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Abstract

Maternal mortality in Nigeria remains alarmingly high, with many deaths resulting from preventable obstetric complications. Primary Health Centers (PHCs), which serve as the first point of contact for most pregnant women, often lack the capacity to manage emergencies effectively. This manuscript examines a capacity-building model aimed at strengthening emergency obstetric care (EmOC) at the primary health level in Lagos State. Drawing from national initiatives and international best practices, the study explores training interventions, simulation exercises, and systemic improvements in supply chains and referral networks. Competency-based training significantly enhanced provider knowledge and confidence, especially when supported by simulation drills and supervision frameworks. Facility-based programs also led to increased use of uterotonics, better partograph documentation, and improved management of hypertensive emergencies. However, challenges such as staff attrition, limited monitoring systems, irregular supply of essential drugs, and fragmented referral coordination persist. The paper argues that sustainable EmOC improvements require policy integration, institutional ownership, and consistent funding. Recommendations include embedding EmOC modules in pre-service and in-service training for nurses and midwives, strengthening referral and transport systems, and ensuring logistical support across PHCs. The Lagos State experience underscores the importance of a systems-based, contextually adapted, and government-led approach to maternal health. If implemented broadly, such a model could accelerate progress toward reducing preventable maternal deaths and achieving Sustainable Development Goal 3.1 across Nigeria and other low-resource settings.
Keywords: Maternal Mortality, Primary Health Care, Emergency Obstetrics Care.