Project Aisha, a maternal health initiative in Lagos and Kaduna states, has achieved a 25% reduction in maternal deaths by empowering women, engaging communities, and improving healthcare worker capacity

[dropcap]A[/dropcap] maternal health initiative, Project Aisha, has led to a 25 per cent reduction in maternal deaths in Lagos and Kaduna states, the Health Strategy and Delivery Foundation has revealed.

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Launched in 2022 and funded by MSD-for-Mothers, the project was implemented in four Lagos LGAs, Ifako-Ijaiye, Ibeju-Lekki, Agege, and Epe, and Zaria LGA in Kaduna by a consortium of four partners, HSDF, Ingress Health Partners, mDOc Healthcare and the Institute for Healthcare Improvement to improve maternal outcomes.

This was made known at the Maternal Healthcare Quality Improvement Summit 2025, with the theme, “Mothers Matter! What does it take to stop maternal deaths? Closing quality gaps in maternal healthcare,” held recently in Lagos.

Reports show that the country has 512 deaths per 100,000 live births.

According to the National Demographic Health Survey, 2018, only 56.8 per cent of women received four or more antenatal care visits, while 43 per cent of deliveries were assisted by a skilled provider, and 39 per cent of deliveries occurred in a health facility.

According to the Director of Project Aisha and Managing Principal, Nigeria Operations of HSDF, Dr Layi Olatawura, the foundation leveraged technology to ensure women’s voices were integrated into the design and delivery of maternal services.

He said, “Since August 2022, this consortium has empowered over 46,000 women to make informed decisions about their maternal care, built the competencies of over 700 healthcare workers to provide respectful and quality care, and delivered maternal health services to over 110,000 unique women.

“We have also leveraged technology to ensure that women’s voices are integrated into the design and delivery of maternal services.

At the heart of our success are the values of leadership, collaboration, innovation, data-driven performance, technology, community engagement, and participation.”

In a presentation on “An Integrated Approach that Leverages Women’s Voices to Address Barriers to Safe Childbirth,” the Project Manager of Project Aisha and the Senior Programme Manager of HSDF, Dr Olasunmbo Makinde, stated that the project has achieved a 25 per cent reduction in facility-based maternal deaths.

She stated that the initiative recorded notable progress in reducing maternal mortality in four local government areas in Lagos, Ifako-Ijaiye, Ibeju-Lekki, Agege, and Epe, and in Zaria LGA in Kaduna State, by integrating women’s voices and preferences into maternal health interventions.

Makinde further noted that the project adopted community-driven solutions and quality improvement strategies that empower both women and healthcare providers.

Highlighting poor access to quality care, cultural barriers, lack of awareness about maternal danger signs, and unequal distribution of skilled healthcare workers as causes of maternal deaths, she stated that Project Aisha adopts a four-pronged integrated approach that focuses on empowering women and their families, engaging community influencers, strengthening healthcare worker capacity, and ensuring leadership accountability within the health system.

Makinde said, “Our integrated approach has four parts to it. One is the women themselves. We are very particular about integrating the voices of women, ensuring they are empowered.

When you empower women, it’s not enough. We also have to empower their partners and other people within the home who influence a decision, especially a maternal decision.

“And I’m sure that, as anybody will say, the grandma, the mother-in-law, and even in some rare cases, you can even see, the father-in-law stating where these women can go for maternal care.”

She added, “What are we doing differently? We’re identifying community resource persons, people who are already familiar with these women, people they listen to and know.

Since August 2022, this consortium has empowered over 46,000 women to make informed decisions about their maternal care, built the competencies of over 700 healthcare workers to provide respectful and quality care, and delivered maternal health services to over 110,000 unique women.

I would call them maternal health influencers. We empower them to be able to teach the women in the community when it comes to maternal health.”

Continuing the Project Aisha Manager, said, “We also have community maternal care providers, I’m referring to the traditional care providers, Lagos and Kaduna.

The policy architecture in both states is slightly different, but they do exist, and they do provide maternal care.

“In addition to building the competency or empowering women to understand maternal dangers, we also went further to ensure that TBA knew these maternal dangers.

Even when the women go into TBA practices, they’re able to see us showing both of them together, and there is no discrepancy in the way we approach it, to make sure that at the end of the day, we want to make sure that no mother is lost while giving and not forgotten.”

Makinde also explained that a digital feedback platform, NaviHealth.ai, is being used to capture women’s experiences with maternal care services and submit feedback based on effectiveness, timeliness, and patient-centeredness.

Presenting some of the project’s achievements recorded in the participating facilities, she said, “Project Aisha has achieved a 25 per cent reduction in facility-based maternal deaths, 65 per cent increase in antenatal care attendance, 82 per cent increase in the quality of ANC services, 168 minutes to 76 minutes reduction in decision to incision time for caesarian section, and a 58 per cent reduction in facility-based maternal deaths due to postpartum hemorrhage, preeclampsia, and obstructed labour.

“63 per cent increase in two-way referrals for obstetric complications, 151 minutes to 51 minutes reduction in time between decision to refer and departure from facility, 245 minutes to 51 minutes reduction in time between decision to refer and arrival at referred facility, 70 per cent improvement in adherence to protocols for management of PEE.

“Over 160,000 women reached with project interventions, 8,677 men reached by MHIs and 39,473 women empowered by MHIs. Over 3,400 maternal care experiences were collected via the Navi-Health platform.”

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She added that the next phase of Project Aisha will focus on scaling up across more LGAs in Lagos and Kaduna, expanding digital feedback tools, and leveraging community health workers to maintain momentum.