Smiles for Mothers Playbook

Postpartum haemorrhage (PPH) accounts for approximately 22% of maternal deaths in Nigeria. Over the years, the Federal Government has taken critical steps to improve maternal health outcomes, including the formation of a 34-person task force and the publication of a roadmap on “Accelerated Reduction in Maternal Mortality in Nigeria” to drive the achievement of the SDGs’ maternal health targets. While these interventions have yielded results, more efforts are required to address key drivers of PPH-related mortality, if Nigeria is to contribute to the global push to reduce maternal mortality ratio to less than 70 deaths per 100,000 live births by 2030.

In December 2020, the Federal Ministry of Health updated its Nigeria Essential Medicine List in line with the updated WHO Essential Medicine List and recommendations on the use of uterotonics for PPH prevention. This update included the introduction of a new uterotonic entrant, heat-stable Carbetocin, for the prevention of PPH. Heat-stable carbetocin is a viable option for countries like Nigeria, where poor power supply and weak cold chain infrastructure, especially at the last mile of the supply chain, pose a threat to the quality of heat-sensitive commodities.

With funding from MSD for Mothers, the Smiles for Mothers program supported the Federal Ministry of Health and Kano, Lagos, and Niger States in adopting the updated WHO recommendations. The program also supported the state governments’ efforts to improve the clinical care and appropriate use of uterotonics, and strengthen the supply chain for uterotonics through training and mentoring of health workers and logisticians, respectively, and in addition, supported demand generation for facility-based antenatal services and delivery, through the deployment of patient literacy materials.

This playbook provides a comprehensive account of the Smiles for Mothers program achievements and lessons learned in the rollout of the WHO recommendations in Kano, Lagos, and Niger States, Nigeria. 

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