Health
Health advocates seek reinstatement of suspended Lagos pregnancy guidelines
Health advocates have renewed calls on the Lagos State government to reinstate the suspended Guidelines on Safe Termination of Pregnancy for Legal Indications (STOP Guidelines), saying the policy could provide doctors with clearer clinical guidance and help reduce preventable maternal deaths.
The call was made by the Project Manager for Pamoja, Rumunse Obi, in an article titled “Dr Majek and the Ghost: Why Lagos Must Revisit the STOP Guidelines”, shared with PREMIUM TIMES on Tuesday.
The article accompanies Dr Majek and the Ghost, a narrative public health project exploring how stigma, misinformation and delays in accessing reproductive healthcare contribute to poor maternal health outcomes in Nigeria.
The project forms part of “ÀJOSE: The Stories That Bind Us”, an initiative that uses film and public dialogue to stimulate conversations around women’s reproductive health.
Earlier this year, the initiative brought together filmmakers, healthcare professionals, creatives and members of the public in Lagos to discuss how stigma, cultural silence and misinformation continue to shape women’s health outcomes.
Participants also previewed Dr Majek and the Ghost alongside other productions before engaging in discussions on maternal mortality, consent and ethical healthcare.
According to Ms Obi, the fictional story follows a physician confronted with deaths that could have been prevented if patients had received timely and lawful medical care.
Although fictional, she said the narrative reflects the experiences of many Nigerian women who continue to die from pregnancy-related complications despite the availability of lifesaving medical interventions.
Why the guidelines matter
Ms Obi said the STOP Guidelines, introduced by the Lagos State government in 2022, were developed to help healthcare providers interpret existing laws governing pregnancy termination in emergencies, particularly where continuing a pregnancy poses a risk to a woman’s life or health.
She explained that the guidelines were developed over several years with contributions from medical and legal experts to support doctors making time-sensitive decisions in high-risk obstetric cases without changing Nigeria’s abortion laws.
However, the Lagos State government suspended the guidelines in July 2022 shortly after their release following opposition from religious organisations and other groups, which argued that the policy could encourage abortion.
At the time, the government said the suspension would allow for broader stakeholder engagement and public sensitisation on the document’s objectives. Nearly four years later, the guidelines have yet to be reinstated.
Ms Obi argued that the controversy surrounding the policy stemmed largely from misconceptions about its purpose, while the clinical challenges it was designed to address remain unresolved.
Citing estimates from the World Health Organisation (WHO) and findings from the Nigeria Demographic and Health Survey (NDHS), she noted that Nigeria continues to bear one of the world’s highest maternal mortality burdens, with limited access to skilled birth attendants, emergency obstetric care and timely referrals contributing to preventable deaths.
Lagos’ maternal health efforts
Ms Obi’s call comes as the Lagos State government continues to implement measures to reduce maternal mortality.
In April 2025, the state partnered with the National Health Insurance Authority (NHIA) to launch the Maternal Initiative for Financing Access to Comprehensive Emergency Obstetric Care (CEmOC) to improve access to lifesaving obstetric services for women experiencing pregnancy-related emergencies.
At the launch, the Lagos State Commissioner for Health, Akin Abayomi, said the state still records about 400 maternal deaths per 100,000 live births, describing the figure as unacceptable for a megacity.
Mr Abayomi said the government was expanding Mother and Child Centres, strengthening referral systems, integrating traditional birth attendants into the formal healthcare system through regulation and training, and expanding health insurance coverage to ensure women receive emergency care regardless of their ability to pay.
The Special Adviser to the Governor on Health, Kemi Ogunyemi, also stressed the need to eliminate delays in emergency obstetric care, saying saving the lives of mothers and babies should take precedence over concerns about payment.
Clearer guidance
Speaking with PREMIUM TIMES on Monday, Temitope Adekanye, a senior registrar in obstetrics and gynaecology at Lagos University Teaching Hospital, said that although he had not reviewed the suspended STOP Guidelines and could not comment on their specific provisions, Nigeria had long needed clearer clinical guidance on abortion within the existing legal framework.
Mr Adekanye described abortion as a sensitive issue because Nigerian law generally prohibits the procedure except where it is necessary to save a woman’s life, creating legal and clinical uncertainty for healthcare providers.
“We should have had a guideline on abortion a long time ago,” he said.
He noted that unsafe abortions continue to contribute to maternal deaths because many procedures are carried out by unqualified persons or in facilities that do not meet minimum medical standards.
The senior registrar, however, emphasised that unsafe abortion is only one of several factors driving maternal mortality in Nigeria.
According to him, postpartum haemorrhage remains the leading cause of maternal deaths, followed by hypertensive disorders such as pre-eclampsia, while sepsis, obstructed labour and unsafe abortion also account for a significant proportion of pregnancy-related deaths.
He attributed many maternal deaths to what health experts describe as the “three delays”—delays in deciding to seek medical care, delays in reaching a health facility and delays in receiving prompt treatment after arrival.
Poor road networks, shortages of skilled healthcare workers, weak referral systems and inadequate hospital capacity, he added, continue to worsen outcomes for pregnant women.
READ ALSO: Nigeria targets expanded MMS coverage for pregnant women
Call for reinstatement
Against this backdrop, Ms Obi argued that although haemorrhage, hypertensive disorders and sepsis remain the leading causes of maternal mortality, unsafe abortion also contributes significantly to pregnancy-related deaths, particularly in countries with restrictive legal environments.
She said uncertainty over the legal interpretation of emergency reproductive healthcare can delay treatment and increase the risk of preventable deaths.
“The suspension of the STOP Guidelines did not remove these clinical realities. It removed a structured framework intended to help clinicians navigate them safely within existing law,” he wrote.
Ms Obi noted that many countries with restrictive abortion laws rely on detailed clinical protocols to guide healthcare providers without changing the law.
She maintained that reinstating the STOP Guidelines would complement Lagos State’s investments in maternal healthcare by providing clinicians with greater clarity in managing complex pregnancy-related emergencies.
She added that restoring the guidelines would not amend Nigeria’s abortion laws but would improve how existing legal provisions are interpreted and applied in clinical practice.
The Medical Women Association of Nigeria (MWAN) Plateau State, in collaboration with the Plateau State Specialist Hospital, has organised a free medical outreach for persons aged 60 and above in Jos.
The outreach, held to commemorate the 2026 International Day of Older Persons, featured free medical consultations, health talks, eye and ear examinations, blood pressure and blood sugar checks, general health screening and provision of basic medications.
The programme was held on October 2, a day after the official International Day of Older Persons, which is observed globally every October 1.
The 2026 celebration is themed “The Age of Longevity: Rethinking Systems for Longer Lives.”
Speaking during the event, Plateau State Commissioner for Health, Nicholas Ba’amlong, represented by the Director of Medical Services, Dr Stephen Bishmang, reaffirmed the state government’s commitment to strengthening the health system and ensuring access to healthcare regardless of age, status or circumstance.
Bishmang commended MWAN and the Plateau State Specialist Hospital for organising the outreach, noting that collaboration between government, healthcare professionals and civil society organisations could help improve healthcare delivery and the wellbeing of older persons.
State President of MWAN, Sekyen Sana, said the initiative was aimed at addressing the healthcare needs of older persons and helping them live healthier and more fulfilling lives.
She noted that ageing is a natural process and should not necessarily be associated with sickness, stress or emotional difficulties.
Sana said MWAN wants older persons to remain healthy, happy and able to enjoy their lives while encouraging them to pay greater attention to their health.
The Chief Medical Director of Plateau State Specialist Hospital, Professor Christopher Yilgwan, represented by Barnabas Saidu, welcomed the beneficiaries and encouraged them to take advantage of available healthcare services.
He also urged retirees and older persons who had not been enrolled in the state health insurance programme to make enquiries and register so they could access available medical services.
Saidu stressed the importance of regular health checks, noting that medical conditions can be identified and treated more effectively when detected early.
Also speaking, the Plateau State Chairman of the Nigeria Medical Association, Dr Shainan Andrew, pledged continued collaboration with MWAN and other stakeholders to expand healthcare interventions for older persons.
Andrew encouraged the beneficiaries to seek medical advice, ask questions about their health and take advantage of available healthcare services.
One of the beneficiaries, Da Samuel Davou, expressed appreciation to the organisers for providing the free medical services.
The organisers appealed to government agencies, non-governmental organisations, companies and other stakeholders to support similar initiatives to enable more older persons to access healthcare and enjoy healthier lives.
Related
The World Health Organisation (WHO) says drug-resistant bacterial infections kill about one million people globally every year, calling for coordinated action across human, animal, food and environmental sectors to curb the growing threat.
Jean-Pierre Nyemazi, Acting Director of the AMR Department at WHO Headquarters, said this at a virtual media conference marking an exhibition at the European Parliament on AMR and its human impact.
The virtual conference preceded the exhibition, “AMR: The Human Stories Behind a Silent Pandemic,” being held at the European Parliament from 28 September to 2 October and featuring stories of people affected by AMR across Europe.
“AMR is taking many lives. One million people die every year due to drug-resistant bacteria alone – that is, two people every minute die of bacterial AMR,” Mr Nyemazi said.
He said the scale of deaths meant that AMR should no longer be treated as a “silent pandemic”, stressing that “we know what works” to prevent and control the threat.
“Preventing infections is the number one priority. This can be done through better vaccination, infection prevention and control, Water, Sanitation and Hygiene (WASH), and improved animal husbandry,” he said.
“All of these work and can prevent AMR.”
Mr Nyemazi said strengthening surveillance, responsible use of antimicrobials, access to quality medicines and diagnostics, and reduction of environmental contamination could also make a difference.
“The tools exist, and the evidence is there, but the cost of inaction is rising. The longer we delay action, the higher the cost becomes,” he said.
He said the One Health approach, which recognises the links between human, animal, plant and environmental health, was essential because drug-resistant pathogens could move across sectors and borders.
According to him, parliamentarians have a critical role in ensuring that national AMR commitments are supported by legislation, financing and accountability.
“The media also plays an indispensable role. Journalists help bring AMR out of scientific circles and into public debate,” he said.
“They raise awareness, combat misinformation, and ensure that AMR remains visible to decision-makers and the public alike.”
He said WHO Member States approved an updated Global Action Plan on AMR at the World Health Assembly in May, providing a framework for combating AMR over the next 10 years through a One Health approach.
Mr Nyemazi said the updated plan placed stronger emphasis on prevention, governance, behavioural change and measurable targets, and that the four Quadripartite organisations developed it jointly.
He said the organisations comprised the Food and Agriculture Organisation (FAO), United Nations Environment Programme (UNEP), WHO and World Organisation for Animal Health (WOAH).
“What is new about the updated Global Action Plan on AMR for the next 10 years is that it is truly multi-sectoral – a genuine One Health plan.
“The previous plan was heavily focused on human health; this time the four Quadripartite organisations worked together and engaged all sectors,” he said.
Mr Nyemazi said a 10 per cent reduction in AMR was achievable through infection prevention and control, vaccination and improved access to quality antimicrobials, with better coordination, education and surveillance capable of delivering further gains.
He also called for investment in new antibiotics, antifungals, phage therapy and other technologies, while stressing the need to preserve existing medicines.
He said there was also a major access problem, with many regions unable to obtain even existing antibiotics.
A member of the European Parliament, Martin Häusling, said excessive antibiotic use in food-producing animals was contributing to the problem, particularly through mass treatment.
“When it comes to food-producing animals, we still use far too many last-resort antibiotics, and we must get away from that,” Mr Häusling said.
He said AMR was a global issue that could affect anyone, adding that it could destroy families and livelihoods.
To tackle it, the parliamentarian said it was important to create public awareness so that parliaments could address the issue properly, adding that the issue was still not taken as seriously as a future challenge should be.
Rob Purdie, an AMR survivor and member of the WHO Task Force of AMR Survivors, said his experience demonstrated the consequences of delayed diagnosis and treatment.
Mr Purdie said an infection that began with a headache eventually progressed to fungal meningitis after he received antibiotics for a condition that had not been properly diagnosed.
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He said he eventually spent about $250,000 on hospital costs and had been unable to work for about five years.
“My ability to earn a living was eliminated for about five years in a single-income household where I provided for my wife and two children,” he said.
Mr Purdie said his experience underscored the need to keep AMR visible in public discussions.
“That is why it is so important for those of us who have survived and can speak, to remove the word ‘silent’ from the ‘silent pandemic’,” he said.
(NAN)
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