In a continued effort to combat maternal mortality, the Lagos State Ministry of Health, in collaboration with the United Nations Population Fund (UNFPA) and the Saving One Million Lives Programme for Results (SOMLPforR), organised a three-day training for healthcare workers on the active management of the third stage of labour.
Held between September 11th and 13th at the LCCI Conference Centre in Alausa-Ikeja, the training sought to equip healthcare workers with the necessary skills to manage childbirth and postpartum complications, with a particular focus on preventing excessive bleeding, which remains a leading cause of maternal deaths in Nigeria.
The training, which brought together about 40 healthcare workers from primary, secondary, and tertiary healthcare facilities, was a blend of theoretical and practical sessions. Participants were exposed to clinical demonstrations using mannequins and hands-on practice with anti-shock garments and uterotonic drugs. The training is part of a larger initiative to strengthen maternal and child health services in Lagos State.
Speaking on the importance of the training, the Director of Family Health and Nutrition, Lagos State Ministry of Health, Dr. Folasade Oludara noted that the training aimed to bridge the knowledge gap among newly recruited healthcare workers and update the skills of existing staff.
According to her, the training addressed one of the primary causes of maternal mortality – postpartum haemorrhage, or excessive bleeding after delivery. She explained that Postpartum haemorrhage is responsible for a significant portion of maternal deaths, both globally and in Nigeria, adding that the training focused on teaching participants the proper use of uterotonic drugs such as oxytocin and misoprostol, which help the uterus contract after childbirth to prevent excessive bleeding.
The Director said that participants were also introduced to new techniques like delayed cord clamping, which allows blood from the placenta to flow back into the newborn, reducing the risk of neonatal anaemia.
She stated that these devices are crucial in emergencies, particularly in low-resource settings where access to blood and blood products might be delayed. Dr. Oludara disclosed that the training also addressed the proper use of the partograph, a simple yet critical tool used to monitor labour and predict potential complications.
While stressing that the training also prioritised the interpersonal skills of healthcare workers, the Director noted that the workshop focused on improving communication and empathy between healthcare workers and patients to enhance the overall birthing experience.
Dr. Oludara expressed optimism that the new skills acquired by healthcare workers would lead to a significant reduction in maternal mortality across the state, saying “We are hopeful that this training will change the narrative for us. Skilled healthcare workers are the key to reducing maternal deaths and ensuring safe deliveries”,
One of the facilitators at the training, Professor Yusuf Oshodi, a renowned obstetrician and gynaecologist from the Lagos State University Teaching Hospital (LASUTH), emphasised that the training was designed to reduce Nigeria’s high maternal mortality rate, which has remained unchanged for decades.
He noted that excessive bleeding and hypertensive disorders in pregnancy are the two leading causes of maternal deaths, and addressing these issues could reduce maternal mortality by 40%. “Our goal is to face these two monsters – postpartum haemorrhage and hypertensive disorders in pregnancy – which account for a large portion of maternal deaths”, Professor Oshodi stated.
During the event, the Director and Reproductive Health Coordinator of the Lagos State Ministry of Health, Dr. Victoria Omoera delivered a comprehensive presentation, titled: “Proposal to Improve Maternal Care, Reduce Maternal Mortality, and Strengthen Systems for Safer Childbirth”.
In her address, Dr. Omoera highlighted the need for improved maternal healthcare services in low-resource settings like Lagos, where healthcare workers often lack the tools, capacity, and training needed to provide high-quality services.
She identified the main causes of these deaths as obstetric haemorrhage, hypertensive disorders, unsafe abortions, obstructed labour, and infections, noting that two-thirds of these cases involve women with no identifiable risk factors.
One of the solutions, Dr. Omoera advocated for was the adoption of low-cost, high-impact interventions such as the Active Management of the Third Stage of Labour (AMTSL), which the World Health Organization (WHO) introduced in 2012.
She pointed out that AMTSL, along with the use of non-pneumatic anti-shock garments (NASG) and newer drugs like Carbetocin and Tranexamic Acid, could reduce maternal mortality by up to 60%. She stated that these measures have already been piloted in Lagos State, with significant improvements in maternal outcomes.
In closing, Dr. Omoera emphasised the need for continued capacity building for healthcare workers. She noted that the Lagos State Ministry of Health had trained 160 healthcare workers between 2019 and 2020, which slightly reduced the state’s maternal mortality ratio. However, she acknowledged that more work needed to be done to meet key targets for intrapartum care.
Participants appreciated the training, noting its practical approach and potential to save lives. Dr. Fakoya Elijah, a Medical Doctor from General Hospital Agbowa, described the training as “impactful” and emphasised the importance of continuous learning for healthcare professionals.
Edna Adinkuye, a Nurse from General Hospital, Ajeromi, shared similar sentiments, stating that the training had provided her with a better understanding of key tools like the partograph.
Lagos State is committed to reducing its maternal mortality rate, which has been gradually improving due to targeted interventions like this. With support from international partners like UNFPA and SOMLPforR, the government continues to focus on capacity-building programmes to ensure that healthcare workers are well-equipped to handle maternal emergencies.
