The BORN Study: Better Obstetrics in Rural Nigeria

Nigerian midwife

photo by DFID - UK Department for
International Development/

Maternal and infant mortality is an enormous problem in Nigeria, Africa's most populous country. More than 250,000 infants die in Nigeria each year, and the country accounts for almost 15 percent of maternal deaths across the globe.

Rural areas are especially at risk. Recent figures suggest that about one out of every 120 births in rural Nigeria results in maternal death, compared to about one out of every 285 births in urban areas.

In response to this troubling issue, the Nigerian government created the Midwives Service Scheme (MSS). The MSS set an ambitious goal to double the proportion of deliveries attended to by skilled birth attendants and to lower maternal and infant mortality in target areas by 60 percent by December 2015.

After it had been operational for a few years, RAND's BORN Study examined what impact the MSS had on:

  • access to emergency obstetric care
  • use of skilled birth attendants
  • maternal and child health.

Featured Publications

  • Evaluating Nigeria's Efforts to Improve Maternal and Child Health

    Sep 15, 2015

    Nigeria is the world's second-largest contributor to under-five and maternal mortality. To address low rates of use of maternal and child health services, the government deployed midwives to work in rural communities. How effective has this program been?

  • Evaluating the Impact of the Nigerian Midwives Service Scheme

    Sep 15, 2015

    To improve maternal and child health, the Nigerian government introduced the Midwives Service Scheme (MSS), a program to increase access to skilled care in rural areas. Experts evaluated the impact of MSS and found that initial improvements were not sustained.