For decades, international health bodies have recognized that the deaths of mothers and babies are largely preventable. Early efforts focused heavily on basic survival and reducing infectious diseases. Over time, global strategies shifted from isolated disease programs to comprehensive primary healthcare approaches that address the broader social and economic determinants of health.
Key milestones in this evolution include:
The Millennium Development Goals (MDGs), active from 2000 to 2015, set clear targets. MDG 4 aimed to reduce child mortality, while MDG 5 focused on improving maternal health and achieving universal access to reproductive health. Although Nigeria and other developing nations made notable progress, many targets were not fully met due to weak health systems, funding gaps, and infrastructure challenges.
Building on the lessons of the MDGs, the Sustainable Development Goals (SDGs) were launched in 2015 with a 2030 deadline. Unlike the MDGs, which largely focused on developing countries, the SDGs apply universally to all nations. They emphasize sustainability, equity, and the interconnections between health, poverty, education, and gender equality.
Sustainable Development Goal 3 (SDG 3) focuses on ensuring healthy lives and promoting well-being for all ages. For midwifery and maternal-child health, SDG 3 contains specific, ambitious numerical targets designed to curb preventable deaths.
| Target | Description | Global Goal by 2030 |
|---|---|---|
| SDG 3.1 | Reduce maternal mortality | Less than 70 per 100,000 live births |
| SDG 3.2 | End preventable newborn and child deaths | Neonatal mortality down to at least 12 per 1,000 live births |
Achieving these targets requires robust emergency obstetric and newborn care, skilled birth attendants at every delivery, and strong referral networks across all tiers of the healthcare delivery system.
Midwives are the backbone of maternal and child health systems, particularly in low-resource settings where access to specialist medical doctors is limited. When educated to international standards, midwives can deliver a vast majority of essential sexual, reproductive, maternal, and newborn health services.
Investing in midwifery goes beyond clinical care; it encompasses supportive supervision, continuous professional development, and ensuring safe working environments. Midwives provide antenatal education, manage normal labor and childbirth, identify complications early, and facilitate timely emergency referrals, making them indispensable to the realization of SDG 3.
Health inequities remain a major barrier to maternal and child survival. Disparities persist between urban and rural populations, as well as across different socioeconomic strata. Women in remote rural areas or impoverished urban slums often lack physical and financial access to quality maternal care.
Universal Health Coverage (UHC) seeks to ensure that all individuals receive the health services they need without experiencing financial hardship. For maternal-child health, UHC means abolishing out-of-pocket user fees for emergency obstetric care, expanding rural health insurance schemes, and deploying skilled healthcare personnel where they are needed most, ensuring that poverty never determines a mother's chance of survival.
Accurate data is essential for tracking progress toward SDG 3. Without reliable health information systems, maternal and neonatal deaths often go uncounted, masking the true burden of disease and preventing evidence-based planning.
In Nigeria, strengthening the District Health Information System (DHIS2) and improving community-level vital registration are critical steps. Midwives play a frontline role in data collection by meticulously recording antenatal visits, deliveries, and birth outcomes in facility registers. Ensuring data accuracy and prompt reporting helps policy-makers allocate resources effectively, hold health institutions accountable, and identify gaps in maternal service delivery across states and local government areas.