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The Federal Government of Nigeria in December 2009 launched midwives service scheme to address the shortage of skilled healthcare workforce needed to drive the efforts at improving maternal and infant health, towards the attainment of MDGS 4 and 5. This was in response to the unrelenting increase in maternal mortality in Nigeria. This review explores the implementation of the scheme and the extent to which its set-goals are achieved vis-a-vis many challenges confronting it. The review first explores the ecologic perspective on maternal mortality to identify factors responsible for high mortality among Nigerian women and the inequality gaps in maternal mortality. The review identifies the need to scale up midwives service scheme to areas in dire health needs, identifies the need for health needs assessment, and recognizes community participation as an essential ingredient in ensuring the sustainability of midwives service scheme. Routine evaluation of midwives service scheme is identified as an important tool for assessing the effectiveness of the scheme in achieving its objectives towards improvement in maternal health and reduction in inequality gaps in maternal mortality. The review proposes multi-sectoral interventions in tackling inequality gaps in maternal mortality with strategic focus on addressing inequalities in health and social determinants of health.

Scaling up Nigeria’s Midwives Service Scheme and Reducing Inequality Gaps in Maternal Mortality