Hadiza Shehu Galadanci

In 2020, for every 100,000 Nigerian women who gave birth, about 1,000 did not survive, according to the World Health Organization (WHO). Dr. Hadiza Galadanci, a professor of obstetrics and gynecology at Nigeria’s Bayero University, knows that problem all too well. Over the more than 20 years she’s practiced as an ob-gyn, she has seen numerous “women dying from conditions when we know what causes them and we know how to treat them.” Often, she wondered, “‘Why is it that we can’t address maternal mortality?’” 

Galadanci decided she would be the one to step up. Over the past few years, Galadanci, who is also the director of the Africa Center of Excellence for Population Health and Policy, has worked with a network of collaborators in other countries to implement and study a simple yet effective system for preventing fatal postpartum hemorrhages, one of the leading causes of maternal mortality. 

First, doctors place a blood-collection drape under a birthing mother, so they can track exactly how much blood she has lost during delivery. (Often, it’s difficult for doctors to assess how much blood the mother has lost.) If the blood pooled in the drape passes a certain level, physicians provide a simultaneous “bundle” of treatments—including uterine massage, medications, and intravenous fluids—rather than trying them one at a time, which can take too long. If the suite of interventions doesn’t work, they move quickly to the operating room.

A 2023 New England Journal of Medicine study found that this intervention, compared to standard care, led to a 60% lower risk of serious complications, including severe blood loss and hemorrhages resulting in surgery or death. Only six months after the study was published, the WHO used it as grounds for updating its childbirth guidelines—lightning fast in the bureaucratic world of global health. It will take a long time to see how the approach affects global maternal-mortality rates, but Galadanci is already seeing change on the local level. “I get to facilities where [they’re using this system] and they’re telling me they haven’t seen any women dying of [postpartum hemorrhage] since they started,” she says. “That’s enough satisfaction that it is working.” 

Already, Galadanci is working toward solutions for other common causes of maternal mortality, including seizures that occur late in a person’s pregnancy or shortly after birth, known as eclampsia. To prevent or treat eclampsia, doctors sometimes give an at-risk expectant mother multiple injections of magnesium sulfate. Galadanci’s team has partnered with WHO to study whether a smaller number of injections proves equally effective, since this approach would be faster, more affordable, and more accessible. She expects data collection to wrap up this spring—and if the results are good, the approach could shortly become part of standard medical practice.