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Health advocates seek reinstatement of suspended Lagos pregnancy guidelines

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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.

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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.

Health

Niger investigates suspected infectious disease after child’s death

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The Niger State government has launched an investigation into a suspected infectious disease following the death of a child and reports that other members of the same family have fallen ill.

The state Director of Public Health, Ibrahim Idris, disclosed this in a statement issued in Minna on Thursday by the Ministry of Information and Orientation.

Mr Idris said the Ministry of Health responded after a father shared videos on social media alleging that a strange illness had affected members of his household.

He said the swift response demonstrated the state’s commitment to protecting residents through prompt public health action.

He said the prompt intervention reflected the commitment of the Governor Umaru Bago-led administration to safeguarding the health and well-being of residents across the state through timely public health responses.

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According to him, every unexplained death deserves a thorough investigation, while every suspected outbreak must be treated with urgency to prevent possible transmission and protect public health.

The director said the affected children had been evacuated to a health facility for comprehensive medical evaluation and treatment as health authorities intensified efforts to determine the cause.

He said preliminary clinical findings suggested that the illness might not be a strange disease but one familiar to medical experts, with diphtheria among the conditions being considered.

“At this stage, no definitive conclusion can be made until laboratory investigations are completed,” he said.

“The samples collected will help determine the exact cause of the illness and guide the response.”

Mr Idris said public health officials had commenced contact tracing in the affected community and in the schools attended by the children to identify similar cases and contain any possible transmission.

He advised parents and caregivers to ensure their children completed all recommended routine immunisation schedules, noting that many life-threatening illnesses could be prevented through vaccination.

The director urged residents to seek prompt medical attention whenever unusual symptoms were observed, stressing that early detection and treatment remained critical to disease control efforts.

Also, Junaidu Inuwa, executive director of the Niger State Primary Health Care Development Agency (NSPHCDA), said preliminary findings showed the deceased child had received only partial immunisation.

He said some of the surviving children were either partially immunised or had not completed their vaccination schedules, exposing them to vaccine-preventable diseases and associated health complications.

ALSO READ: Niger Assembly has no website, limiting residents’ access to information

According to him, the development underscores the critical importance of routine immunisation in protecting children against vaccine-preventable diseases and reducing childhood mortality across communities.

Mr Inuwa said health officials also visited the isolation centre at the General Hospital, where affected family members had been placed on appropriate antibiotic treatment and were receiving care.

He said health authorities would continue to provide timely updates as investigations progressed and would intensify surveillance, contact tracing, and other interventions if the illness was confirmed to be infectious.

He reiterated that complete immunisation remained the safest and most effective protection against vaccine-preventable diseases and urged parents to utilise vaccination services available across the state. (NAN)


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FG launches $1.07 billion programmes to strengthen PHCs, education, governance

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The federal government has launched development programmes valued at more than $1.07 billion to strengthen primary healthcare, improve governance and education, and accelerate poverty reduction as part of its economic recovery agenda.

The programmes include the Human Capital Opportunities for Prosperity and Equity Governance (HOPE GOV) programme, backed by $500 million, and the Primary Healthcare Provision Strengthening Programme (HOPE PHC), financed with $570 million.

The government also launched the Nigeria Community Action for Resilience and Economic Stimulus Additional Financing (NG CARES AF), the broader HOPE programme comprising HOPE GOV, HOPE PHC and HOPE EDU, and the Solutions for Internally Displaced Persons and Host Communities (SOLID) programme.

Speaking at the launch in Abuja on Thursday, President Bola Tinubu said the initiatives were designed to ensure that the gains from the country’s economic reforms translate into improved living standards for Nigerians.

Mr Tinubu, represented by the Minister of Finance and Coordinating Minister of the Economy, Taiwo Oyedele, said the programmes form part of a coordinated strategy to strengthen human capital development, improve public service delivery and build resilience in communities across the country.

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He said the government had recorded improvements in key economic indicators, including GDP growth, foreign reserves and inflation.

He added that about 15 million vulnerable households had benefited from the expanded social transfer programme.

According to him, the HOPE GOV programme will improve governance by strengthening budget planning and supporting the recruitment of teachers and healthcare workers, particularly in underserved communities, while the HOPE PHC programme will improve service delivery at primary healthcare facilities through the Basic Health Care Provision Fund (BHCPF).

Health reforms

Also speaking, the Coordinating Minister of Health and Social Welfare, Muhammad Pate, said the programmes would support the implementation of the Nigeria Health Sector Renewal Investment Initiative (NHSRII), the government’s flagship reform agenda for the health sector.

Mr Pate said the initiative was anchored on four pillars: strengthening governance and accountability, improving equitable access to quality healthcare, developing the healthcare value chain, and enhancing health security and resilience.

Highlighting progress made under the reforms, he said the federal government had revitalised 3,026 primary healthcare centres nationwide and supplied maternal and newborn care equipment to 231 secondary hospitals.

He added that 43,417 women and newborns had been transported through rural emergency and maternal transport services, while 42,970 comprehensive emergency obstetric and newborn care services were provided between October 2024 and March 2026.

Mr Pate said the reforms had also led to increased use of healthcare services, with more women opting to deliver in health facilities.

“The reforms are increasing service utilisation, with more women choosing to give birth in health facilities, reflecting renewed confidence in the health system. They are increasing uptake of essential health services, with more families choosing modern family planning and more children receiving life-saving vaccines,” he said.

READ ALSO: In Adamawa, rural PHCs rely on volunteers due to staffing shortages

World Bank backs programme

The World Bank Country Director for Nigeria, Matthew Verghis, said the country’s efforts to expand access to quality healthcare had been strengthened through collaboration among the federal, state and local governments, development partners, civil society organisations and the private sector.

Mr Verghis said the HOPE PHC programme and the investments supporting it provide an opportunity for Nigeria to improve health outcomes, particularly for mothers, children and vulnerable populations, while strengthening accountability in the health sector.


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