AEARI – Accelerating the Expanded Adoption of RMNCH Innovations and Health Reforms
The Challenge
Nigeria continues to carry one of the highest burdens of maternal and newborn mortality globally. Postpartum haemorrhage, infections, pre-eclampsia, and complications during childbirth remain leading causes of preventable maternal deaths. In Kano State, gaps in skilled birth attendance, postnatal care, health worker competency, and access to quality emergency obstetric care continue to affect outcomes for mothers and newborns alike.
Baseline assessments conducted across 168 health facilities at the start of the programme revealed critical service delivery and competency gaps, even in facilities already providing maternal and newborn care. Only 24% of Skilled Birth Attendants and 12% of Maternal and Child Health coordinators demonstrated strong clinical competency during assessments, reinforcing the urgent need for practical retraining, mentoring, and sustained quality improvement support.
Why Kano state?
With a population of over 15 million and a primary healthcare system serving some of Nigeria’s highest-risk communities, Kano State represents both a critical challenge and a significant opportunity. Strengthening MNH service quality at primary care level in Kano has the potential to drive measurable reductions in preventable maternal and newborn deaths at scale.
- 18 LGAs, Kano State
- Status: April 2024 - Ongoing
- Gates Foundation / TAConnect
- WCAHealth Options
- 18 LGAs, Kano State
- Status: April 2024 - Ongoing
- Gates Foundation / TAConnect
- WCAHealth Options
Our Approach
AEARI uses a government-led health system strengthening approach focused on scaling proven maternal and newborn health innovations, improving service delivery quality, and strengthening data-driven decision-making across health facilities. Implemented by WCAHealth Options with support from the Gates Foundation through TAConnect, the programme works closely with the Kano State Ministry of Health, Primary Health Care Management Board, and key RMNCAH stakeholders to improve the quality, availability, and uptake of maternal and newborn health services across the continuum of care.
Adopt and Scale MNH Innovations
Supporting Kano State to systematically adopt and scale evidence-based innovations along the full continuum of maternal and newborn care, from antenatal and intrapartum care through postnatal and newborn management.
Strengthen Service Delivery Quality
Through facility-based training, structured mentorship, and real-time data feedback, improving the quality and coverage of high-impact RMNCAH+N interventions at both facility and community levels, with a focus on primary health care.
Embed in Government Systems
Working directly with state and LGA health teams, adolescent health focal persons, PHC coordinators, and community leadership structures to strengthen local ownership, embed the programme in government systems, and ensure long-term sustainability.
Programme supports
Adoption and scale-up of evidence-based MNH interventions
Competency-based training and mentoring for frontline health workers
Strengthening of postpartum haemorrhage (PPH) prevention and management
Facility readiness and commodity availability
Data optimisation and quality improvement systems
Integration of innovations into government planning, financing, and service delivery structures
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Programme Delivery Pathway
A structured approach that ensures every programme is planned, delivered, and evaluated for maximum impact.
Assess
Train
Mentor
Use Data
Scale
Improving Quality of Maternal Care
AEARI has strengthened the implementation of the PPH Bundle of Care (E-MOTIVE approach) across supported facilities, improving early detection and treatment of postpartum haemorrhage. The programme generated the first systematic clinical outcome data from MAMII-aligned Kano State primary health facilities, tracked through the TAConnect TAMIS data system.
Of the 380 women treated for PPH across the 75 supported facilities between January and April 2026, between 67% and 74% received full bundled care in any given month, a significant achievement given that this represents a new clinical standard for Kano’s primary healthcare system. Bundled care outcomes showed near-zero case fatality, in stark contrast to the much higher risk associated with isolated, unbundled interventions. Hundreds of women with PPH were successfully treated and discharged following intervention support across programme facilities.
The programme also supported:
- Distribution of life-saving MNH commodities and calibrated drapes to supported facilities
- Deployment of 35 MamaNatalie obstetric simulation mannequins and 35 procedure tables to 28 hub-supported sites
- Integration of calibrated drapes into the Kano DMCSA procurement dashboard, strengthening supply chain visibility
- Strengthening of supply chain planning and coordination with NPHCDA and AXMED
Key Results and Achievements
168
Facilities assessed at baseline
75
MAMII-aligned sites supported
18
LGAs Full state coverage achieved
242
Skilled birth attendants trained
30
Master trainers prepared
50
MCH coordinators trained
37
Clinical mentors deployed
242
Skilled birth attendants trained