Executive Summary
The Accelerating the Expanded Adoption of RMNCH Innovations and Health Reforms (AEARI) Learning and Dissemination Meeting, held on 30 June 2026, brought together representatives from the Kano State Government, development partners, academia, professional associations, health care facility representatives, clinical mentors, data optimizers and frontline health workers to reflect on the implementation of the AEARI project. More than a project close-out event, the meeting served as a learning and transition platform to share achievements, implementation experiences, and evidence generated throughout the project, while identifying practical strategies for sustaining maternal and newborn health innovations within government-led systems.
The event demonstrated how AEARI strengthened maternal health systems through a bundled implementation approach that combined co-creation, facility readiness and competency assessment, onsite training, PPH/E-MOTIVE practice, clinical mentorship, commodity tracking, data optimization, TAMIS reporting, policy dialogue and government ownership. Across implementation, AEARI supported 168 facility assessments across 44 LGAs, 136 SBA competency assessments, 50 MCH coordinator assessments, 242 SBAs trained, 37 mentors deployed, 18 Data Optimizers trained and deployed, 75 MAMII-aligned PHCs supported, and 800 Phase II frontline healthcare workers supported.
Between January and May 2026, supported facilities recorded 14,002 vaginal deliveries, 4,858 deliveries monitored using calibrated drapes, 575 women treated for postpartum haemorrhage (PPH), 507 women treated and discharged, 67 women referred out and one recorded death among women managed for PPH. These results were framed within a broader state-level trend showing a reduction in Kano State maternal mortality estimates from 937 to 584 maternal deaths per 100,000 deliveries, representing a 37.6% reduction from the KASSEP baseline surveillance estimate.
Stakeholder reflections converged around one central lesson: maternal health innovations are most likely to endure when training, commodities, mentorship and data are treated as one integrated package and embedded within existing government systems. The panel discussion therefore focused on institutionalizing AEARI gains through routine supervision, low-dose/high-frequency training, continuous mentorship, financial protection, commodity financing, data review platforms, and transition into TEAM OB/NEO.
Area | Result / evidence presented |
Implementation footprint | 168 PHCs assessed across all 44 LGAs; 75 MAMII-aligned PHCs supported across 18 LGAs. |
Capacity strengthening | 242 SBAs trained; 37 mentors deployed; 18 Data Optimizers deployed; 800 Phase II frontline healthcare workers supported. |
PPH treatment | 575 women treated for PPH from January to May 2026; 419 (73%) received bundled PPH care. |
Outcome of care | 507 women treated and discharged; 67 referred out; one death recorded among reported PPH cases. |
Objective blood-loss monitoring | 14,002 vaginal deliveries recorded; 4,858 monitored with calibrated drapes; 34.7% monitoring rate. |
Mentorship and data systems | Mentoring performance improved from 68.0% to 81.9%; Q1 reporting/completeness reached 100%. |
Background and Purpose
Nigeria continues to bear one of the highest burdens of maternal mortality globally, with postpartum haemorrhage (PPH) remaining a leading cause of preventable maternal deaths. In response, the Accelerating the Expanded Adoption of RMNCH Innovations and Health Reforms (AEARI) Project was implemented by WCAHealth (formerly Options Consultancy Services Limited) with funding from the Gates Foundation through TAConnect to accelerate the adoption and scale-up of evidence-based maternal and newborn health innovations while strengthening health systems for sustainable improvements in quality of care across Kano State.
The project adopted a systems-strengthening service delivery approach that combined stakeholder engagement, baseline assessments, competency-based capacity building, clinical mentorship, commodity management, data system strengthening, and quality improvement. Implemented in close collaboration with the Kano State Ministry of Health, Kano State Primary Healthcare Management Board, and other key partners, AEARI aligned its interventions with national and state priorities, particularly the Maternal Mortality Reduction Innovation Initiative (MAMII), while integrating innovations such as the E-MOTIVE PPH Bundle of Care into routine government systems.
As the project transitioned, WCAHealth convened the AEARI Learning and Dissemination Meeting to share project achievements, document implementation lessons, and facilitate dialogue on sustaining and institutionalizing project gains. The meeting brought together stakeholders from government, development partners, academia, professional associations, and healthcare facilities through both physical and virtual platforms to review evidence, exchange experiences, and identify practical strategies for transitioning successful interventions into routine health programmes, including the Team OB/NEO initiative.
Figure 1. Event reach across physical attendance, Zoom registration and YouTube livestream participation.
The participation data shows that the meeting reached stakeholders beyond the physical venue. This strengthened the value of the session as a dissemination and transition platform, allowing government, partners and wider audiences to follow the learning process across physical, Zoom and livestream channels.
The panel session focused on sustainability and system integration under the topic: Institutionalizing RMNCH Innovations in Kano State’s Health System: What Worked, Why It Worked, and What Must Be Sustained. This focus reflected the meeting’s central purpose: to move from project documentation to a practical operating package that government and partners can carry into routine systems and TEAM OB/NEO.
Welcome and Goodwill Messages
The session acknowledged representatives from the Kano State Government, KSPHCMB, SMOH, KSCHMA, DMCSA, TAConnect, the Gates Foundation, WCAHealth, facility teams, partners and online particpants.
In his welcome remarks the Director Family Health Dr Aliyu Zubair welcomed participants and emphasized that innovations introduced to address maternal mortality must continue with or without donor project structures. He reaffirmed the Kano State Government’s commitment to sustaining the innovations introduced through the AEARI project. He also emphasized the government’s determination to institutionalize these interventions within existing health systems to ensure their long-term impact. He also expressed appreciation to the AEARI team for their invaluable support to the State, particularly for working through existing government structures to successfully implement the E-MOTIVE approach across primary healthcare facilities.
The State MCH Coordinator Mansura Yahaya Haruna restated the meeting objectives and emphasized the need to use the gathering to jointly identify strategies that ensure the project impact is not left behind.
Director Drugs, Drug & Medical Consumable Supply Agency (DMCSA) Pharmacist Salisu Hashim on behalf of the Director General and the entire Management Staff of DMCSA, expressed appreciation to the AEARI Project for its life-saving initiative. He noted that the project has made a significant impact by helping to save many lives. He also acknowledged the numerous partners that have supported the State by providing essential life-saving medicines. Through collaboration with the AEARI Project, DMCSA supply Chain Management ensured that, commodities reached the facilities through last-mile distribution (LMD), ensuring that the medicines reached those who needed them most.
Dr. Lilian Anomnachi of TAConnect described AEARI as an example of what is possible when government, partners, organizations and communities work with a shared purpose. She congratulated WCAHealth and Kano stakeholders for the milestones achieved and emphasized that dissemination should not be treated as the end of the journey. Rather, stakeholders should scale what worked, refine what needs improvement and ensure that quality healthcare reaches every mother and newborn who needs it.
Dr. Ufuoma, CEO of WCAHealth, offered a personal and powerful reflection on why maternal mortality reduction matters. He described WCAHealth’s work in Kano as deliberate and rooted in commitment to women, girls and safe pregnancy. Drawing from personal experience of preventable maternal loss, he framed the work as both professional and deeply personal, stressing that preventable maternal deaths must end. He also highlighted the scale of Kano’s delivery burden, noting that between January and May alone, supported facilities recorded approximately 14,000 deliveries, underscoring why innovations such as calibrated drapes, PPH/E-MOTIVE, commodities, mentorship and data systems must be sustained.
ES Kano State Contributory Health Care Management Agency (KSCHMA), Dr Rahila A Mukthar, on behalf of the Kano State KSCHMA, welcomed all participants to the meeting. She stated that KSCHMA is mandated to achieve Universal Health Coverage (UHC) and remains committed to supporting initiatives that promote maternal health.
She further emphasized that the Agency is open to partnerships, collaborations, and stakeholder engagements aimed at improving maternal health outcomes. She noted that KSCHMA welcomes individuals and organizations with innovative ideas or interventions that can contribute to reducing maternal mortality and assured participants of the Agency’s readiness to provide the necessary support to advance such initiatives.
Opening remarks by the HCH:
In his remarks, he began by thanking Almighty Allah for making the important event possible. He also expressed his gratitude to the Executive Governor of the State for his unwavering support in strengthening the health system across the State. In addition, he acknowledged WCA Health for its continued support in helping the State reduce maternal mortality.
He extended his sincere appreciation to the dedicated advocate for maternal and child health, Prof. Hadiza Shehu Galadanci, whose invaluable contributions have played a pivotal role in the State’s achievements. He noted that without her commitment and support, the State would not have reached its current level of progress.
He stated that the event provided an opportunity to showcase the State’s achievements in maternal and newborn health. He emphasized that the State places the highest priority on ensuring that every pregnant woman has a safe pregnancy, a successful delivery, and a healthy baby, which remains one of the government’s foremost objectives.
He further noted that the State recognizes the need to identify gaps and areas requiring additional effort to address the remaining challenges and improve maternal health indicators. He reaffirmed the government’s commitment to achieving zero preventable maternal deaths and stressed that the State remains resolute in pursuing this goal.
He commended the significant progress made in reducing maternal mortality, highlighting the decline from 1,025 to 584 maternal deaths based on the 2024–2025 KASSEP data. He further stated that the State is committed to sustaining this progress by procuring 484 mini ambulances for distribution to the 484 Apex Primary Health Care (PHC) facilities across the State. These ambulances will improve the timely transportation of pregnant women to nearby health facility. He declares the meeting open.
Summary of Presentations
4.1 Dr. Mukhtar Muhammad: implementation journey and project architecture
Dr. Mukhtar Muhammad presented the opening segments of the project presentation, tracing AEARI’s evolution from an earlier G-ANC and high-impact MNH intervention platform into a focused, state-aligned AEARI package. He explained that the project formally came to life in March 2024, later transitioned from Options to WCAHealth in August 2025, and aligned with national and state priorities, including NPHCDA and MAMII. He emphasized that AEARI did not operate as a stand-alone externally designed intervention; rather, the project began with stakeholder sensitization and co-creation in Kano, enabling government buy-in from inception.
“Anything we achieved, we achieved because of this approach: we were not working in silos. We carried government and stakeholders along from day one.” |
“We have now proven that E-MOTIVE can work at PHC level.”
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Figure 2. Kano State maternal mortality ratio trend presented during the AEARI dissemination meeting. Source: KASSEP/AEARI presentation, June 2026.
The downward trend in the maternal mortality ratio provided important context for the meeting. While the reduction reflects wider state-level and partner investments, the trend reinforced the relevance of AEARI’s contribution to PPH prevention, early detection, treatment readiness, data use and accountability.
Dr. Mukhtar highlighted the evidence-led design of the project. AEARI assessed 168 apex PHCs across the 44 LGAs and complemented facility readiness assessment with competency assessment of SBAs and MCH coordinators. The findings informed facility selection, training priorities, mentorship focus and commodity advocacy. After national alignment, implementation narrowed to 75 MAMII-aligned facilities across 18 LGAs, supported by 18 Data Optimizers, 37 mentors and 242 SBAs trained through an onsite model rather than a conventional classroom approach.
4.2 Gift Iliya: data, service delivery and outcome results
Gift Iliya presented the data and results components, covering baseline evidence, training outcomes, uterotonic use, calibrated drape coverage, PPH detection, PPH treatment patterns, outcome of care, commodity tracking and reporting systems. The data showed that oxytocin remained the dominant uterotonic used across the 75 supported facilities, with 8,724 recorded uses from January to May 2026, followed by 3,685 uses of oxytocin plus misoprostol, 705 misoprostol-only uses and 455 HSC uses. Ergometrine was not recorded during the reporting period.
Figure 3. Uterotonics used in the third stage of labour across supported facilities, January-May 2026. Source: TAMIS.
Oxytocin remained the dominant uterotonic across supported facilities, indicating strong routine use during the third stage of labour. However, the lower use of HSC and misoprostol-only reinforces the need for continued commodity monitoring, appropriate clinical decision-making and documentation of uterotonic use.
“Oxytocin remains the highest and most dominant uterotonic used across all 75 facilities.” — Gift Iliya
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Figure 4. Average knowledge gain by training cohort. Source: AEARI training and OSCE analysis.
The strongest knowledge gains were recorded among MCH Coordinators and onsite training participants, showing the value of strengthening both supervisors and facility-based providers. The comparatively lower gain among master trainers should be interpreted alongside their stronger starting competence and the refresher nature of their training.
Figure 5. Calibrated drape monitoring rate from baseline to May 2026. Source: TAMIS Jan-May 2026.
The increase from a 4% baseline to almost half of eligible deliveries monitored with calibrated drapes in May shows clear movement toward objective blood-loss measurement. The dip observed in April underscores the importance of sustained commodity availability and continuous mentorship to maintain routine use.
Gift also presented evidence of movement from a baseline gap in calibrated drape availability to routine objective blood-loss monitoring. Across January to May 2026, 14,002 vaginal deliveries were recorded and 4,858 were monitored using calibrated drapes, representing a 34.7% monitoring rate. The strongest acceleration occurred in May, when 1,461 deliveries were monitored with drapes and nearly half of eligible vaginal deliveries were covered. PPH case detection also shifted toward calibrated drapes by May, when 90 of 144 PPH cases were detected through drapes compared with 54 through clinical judgement, representing a 62.5% drape-based detection rate.
Figure 6. Bundled PPH care coverage by month. Source: TAMIS Jan-May 2026.
Bundled PPH care remained the dominant treatment approach across the reporting period and improved to 78.5% by May. Sustaining this level of adherence will depend on reliable availability of all bundle commodities, provider confidence and routine supervisory reinforcement.
“For bundled care, that is what we are hoping to achieve, and that is why we keep pushing for the availability of commodities within facilities, so that all necessary care can be given to mothers and their lives can be saved.” — Gift Iliya
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Figure 7. Outcome of PPH care across supported facilities, January-May 2026. Source: TAMIS.
Interpretation: The outcome data demonstrates that most women treated for PPH were discharged successfully, with referrals and death remaining comparatively low. This supports the value of early detection and timely facility-level management, while also emphasizing the need to maintain escalation and referral readiness for complicated cases.
The PPH treatment analysis showed that 575 women were treated for PPH from January to May 2026; 419 (73%) received bundled PPH care, while 156 (27%) received unbundled care. Outcome data showed 507 women treated and discharged, 67 referred out and one death recorded. Commodity tracking showed improvement but also remaining gaps: in May, TXA had the highest reported stockout rate at 23%, followed by calibrated drapes and HSC at 15% each, oxytocin at 10% and misoprostol at 6%. Data systems were strengthened through PPH registers, Monthly Summary Forms, TAMIS reporting, Data Optimizers and routine data validation, with 100% reporting/completeness reported for Q1 across supported sites.
4.3 Elizabeth Aumbur Tondu: mentoring trends, success stories and sustainability
Elizabeth Aumbur Tondu presented the mentoring trends, success stories, lessons learned, challenges, mitigation measures and sustainability priorities. Her presentation showed that mentoring performance improved from 68.0% in March to 79.1% in April and 81.9% in May, producing a 13.9 percentage point gain. Post-training health worker retention remained high across the same period, with retention above 93% across the three months. Elizabeth emphasized that mentoring should now move from broad reinforcement to targeted gap closure and routine quality-improvement ownership by LGA and facility teams.
Figure 8. Mentoring performance and post-training health worker retention, March-May 2026. Source: mentorship monitoring data.
Interpretation: Mentoring performance improved steadily from March to May while trained health worker retention remained above 93%. This suggests that post-training support helped translate knowledge into practice and that routine mentorship should remain part of LGA and facility quality-improvement systems.
The presentation highlighted success stories from supported facilities. At Abbas PHC, onsite training created a real-time opportunity for providers to apply NASG and stabilize a woman presenting with antepartum haemorrhage before referral. At Mariri PHC, calibrated drape use, AMTSL and close monitoring supported safe delivery and a stable outcome for mother and baby. These stories illustrated that simulation, real-time mentoring and practical tools helped providers translate learning into lifesaving action.
“Models are more scalable when training, commodities, mentorship and data are treated as one integrated bundle of support from the state down to the supported facilities.” — Elizabeth Aumbur Tondu |
“A successful close-out leaves a practical operating package, not just a report.” — Elizabeth Aumbur Tondu |
Panel Discussion and Stakeholder Reflections
The panel discussion was moderated by Nafisa Murtala and focused on “Institutionalizing RMNCH Innovations in Kano State’s Health System: What Worked, Why It Worked, and What Must Be Sustained.” The protocol positioned the discussion around government ownership, partnerships, data use, quality improvement, accountability systems, commodity management, financing and transition to TEAM OB/NEO. The panelists were Dr. Aliyu Zubairu, Director of Family Health, KSPHCMB; Mansura Yahaya Haruna, State MCH Coordinator, SMOH; Dr. Rahila Mukhtar, Executive Secretary, KACHMA/KSCHMA; Pharm. Gali Sule, Director General, DMCSA; and Prof. Hadiza Shehu Galadanci, Director, ACEPHAP, Bayero University Kano.
Panel discussion on institutionalizing RMNCH innovations in Kano State’s health system. | |
Panelist | Key discussion points captured for the report |
Dr. Aliyu Zubairu, DFH KSPHCMB | Reflected on adoption of AEARI-supported RMNCH innovations, especially PPH/E-MOTIVE, within PHC service delivery. He emphasized that adoption was possible because the project worked through government structures, facility teams and supervisory systems rather than parallel structures. He also highlighted the need for continued government leadership, facility ownership and routine supervision to sustain gains. |
Prof. Hadiza Shehu Galadanci, Director ACEPHAP | Emphasized that sustainability depends on government ownership, collaboration and partnership. She linked AEARI lessons to the design and implementation of TEAM OB/NEO, noting that the transition provides an opportunity to deepen maternal and newborn health reforms, strengthen institutional ownership and scale successful innovations beyond donor-supported projects. |
Mansura Yahaya Haruna, State MCH Coordinator, SMOH | Stressed that implementation services required to sustain innovations go beyond one-off training. She emphasized institutionalizing training through low-dose/high-frequency approaches, continuous mentorship and routine supportive supervision. She also linked sustainability to data use, service delivery quality, accountability and retaining lessons beyond MAMII support. |
Dr. Rahila Mukhtar, ES KACHMA/KSCHMA | Positioned financial protection as essential to sustaining clinical gains. She noted that clinical gaps must be matched with financial provisions if utilization is to be sustained, and discussed how E-MOTIVE and family planning commodities were incorporated into the benefit package. She also reiterated KACHMA/KSCHMA’s openness to collaboration on maternal health. |
Pharm. Gali Sule, DG DMCSA | Focused on commodity systems and last-mile delivery. He emphasized that lifesaving MNH commodities must be sustained through reliable procurement, redistribution, DRF/Free MCH mechanisms and supply chain accountability. The discussion reinforced the need to close remaining gaps in TXA, calibrated drapes, HSC and other PPH-related commodities. |
Key Quotes and Messages from the Event
Speaker | Quote / key message |
Elizabeth Aumbur Tondu | “Models are more scalable when training, commodities, mentorship and data are treated as one integrated bundle of support from the state down to the supported facilities.” |
Elizabeth Aumbur Tondu | “A successful close-out leaves a practical operating package, not just a report.” |
Gift Iliya | “Oxytocin remains the highest and most dominant uterotonic used across all 75 facilities.” |
Mansura Yahaya Haruna | “Implementation services to sustain innovations is not only concerned with training a person but to institutionalize the training through low-dose, high-frequency training as well as continuous mentorship.” |
Dr. Rahila Mukhtar | “Clinical gaps must be matched with financial provisions if utilization status must be sustained.” |
Prof. Hadiza Galadanci | “For a project to be sustainable, there must be government ownership, collaboration and partnership.” |
Dr. Lilian Anomnachi | The meeting was described as evidence of what is possible when organizations, governments, partners and communities come together with a shared purpose. |
Dr. Ufuoma | Preventable maternal death was framed as personal and unacceptable, with a call to continue until every pregnancy is safe and every woman has access to safe delivery. |
Lessons Learned
- Co-creation and early government engagement created ownership and accelerated implementation readiness.
- Competency assessment before training helped identify real skills gaps and shaped the content of capacity-building activities.
- Onsite training was effective because it reached providers within their service environment and was reinforced by mentorship.
- Clinical mentorship improved provider confidence, PPH register quality, protocol adherence and practical problem-solving.
- Objective blood-loss measurement using calibrated drapes improved PPH detection and reduced dependence on clinical judgement alone.
- Data systems, including TAMIS, PPH registers, MSFs and Data Optimizers, improved reporting discipline and enabled evidence-based review.
- Commodity availability remains central to sustaining PPH/E-MOTIVE practice; training alone cannot improve outcomes when lifesaving commodities are unavailable.
- Sustainability requires integration into AOP, DRF/Free MCH, KACHMA/KSCHMA benefit packages, TWG platforms, MPCDSR and TEAM OB/NEO transition planning.