Project Aisha is being implemented by a consortium of four organisations: the Health Strategy and Delivery Foundation (HSDF), Ingress Health Partners, mDoc Healthcare, and the Institute for Healthcare Improvement (IHI).
Stakeholders in Nigeria's health sector have confirmed a 58 per cent decline in maternal mortality rates across 32 health facilities in Lagos and Kaduna States, achieved through implementing Project Aisha.
This was highlighted during the Maternal Health Quality Improvement (MHQI) Summit on Thursday in Lagos, where health experts, government representatives, and implementing partners gathered to reflect on the progress.
Project Aisha, meaning alive and well, is a maternal health initiative designed to address the high rates of maternal mortality and obstetric complications in Nigeria.
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Project Aisha, supported by MSD for Mothers under the Strengthening Systems for Safer Childbirth initiative, is being implemented by a consortium of four organisations: the Health Strategy and Delivery Foundation (HSDF), Ingress Health Partners, mDoc Healthcare, and the Institute for Healthcare Improvement (IHI).
According to the Director of Project Aisha and Managing Principal, Nigeria Operations at HSDF, Layi Olatawura, the initiative has strengthened the competencies of over 700 healthcare workers and reached more than 110,000 women with maternal health services.
Government intervention
At the summit, the Coordinating Minister of Health and Social Welfare, Muhammad Pate, emphasised the critical role of "quality care as an accelerator for maternal health equity."
Mr Pate, represented by Samuel Oyeniyi, Head of the Reproductive Health Division, noted that quality care ensures every pregnant woman receives effective, safe, respectful, and timely services across pregnancy, childbirth, and postnatal care.
"Despite progress, maternal mortality remains unacceptably high, with Nigeria's maternal mortality ratio recorded at 512 deaths per 100,000 live births as of 2018," he said.
"The current figures for 2024 are still being analysed, but the need to reduce these numbers is urgent."
While acknowledging the impact of Project Aisha, he also highlighted government efforts to combat maternal mortality.
Mr Pate said the ministry is scaling up several initiatives, including establishing maternal health centres equipped with essential commodities and staffed by skilled healthcare workers.
He noted that the ministry advocates for the establishment of dedicated departments of family health at the state level to coordinate maternal mortality reduction programmes effectively.
He also highlighted the importance of financial protection mechanisms, such as community-based health insurance, to reduce out-of-pocket expenses that often prevent women from accessing quality care.
The summit also featured panel sessions that featured the Director General, National Health Insurance Authority (NHIA), Kelechi Ohiri; Co-Founder & CEO, mDoc; Nneka Mobisson, SA to the President on Health, Salma Anas, represented by an official, Fatima Mahmood; and National Coordinator, Sector-Wide Approach, Nigeria, Muntaqa Umar-Sadiq, among others.
Project objectives, achievements
Since its inception in September 2022, Project Aisha, according to HSDF, has supported over 200,000 women through improved access to quality maternal health services across 48 public and private health facilities.
According to the Managing Principal for Global Operations at HSDF, Yewande Ogundeji, the project has also engaged traditional birth attendants to bridge community gaps.
Ms Ogundeji noted that results include a 25 per cent reduction in facility-based maternal deaths and a 58 per cent decline in deaths due to severe pre-eclampsia, postpartum haemorrhage, and obstructed labour.
"But the real question is-how do we sustain these gains? How do we embed them into long-term health system reform? How do we ensure that quality improvement becomes a permanent feature of our healthcare culture-institutionalised, locally led, and financially sustainable?" she said.
Ms Ogundeji emphasised the need for alignment with national programmes such as the NHIA's Comprehensive Emergency Obstetric and Maternal Care (CEOMC) scheme to guarantee timely access to life-saving interventions.
She also suggested integrating the "proven tools" like the Change Package Document, which was launched at the summit, into the national quality improvement frameworks to guide public and private sector improvement interventions.
Proven strategies
Highlighting the components of the intervention, Orode Doherty, Medical Director at Ingress Health Partners, said the project's success stemmed from improvements in clinical decision-making, reduced waiting time, and a focus on high-risk cases.
Speaking on the Change Package, Ms Doherty said the document compiles tested, proven interventions that any health facility can adopt to reduce maternal deaths.
"This package offers a step-by-step roadmap that other providers can use to reduce maternal deaths in their contexts," Ms Doherty added.
In his comments, the Permanent Secretary of the Lagos State Primary Health Care Board, Ibrahim Mustafa, noted that the success recorded under the initiative underscores the importance of continuous quality improvement in healthcare delivery.
Mr Mustafa emphasised the importance of institutionalising quality improvement processes, noting that progress is already visible.
"Quality improvement is not a one-off. It is a continuous process, and the good thing is that we are beginning to see improvement. We need to embed this into the system," he said.
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From the funder's side, Iyadunni Olubode, Nigeria Country Lead for MSD for Mothers, stressed that tackling maternal mortality in Nigeria should not be left to the government alone.
"Nigeria remains one of the most dangerous places in the world to give birth. Solving this crisis requires multisectoral collaboration -- and that includes the private sector stepping up, as we've done here," she said.
Lessons from Africa
In his presentation, the Chief Executive Officer (CEO) of the National Vaccine Institute, Ghana, Sodzi Sodzi-Tettey, reinforced the critical importance of quality improvement frameworks in combating maternal mortality.
Citing a 40 per cent reduction in maternal deaths over the past 23 years, she acknowledged that Africa still bears 70 per cent of the global burden of maternal deaths, with Nigeria's rate currently around 545 per 100,000 live births.
Mr Sodzi highlighted successful quality improvement interventions from Mozambique and Ethiopia, where targeted strategies addressing both direct medical causes and systemic challenges led to declines in maternal deaths.
He urged stakeholders to address the role of healthcare facility environments and widely share Nigeria's progress and lessons across Africa.
