Nigeria: Technology Aids in Calculating Travel Times, Urging Faster Access to Hospitals for Pregnant Women

Urban maternal health in Nigeria presents a complex landscape marked by significant challenges and disparities, as highlighted by recent research and studies. Nigeria, contributing to 28% of global maternal deaths and 10% of stillbirths annually, faces pronounced issues in urban areas, particularly in the southern regions. These challenges stem from a combination of poor road infrastructure, haphazard urban development, traffic congestion, and inadequate access to health facilities in expanding informal settlements.

Research conducted by maternal health experts, including studies published in esteemed journals like The Lancet Global Health and Nature's Communication Medicine, underscores the inadequacies of traditional methods used to estimate travel times to emergency obstetric care facilities. Historically, methods relying on self-reported travel times or proximity mapping have proven insufficient in accurately reflecting the urban realities faced by pregnant women seeking critical maternity services. These limitations have hindered effective policy formulation and service planning aimed at improving maternal health outcomes.

The emergence of innovative approaches pioneered by the OnTIME Consortium in collaboration with Google represents a significant step forward in addressing these challenges. Leveraging advanced software, particularly Google Maps, researchers have been able to more accurately calculate travel times to emergency obstetric care facilities across Nigeria's largest cities. This approach has provided crucial insights into the variability of travel times based on factors such as time of day and geographical location within urban centers.

Key findings from these studies highlight the dynamic nature of travel times in urban Nigeria. During peak traffic hours, travel times can extend significantly, sometimes up to two hours from suburbs and informal settlements to the nearest hospital offering emergency obstetric care. Conversely, travel times are shorter during off-peak hours, emphasizing the impact of traffic congestion on access to critical health services for pregnant women.

Access to emergency obstetric care within a 30-minute drive varies widely across Nigeria's urban centers. Cities like Aba exhibit lower accessibility rates to public hospitals, with only 33% of women residing within a 30-minute drive. In contrast, Maiduguri demonstrates higher accessibility, with 97% of women within the same proximity to public hospitals. For combined access to both public and private hospitals within a 30-minute drive, cities like Ibadan, Ilorin, Lagos, and Maiduguri show higher percentages ranging from 75% to 98%, indicating relatively better access to health facilities offering emergency obstetric care.

Despite these variations, disparities in service availability and travel times remain pronounced, particularly in cities such as Benin City, Port Harcourt, Kaduna, Abuja, and Jos. These cities reflect significant inequalities favoring wealthier neighborhoods, where residents benefit from shorter travel times and better access to health services. In contrast, less affluent areas within these cities face longer travel times and limited access to emergency obstetric care, exacerbating health disparities among socioeconomically disadvantaged populations.

To address these challenges effectively, stakeholders, including the Nigerian government and healthcare authorities, are called upon to prioritize investments in comprehensive health systems and infrastructural improvements. Recommendations include the implementation of ambulance-only lanes and direct access routes to hospitals in urban redesign projects. These measures aim to enhance the efficiency of emergency response systems and improve timely access to critical health services for pregnant women.

Furthermore, public awareness campaigns are essential to educate commuters about the importance of yielding to emergency vehicles, thereby ensuring unimpeded access for healthcare providers during emergencies. These initiatives are crucial steps towards creating a supportive environment that prioritizes maternal health and mitigates the risks associated with delayed access to obstetric care in urban settings.

The economic implications of inadequate maternal health services in Nigeria are significant. Reports by organizations like Top10VPN estimate economic losses of approximately $1.9 billion in 2023 due to internet disruptions alone, underscoring the financial toll of infrastructural challenges on the country's economy. These findings underscore the urgent need for sustained investments in health infrastructure and policy interventions aimed at improving maternal health outcomes and reducing economic losses associated with preventable maternal deaths and stillbirths.

In conclusion, while advancements in technology and research have provided new insights into urban maternal health challenges in Nigeria, concerted efforts are needed to translate these findings into actionable policies and infrastructural improvements. By addressing the underlying factors contributing to maternal mortality and stillbirths, Nigeria can move towards achieving better health outcomes for its urban population and ensuring equitable access to critical maternity services across the country.