Women in northern Nigeria continue to bear a disproportionate burden of maternal deaths, with the Northwest and Northeast geopolitical zones accounting for about three-quarters of reported fatalities in health facilities, according to the 2026 Joint Annual Review (JAR) Statistical Book.

The report also highlights significant disparities in maternal health outcomes between rural and urban areas, with rural women recording a maternal mortality ratio of 656 deaths per 100,000 live births, compared with 444 deaths per 100,000 live births in urban areas.

Produced by the Federal Ministry of Health and Social Welfare, the report reviews the third year of implementation of the Health Sector Strategic Blueprint. It was presented at the third Nigeria Health Sector Joint Annual Review in Abuja on 10 November.

The findings highlight persistent inequalities in maternal healthcare access and outcomes, despite a reported decline in maternal deaths across health facilities nationally.

According to the report, Nigeria recorded thousands of maternal deaths in health facilities between January and September 2026, although the figures represent only deaths captured by the facility reporting system.

The ministry acknowledged that the figures could be underreported or overreported but described the data as reliable for monitoring trends in the health sector.

Maternal mortality remains high

Maternal mortality refers to the death of a woman during pregnancy, childbirth or within 42 days of the termination of pregnancy from causes related to or aggravated by the pregnancy or its management.

Most maternal deaths are preventable through timely access to quality antenatal care, skilled birth attendance, emergency obstetric services and appropriate postnatal care.

Despite the reported improvements, Nigeria’s maternal mortality ratio remains a major public health concern.

The JAR Statistical Book puts the country’s maternal mortality ratio at 572 deaths per 100,000 live births, significantly above the Sustainable Development Goal (SDG) target of fewer than 70 deaths per 100,000 live births by 2030.

The burden is particularly concerning given Nigeria’s contribution to global maternal deaths.

In its 2023 report, titled “Improving Maternal and Newborn Health and Survival and Reducing Stillbirths: Progress Report 2023”, the World Health Organisation (WHO) estimated that Nigeria recorded 82,000 maternal deaths, 181,000 stillbirths and 277,000 neonatal deaths in 2020.

The combined 540,000 deaths accounted for 12 per cent of global maternal, stillbirth and neonatal deaths, despite Nigeria contributing only six per cent of global live births.

The report ranked Nigeria second after India among countries with the highest combined burden of maternal deaths, stillbirths and neonatal deaths.

Reported maternal deaths decline

The JAR data indicate a downward trend in facility-reported maternal deaths over the review period.

The country recorded 5,391 maternal deaths in health facilities in 2024, compared with 4,455 in 2025.

The figure declined further in 2026, although the exact total requires confirmation against the final statistical table. The quarterly data also indicate improvements.

Following a peak in the second quarter of 2024, maternal deaths and the maternal mortality ratio generally declined. By the third quarter of 2026, the maternal mortality ratio had fallen to 128 deaths per 100,000 live births, representing a reduction of about 46 per cent from the earlier peak.

Maternal deaths during the same period also declined by approximately 40 per cent to 947.

However, these improvements have not been evenly distributed across the country.

Northern states bear the burden

According to the report, maternal deaths over the past three years were heavily concentrated in the Northwest and Northeast geopolitical zones.

By 2026, the two zones together accounted for approximately three-quarters of all documented maternal deaths in health facilities.

The five northern states with the highest maternal mortality burden were Kano, Borno, Jigawa, Yobe and Katsina.

While the national figures showed a downward trend, maternal deaths reportedly increased across the two northern zones, contrasting with reductions recorded in southern parts of the country.

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In most southern states, fewer than 50 maternal deaths were reported. The states with the lowest recorded numbers included Osun (four deaths), Abia (five), Enugu (eight), Ekiti (nine), and Bayelsa (nine).

Maternal morbidity

Beyond deaths, the report also highlights the burden of maternal morbidity, including complications that can have lasting effects on women’s health, wellbeing and livelihoods. In 2026, approximately 3,060 women were diagnosed with vesicovaginal fistula (VVF), compared with 4,350 in 2025.

VVF is an abnormal opening between the bladder and vagina that can result in continuous, involuntary leakage of urine, often following prolonged or obstructed labour.

Of the women diagnosed in 2026, 1,737 underwent surgical repair, representing 56.8 per cent of those diagnosed. This was lower than in 2025, when 2,564 women (59 per cent) underwent repairs.

The Northwest and Northeast again recorded the highest burden, with 1,420 and 982 cases, respectively, in 2026. The figures underscore the need to strengthen access to emergency obstetric care, timely referrals and surgical treatment, particularly in underserved communities.