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Abstract

High-risk pregnancies contribute significantly to maternal morbidity and mortality in rural Nigeria due to fragmented care and weak referral systems. Primary health centers often lack the resources, training, and specialist linkages needed to manage obstetric emergencies effectively. This manuscript proposes a collaborative care model that strengthens the interface between primary care providers and specialist obstetric services to improve outcomes for high-risk pregnancies in rural settings.  We describe a theoretical pilot model involving structured task-sharing, digital triage platforms, and referral coordination through designated family physicians. Key components include WhatsApp-based consultation groups, standardized referral protocols, and quarterly case review meetings between primary and tertiary providers. The model outlines measurable outcomes such as improved referral accuracy, reduced time to definitive care, and enhanced provider confidence. It also identifies implementation challenges including transport delays, network connectivity issues, and role ambiguity among providers. Sustainability requires ongoing training, alignment with national maternal health policies, investment in rural infrastructure, and workforce retention strategies. Embedding such models into existing health systems could bridge critical gaps and reduce preventable maternal deaths. A scalable, collaborative model integrating primary and specialist obstetric care holds promise for addressing systemic delays and improving maternal outcomes in rural Nigeria. Institutional commitment and policy alignment are essential for successful implementation.
Keywords: High Risk Pregnancy, Maternal Mortality, Family Physicians, Maternal Health, Primary Care.