Primary health centres in Kaduna State are introducing the E-MOTIVE approach to detect and manage postpartum haemorrhage, after the Task Shifting Task Sharing project trained Community Health Extension Workers to act on excessive bleeding following childbirth.
The project is implemented by Pathfinder International in partnership with Impact Catalysts, with support from the Bill and Melinda Gates Foundation, according to a Premium Times report. Programme records reviewed by Premium Times show 77 CHEWs were trained across 77 primary healthcare facilities in nine local government areas: Kaduna North, Kaduna South, Igabi, Soba, Sabon Gari, Makarfi, Kaura, Jema’a and Zangon Kataf. The CHEWs are supported by nine clinical mentors and nine reproductive health coordinators.
At PHC Abdukwari in Sabon Gari LGA, antenatal care provider Zainab Garba told Premium Times that the training and the E-MOTIVE approach had strengthened the facility’s response to heavy bleeding after delivery. “With the presence of E-MOTIVE and the training given to us, we now do better,” she said. “The majority stop bleeding without even being referred.”
The training described in programme records focused on competency-based skills in prevention and management of postpartum haemorrhage, basic emergency obstetric and newborn care, and other maternal and newborn health services, including use of the E-MOTIVE treatment bundle.
Postpartum haemorrhage, or PPH, is a major cause of maternal death globally. A 2026 Lancet Series, as highlighted by the World Health Organisation, estimates PPH affects about 27 million women and results in nearly 43,000 deaths each year worldwide, and imposes costs in excess of $10 billion annually. The WHO also estimates that more than 85 per cent of deaths from PPH occur in sub-Saharan Africa and South Asia, and that in Nigeria PPH accounts for an estimated 23 to 30 per cent of maternal deaths, Premium Times reported.
Locally, a Kaduna State Primary Health Care Board review for the first quarter of 2026 identified PPH as the leading cause of maternal death among cases with detailed causes, with PPH-related deaths reported in Kudan, Birnin Gwari and Lere local government areas. Premium Times also reported that the state’s community maternal and perinatal death surveillance for the last quarter of 2025 linked several maternal deaths to PPH, often following deliveries outside health facilities.
The World Health Organisation recommends earlier, objective measurement of blood loss after childbirth to speed treatment. Premium Times described WHO guidance that once bleeding is recognised, the MOTIVE bundle should be used: massage of the uterus, oxytocic medicines, tranexamic acid, intravenous fluids, examination of the genital tract, and escalation of care where needed. One tool for earlier detection reported by Premium Times is a calibrated drape placed under the woman after delivery to collect and measure blood instead of relying on visual estimates.
Evidence cited in the report includes a large randomised trial across hospitals in Nigeria, Kenya, South Africa and Tanzania involving more than 200,000 women, which found that early detection and bundled treatment using E-MOTIVE reduced the combined outcome of severe PPH, surgery for bleeding or death from bleeding by about 60 per cent compared with usual care.
Premium Times noted that having an effective treatment approach is only part of the solution; there must also be trained personnel at the primary health level to use it when a woman starts bleeding.
Source: Premium Times Health.
Featured image: Kambai Akau via Wikimedia Commons, CC BY-SA 4.0.
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