Beyond Maternal Statistics: Turning Commitment into Action on Maternal Nutrition

Rodio Diallo

Nigeria’s National Development Plan (2021–2025) identifies the protection of women’s maternal health as a key driver of national development. Central to the plan is the goal of reducing maternal mortality from 512 deaths to 300 deaths per 100,000 live births by 2025, while also tackling malnutrition among women of reproductive age. The broader ambition aligns with Nigeria’s commitment to the Sustainable Development Goals (SDGs) and the global “Zero Preventable Maternal Deaths” initiative, which seeks to reduce maternal mortality to 70 deaths per 100,000 live births by 2030.

But behind every statistic is a person. A name. A story. When I think about what this crisis actually means, I think about pregnant women whose lives are endangered daily by lack of access to essential nutrition and healthcare. I also think about whose resilience, alongside that of the health workers and communities around them, rarely makes it into the policy conversation.

At the core of the fight to keep mothers alive is sustained financing and consistent access to lifesaving nutrition interventions, including multiple micronutrient supplements (MMS), which help address deficiencies in iron, folate and other essential nutrients. Deficiencies in these nutrients continue to fuel Nigeria’s high maternal mortality rate.

According to the 2023 Nigeria Demographic and Health Survey (NDHS), Nigeria still records 512 maternal deaths per 100,000 live births.

The picture for children is equally alarming – Nigeria currently ranks second only to India among countries with the highest number of stunted children globally. UNICEF, WHO, and World Bank Joint Child Malnutrition Estimates indicate that about 32–34 per cent of Nigerian children under five, roughly 14 million children, are stunted, while about two million suffer from severe acute malnutrition.

These are not abstract figures. They represent a compounding emergency – one that demands both honesty about how much remains to be done, and recognition of the change already being built from within.

Nigerian-led solutions are gaining ground, but challenges remain

What gives me cause for optimism is the work of Nigerian-led coalitions who are building solutions from within their own communities which I witnessed firsthand during a recent visit to Kaduna State. 

The Civil Society-Scaling Up Nutrition in Nigeria (CS-SUNN) is a key collaborative civil society alliance that plays a central role in strengthening coordination, advocacy and accountability across government, implementing partners and development partners in Nigeria’s nutrition sector. The alliance, made up of more than 400 civil society groups, media organisations, academics, development partners such as the Gates Foundation, and government stakeholders, has been driving efforts to strengthen nutrition policies, increase funding commitments and improve accountability systems at both national and state levels.

Through its Partnership for Improving Nigeria Nutrition Systems (PINNS) project in Kaduna, Kano, Niger, Nasarawa, and Lagos States, CS-SUNN has brought together state governments, lawmakers, traditional rulers, religious leaders, and policymakers to drive reforms aimed at improving nutrition outcomes. The initiative has strengthened planning, budgeting, monitoring, and digital accountability systems, allowing progress to be tracked in real time.

One major achievement is the revival of 24 previously inactive State Committees on Food and Nutrition – realigning them with the National Multisectoral Plan of Action and improving coordination across government agencies in ways that had stalled for years.

However, stronger coordination alone will not improve nutrition outcomes. Governance structures must now be matched by predictable financing, timely budget releases and sustained implementation if progress is to be achieved at scale.

Lessons learned from Kaduna

In the Ungwan Boro community in Kaduna State, I met Martha Obiagwu, officer-in-charge of the local health centre in Sabon Tasha. She described a shift she had not anticipated: women were coming back.

“We have noticed a great increase in the number of women accessing services at the facility, because many women in the community did not know about multiple micronutrient supplements before now. But now that they see their friends or neighbours benefiting from it, they come. Even those who attend private clinics sometimes still come here specifically to request MMS. During Maternal, Newborn and Child Health Week, the demand becomes even higher,” Obiagwu explained.

This matters enormously. Northern Nigeria records some of the highest rates of anaemia in pregnancy nationally – majority of the cases linked to iron deficiency, compounded by poverty, food insecurity, and insecurity more broadly. Rebuilding trust in primary healthcare, one woman at a time, is part of how those numbers change.

The funding picture in Kaduna has also shifted. Ramatu Musa Haruna, the state’s Nutrition Officer, explained how CS-SUNN’s -in collaboration with UNICEF and Gates Foundation- sustained advocacy has started to be translated into concrete government commitments. “All local government chairmen have agreed to contribute N20 million each to support the Child Nutrition Fund, alongside the governor’s commitment of N500 million this year,” she said. “These funds will help sustain the procurement of multiple micronutrient supplements and other essential commodities.” Political will can move quickly.

Turning commitments into financing

That political commitment is increasingly reflected in public budgets. Health allocations have increased significantly in recent years. In 2025, N170.01 billion was allocated directly to nutrition programmes, representing a 33.7 per cent increase from the N127.24 billion allocated in 2024 and a substantial rise from the N10.8 billion allocated in 2021.

These are important signals.

Yet allocations alone do not save lives. One of the greatest challenges facing nutrition programmes in Nigeria today is ensuring that budget commitments translate into actual releases and implementation. Despite growing recognition of the importance of MMS, funding for procurement remains insufficient or uncertain in many states. As a result, access to these lifesaving supplements remains uneven, leaving many pregnant women without the support they need.

The experience of Kaduna and other states demonstrates what is possible when political commitment is matched by financing and the timely release of funds. However, these examples remain exceptions rather than the norm. Sustained progress will require more states to prioritise nutrition and convert commitments into action.

The continued rise in inflation also cannot be ignored. Budgetary increases may not fully match the scale of the crisis in real terms. This makes accountability, transparency and effective monitoring more critical than ever, as does sustained investment in primary healthcare, particularly in rural communities where the women most at risk depend on local facilities for their survival and that of their children.

Nigeria’s Federal Ministry of Health and Social Welfare has not minced words, describing the nutrition crisis as “a development emergency” and warning that urgent action is needed across all levels of government.

The 2023 NDHS shows that 58 per cent of women of reproductive age in Nigeria are anaemic, while 61 per cent of pregnant women suffer from anaemia. Regional disparities remain significant, with anaemia among pregnant women standing at 55.2 per cent in the South-west and 71.1 per cent in the South-east, while iron deficiency remains a dominant driver across the North.

The progress witnessed in some states is real. But it belongs, above all, to the communities, health workers, civil society organisations, and government officials who made it happen. Development partners like the Gates Foundation can play a supporting role, but the architecture of change is being built by Nigerians.

The gains achieved so far remain fragile and could easily be reversed without stronger commitment, sustained investment and consistent funding for high-impact nutrition interventions such as MMS. Global evidence suggests that every dollar invested in nutrition can generate returns of between US$16 and US$27 through improved health, productivity and economic outcomes.

Government at all levels must now protect and build on the gains achieved through years of collaboration with communities, civil society organisations and development partners.

A call to action

The commitment to funding nutrition programmes at all levels is a critical lifeline for sustainability. Policies and reforms are important first steps, but they must be accompanied by adequate financing, timely release of funds and strong accountability mechanisms.

The question is no longer whether Nigeria knows what works. The evidence is clear. The question is whether proven interventions such as MMS will receive the sustained financing required to reach every woman who needs them.

Kaduna State has demonstrated what is possible when political commitment is matched by financing and the release of funds for nutrition interventions, including MMS. Their experience should not be the exception.

During this year’s World Nutrition Day last week, we were reminded to reinvigorate our concerted efforts to tackle the burden of malnutrition in Nigeria not only through enabling policies but also through accelerate implementation of proven, high-impact nutrition intervention with sustained domestic financing by State and local governments.

Sustained financing for nutrition and MMS should remain a standing agenda item at the Nigeria Governors’ Forum and across federal and state decision-making platforms.

Nigeria’s maternal health crisis demands urgency, coordination and accountability. Behind every statistic is a woman fighting to survive childbirth and a child struggling for a healthy start in life.

What Kaduna shows is that progress is possible. The challenge now is ensuring that every state follows through on its commitments so that lifesaving nutrition interventions reach the women and children who need them most.

·         Ms Diallo is the Deputy Director, Family Health at the Gates Foundation Nigeria