Foreign Perspectives on The Southerner Newspaper 

Wednesday, December 10, 2025

“No data, no problem. No problem, no funding. No funding, no solution.”

This maxim has haunted me for years — not because I don’t believe in goodwill, but because I have seen what happens when problems slip into invisibility. In many developing countries, especially across Africa, weak or nonexistent data collection systems allow tragedies to remain uncounted. And when tragedy is uncounted, it becomes unremarkable: no headlines, no urgency, no mobilization of funds, no accountability — and no change.

In contrast, governments and institutions in developed nations invest heavily not only in health services, but in data systems — because they understand that data is the foundation of priority setting, funding, and lives saved. If data is the new money, then health data is perhaps the most precious currency of all.

Below, I present a comparative and evidence-based analysis of maternal and infant mortality globally, regionally (Africa), in developed settings (U.S. / Europe), and in my beloved Nigeria — paired with a reflection on funding commitments such as those under the Abuja Declaration. I write this not only to inform — but to compel.

Global Progress — But Progress Uneven*

According to the most recent estimates from the United Nations Maternal Mortality Estimation Inter‑Agency Group (MMEIG), the world’s maternal mortality ratio (MMR) fell from 328 deaths per 100,000 live births in 2000 to 197 per 100,000 in 2023 — a reduction of about 40%. Yet even with that success, the global number remains horrifying: in 2023 around 260,000 women died from pregnancy- or childbirth-related causes — roughly one woman every two minutes.

This progress, though significant, obscures a harsh truth: global averages mask stark inequalities. Many regions have seen rapid improvements — others hardly at all. Because of limitations in data collection, estimating infant mortality globally remains more challenging; but linked indicators — neonatal deaths, under-five mortality — show that millions of newborns and young children still die each year, disproportionately so in poor countries with fragile health systems.

In short: yes, the world is safer in childbirth than two decades ago. But for many,especially in developing countries, it remains highly risky and often life threatening.

Developed World — Low Mortality, High Data, Strong Systems*

Take the case of the United States. In 2023, official data show 18.6 maternal deaths per 100,000 live births.

This is far below the global average — and dramatically lower than the rates in high-burden countries. Still, the U.S. is often cited as underperforming compared to peer high-income nations: some evidence briefs show 22 per 100,000 in 2022, a rate many see as unacceptably high for a wealthy country.

Why the difference from high-burden countries? Because in systems like those in the U.S. (and many European nations), nearly all births are attended by skilled professionals; vital registration systems, maternal care, postnatal follow-up, intensive neonatal care, emergency obstetric care — all are widely available. Data is comprehensive, reliable, and timely. Outcomes reflect that.

This contrast underscores an important point: maternal and infant safety is not merely about biology or geography — it is about policy, investment, infrastructure, and above all, data.

Africa & Sub-Saharan Africa — Heavy Burden, Fragile Systems*

The burden remains heaviest in Africa. According to the most recent global estimates, low- and lower-middle income countries — many of them in Africa — accounted for the vast majority of maternal deaths in 2023.

Indeed, as recently as 2025, commentators noted that nearly 70% of all maternal deaths globally occurred in Sub-Saharan Africa.

Despite modest progress over the decades, the pace remains slow, and many African countries — due to weak data systems, underinvestment, and fragile health infrastructure — remain far behind global averages. Vital registration, hospital births, skilled birth attendance, newborn care — all are inconsistent or missing. As a result, many deaths go unrecorded, uncounted, and unaddressed.

In effect: lack of data does not mean lack of problems. It often means problems continue unseen.

Nigeria — The giant in crisis

Nothing exemplifies the tragic intersection of population growth, weak systems, and underinvestment more than the situation in my home country, Nigeria. With over 220 million people and one of the highest birth rates globally, Nigeria is often called the “Giant of Africa.” Yet for maternal and infant health, that giant remains crippled.

Recent reports estimate Nigeria’s maternal mortality ratio at 1,047 per 100,000 live births — among the highest in the world.

One global report suggests that Nigeria alone may account for over one-quarter of all global maternal deaths.

Infant and under-five mortality remain unacceptably high. According to data from the national health profile, over the past five years the infant mortality rate has hovered (though high) — and under-five mortality remains alarmingly elevated.

The facts are stark: for a country with Nigeria’s potential — demographically, culturally, and economically — these numbers are not just statistics. They are avoidable tragedies, livelihoods lost, futures cut short.

Funding & the Abuja declaration — Promise vs Reality

In April 2001, African leaders signed the Abuja Declaration, pledging to commit at least 15% of their national budgets to health. The aim: to build resilient health systems, strengthen maternal and child health, expand access to care, and — crucially — invest in data, monitoring, and reporting.

Had this pledge been honored fully and consistently, the lives of millions could have been transformed. With stable funding comes skilled birth attendants, functioning facilities, emergency obstetric care, neonatal units, postnatal and antenatal care — and the data systems to monitor and guide action.

Yet more than two decades later, for many countries — Nigeria among them — the 15% target remains unmet or intermittently met. Underfunding, weak political will, corruption, competing priorities, and systemic inefficiencies have all undermined the promise. The result: weak health systems, patchy data, high mortality. In essence — broken promises, unmeasured suffering.

Why This Matters — And what must change

• Documentation — not denial. Weak data systems allow suffering to remain invisible. When maternal and infant deaths are not recorded, they become statistics we ignore — tragedies we forget. By strengthening data collection, reporting, and transparency, Nigeria (and other high-burden countries) can begin to hold systems accountable, allocate resources correctly, and monitor progress.

• Invest like you mean it

The Abuja Declaration was more than symbolic. It was a commitment to life. Nigeria must recommit — not in words, but in budgets. Health funding must be prioritized, sustained, and shielded from political whim.

• Build resilient health infrastructure

Maternal and newborn survival requires more than midwives — it requires functional hospitals, emergency obstetric care, reliable supply chains, neonatal care, postnatal support, and community health systems that reach rural areas. That demands investment, planning, accountability.

• Use data for equity

Data doesn’t just show how many die. It reveals where they die — which states, which communities, which socioeconomic groups. That reveals inequities. And inequities demand targeted responses: more resources, prioritized services, community outreach, education.

A call to conscience and action

We — Nigerians, Africans, global citizens — must ask ourselves: do we accept that every day, mothers and babies die because of poverty, neglect, and silence?

I refuse to accept that. I write this because I believe that lives — data points — are sacred. Each number represents a mother, a newborn, a family, a future. And each lost life weakens our nation, erodes our potential, shatters our humanity.

We must rebuild our moral and ethical compass. We must renew our commitment to health, justice, equity. We must demand data, demand transparency, demand funding. Because data is not just numbers. Data are lives.

As I have long said: No data, no problem. No problem, no funding. No funding, no solution.