Mental health specialists are calling for expanded psychiatric support within maternity services, warning that perinatal mental illness remains one of the most widespread yet under-recognized complications associated with pregnancy and childbirth.

The concerns come amid growing attention to gaps in screening, specialist access and treatment pathways for women experiencing psychiatric symptoms during pregnancy and the postnatal period.

Experts in the field say many women continue to face delayed diagnosis and inconsistent care despite national guidelines recommending routine psychosocial screening during pregnancy.Edna Lekgabe, a perinatal psychiatrist and co-founder of WARM Health Collective⁠, said the scale of the issue remains poorly understood relative to other pregnancy-related complications.

“Mental illness is the number one complication of pregnancy and the postnatal period,” Lekgabe wrote in an analysis examining failures within current maternity mental healthcare systems.Perinatal mental illness refers to psychiatric conditions occurring during pregnancy or within the first year following childbirth. According to specialists and public health agencies, up to one in five women experience a diagnosable mental health condition during that period.

Conditions can include depression, anxiety disorders, post-traumatic stress disorder related to traumatic births, obsessive-compulsive symptoms involving intrusive fears about infant harm, and, in rare cases, postpartum psychosis.Medical experts classify postpartum psychosis as a psychiatric emergency because of the heightened risk of self-harm, suicide or harm to the infant if untreated.

Lekgabe described a recurring clinical pattern in which women initially report symptoms during routine antenatal care but are reassured that emotional distress, insomnia or anxiety are normal features of pregnancy.

According to her account, many patients eventually reach specialist psychiatric care only after symptoms have significantly worsened.One illustrative example described a pregnant woman experiencing severe insomnia, hopelessness and suicidal thinking during the third trimester after earlier concerns were dismissed as routine pregnancy-related stress. The psychiatrist noted the case was fictionalized but based on recurring patterns observed across hundreds of patients.

The issue has gained increasing attention internationally as healthcare systems attempt to integrate mental health more fully into maternal care frameworks. Public health researchers have repeatedly linked untreated perinatal psychiatric illness to poorer outcomes for both mothers and infants, including impaired maternal functioning, disrupted bonding and elevated long-term developmental risks for children.

Despite those risks, specialists say mental healthcare remains inconsistently integrated into maternity services.In Australia, national guidelines recommend routine psychosocial screening during pregnancy and after childbirth, with many providers using the Edinburgh Postnatal Depression Scale, a standardized questionnaire designed to identify women at risk of depression and anxiety.

Lekgabe argued, however, that screening tools alone are insufficient without accessible treatment systems behind them.

“A screening tool is only as good as the pathway behind it,” she wrote.Mental health advocates and clinicians have raised concerns that women identified as high-risk frequently encounter lengthy delays for psychiatric assessment or psychological treatment. In Australia’s public healthcare system, wait times for mental health services can extend for months, particularly outside major metropolitan areas.

The psychiatrist pointed to disparities between urban and regional care availability, noting that specialist mother-baby psychiatric units and dedicated perinatal mental health services remain concentrated in larger cities. Women dependent on public healthcare or unable to afford private treatment often face more limited access.

Organizations including PANDA (Perinatal Anxiety & Depression Australia)⁠ and Centre of Perinatal Excellence (COPE)⁠ have sought to increase public awareness and improve access to support services across Australia.

Lekgabe also identified cultural expectations surrounding motherhood as a barrier to early intervention. According to her analysis, social narratives that idealize pregnancy and early parenthood can lead women to interpret severe psychological distress as personal inadequacy rather than a treatable medical condition.

The psychiatrist referenced the growing use of the term “matrescence,” which describes the emotional and identity transition associated with becoming a mother. While acknowledging the concept’s value in normalizing emotional adjustment, Lekgabe warned against conflating ordinary stress or disorientation with clinically significant psychiatric illness.

“There is a vast difference between the disorientation of new parenthood and a major depressive episode,” she wrote.Specialists in maternal mental health have increasingly emphasized that early symptoms are often minimized both by patients themselves and by healthcare systems focused primarily on physical outcomes such as blood pressure, fetal development and obstetric complications.

Lekgabe said many women internalize the belief that struggling emotionally reflects failure as a parent rather than evidence of illness requiring treatment.“I thought I was just a bad mother,” she said patients frequently tell her.The psychiatrist argued that statement reflects systemic diagnostic failure, particularly when women interact repeatedly with healthcare providers without receiving meaningful psychiatric evaluation or referral.

Mental health professionals have advocated for a more integrated care model in which psychiatric services are embedded directly within maternity clinics and obstetric care settings. Under such systems, psychiatrists, psychologists and mental health nurses would work alongside obstetricians and midwives rather than operating through separate referral systems.

Lekgabe identified three priorities for reform: integrating mental healthcare into maternity services, expanding the number of trained perinatal psychiatrists and improving public understanding of perinatal psychiatric illness.Australia currently has relatively few psychiatrists specializing in perinatal and reproductive mental health compared with overall demand, according to clinicians in the field.

Training opportunities within the subspecialty also remain limited.The psychiatrist stressed that perinatal mental illness is highly treatable when recognized early and managed appropriately. Treatment options can include psychotherapy, medication considered safe during pregnancy, supported birth planning and coordinated postpartum care.

The fictionalized patient example described in Lekgabe’s analysis ultimately improved after receiving psychiatric medication, psychological treatment and coordinated maternity support tailored to her mental health needs.However, the psychiatrist argued that many women never receive that level of coordinated intervention.

“Not every woman who walks the path Mia walked finds that team,” Lekgabe wrote.

Mental health organizations globally have increasingly highlighted maternal suicide and severe psychiatric illness as major public health concerns linked to inadequate perinatal care systems. Several countries, including the United Kingdom and Australia, have expanded investment in specialized maternal mental health programs over the past decade, though advocates argue access remains uneven.

Lekgabe said greater public literacy around perinatal psychiatric illness could help reduce stigma and encourage earlier intervention among expectant parents and their families.

“We need expectant parents and their families to understand that perinatal mental illness is common, treatable and not a reflection of character,” she wrote.

At Jemo Health Centre on the outskirts of Addis Ababa, health worker Tewodros Tibebu says social stigma and limited awareness continue to delay access to comprehensive abortion care, despite Ethiopia legalizing broad abortion services more than two decades ago.

Tibebu, who has worked in comprehensive abortion care for four years, is among only three trained providers currently delivering the service at the facility. According to his account, many patients arrive after significant delays, often seeking help only after complications emerge from procedures carried out elsewhere.

“The biggest challenge is stigma,” Tibebu said in a feature published by the World Health Organization on May 5. “Many women are afraid someone will recognize them when they come here. Others do not even know the service exists.”Comprehensive abortion care has reportedly been available at Jemo Health Centre for nearly a decade.

However, Tibebu said access barriers remain widespread, particularly for women seeking confidential and medically supervised treatment.According to his account, many patients first visit private clinics where procedures may be carried out by practitioners lacking formal training in abortion care. By the time some women reach public facilities such as Jemo, they are already suffering from infections or sepsis that could have been prevented through earlier medical intervention.

Ethiopia expanded legal access to abortion in 2005 under revised provisions that allowed the procedure under broader circumstances than previously permitted. Despite the legal framework, health care providers and reproductive health organizations have continued to report uneven access across regions, driven by social stigma, provider shortages and gaps in public awareness.

Tibebu said the stigma surrounding abortion services affects providers as well as patients. “Some coworkers oppose the comprehensive abortion care department,” he said. “Some people in my community do not know what I do.”The social pressures attached to abortion care are a recurring issue in reproductive health systems globally, particularly in countries where legal reforms have outpaced shifts in public attitudes or health infrastructure.

Health workers often face professional isolation, ethical scrutiny and personal criticism while providing services that remain politically and culturally contested.Tibebu said professional training helped him better understand both the clinical and ethical dimensions of abortion care. “Before, it was difficult,” he said.

“After I received specific training, I understood the work differently and could provide the care women need.”The experiences described by Tibebu formed part of a broader announcement by the Human Reproduction Programme, known as HRP, regarding a new international training initiative on comprehensive abortion care.

The programme, launched through the WHO Academy platform, combines four separate learning modules focused on medical abortion, surgical abortion, post-abortion care and human rights integration in comprehensive abortion care. According to HRP, the courses are designed to provide modular and interactive learning environments that simulate real clinical decision-making scenarios encountered by frontline health workers.

WHO said the training initiative is intended to strengthen evidence-based care and improve consistency in abortion services across different health systems. The programme also places emphasis on privacy, non-discrimination and accountability within clinical practice.

The human rights integration component links medical treatment with broader principles related to patient dignity and access to care, according to WHO. Together, the courses are intended to establish a standardized framework for providers working in comprehensive abortion care settings.The launch reflects continuing international efforts by global health organizations to reduce preventable maternal complications associated with unsafe abortion procedures.

WHO has repeatedly stated in policy guidance that access to trained providers, accurate information and safe clinical environments are central to reducing maternal morbidity and mortality.At facilities such as Jemo Health Centre, providers say the gap between legal availability and practical access remains significant.

Tibebu noted that many patients learn about the service only through informal networks and word-of-mouth referrals rather than official health campaigns or referrals from primary care systems.That reliance on informal communication channels, he said, contributes to delays that can worsen medical outcomes.

The WHO feature also highlighted the operational pressures facing providers in facilities with limited staffing. With only three trained workers handling abortion care services at Jemo, workloads remain concentrated among a small number of clinicians.

Training programmes such as the one launched by HRP are intended in part to address those shortages by expanding provider knowledge and strengthening clinical capacity. WHO said the interactive nature of the courses allows health workers to engage with practical decision points similar to those encountered during patient care.

The organization has increasingly used digital and modular learning systems to expand access to specialized medical training, particularly in lower-resource health settings where formal clinical education opportunities may be limited.Tibebu said the training reinforced his understanding of abortion care not only as a technical medical service but also as direct patient support during periods of vulnerability and medical risk.

“People may not understand what we do,” he said. “But when you think about the woman in front of you, the decision is clear. You are helping someone.”WHO separately announced a webinar linked to the comprehensive abortion care learning programme scheduled for April 28, 2026.

The organization also published updated abortion-related fact sheets in December 2025 as part of its broader reproductive health guidance materials.The HRP programme operates jointly under the United Nations Development Programme, the United Nations Population Fund, the United Nations Children’s Fund, WHO and the World Bank, focusing on research, policy development and training in human reproduction and reproductive health services.

For years, she wanted a child. After a decade of waiting, hope and uncertainty, pregnancy finally arrived carrying both joy and fear in equal measure. What followed, however, was not the soft, instinctive transition into motherhood that culture often promises, but a physically traumatic birth, emotional numbness and a long struggle to recognise herself in her new life.

During pregnancy, she found herself largely alone. Her husband, though supportive and loving, was frequently absent, consumed by the demands of a startup consultancy he had recently founded with two academic partners.

Medical appointments, including an amniocentesis prompted by concerns over possible chromosomal abnormalities, were often faced without him because he was abroad for work.

She attended prenatal classes, but support systems felt limited. Only one person in her close circle had children, and her relationship with her own mother, who lived in Italy, was strained. The isolation deepened her anxiety, particularly because childbirth itself frightened her.

When she raised those fears with her general practitioner, she recalls receiving a familiar reassurance that did little to ease them.“Don’t worry, birth isn’t an illness,” her male GP told her. “It’s all perfectly natural.”She felt the dismissal ignored her lived reality. She was asthmatic and suffering from undiagnosed endometriosis that caused severe pain every few weeks.

Pregnancy did not feel simple or natural. It felt uncertain and medically significant.Still, she felt deeply connected to the child growing inside her. She recognised her daughter through movement alone—the shape of limbs pressing against skin, strong kicks in response to passing sirens, a physical presence both strange and intimate.

She imagined a temperament already forming: long legs like her father, a temper like her own.She expected love to be immediate. After waiting so long, how could it not be?Her due date passed. Then another week.

Then another. At more than 44 weeks pregnant, she says she had to insist repeatedly before her GP agreed to induction. Only when hospital monitoring showed signs of fetal distress did medical staff finally intervene and break her waters.

Labour lasted 20 hours.

She describes induced labour not as a gradual progression but as a sudden collapse into nausea, pain and exhaustion. Hours passed with no progress. She was unable to receive an epidural at first because she was not dilating. The pain became all-consuming.

At one point, fearing the worst, she asked her husband to make a promise: if doctors had to choose between saving her life and their child’s, he should choose the baby.“I am not going to lose either of you,” he replied.

She remembers University College Hospital at the time as a place that inspired little confidence—a crumbling Victorian building with filthy bathrooms, blood on the floors and junior doctors exhausted by punishing shifts. Around her, the maternity ward echoed with the sounds of women in labour: groans, cries, gasps and fear.Eventually she received an epidural, but the baby remained stuck.

Just before midnight, an emergency forceps delivery and episiotomy were performed. Her husband later told her there were 13 people in the room.Then their daughter arrived.She weighed just under 4.5 kilograms—almost 10 pounds.

The mother had lost so much blood that the experience felt, in her words, like surviving a car crash. Her husband, standing in blood-soaked jeans, was overwhelmed with joy.“Isn’t she wonderful?” he said.She felt nothing.

She describes the absence of emotion not as rejection, but as total numbness, as though the epidural that had numbed her body had also severed access to feeling. She spent the night awake in the recovery ward waiting for the expected rush of maternal love that never came, listening to other women crying as anaesthesia wore off.

Instead, she felt transported back to boarding school dormitories, where she had learned early to suppress everything except anger.“Rage has served me quite often as a stimulant against exhaustion,” she writes. “Every woman who goes through childbirth has, I believe, been through the equivalent of war.

”She compares childbirth to trauma rather than celebration, arguing that many women leave the experience carrying symptoms closer to post-traumatic stress than to joy.

She believes poor maternity care intensified that reality.Her experience took place during years of severe strain on Britain’s National Health Service, when long-term underfunding and overstretched staff affected standards of care.

But she also sees a broader cultural issue: motherhood itself, she argues, is often insufficiently respected.At the time, general practice and obstetrics were still dominated by men.

She does not argue that male doctors cannot provide excellent care, but believes many failed to understand how dangerous childbirth could still be, or how often women’s pain was normalised rather than addressed.She was discharged the next day after a blood transfusion and severe physical trauma. She could barely walk.

Her husband worried about her physical recovery, but neither of them recognised the mental damage taking shape beneath it.When the baby began crying—night after night, almost without pause motherhood became a contest between exhaustion and fury.

“Once our baby began to cry relentlessly every night, all night, it felt like a battle between my rage and hers,” she recalls.Then one day, something changed.Her daughter, whose eyes had until then seemed distant and unfocused, suddenly looked directly at her. Then came a smile—clear, unmistakable and full.It was not simply recognition. It felt like acceptance.

“She seemed not only to recognise me, but to greet me with unconditional love and delight,” she writes.She understood intellectually that infant smiles are biological survival mechanisms, but the emotional impact was overwhelming.

The joy felt so sharp it was almost painful.“Oh!” she remembers saying. “It’s you. It’s you.”That first smile altered everything.The sleepless nights did not disappear. The crying continued. But something fundamental shifted in her understanding of motherhood, of love and even of her own mother.

Her relationship with her mother, long marked by pain and distance, softened. She began to understand her mother’s own unresolved grief and emotional absences not simply as cruelty, but as the result of childhood bereavement and wounds never healed.Motherhood brought not only responsibility, but perspective.

As a writer, she found that literature had offered little preparation for the reality of childbirth. Victorian novels she loved moved quickly past pregnancy and motherhood, treating them as narrative transitions rather than lived experiences.

Even contemporary women writers often avoided describing the devastation of birth itself.When she included the physical brutality of childbirth in her 1996 novel A Vicious Circle, critics attacked what one reviewer called “revolting details.”

Yet she says she had still softened the truth, giving her fictional heroine an instant maternal bond she herself had not felt.Years later, much changed. Hospitals improved. Her GP practice became staffed by younger, mostly women doctors. She had a second child, a son, whose birth was entirely different and with whom she bonded immediately.

Her daughter, Leon, grew into a novelist herself—healthy, loving and brilliant.Looking back, she says motherhood brought both unimaginable suffering and extraordinary love.

Public conversation often reduces it to either sentimental joy or unbearable hardship. The truth, she argues, is both.And if the early days felt like darkness, what remained was not the trauma alone, but the light that followed.

The UNICEF Executive Board concluded its first regular session of 2026 with a warning that decades of progress in child survival could be reversed as funding constraints, conflict and systemic pressures weaken global health systems, according to statements delivered during the meeting.

The two-and-a-half day session reviewed a range of institutional priorities, including implementation of the United Nations’ UN80 reform initiative, UNICEF’s global evaluation plan for 2026–2029, and updates on the work of national committees engaged in fundraising and youth outreach. Financial oversight, programme delivery and governance issues were also examined as part of the Board’s agenda.

A central focus of the session was child health, highlighted during discussions on eight newly approved country programme documents covering Argentina, Cuba, Georgia, Malaysia, Mexico, Somalia, South Africa and Sudan. Board members and senior officials framed investment in primary healthcare as critical not only to survival outcomes but to broader human development and social stability.

Opening the session, Rein Tammsaar, President of the Board and Estonia’s Permanent Representative to the United Nations, emphasized inclusive governance as a priority for 2026. He also pointed to the potential role of artificial intelligence in expanding access to and improving the quality of education.

Tammsaar acknowledged UNICEF personnel working in high-risk environments, stating that their operational commitment underpins the organization’s credibility.In her introductory remarks, Catherine Russell cautioned that progress in reducing child mortality could stall for the first time in three decades.

She identified child and maternal health as core priorities and cited the establishment of a global Centre of Excellence in Nairobi aimed at strengthening technical capacity in health, nutrition and water, sanitation and hygiene services.Senior officials presented evidence of significant global gains, including a reduction in annual under-five deaths to below 5 million and an estimated 4.2 million child deaths prevented annually through immunization.

Maternal mortality has declined by roughly one third since 2000. However, speakers stressed that these achievements remain fragile.Douglas Noble, Associate Director of Health, said abrupt reductions in development funding are disrupting essential services and exposing structural weaknesses in health systems. He added that misinformation is undermining vaccine confidence, while conflict, climate-related shocks and economic instability are increasing displacement and limiting access to care.

Noble stated that survival alone is no longer an adequate benchmark for child development, arguing for integrated approaches that include mental health, psychosocial support and adolescent well-being alongside physical health services. He urged governments to prioritize primary healthcare in national budgets, protect health spending during fiscal pressures and invest in community-level health workers.

Panel discussions reflected concerns that setbacks are not confined to low-income countries. Participants noted declining vaccination rates in Argentina and signs of reversal in child survival indicators in South Africa. Rising mental health challenges among adolescents, including increased suicidal behaviour in Malaysia, were also highlighted.

Speakers from governments, international organizations, academia and civil society reiterated that access to healthcare should not be treated as a privilege. They stressed the need for age-appropriate services that address both communicable and noncommunicable conditions, supported by integrated systems spanning health, education and social protection.

Testimony from field representatives underscored the impact of conflict on health infrastructure. Ayoub Ibrahim Arabi Mohammed described conditions in Sudan, where ongoing violence has displaced populations and disrupted medical services. He reported shortages of fuel, medicine and basic supplies in hospitals, while some clinics have ceased operations entirely, leaving families without access to care.

He emphasized the role of frontline health workers as critical to sustaining services in conflict settings and called for their protection. He also warned that children are dying due to the inability of healthcare systems to function effectively under prolonged instability.Across discussions, a consistent theme emerged that sustaining progress in child survival requires resilient primary healthcare systems capable of withstanding external shocks.

UNICEF outlined key policy areas for governments, including strengthening primary care, restoring trust in immunization programmes, addressing underlying determinants such as malnutrition and sanitation, and integrating mental health and noncommunicable disease responses into health strategies.

Mental health featured prominently in the session, with officials noting that one in seven adolescents aged 10 to 19 is living with a mental health condition. Data presented indicated that one in four children has a caregiver experiencing mental health challenges, highlighting broader social implications.

Officials also cited global estimates suggesting that a young person dies by suicide every 11 minutes, underscoring the scale of the issue.Meylan Alejandra Ramos Espejel, speaking on behalf of young people, linked mental health challenges to wider global pressures including migration, conflict and climate-related disruptions.

She called for greater inclusion of youth perspectives in policymaking and emphasized the need for tangible support mechanisms.Noncommunicable diseases were identified as another growing concern, affecting more than 2 billion individuals under the age of 20 through direct conditions or exposure to risk factors.

Officials noted that these diseases disproportionately affect children in lower-income settings, challenging the perception that they are confined to wealthier populations.The Board also reviewed progress on international policy commitments.

A political declaration adopted by heads of state in September 2025 on noncommunicable diseases and mental health was cited as a milestone, with references to children and youth included multiple times, reflecting increased global attention to these issues.Despite broad agreement on key priorities, the Board did not reach consensus on all agenda items, with some decisions requiring formal votes.

By the end of the session, seven decisions were adopted, covering areas including governance, financial oversight, evaluation frameworks and fundraising strategies.The Board approved eight country programmes and extended a subregional programme for the Gulf Area.

These programmes are intended to guide interventions across sectors including health, education, nutrition and child protection, reflecting an integrated approach to humanitarian and development challenges.In closing remarks, Russell said the approved programmes provide operational frameworks for delivering measurable outcomes, while acknowledging the absence of consensus on certain items.

Tammsaar expressed concern over divisions within the Board, stating that consensus-based decisions strengthen institutional unity and effectiveness.The next annual session of the Executive Board is scheduled to take place from June 16 to 19, 2026.

Sixteen-day-old Shiman was born inside a roadside tent to her mother, Haifa Kenjo, who had fled the southern suburbs of the capital as bombardments intensified. The family escaped with no belongings, leaving behind their home and savings amid the destruction.

Now living under a tarp secured with rocks near central Beirut, the family faces harsh conditions marked by damp bedding, insects and limited access to food and medical care. Kenjo said she had intended to give birth in a hospital but was unable to afford the costs after their home and their savings were destroyed in an airstrike.

According to the United Nations Population Fund, around 13,500 pregnant women are among those displaced in Lebanon, with more than 1,500 expected to give birth in the coming month, many without adequate maternal care.

When Kenjo went into labor on March 28, the family initially sought hospital treatment but could not raise the approximately $500 required for delivery. She returned to the tent, where a midwife assisted the birth under unsanitary conditions, using bottled water amid rain and mud.

The infant is showing signs of distress, including coughing and weakness, while access to infant formula remains limited. Kenjo said she has been unable to breastfeed, and the cost of formula exceeds her husband’s daily earnings.

Humanitarian volunteers have provided small quantities of aid, but supplies remain insufficient, reflecting broader shortages in displacement camps across the city.

The conflict, which has triggered mass displacement and strained Lebanon’s already fragile infrastructure, continues to disrupt access to essential services, leaving vulnerable populations including newborns and pregnant women at heightened risk.

Zuwaira Hanafi stood outside a healthcare facility in Kaita, in Nigeria’s northern Katsina state, as medical staff hurried into a ward where her eight-month-old daughter lay semiconscious, underscoring the urgency confronting health workers in a region grappling with rising levels of severe malnutrition.

At the entrance, clinicians used colour-coded measuring tapes to assess the mid-upper arm circumference of children, a standard method for diagnosing malnutrition.

A steady flow of mothers, including teenagers, arrived with infants in critical condition, reflecting what humanitarian agencies describe as a deepening hunger crisis affecting large parts of the country.The International Federation of Red Cross and Red Crescent Societies has warned that as many as 33 million Nigerians could face severe hunger in 2026, a record level.

Data from the United Nations Office for the Coordination of Humanitarian Affairs indicates that approximately 6.4 million children in Nigeria are expected to be acutely malnourished by the end of the year, with the burden concentrated in northern regions such as Katsina.

Dr Soma Bahonan, head of the Nigeria mission for the Alliance for International Medical Action (Alima), which operates the Kaita facility in partnership with local authorities, said the crisis is expanding beyond children. Increasing numbers of mothers are also presenting with acute malnutrition, compounding the risks to infant health and survival.

Alima has expanded its operations to include mobile clinics designed to reach remote populations unable to travel to fixed facilities. These services include transport support for critical cases from surrounding communities.

However, Bahonan described the scale of need as exceeding operational capacity, particularly in Katsina, which has become a focal point of what aid workers describe as an intergenerational hunger crisis.Longstanding drivers of food insecurity, including climate variability and structural governance challenges, have been intensified by rising insecurity.

Attacks by jihadist groups and other non-state actors have disrupted farming activities and restricted access to agricultural land, further weakening household food production and income stability.The strain on the healthcare system is evident in workforce shortages. Nigeria’s doctor-to-patient ratio is estimated at roughly 1:9,000, significantly below the World Health Organization’s recommended ratio of 1:600.

Medical professionals continue to leave the country, citing delayed salary payments and limited career prospects, further reducing service capacity in already underserved areas.While digital health startups and private-sector partnerships have made progress in urban centres such as Lagos and Abuja, their reach remains limited in rural and conflict-affected regions due to infrastructure deficits and high inflation.

This uneven distribution of innovation has widened disparities in healthcare access.Analysts describe Nigeria’s current situation as a convergence of multiple crises. Joachim MacEbong, a senior analyst at Control Risks in Lagos, said the country faces overlapping economic, security, and human development challenges that reinforce one another.

He noted that these interconnected pressures are contributing to deteriorating health outcomes and weakening institutional response capacity.Humanitarian organisations have begun planning for the annual lean season, typically spanning June to September, when food stocks decline and malnutrition rates tend to rise.

The period is expected to place additional stress on already constrained health and nutrition services.Policy interventions have been introduced, though their impact remains uncertain.

In 2025, the Nigerian government partnered with the World Bank to implement the Accelerating Nutrition Results in Nigeria project, aimed at delivering basic nutrition services to vulnerable households.

A second phase of the programme is currently under way, but experts say broader structural reforms are required to improve food affordability and strengthen social protection systems.Supply chain inefficiencies continue to limit access to essential medicines and equipment.

Peter Bunor Jr, co-founder and head of growth at Field Intelligence, a health technology company focused on pharmaceutical logistics in Africa, said disruptions in global and domestic supply chains are contributing to shortages at the point of care.

Patients often travel long distances only to find that prescribed drugs are unavailable or replaced with alternatives, frequently at higher cost.Bunor said the impact of these shortages is amplified during a hunger crisis, as malnourished individuals are more susceptible to infections and require timely medical intervention.

He emphasised the need for better data integration and forecasting to prevent stockouts.In 2018, Field Intelligence launched the Nigeria Health Logistics Management Information System, a platform designed to track pharmaceutical supply data across public health programmes.

The system, now managed by the federal health ministry, has been expanded with support from UNICEF, and stakeholders are encouraging wider adoption among health agencies to improve coordination and anticipate shortages.Funding constraints remain a central concern.

Nigeria allocated approximately 5.2% of its 47.9 trillion naira national budget to the health sector, well below the 15% target set under the Abuja Declaration by African Union member states. Per capita health spending remains among the lowest on the continent.

In February, Health Minister Muhammad Ali Pate disclosed that of the 218 billion naira allocated for operations and capital projects under the ministry, only 36 million naira had been released. The figure, representing a small fraction of the approved budget, has raised concerns about implementation capacity and fiscal prioritisation.

MacEbong said the funding gap illustrates broader structural challenges in public finance management, noting that limited budget execution undermines service delivery even where allocations exist. He added that the scale of the crisis requires sustained government attention, particularly in sectors directly linked to human capital development.

Aid organisations continue to call for increased domestic investment in health and nutrition, alongside improved coordination with international partners.

As conditions in northern Nigeria worsen, frontline health workers face mounting pressure to manage a growing caseload with limited resources, highlighting systemic vulnerabilities in one of Africa’s largest economies.

Speaking at a Reuters Newsmaker event in New York, Gates said the world was at a crossroads, with millions of children at risk of dying if funding drops too steeply.

The Gates Foundation’s pledge matches its donation in 2022. That was the last time the Global Fund, a Geneva-based independent nonprofit, raised money on its three-year budget cycle. The announcement follows deep aid cuts from governments around the world, led by the United States.

“A kid born in northern Nigeria has a 15% chance of dying before the age of 5. You can either be part of improving that or act like that doesn’t matter,” Gates said in an interview before the foundation’s annual Goalkeepers event in New York on Monday.

The event celebrates and seeks to accelerate progress on United Nations global development goals set for 2030, including improving health and ending poverty.

“I am not capable of making up what the government cuts, and I don’t want to create an illusion of that,” he said about his pledge.

The Gates Foundation, the philanthropy started by the Microsoft co-founder and his then-wife in 2000, is one of the world’s biggest funders of global health initiatives, with a particular focus on ending preventable deaths of mothers and babies, tackling infectious diseases and lifting millions out of poverty.

Earlier this year, Gates pledged to give away almost his entire $200 billion fortune by 2045, more quickly than planned because of the urgent need worldwide.

Millions More Could Be Saved

According to the U.S.-based Institute for Health Metrics and Evaluation, global development assistance fell by 21% between 2024 and 2025 and is now at a 15-year low.

That could still change, said Gates, with organizations like the Global Fund trying to raise money before the end of the year. But if the trajectory remains the same, progress that cut child mortality in half since 2000, saving 5 million lives a year, could be in jeopardy, he said in a statement.

Gates said that there was still an opportunity to save millions of lives and end some of the deadliest childhood diseases by the time he will have donated the rest of his fortune in 2045.

That would require maintaining funding for institutions like the Global Fund as well as Gavi, the Vaccine Alliance, prioritizing primary healthcare and rolling out innovations – such as the long-acting HIV prevention drug lenacapavir – quickly.

“What’s happening to the health of the world’s children is worse than most people realize, but our long-term prospects are better than most people can imagine,” Gates said in a statement.

At the Goalkeepers event, the foundation gave Spanish Prime Minister Pedro Sánchez its annual Global Goalkeeper Award. While other countries reduced global health support, Spain increased its donations to the Global Fund this year by 12% and Gavi by 30%.

The Goalkeepers event usually involves publication of a progress report on the U.N. sustainable development goals, originally adopted in 2015. But that has been delayed until an event in Abu Dhabi in December, when global health funding will be clearer, the foundation said.