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When Ummi Suleiman went into labour in northeastern Nigeria, her newborn arrived motionless and silent. For a few terrifying moments, there was no sign of breathing. Health workers immediately stepped in. Using equipment and skills gained through the Safer Births Bundle of Care (SBBC) programme, they began resuscitation. Moments later, the baby took its first breath and cried.
"I am overjoyed and deeply grateful that my baby is alive today," says Ummi.
Across Borno State, stories like hers are becoming increasingly common.
That matters in a country where maternal mortality remains one of the world's biggest health challenges.
"Maternal mortality is a big problem in Nigeria, and every eight minutes a woman dies while giving birth," says Prof. Baba Mallam Gana, Honourable Commissioner for Health and Human Services in Borno State.
"The Safer Births Bundle of Care began with a simple but urgent realisation: we could no longer accept preventable maternal and newborn deaths as inevitable."
The Safer Births Bundle of Care was developed over more than a decade at Haydom Lutheran Hospital in Tanzania. Supported by Norwegian Church Aid, Haydom Lutheran Hospital, Laerdal Global Health, the Federal Ministry of Health and health authorities in Borno State, the model was adapted and introduced in Nigeria.
The programme combines simulation-based training, mentoring and practical technologies that help health workers recognise danger signs early and respond quickly when complications arise.
"In a fragile, post-conflict setting like Borno, improving access alone is not enough," says Dr. Mohammed Jamiu Sule, Technical Advisor to the Honourable Commissioner for Health and Human Services.
"The real shift comes from strengthening the quality of care at the facility level."
The Safer Births Bundle of Care was developed over more than a decade at Haydom Lutheran Hospital in Tanzania. Supported by Norwegian Church Aid, Haydom Lutheran Hospital, Laerdal Global Health, the Federal Ministry of Health and health authorities in Borno State, the model was adapted and introduced in Nigeria, thanks to funding from Norad.
Before the programme began, data from four health facilities in Maiduguri painted a worrying picture.
Over a 12-month period, the facilities recorded more than 7,000 births, including 176 stillbirths and 36 maternal deaths. Two-thirds of the stillbirths occurred during labour, indicating that many might have been prevented through earlier detection and intervention.
The assessment also revealed major gaps in monitoring and newborn care. Across the 7,000 deliveries, only one abnormal fetal heart rate had been documented.
Health workers were often making life-and-death decisions without the tools, systems or training needed to respond effectively.
Just over a year after implementation began, the results have exceeded expectations.
The original targets were ambitious: to reduce maternal deaths by 30 per cent, stillbirths by 20 per cent and early neonatal deaths by 45 per cent.
The results have far exceeded this.
Across participating facilities and more than 5,546 deliveries:
Moyo fetal heart rate monitoring is now used in 89 per cent of deliveries and NeoBeat monitoring is used in 99 per cent of newborn resuscitation cases.
"When we saw babies surviving, we knew it was working," says Professor Abubakar Ali Kulima, Chief Medical Director of the Borno State Hospital Management Board.
The numbers are impressive, and behind every percentage point is a mother, a baby and a family whose lives have been changed.
For Ummi, that meant hearing her baby cry after fearing the worst.
For Zara Mohammed, it meant seeing her newborn survive after being born without breathing.
"My baby was born without breathing, but with the skill of the midwife and the SBBC equipment, I can now see my baby breathe," she says.
Health workers have also seen the difference.
"Being a mentor of SBBC has changed how I care for mothers and babies," says Abigail Anthony, a midwife and SBBC mentor at Mallakachalla PHC.
"I now approach every delivery with more confidence, and I've seen more babies survive and mothers leave the facility with relief and joy."
For nurse Kaka Mercy, the technology has transformed how healthcare workers respond in critical moments.
"Years back, when a baby was born and wasn't crying or breathing, we often assumed the worst," she says. "Now, with NeoBeat, we can detect even the faintest heartbeat. It gives us hope and a real chance to revive the baby."
The success of the programme has sparked growing interest in expanding the approach to more facilities across Borno State and beyond.
"We have seen a real reduction in newborn deaths in these pilot facilities. This has given us the confidence to expand the approach across the entire state," says Professor Kulima.
The results from Borno State show that even in some of the most challenging settings, preventable maternal and newborn deaths can be reduced.
Through strong partnerships between health authorities, healthcare workers, researchers and organisations like Norwegian Church Aid, one thing is becoming increasingly clear: even in some of the most challenging settings, preventable maternal and newborn deaths can be reduced.
Because every mother deserves a safe delivery.
And every newborn deserves the chance to take that first breath.
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