One midnight in September 2025, as labour pains intensified, Blessing Okon was rushed through the dark roads of Oko-Ita in Ibiono Ibom Local Government Area of Akwa Ibom State in search of help.

They passed the newly commissioned Mother and Child Hospital, a modern fully built facility designed to serve women like her, and which is less than a kilometre from her home. But its gates were locked.

She and her husband went to a primary healthcare centre (PHC) in Ikot Usen, about 30 minutes away. When they arrived, no health worker was on duty.

They waited nearly an hour as her condition worsened. No help came.

“I had felt the signs earlier but thought it was not serious and could wait till morning,” Mrs Okon recalled.

With no alternative, her husband drove her back home, where a traditional birth attendant (TBA) was called in to assist with the delivery.

The outcome was severe.

Mrs Okon said she suffered complications and heavy bleeding that left her unable to walk properly or carry heavy objects for months.

“The TBA tried her best. At the time, I had already become weak and lost a lot of blood,” she said. “If not for the intervention of the TBA, I would have died.”

The irony is that the facility meant to tend to such emergencies was within reach but remained closed.

The Renewed Hope Mother and Child Hospital in Oko-Ita, a 100-bed specialist facility built to serve Ibiono Ibom and surrounding communities, had been commissioned months earlier but had never opened its doors.

A paved access road leads into the compound. Streetlights line the entrance. Air-conditioning units are fixed along its walls. But behind the gates sit empty wards and silent corridors.

There are no patients. No staff. No activity.

“We live close to the facility; it is even within walking distance,” Mrs Okon said. “But I couldn’t go there because it was locked.”

The statistics behind the crisis

Nigeria continues to record some of the highest maternal and child mortality rates in the world, with tens of thousands of women dying each year from pregnancy and childbirth-related complications.

The major drivers include delayed access to skilled care, weak health infrastructure, and shortages of trained health workers.

According to the 2024 Nigeria Demographic and Health Survey, Akwa Ibom has one of the lowest percentages (38.6 per cent) of live births delivered in a health facility in the country. It ranks lowest among Nigeria’s 17 southern states. It also ranks lower than five of the six north-central states and three out of six north-east states.

The report further shows that Akwa Ibom has one of the lowest percentages of births delivered by a skilled provider (51.5 per cent) in Nigeria, the lowest across the southern and North-central states except Niger.

Akwa Ibom State has a maternal mortality rate of 774 per 100,000 live births, according to District Health Information Software 2, a free and open-source software platform primarily used for managing and analysing health information in Nigeria.

It was against this backdrop that the federal government, through the Office of the Senior Special Assistant to the President on Sustainable Development Goals, launched the Renewed Hope Mother and Child Hospitals initiative to expand access to maternal, neonatal, and child healthcare in underserved communities.

The initiative delivered purpose-built specialist hospitals across several states, designed to provide antenatal and postnatal care, safe delivery services, emergency obstetric care, neonatal care, and diagnostic support.

The Senior Special Assistant to the President on Sustainable Development Goals, Adejoke Orelope-Adefulire, described the hospitals as symbols of renewed hope for women, newborns, and families nationwide.

In Akwa Ibom, a 100-bed Mother and Child Hospital was commissioned in Oko Ita, Ibiono Ibom LGA, on 6 August 2025. The facility was expected to serve more than 24 communities and about 30,000 residents.

Community leaders said the commissioning raised expectations. David Udofia, the head of Oko-Ita, recalled that residents trooped out in large numbers for the event, hopeful that access to quality maternal care had finally arrived.

“We were thankful to the government and believed that in no distant time, the hospital would become operational and our women and children would begin to access care close to home,” he said.

Similarly, the village head of Ikot Obong, Okon Robert, said the facility quickly became a symbol of hope for women who had long endured difficult, sometimes fatal, childbirth experiences.

At the commissioning, Governor Umo Eno, represented by his deputy, Akon Eyakenyi, said the hospital would strengthen healthcare delivery in the state and expand access to affordable services, particularly in rural communities.

A non-functional facility

Months after its commissioning, the Renewed Hope Mother and Child Hospital in Oko-Ita remains closed and unused.

Visits to the facility in May and June show a completed structure standing idle. The compound is quiet. There is no movement of patients or staff.

The gates remain locked. Inside, wards and consultation rooms are empty. Equipment installed in the facility has never been used.

Two security guards at the entrance said the hospital has remained shut since it was commissioned. They said no doctors, nurses, or administrative staff have been deployed to the facility.

At the reception area, a plaque still hangs on the wall. It reads: “Regular antenatal care reduces the risk of complicated pregnancy. FG/Akwa Ibom Government cares.” But there is no service delivery behind the message.

“We have not seen any doctors or nurses,” the village head of Ikot Obong, Mr Robert, said. “Our women keep checking, hoping to find someone, but there is no one to attend to them, and repeated efforts to engage authorities have yielded no results.

Residents said the situation has remained unchanged since commissioning. Women who need maternal care still travel to distant health centres or rely on lower-level facilities with limited capacity.

Mr Robert said several women had died during childbirth due to delayed access to care. Although private hospitals are available, the charges are out of reach for many families.

“These deaths could have been avoided if we had a functional hospital with doctors and nurses available,” he said. “The government needs to rescue us. Our women are dying.

Mfoniso Basset, the youth leader of Ikot-Obong, said repeated efforts to get authorities to open the hospital have not yielded results.

“We keep going there hoping it will open one day, but nothing has changed,” he said.

A system without alternatives

In the absence of the hospital, residents rely on distant and overstretched facilities.

Apart from the PHC in Ikot Usen, the Ikpa PHC operational base serves as another option. Located about 15 minutes away, patients spend about N1,500 on transport to reach it.

The facility, staffed by about seven health workers, provides immunisation, antenatal care, family planning and nutrition services to several communities.

But its capacity is limited.

Ikaite Eneti, a nurse-midwife at the centre, said complicated cases, such as obstructed labour or severe postpartum haemorrhage, are referred to larger hospitals, including St Luke’s General Hospital in Anua, Uyo, about one hour away, or facilities in Ikot Ekpene, roughly 40 minutes away.

Even then, patients often face delays and overcrowding.

Health experts warn that such delays significantly increase the risk of severe complications, including haemorrhage, infection, organ damage and long term reproductive health problems.

Heavy reliance on TBAs

With limited access to skilled care, many women turn to TBA.

“We are not happy patronising TBAs, but emergencies leave people with no choice,” said the woman leader of Oko-Ita, Alice Okon.

For some families, the consequences are severe.

In 2021, Uwem Okon-Urua went into labour at night and was taken to Ikot Usen health centre, only to find it locked.

A TBA, later, gave her a local concoction to induce labour. The baby was eventually delivered, but not without complications. She lost a significant amount of blood and suffered severe tears.

“I wouldn’t have taken it under normal circumstances, but I was desperate,” she said. “I thought I would not survive. The pain was unbearable. After delivery, I was advised to seek proper medical care.”

Ms Eneti, the nurse-midwife at Ikpa, confirmed that depending on TBAs is common. She recounted a case in February involving a newborn brought in for immunisation with a severely infected umbilical cord.

“The mother said a TBA instructed her to apply salt and toothpaste,” she said. “That led to the complication. After attending to the child, we educated her to always come for a proper check-up instead of accepting whatever she is told by TBAs.”

When delay becomes death

When Isaiah Udofia learned that his wife, Sarah, was pregnant with twins, he could not contain his joy. In their modest home in Ikot Mbuk, Idoro, another community in Ibiono Ibom LGA of Akwa Ibom State, the family began counting down the months, already imagining the names of the children they expected.

But when labour began one evening in 2025, that anticipation collapsed into panic.

The Comprehensive Health Centre in Idoro, meant to serve as the first point of care in emergencies, had no bed and no nurse on duty. The facility stood with walls, but without care. It was built by the community and handed over to the state government years ago.

Mr Udofia said the centre, which once served 27 villages, deteriorated over time. Part of the roof has been torn off by the wind, and bushes now grow through the wards that once held patients.

Its white-tiled toilets have darkened with neglect, and the beds have rusted after years of exposure. Reptiles now move through rooms once meant for care. Only one small room remains in use, reserved for immunisation and antenatal services.

In that moment of urgency, Mr Udofia said his thoughts turned to the newly built Mother and Child Hospital, designed to provide comprehensive maternal and newborn care. Although completed, the facility had never opened its doors.

With no functioning public facility nearby, he took his wife to a TBA in the community. The attempt to deliver the twins there also failed when complications set in, forcing another desperate search for help.

“I spent about an hour before I could find a motorcycle,” Mr Udofia recalled, his voice heavy. “Our road is bad. From our community to the nearest PHC at Ono took us about 50 minutes.”

At the PHC in Ono, there was still no solution, only another referral. From there, they were sent onward to the University of Uyo Teaching Hospital in the state capital.

By the time doctors intervened, both babies were dead. His wife, Sarah, survived only after emergency surgery to remove the lifeless twins.

“The failure to get the Mother and Child hospital operational and the distance to other options killed my children,” Mr Udofia said. “Each time I remember them, I am pained because they would have survived.”

At the Idoro Comprehensive Health Centre, the Officer-in-Charge, Anietie Natan, said pregnant women only come for routine care. She added that the absence of the Mother and Child Hospital as a functional alternative has deepened the pressure on the facility.

For residents like Ukeme Udom, the situation reflects more than neglect.

“The failure to get the hospital operational, as well as address healthcare needs in Idoro, is no longer just neglect; it is an injustice,” he said.

“People die because they have nowhere to go. The roads are terrible. Many don’t make it to distant hospitals.”

Over N500 million spent, yet the hospital remains idle

An analysis of publicly available spending records on Govspend, a platform that tracks government expenditure, shows that more than N500 million was paid for the construction of the Mother and Child Hospital in Oko-Ita.

Records show that on 22 May 2023, Westfield Global Construction Ltd received N145 million for construction works on the hospital. A further payment of N190 million was made to the same company on 26 March 2024, bringing the total payments to the contractor under the project to N336 million.

Another contractor, Taruve Nigeria Limited, received N167 million on 31 December 2025 for external works, including access roads with kerbs, drainage systems, and stamped concrete flooring within the hospital complex. The payment was processed under the same project code, 0554008001.

Taken together, total verified construction spending on the facility stands at N503.6 million.

This figure does not include the costs of medical equipment.

According to information published by the Office of the Senior Special Assistant to the President on Sustainable Development Goals, the hospital was equipped with operating theatres, recovery rooms, private and general wards, consultation rooms, a laboratory and scanning unit, as well as equipment such as an ultrasound machine, vacuum extractor delivery set, and fully stocked emergency carts.

Further review of the Akwa Ibom State 2026 budget shows that N350 million was also allocated for the rehabilitation of the facility and construction of internal roads, even though the hospital has not commenced operations, and the internal road network within the complex already exists.

A staffing problem

The Akwa Ibom State Commissioner for Health, Ekem Emmanuel, did not respond to calls, WhatsApp messages and text messages sent to him on 25, 27 and 28 April requesting comments on the findings of this investigation.

However, the Chairman of the Akwa Ibom State House of Assembly Committee on Health, Moses Essien, said the delay in opening the hospital is largely due to a shortage of health workers, describing it as part of a broader workforce gap in the state.

Mr Essien said more than 2,000 medical professionals have been approved for recruitment by the state government following a health-sector emergency declaration on 12 September 2025.

According to him, the recruitment process has reached the computer-based testing stage, while oral interviews are ongoing.

“I have been following up, and I am sure that when the process is completed, personnel will be sent to the facility to work,” he said. “Some doctors from the local government have also reached out to me, expressing worry about the facility.”

He added that medical superintendents were appointed in November 2025 to oversee the facility pending full deployment of staff. He also noted that the recruitment process has been highly competitive, with about 35,000 applicants vying for 2,000 positions.

A national staffing benchmark shows that a functional secondary or specialist hospital typically requires about five doctors, around 40 nurses and midwives, and at least four personnel each in the laboratory and pharmacy units to sustain 24 hour service delivery.

Sources in Ibiono Ibom also said delays in deployment may be linked to the absence of staff accommodation, as the hospital was constructed without staff quarters.

While staff housing is not formally required under Nigeria’s minimum standards for secondary healthcare facilities, it is widely considered essential in practice for facilities expected to operate around the clock.

Responding to this, Mr Essien said provisions have been made under the emergency declaration to address accommodation challenges, adding that the primary issue remains deployment rather than housing.

“There are other locations where infrastructure will be upgraded, and the governor is working with the contractors to handle them,” he said.

“He has given us assurances that he will improve the health sector maximally. He has shown that by not only allocating 11.9 per cent of the 2026 budget, about N139 billion out of 1.38 trillion, to the sector, but also making some releases.”

Expedite recruitment of health workers

Speaking with PREMIUM TIMES, the Chairman of the Nigerian Medical Association, Akwa Ibom State, Aniekan Peter, said it is important to expedite recruitment of health workers, warning that continued delays are worsening pressure on an already overstretched health system.

Mr Peter said health should not be treated as routine civil service administration but as an essential service requiring urgent attention, adding that delays in recruitment are directly affecting service delivery across the state.

While acknowledging government efforts in building and expanding health facilities, he warned that infrastructure gains risk being undermined by staffing gaps.

He also clarified that the state did not receive enough qualified applicants for the 400 doctor slots advertised, adding that a fresh recruitment call would be necessary.

This, he said, explains why the reported 35,000 applicants applied for other categories of health workers.

“The governor must give immediate directives to the Head of Service and the Civil Service Commission to do their job quickly. Employment should not take two months, but we have been on this for more than six months,” he said.

He added that the state faces a health workforce deficit of more than 10,000 personnel and noted that recruitment must be continuous to meet demand.

“Health centres must have at least four doctors, but we have a situation where even general hospitals are struggling with two. In other climes, a comprehensive health centre has more than 10 doctors attending to people. We must do things differently if we are serious about healthcare delivery. Health is life and death,” he said.

Mr Peter also recommended removing health worker recruitment from the general civil service bureaucracy and placing it under the Ministry of Health, which he said is better positioned to understand the urgency of medical staffing.

“The ministry will be faster with recruitment, and we can also hold the health commissioner accountable for any failure,” he said. “In matters of health, a second look matters a lot. Any day spent delaying recruitment, people die.”

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He also suggested that recruitment processes should be completed before commissioning new hospitals to ensure the immediate deployment of staff and to avoid situations where completed facilities remain unused.

A pattern that continues to haunt communities

Months after that night, Mrs Okon still remembers not only the pain of childbirth, but the reality that help was physically close yet functionally out of reach.

Each time she passes the silent gates of the Renewed Hope Mother and Child Hospital in Oko-Ita, she is reminded of what could have been different.

Around her, the pattern continues: women still travel long distances in the dark, still gamble between distance and delay, and still turn to unskilled care when time runs out.

This reporting was completed with the support of the Centre for Journalism Innovation and Development (CJID).

The National Agency for the Control of AIDS (NACA), in collaboration with the Global Fund and key implementing partners, will convene a national close-out meeting on 25 June to reflect on the achievements, lessons learned, and lasting impact of the COVID-19 Response Mechanism (C19RM) investments in Nigeria.

The meeting, to be held in Abuja, will bring together representatives of the Federal Ministry of Health, state governments, development partners, civil society organisations, implementing partners, healthcare workers, and other stakeholders who played critical roles in implementing the C19RM grant between 2021 and 2025.

The Global Fund’s COVID-19 Response Mechanism was established to support countries in mitigating the impact of the COVID-19 pandemic while strengthening health systems and safeguarding progress against HIV, tuberculosis, and malaria. In Nigeria, the investment supported a wide range of interventions to strengthen public health preparedness and response capacities, including improvements in disease surveillance, laboratory systems, infection prevention and control, oxygen infrastructure, cold-chain systems, healthcare workforce capacity, and emergency response mechanisms.

The Director-General of NACA, Temitope Ilori, said, “We learned through COVID-19 that being prepared for one emergency isn’t just about that emergency, it’s about being prepared for any emergency.

“C19RM investments in emergency response mechanisms, supply chain resilience, and rapid deployment capacity are now embedded in our health systems planning and programming.”

The close-out meeting will provide an opportunity to showcase key achievements recorded under the grant, examine lessons from implementation, highlight innovations and best practices, and discuss strategies for sustaining the gains made through the investment.

The event will also feature presentations from implementing agencies and partners, stakeholder reflections, panel discussions, and the premiere of documentary and storytelling products developed to capture the human impact and legacy of the C19RM investment across Nigeria.

Tajudeen Ibrahim, executive secretary, Country Coordinating Mechanism (CCM) Nigeria, said, “The C19RM grant demonstrated the power of effective partnership, positioning, coordination, engagement, oversight and country ownership in responding to a public health emergency.

“Beyond supporting Nigeria’s COVID-19 response, the investments have strengthened critical health systems and facilitated pandemic preparedness and response capacities that will continue to benefit the country for years to come. As we close this chapter, our focus must remain on sustaining these gains and leveraging the lessons learned to build a more resilient health system for all Nigerians.”

Speaking ahead of the event, stakeholders noted that the close-out meeting is not only an opportunity to celebrate achievements but also to strengthen the collective commitment to building resilient health systems that can respond effectively to future public health emergencies.

As Nigeria continues to strengthen its health security architecture, the lessons and investments from the COVID-19 Response Mechanism remain an important foundation for future preparedness, disease control, and health system resilience.

READ ALSO: DRC Ebola outbreak tops 1,000 cases as death toll reaches 277- WHO

The close-out meeting is expected to attract senior government officials, development partners, public health experts, implementing organisations, and representatives from communities that benefited from the intervention.

Attendance Information

Attendance at the C19RM Close-Out Meeting is by invitation only and will include representatives from government institutions, development partners, implementing organisations, civil society, academia, and other key stakeholders involved in implementing the C19RM grant.

Members of the public and interested stakeholders who are not attending in person are encouraged to participate virtually through the event livestream.

Livestream Details: https://bit.ly/c19rm

About COVID-19 Response Mechanism (C19RM)

The COVID-19 Response Mechanism (C19RM) is a special funding mechanism established by the Global Fund to support countries in responding to the COVID-19 pandemic, mitigating its impact on HIV, tuberculosis, and malaria programmes, and strengthening health and community systems for future emergencies.