international obligations to guarantee healthcare for all.”
The Road Ahead
The MRH Collective recommends behavioural change campaigns at the community level, sustained mentoring for health workers, and targeted policies to break financial barriers. But unless insurance moves from paper to practice, millions of women will continue to face childbirth with uncertainty hanging over their lives.
At 65 years of independence, the question lingers: can Nigeria muster the political will to protect its mothers and children, or will progress remain hostage to rhetoric and half-measures?
