By Fatima Saka
Abuja, Nigeria — Maternal health experts on Monday urged the Federal Government to confront the deepening human-resource crisis in primary healthcare, warning that Nigeria cannot reverse its high maternal mortality rate unless task-shifting is properly structured, supervised, and supported by evidence-based policy.
Speaking at the Task-Shifting Symposium 2025, themed “Bridging Research, Policy, and Practice for Better Maternal Healthcare in Nigeria,” stakeholders emphasized that frontline realities in primary healthcare (PHC) must shape national reforms.
Delivering the keynote address, Dr. Adedolapo Fasawe, Mandate Secretary of the Health Services and Environment Secretariat, FCT Administration, said the findings from the Oxford-led study being disseminated at the symposium provide “a rare opportunity to examine our primary healthcare system through the eyes of our frontline workers.”
Fasawe reminded participants that Nigeria accounts for more than one-quarter of global maternal deaths, according to WHO, and that most of these deaths are preventable.
“Task shifting has been globally recognised as an effective strategy to expand access to essential maternal healthcare,but only when implemented with clear protocols, supportive supervision, and continuous training,” she said. “In many PHCs, task shifting is already happening informally, with workers doing far beyond their scope without adequate support or protection.”
She noted persistent gaps: unclear role definitions, contested professional boundaries, inconsistent training, inadequate resources, and community-driven improvisation that sometimes overrides policy.
Fasawe said the FCT is strengthening PHC systems through improved supervision, digital clinical support tools, and clearer competency-based task allocations. “Effective task shifting is not giving more work to lower cadres; it is equipping, protecting, and supporting them to deliver safe, high-quality care,” she added.
Asked about the wider message of the symposium, Fasawe stressed that the FCT maintains zero tolerance for maternal, neonatal, or infant deaths. She urged pregnant women to attend free antenatal care and register on the FCT health insurance scheme, noting the administration’s commitment under Minister Nyesom Wike and President Bola Ahmed Tinubu to end preventable maternal deaths.
Presenting the findings of his doctoral study, Dr. Francis I. Ayomoh, Honorary Postdoctoral Research Fellow at the University of Oxford, said the symposium was organised to disseminate evidence on the policy and practice of task shifting for maternal health in Nigeria, with a focus on both national-level governance and PHC delivery in the FCT.
His study reveals that task shifting remains unavoidable because of severe workforce shortages, but current implementation threatens service quality.
“We shouldn’t ideally be relying on task shifting, but we cannot do without it,” Ayomoh explained. “The dilemma is balancing increased access with optimal quality. Task shifting can only work if the issues affecting its implementation are fixed.”
Ayomoh urged the government to show stronger political will in hiring available health workers, many of whom, he noted, are already working as community volunteers without pay.
“At least 50 percent of PHC workers in the FCT are volunteers who depend on stipends. They are not salaried. This must change,” he said.
He recommended:
Increased government funding to employ existing qualified personnel
Intentional training and continuous supportive supervision
Alignment of professional interests toward patients’ welfare
Sustained, not reactionary, solutions to health-worker strikes
He warned that frequent strikes force Nigerians into private hospitals, unregulated providers, or home remedies, “all of which lead to preventable deaths.” He called for deeper trust-building between government and health workers and long-term solutions after each strike.
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Ayomoh stressed that improving PHC delivery is critical for reducing Nigeria’s maternal mortality. “If we make the welfare of the mother and child the primary focus, one step at a time, one mother at a time, Nigeria will begin to see real improvement.”
The symposium closed, experts agreed that research must guide decisions, policy must reflect frontline realities, and task shifting must become safer, structured, and properly supervised if Nigeria is to end preventable maternal deaths.
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