The Tortuous Road to Ending Preventable Maternal Deaths in Nigeria.

Nigeria continues to bear a disproportionate share of the global burden of maternal mortality despite decades of national and international commitments to its reduction. This viewpoint examines the tortuous and unstable trajectory of efforts to end preventable maternal mortality in Nigeria, noting a modest decline from extremely high levels exceeding 1000 maternal deaths per 100,000 live births. A shift that signals incremental progress, however, remains fragile, nonlinear, and vulnerable to reversal due to recurrent programmatic setbacks and weak health system resilience. The article situates Nigeria's experience within the global ending preventable maternal mortality framework, analyzing the continued relevance of its five strategic objectives in the Nigerian context. It reviewed key national initiatives from the Midwives Service Scheme to the widely acclaimed "Abiye" program in Ondo State-highlighting how political transitions, funding instability, and weak institutionalization have undermined continuity and scale-up. It argues that Nigeria's fluctuating maternal mortality trends are closely linked to inconsistent coverage, quality, and sustainability due to discontinuity driven by political turnover. It calls for the elimination of all barriers to care, functional emergency obstetric care services, governance, and accountability through the Maternal and Perinatal Death Surveillance and Response program.