Stakeholders Advocate WHO-approved Strategies To Reduce Childbirth Bleeding
Stakeholders have called for the wider adoption of the World Health Organisation-approved E-Motive approach, and stronger investments in frontline healthcare, community engagement, and social behaviour change to combat postpartum haemorrhage, one of the leading causes of maternal deaths in Nigeria.
They spoke in separate interviews on Friday, on the sidelines of the 66th National Council on Health held in Calabar, Cross River State.
According to them, the early detection of PPH and treatment using the World Health Organisation-approved E-Motive response bundle provides help in reducing deaths from childbirth-related bleeding.
The E-Motive initiative includes a blood-collection drape with calibrated lines to accurately measure blood loss, enabling early detection of PPH.
It also involves the WHO-recommended first-response treatment bundle, which comprises massaging of the uterus, oxytocic drugs, tranexamic acid, IV fluids, and a structured process for examination and escalation.
The E-Motive trial Nigerian arm was coordinated and conducted at the Africa Centre of Excellence for Population Health and Policy, Bayero University, Kano.
Nigeria continues to grapple with one of the highest maternal mortality rates in the world. The 2025 Nigeria Health Statistics Report released by the Federal Ministry of Health and Social Welfare showed that Nigeria recorded an estimated 3,689 maternal deaths between January and September 2025.
The top 10 leading causes of maternal deaths, according to the data, are maternal complications, cardiovascular diseases, malaria, cancer, HIV/AIDS, diabetes mellitus, sepsis, anaemia, tuberculosis, and neonatal complications.
PPH is the loss of more than 500 mL of blood within 24 hours after birth. It affects an estimated 14 million women each year and results in around 70,000 deaths, mostly in low and middle-income countries, equivalent to one death every six minutes, according to the WHO.
Speaking, the Country Lead of the Maternal Mortality Reduction Innovation and Initiatives Programme, Dr. Dayo Adeyanju, said PPH remains a major threat to women during childbirth and requires urgent action at the frontline of care.
He explained that the E-Motive model, which is a WHO-recognised emergency response bundle for managing PPH, is already showing promising results in facilities where it has been introduced.
According to him, calibrated drapes used under the E-Motive protocol help health workers accurately measure blood loss, eliminating guesswork and enabling faster intervention.
He added that the ongoing training of midwives and nurses through simulation centres is boosting confidence and competence in responding to emergencies.
He said, “E-Motive is truly effective. In fact, it has now been recommended by the WHO as a practical and proven approach. Its various components are already being integrated into our training programmes, particularly through simulations in our simulation corners. It is also embedded in the Maternity Foundation Lab that we are introducing. Although it is an offline learning platform, we have asked them to contextualise the E-Motive model within it because we know it works.
“This initiative began with Prof. Hadiza Galadanci and his team in Kano. We actually started at MAMII in Kano because the state has the largest number of Local Government Areas with a high burden of maternal mortality.
“We are collaborating with Pro. Galadanci to incorporate E-Motive into our Social and Behavioural Change Communication and maternity care for Advanced Recovery and Preparedness, so that women can be empowered and competent enough to detect PPH early. That ability to recognise postpartum haemorrhage quickly and intervene immediately is what saves lives.”
“We must ensure that every health worker on the frontline can detect PPH early and arrest bleeding immediately. With E-Motive embedded into our care bundle, we are reducing delays and saving more lives,” he said.
Also speaking, the Executive Director of the Centre for Communication and Social Impact, Babafunke Fagbemi, said strengthening citizens’ confidence in public health facilities is crucial to saving mothers’ lives.
According to her, the current administration has shown commitment to primary healthcare revitalisation and universal health coverage, and citizens are beginning to respond positively.
However, she stressed that reducing maternal deaths, especially from PPH, requires dismantling social and cultural barriers that prevent women from seeking timely care.
“No woman should die from giving birth. The E-Motive approach, recognised by the WHO, is unique because it provides a simple solution that enables health workers to build their capacity and resilience, helping prevent maternal deaths from postpartum bleeding.
“The calibrated drape promoted through the E-Motive approach is now being produced locally in Nigeria, ensuring the solution is contextually relevant and accessible. The government has worked to ensure that the approach is not only recognised but effectively practised across the country.
“With proper training, health workers can significantly reduce the number of women who die from bleeding after delivery,” Fagbemi stated.
The Technical Specialist for Reproductive and Maternal Health at UNFPA Nigeria, Dr Lordfred Achu, emphasised that PPH remains the most frequent cause of maternal deaths, particularly among women who deliver at home or present late to health facilities.
He said strategic investments are needed to improve antenatal monitoring, nutrition, access to skilled birth attendants, and availability of life-saving drugs.
He stressed that money must never be placed above a woman’s life in emergencies.
“Reducing maternal deaths begins with encouraging women to attend antenatal clinics. These visits should not be routine check-ins where the health worker merely asks if there are problems, notes the response, and sends the woman home.
“There should be focused antenatal care. Focused antenatal care means that nurses, midwives, and doctors carefully monitor vital signs, including haemoglobin levels, blood pressure, and weight, while providing comprehensive guidance on nutrition and supplements. Socio-cultural barriers must also be addressed to help build their blood and overall health.
“Women who arrive at delivery with sufficient blood reserves are better able to withstand bleeding, while those with low reserves risk rapid deterioration.
“Strategies to reduce maternal deaths include ensuring proper antenatal care, improving nutrition, training health workers to identify and manage excessive bleeding, and guaranteeing the availability of life-saving drugs”, Achu added.