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American Journal of  Economics and 
Business Innovation (AJEBI)

Maternal Mortality in Nigeria and Implications for Economic Development
Adeniyi Idowu Okeowo1*, Abayomi Oluwaseun Japinye2, Segun Amos Adewale1

Volume 4 Issue 3, Year 2025
ISSN: 2831-5588 (Online), 2832-4862 (Print)

DOI: https://doi.org/10.54536/ajebi.v4i3.5545
https://journals.e-palli.com/home/index.php/ajebi

Article Information ABSTRACT

Received: June 20, 2025

Accepted: July 24, 2025

Published: October 07, 2025

The study examined maternal mortality in Nigeria and its implications for economic 
development, and it considered the impacts of  the maternal mortality ratio on economic 
growth. The study uses annual time series data spanning 33 observations from 1989 to 2022. 
Thus, the data’s primary sources are the World Health Organization and the World Bank 
Development Indicators, 2022. Gross Domestic Product (GDP) serves as the proxy for 
economic growth, which is the dependent variable, while Fertility Rate (FERATE), Health 
Expenditure (HEAEXP), and Maternal Mortality Rate (MMR) serve as the exogenous 
variables. Augmented Dickey-Fuller (ADF) test was utilised to determine the stationarity 
level of  the variables. The Bound and Co-integration Tests show that there exists a long-run 
relationship among the variables and Fully- modified OLS (FOLS) was used to analyse the 
Maternal Mortality in Nigeria and Implications for Economic Development from 1989 to 
2022 using the E-Views 10 statistical software. In contrast to MMR and FERATE, which have 
negative relationships with the dependent variable (Gross Domestic Product), HEAEXP 
has a positive relationship with the dependent variable. The following recommendations 
were made: Nigeria should increase access to family planning, enhance maternal health 
services, and provide incentives for smaller families to spur economic growth. Public-private 
partnerships and open budgeting combined with efficient health spending can improve 
productivity and healthcare. Lastly, cross-sector cooperation integrating health and economic 
policies would promote sustainable growth and higher living standards nationwide.

Keywords
Fertility Rate, Health Expenditure, 
Maternal Mortality, Race

1 Department of  Economics, Caleb University, Imota, Lagos, Nigeria
2 Central Bank of  Nigeria, Nigeria
* Corresponding author’s e-mail: adeniyi.okeowo@calebuniversity.edu.ng

INTRODUCTION
The high maternal mortality figures in Nigeria are not just 
a serious public health issue, but a pressing concern that 
demands immediate attention. Nigeria, with one of  the 
highest rates of  maternal mortality in the world, records 
59,000 maternal deaths every year. The ongoing effort 
to reduce these figures is hindered by challenges such as 
poverty, cultural values, and poor healthcare infrastructure. 
These factors limit women’s access to essential maternal 
health services, leading to high rates of  maternal mortality 
and morbidity. The complex relationship between 
maternal mortality and economic development is a call 
for urgent action. High maternal mortality does not only 
reflect the quality of  healthcare service provided but also 
perpetuates the cycle of  poverty, hindering the nation’s 
ability to develop and grow sustainably.
The need for a different socio-economic trajectory 
becomes even more apparent considering the high rate 
of  maternal mortality that weakens Nigeria’s rate of  the 
labour force and intensifies health care costs. When we 
critically analyse the persistent incidences of  maternal 
deaths, we indeed observe that these deaths entail 
human losses that reverberate not only in small circles of  
families but also in a complex way that impacts national 
economic viability. Crucially, it is worth noting that such 
economic losses incur whenever a maternal death occurs 
because it contributes to reductions in the workforce and 
increases the care burden with a subsequent likelihood of  
entrenching poverty cycles (Ogunjimi & Adebayo, 2019). 
Importantly, high-quality health services are needed not 

just as a ‘luxury’ but as a fundamental. It will likely make 
economic sense for countries to pump more money into 
their health sectors because there are positive correlations 
between higher health spending and GDP growth 
(Nwankwo et al., 2022). 
Critically, we must reconsider the state’s role and the 
private role in shaping health and socio-economic 
outcomes by recognising that investing in rural maternal 
health services will avert maternal deaths, and this will 
perhaps achieve a dual health and economic impact in 
terms of  addressing health and poverty. At last, we must 
ask to what extent maternal health successes bring about 
broader socio-economic improvements. Overall, we must 
critically think through the prospects of  maternal health 
interventions succeeding in the long term so that they 
can help bring sustainable development and ensure the 
Sustainability Development Goals (SDGs) are met (Liadi 
et al., 2024).
Nearly 59,000 women die each year due to complications 
of  pregnancy and childbirth in a population of  200 
million, which makes it a major public health crisis and 
also contributes to the loss of  a significant amount of  
economic productivity. With all its possible repercussions 
for the future, this crisis is also an opportunity for immense 
positive change. The contributing factors include a fragile 
health system that was not able to scale up access to skilled 
birth attendance, weak social protective measures, and 
socio-cultural factors such as stigma, lack of  awareness, 
and poor uptake of  care, which still discourage women 
from seeking proper medical care in time. 



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The maternal mortality ratio, at about 540 deaths per 
100,000 live births, illustrates the need to focus on the 
immediate health risks as well as how maternal deaths 
affect the productivity of  the economy and cause 
increased expenses on health systems, thus creating 
costs that the country’s overall economic growth cannot 
sustain. Investing in maternal health care programs and 
removing barriers leads to fewer maternal deaths. In fact, 
the state of  maternal deaths in Nigeria has been linked 
to an equivalent lack of  investments in maternal health 
programs by successive governments.
When less government money is forthcoming, maternal 
mortality ratios increase, and the economy contracts. The 
challenge of  maternal mortality is multifactorial, with 
both access to health care and socio-economic reforms 
critical to solving the crisis. This is where the audience’s 
role becomes crucial. Nigeria must improve women’s 
education and economic position, and the audience, 
including policymakers, researchers, and stakeholders, 
is essential to this process. The more educated and 
empowered women are, the more likely they are to receive 
care. A trajectory of  improved health, prosperity, and 
development is one upon which the audience can act to 
effect reforms. The audience is important and integral to 
the country’s brighter future. 
A straightforward research program needs to be 
established to show how maternal mortality undermines 
economic development as it relates to the socio-economic 
dynamics of  Nigeria. The main objectives include 
assessing the relationship between maternal mortality and 
government health expenditure. Lack of  investment in 
health has been identified as the cause of  higher mortality 
that affects economic productivity (Gao et al., 2023). 
Also, the research objective is to evaluate the socio-
economic determinants of  maternal health, focusing on 
education and employment opportunities for women, 
as they have been proven to be the main determinants 
of  maternal mortality (Osemwengie & Shaibu, 2020). 
These relationships between the social determinants and 
maternal mortality must be understood to formulate 
policies that will reduce maternal deaths while general 
economic health is improved (Dias et al., 2015). 
Overall, the research aims to give the required actionable 
guidelines that inform government policies and activities 
to ensure that Nigeria realises sustainable development 
while achieving better maternal health outcomes. The 
findings of  this research can potentially inform and 
shape policies and practices in the fields of  public health, 
economics, and social development, leading to improved 
maternal health outcomes and sustainable development 
in Nigeria.
Apart from the central argument in the study, there should 
be a succinct formulation of  the research questions to 
provide an anchor for exploring the problem within 
its broader socio-economic context. These questions 
are essential to gripping current problems and shaping 
targeted reform agendas and a deeper understanding 
of  the dynamics of  socio-economic issues. For 

instance, the question ‘How do specific socio-economic 
determinants, such as the proportion of  women with 
at least secondary education and the proportion of  
women using informal community health workers, 
influence maternal mortality rates in Nigeria?’ is a sign 
of  a whole other set of  complicated questions to unpack. 
As Igboanugo and MaryNwakeze (2023) stress: ‘The 
economic determinants of  maternal mortality in Nigeria 
is an extremely multifactorial question that is influenced 
by employment, health spending, and women’s education 
(as a driver of  economic growth and development).’ 
As Vincent (2021) rightly asks: ‘When there is adequate 
government spending on maternal healthcare, will there 
be any systemic effects on mortality rates or growth?’ 
This question becomes a critical concern given that ‘an 
estimated 59,000 women die annually from causes related 
to pregnancy and childbirth’ (Olonade et al., 2019).
This study examines the relationship between maternal 
mortality and economic growth in Nigeria, emphasising 
the most important hypotheses. It is hypothesised that 
the extension of  the government’s fiscal expenditure on 
health reduces maternal mortality rates, and improvement 
in female education lowers the mortality rate considerably 
because of  better health knowledge and access to health 
services. Also, socio-economic factors such as poverty 
reduction and healthcare access will likely mediate the 
relationship between maternal health and economic 
productivity. Testing these hypotheses will be a highly 
effective method to separate these connections and 
clarify the nature of  direct policy action. 
 As such, this research is important to health policies and 
broader economic planning, including efforts to achieve 
a viable and forward-looking African country such as 
Nigeria: ‘Maternal mortality affects productivity and 
the workforce.’ Economic planning at all levels would 
benefit from stronger health systems and increased 
investment in maternal health services. The findings 
provide data that informs policymakers on developing a 
comprehensive set of  processes to tackle maternal health. 
Currently, approximately 59,000 women die yearly from 
pregnancy-related complications, a startlingly high rate 
for a nation with 200 million inhabitants. This alarming 
statistic represents one of  the leading public health 
crises and a substantial loss of  economic productivity. 
However, it also presents an opportunity for significant 
positive change. Factors contributing to this crisis include 
a fragile healthcare system that has not been able to 
scale up access to skilled birth attendance, poor social 
protective measures, and persisting socio-cultural barriers 
such as stigma and poor awareness, which discourage 
women from seeking appropriate medical care on time. 
Overcoming these challenges reduces families’ financial 
burden and improves social and economic resilience.

LITERATURE REVIEW
Global Overview of  Maternal Mortality and 
Economic Development
The relationship between economic development in 



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Nigeria and maternal mortality has received significant 
attention. Researchers have closely examined the link 
between economic progress and maternal health due 
to the widespread impact of  high maternal mortality 
rates (Dias et al., 2015). Evidence from the literature 
indicates that there is a clear correlation between the 
financial burden of  maternal death, especially in regions 
characterised by severe social disparities, and the amount 
of  money spent on healthcare and the availability of  
high-quality medical services (Nwankwo et al., 2022). This 
requires a deeper analysis of  the claimed returns on public 
health investments. Gendered inequalities, deeply rooted 
in socio-cultural factors, significantly limit women’s 
access to health resources and jeopardise maternal health 
outcomes. These inequalities, often perpetuated by 
entrenched cultural ideologies, underscore the need for 
gender-sensitive policies and interventions (Ogunjimi  & 
Adebayo, 2019). 
The literature shows that improving female education 
and access to health care is not just a health intervention. 
Instead, it is a direct economic intervention that materially 
reduces maternal mortality while creating the conditions 
for further economic growth by producing a healthier 
workforce (Olonade et al., 2019). Taking deliberate 
policy steps to address these multiple challenges and 
engaging communities through community health 
literacy programmes can help Nigeria reach some of  
the sustainable development goals – goals that promote 
better maternal health outcomes (Van Niel et al., 2020; 
Olonade et al., 2019). Reimagining a new economic 
future will require critically interrogating the relationship 
between economic development and maternal morbidity 
and mortality. It is crucial to consider new liberatory 
economic interventions that work not just at the level 
of  material resources but also with social and cultural 
factors. A comprehensive approach that addresses all 
these factors is essential for significant change. 
A side-by-side comparison of  Nigeria’s maternal 
mortality rates with those in other African countries 
strongly demonstrates that these are unjustifiable. These 
reasons are not evident and will take another paper to 
address. However, it is sufficient to state that the health 
infrastructure is poor, the society is not sufficiently 
equitable, and the health sector is grossly underfunded. 
These factors and others contributed to Nigeria having 
19 per cent of  the world’s maternal mortality in 2017. 
However, we should insist on knowing why maternal 
mortality in Nigeria remains at a concerning figure of  
917 per 100,000 live births despite some positive trends 
that occurred over the years. In 2017, it was 26 per cent 
higher than the regional average of  546 per 100,000 live 
births (Dauda, 2023). By contrast, South Africa did much 
better: 120 maternal deaths per 100,000 in the same year 
(Nwankwo et al., 2022). This stark contrast underscores 
the urgent need for societal change to address inequity. 
An important question to ask is: What are the specific 
health policies being implemented by South Africa that 
are different from what Nigeria does? Moreover, Rwanda 

presents a rare opportunity for innovative research and 
practice. Between 1990 and 2017, Rwanda improved 
several critical health indicators and maternal mortality 
tremendously: the maternal mortality ratio (MMR) 
decreased from 1,100/100,000 live births in 1990 to 
350/100,000 in 2017 (Jaiswal et al., 2024). The rate is now 
almost identical to the regional average.’ An important 
question is: what are the specific health policies being 
implemented in Rwanda, and can these be adapted for 
Nigeria’s context?
On the other hand, there are broader problems, such as 
inadequate healthcare infrastructure, consistent under-
investment, and social-cultural practices, that could 
explain why Nigeria’s maternal mortality rates are not too 
different from other African countries on average. These 
include the fact that ‘many women in Nigeria still travel 
long distances to access routine care, with approximately 
20-35 percent of  women having to travel more than 20 
km from their homes to the nearest healthcare facility’ at 
any given time (Osemwengie & Shaibu, 2020). There is 
undoubtedly a need for the Nigerian government to make 
focused policy reforms to equip the healthcare system to 
address the issues at the root cause. Strategic investments 
in healthcare, inspired by successful models in other 
African countries, will help Nigeria to better aligned 
with what other African countries have done (Odey et al., 
2024; Jaiswal et al., 2024). Through this holistic view of  
the issues, stakeholders can begin to address the bigger 
picture and ultimately drive improvement.

Causes of  Maternal Mortality
For all the progress achieved in other endeavours, 
Nigerian maternal mortality shows no signs of  
abatement. Understanding the systemic factors in play 
requires navigating a complex web of  governmental and 
non-governmental stakeholders. First, access to essential 
healthcare is gravely impaired in rural areas, where 
facilities are under-resourced more than in urban centers. 
These limiting conditions not only hinder a woman’s 
access to appropriate care, often a lifeline for her during 
pregnancy and childbirth, but also provide a considerable 
springboard as to how systemic inequalities within the 
system are sustained (Nwankwo et al., 2022). In a study 
examining health investment determinants in Nigeria, 
the authors found that maternal education, access to 
healthcare, and poverty were key deciding factors in 
health outcomes, including maternal mortality (Meroyi, 
2018). Poverty compounds the barrier not only because 
of  the apparent effect of  financial exclusion among many 
women, who consequently lack the medical care they need, 
but are pushed into birthing at home, often with callous 
traditional birth attendants with no medical supervision. 
Research indicates that lower levels of  education are 
linked to higher maternal mortality rates. Educated 
women are significantly more likely to effectively access 
healthcare services and navigate complex health systems, 
which can be challenging for those who are less informed 
(Salisu & Hamza, 2024). Health infrastructure is dismal, 



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characterised by the absence of  critical services, such as 
skilled birth attendance, emergency obstetric care, and 
basic maternal health supplies, which not only results in 
high incidences of  preventable maternal deaths but should 
pointer in studying what health systems are required care, 
educational outreach not be viewed as isolated responses 
seeking to tackle the crisis. Rather, each intervention is 
as important as the other, understanding that what each 
can achieve when used in concert is more effective than 
working in isolation. Ensuring no woman should be 
unable to access care should be seen as a non-negotiable, 
with an understanding that women’s health must become 
a national imperative (Dias et al., 2015; Meroyi, 2018). This 
can be achieved only by ensuring that all stakeholders and 
actors explore and identify critical issues in the system, 
from how maternal education and poverty, for example, 
have historically stunted progress in these areas.

Role of  healthcare infrastructure in maternal health
A good healthcare infrastructure is crucial for cutting 
down on the high incidences of  maternal deaths in 
Nigeria, whose weak system forms a significant barrier 
to women’s access to medical services during pregnancy 
and childbirth. The glaring shortcomings in facilities, 
especially in the rural areas, aside from severely reducing 
the number of  skilled birth attendants (with an annual 
estimate of  over 59,000 deaths resulting from preventable 
complications, also raise some serious concerns about the 
apportionment of  resources in the sector and whether 
the sector’s policy priority is distinct (Olonade et al., 2019). 
Aside from exposing women to immediate dangers, the 
high prevalence of  maternal deaths in Nigeria serves as 
a testimony to the lingering effects of  these deaths on 
bereaved families and the wider community. While there 
have been some positive developments on the sector’s 
front, such as the increase in the percentage of  women 
accessing antenatal care from 38.2 percent to 42.6 percent 
in the SDG era (Tolossa, 2024), there remains a wide 
gap in the access and affordability of  healthcare. This 
is evidenced in the lack of  trained human resources for 
quality healthcare, adequately equipped medical facilities 
to cope with the high-risk deliveries, lack of  government 
funds for health, and dilapidated hospital structures 
coupled with poor bed space. In Nigeria, maternal 
mortality, which is the second highest in the world, 
exemplifies the calamitous repercussions of  defective 
healthcare facilities where socio-economic inequalities and 
economic productivity are heightened (Salisu & Hamza, 
2024; Olufadewa et al., 2024). Relevantly, tackling these 
challenges in healthcare delivery does not merely involve 
an exercise in health equity but is also fundamentally a 
pivotal strategy to break poverty cycles and provide 
the bedrock for enhanced educational outcomes in the 
future. Sound policy programs must, therefore, involve 
an improved healthcare delivery system, increased 
government funding for healthcare, and heightened 
provision of  education and resources towards sustainable 
development (Dias et al., 2015). Maternal deaths can be 

averted, and this will go a long way in creating a healthy 
future for mothers and babies and, indeed, the well-being 
of  the entire community.

Impact of  healthcare policies on maternal mortality
Healthcare policy is a key aspect in combating the high 
figures of  maternal mortality that are having a severe cost 
on Nigeria’s economic development. Various policies 
promoting investment in maternal health services – such 
as the free Maternal and Child Health Care Programme 
of  the Federal Ministry of  Health – are helping to make a 
difference. However, a closer look at the evidence shows 
that, due to unstable funding and poor implementation, 
their proven potential to change maternal outcomes is 
severely limited (Ogu & Ephraim-Emmanuel, 2018). 
Inadequate healthcare infrastructure, coupled with the 
lackluster implementation of  healthcare policies and 
socio-economic barriers, drive the need for informal 
healthcare systems that lack the training and supervision 
of  standard healthcare practice. This creates an undue risk 
to the care of  expectant mothers. For example, although 
the Nigerian government has made several commitments 
to improving maternal health, data from studies show 
that occurrences of  intimate partner violence and low 
socio-economic status have continued to fuel barriers 
to accessing quality care (Liadi et al., 2024; Adetutu et 
al., 2024). This illustrates the need to examine the link 
between these socio-cultural dynamics and policy efficacy. 
Consequently, robust healthcare reforms – improved 
financing, increased training of  healthcare personnel, 
and targeted public awareness initiatives – are good for 
maternal and foetal outcomes and vital in mitigating 
maternal mortality, thereby creating a healthier workforce 
that fuels economic growth in Nigeria. This shows the 
interplay between health and economic policies.

Maternal Mortality and Economic Development
The link between maternal mortality and economic 
development outcomes is long-established. This is because 
of  the wealth of  literature establishing the impact of  
health on labor productivity, human capital development, 
and economic development outcomes generally. Maternal 
mortality affects labour productivity. Healthier women are 
more likely to be in the workforce, especially in developing 
nations where women dominate labor both in the formal 
and informal sectors. Much research, such as the studies 
by Okwan and Kovacs (2020), has shown that improved 
maternal mortality can reduce absenteeism and improve 
the quality and productivity of  the female workforce. The 
former can lead to better economic outcomes. Maternal 
health is also crucial for human capital development. 
The mortality of  mothers can have long-lasting negative 
impacts on families by hampering children’s educational 
attainment and, as a result, weakening the future working-
age population. According to the research by Ogunjimi 
and Adebayo (2019), investment in maternal health 
can have long-term economic benefits because of  the 
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of  intergenerational productivity. This argues the case for 
maternal mortality not only as a health issue but as an 
economic development strategy.

Theoretical Framework Linking Health to Economic 
Growth
The theoretical framework that links health to economic 
growth argues that health improvements, especially 
maternal health, act as a catalyst for the sustainable 
economic development of  nations. From the perspective 
of  Human Capital Theory, a healthier population leads 
to a more productive workforce and a more significant 
contribution to economic output (Bosworth et al., 
2021). In particular, when survival also means reducing 
maternal mortality rates, women emerge fully into the 
labor market, where they could contribute substantially 
to aggregate productivity. This is consistent with the 
Solow Growth Model, according to which a health 
improvement determines a more efficient use of  labour 
and capital (The Solow Growth Model, 2024), as well 
as with the Endogenous Growth Theory, according to 
which the investment in maternal health determines the 
growth of  persons’ skills and level of  education, thereby 
adding a ‘human capital’ contribution to economic growth 
(Salvatore, 2023). In the empirical literature, we see that 
the increase in health expenditure determines a reduction 
in maternal mortality, and through this mechanism, an 
investment-growth feedback loop is produced; that is, 
the improvement in economic growth determines the 
increase in health investments, which in turn determine 
better results (Raghupathi & Raghupathi, 2020).
This conjecture is additionally supported by the Health-
Led Growth Hypothesis: maternal health is fundamental 
to macroeconomic stabilisation over the long term 
(Erdogan & Erdogan, 2024). For instance, as maternal 
deaths are still high in countries such as Nigeria, lowering 
the deaths not only increases the labor force but also 
lowers the pressure on the health system, which may 
free up the resources that can be used in other economic 
development policies. Evidence shows that better 
maternal care can lead to increased labour productivity, 
especially in those sectors where the demand for labour is 
exceptionally high for women. This, in turn, provides an 
argument for even more targeted healthcare interventions. 
The economic impact of  maternal mortality thus further 
illustrates the essential role of  health in labour and 
economic policymaking. The connection between the 
productivity of  female labour and maternal health has 
medical policy implications (Piabuo & Tieguhong, 2017).
Further theoretical frameworks include the Social 
Determinants of  Health and the Demographic 
Transition Theory, which highlight other pathways 
by which maternal health impacts broader economic 
outcomes (Wang, 2013). Social determinants of  health, 
such as poverty and education, directly affect health 
outcomes and are also proxies for economic outcomes; 
maternal health is directly linked to improving such 
social determinants of  health, which, for example, leads 

to increased labour force participation and can have 
long-term benefits for the economy (WHO, 2019). The 
Demographic Transition Theory links falling maternal 
mortality to demographic change, which, in turn, is linked 
to economic growth. This growth is often experienced 
as a period of  rapid expansion in a country’s economy, 
known as demographic dividends. These dividends 
are a direct result of  demographic changes, such as the 
lowering of  fertility (Wang, 2013). The Cost of  Illness 
framework shows how the loss of  workforce participation 
and increased healthcare costs contribute to reduced 
productivity. Together, these theories draw our attention 
to the long-term importance of  investing in maternal 
health to reap economic stability and growth (Hamal et 
al., 2020).

Government Policies and Initiatives
Although several international programs like 
Millennium Development Goals (MDGs) and 
Sustainable Development Goals (SDGs) have been 
launched by United Nations organisations to curtail 
maternal mortality and sustainably develop health, and 
Nigeria has benefited from these global partnerships, 
Nigeria failed to reduce maternal mortality neither in 
MDGS nor in SDGs. However, this review is proof  
of  the burden of  increasing attention to this issue. 
The MDGs (2000-2015) were eight international 
development goals thataimed to reduce global poverty. 
In overview, MDGs aimed at reducing maternal 
mortality by 75 percent from a baseline in 1990. 
By the end of  2015, barely half  (50%) of  the target 
was achieved in Nigeria (Nwankwo et al., 2022). The 
failure was due to the financial constraints to build a 
robust health system badly needed; poor training of  
healthcare workers that ensured bad clinical skills and 
low system efficiency; and sometimes essential services 
to women and children such as antenatal care, delivery, 
and tertiary care were unavailable even in some villages. 
SDGs aim to build the future we want, a sustainable 
and better world for everyone and were launched in 
2016. Aimed at reducing maternal mortality to below 
70 per 100,000 live births by 2030, its target is more 
ambitious than MDGS as it encourages member states 
to ensure that all (everyone) has access to reproductive 
health services (Olonade et al., 2019). Another reason 
SDGs encouraged Nigeria may be because it affords 
her the benefit of  30 years (2016-2030) to improve her 
systematic structural problems - slow socio-economic 
development and cultural barriers that hinder natural 
progression. In all, government policies and initiatives 
are the bedrock for national development, not only in 
the health sector but also in general macroeconomic 
development (Okeowo et al., 2024; Okeowo, 2023).

Socioeconomic Implications
The high maternal mortality rate has severe economic 
consequences as it worsens inter-generational cycles of  
poverty and inequality in the country. Maternal mortality 



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significantly affects the economy because women are 
primary caregivers and income earners within their 
households. Among other things, the lack of  maternal 
health services adds to catastrophic health expenditures, 
which have a negative impact on the household economy 
as well (Taiwo et al., 2023). Furthermore, culturally 
induced educational barriers for women have also limited 
their access to comprehensive maternal health services. 
The high mortality rates are most likely the result of  
gender-based violence and restricted access to maternal 
health services in Nigeria. These issues also contribute to 
reducing national productivity and lifespan. It is critical 
for any nation to invest in mothers’ health care, which can 
solve the issue of  maternal mortality, which is, in turn, 
beneficial for long-term socio-economic stability.
According to World Health Organization (WHO) 
reports, nations that are more concerned about maternal 
health care can provide better health care to all citizens, 
eventually saving lives and improving long-term socio-
economic stability.

Long-Term Economic Consequences of  Maternal 
Mortality
Beyond individual families, maternal mortality has long-
term consequences for national economic stability. Each 
maternal death represents lost human capital, worsening 
the odds of  productivity and stability by unsettling 
communities and burdening the developing country with 
poverty (Ogunjimi & Adebayo, 2019). High death rates 
among mothers lead to less healthy or educated children, 
who, in turn, produce less productive workers in the 
future. It also decreases investment in health care and 
businesses, slowing economic growth and inventions. In 
sum, if  Nigeria wants to reduce maternal mortality rates, 
enhancing social outcomes and building a sustainable 
future for its people are equally important goals.

MATERIALS AND METHODS
The methodology to deploy in empirical analysis depend 
on the data characteristics (Okeowo, 2023; Okeowo & 
Awotade, 2024; Okeowo & Japinye, 2025). Having observe 
the data characteristics, this study evaluates maternal 
mortality in Nigeria and implications for economic 
development using time series data and econometric 
techniques. Maternal mortality rate, health expenses and 
fertility rates are the exogenous factors, or independent 
variables. Gross Domestic Product acts as the dependent 
variable’s stand-in. To accomplish this objective, the study 
incorporates all of  these measures. The study uses annual 
time series data that span 33 observations from 1989 
to 2022. Thus, the data’s primary sources are the World 
Health Organization and the World Bank Development 
Indicators, 2022. 

Model Specification
In order to show the relationship between maternal 
mortality in Nigeria and implications for economic 
development, this article developed an econometric 
model. 
GDP = f(MMR, HEAEXP, FERATE)          ....(1)
Where,
GDP-Gross Domestic Product
MMR-Maternal Mortality Rate
HEAEXP- Health Expenditure
FERATE-Fertility Rate
Where all variables are as earlier defined. In the Fully- 
modified OLS (FOLS) form the model is specified as:

RESULTS AND DISCUSSION
Analysis of  Unit Root Test
The unit root test was performed to ascertain the 
stationarity of  the time series data under study to avoid 
running a spurious regression.

Table 1: Augmented Dickey Fuller Unit Root Test Results
 Level First Difference
Variables T-Stat Critical Values 

5%
P-Values T-Stat Critical Values 

5%
P-Values Order of  

Integration
GDP 1.0131 3.5529 0.9998 4.0878 3.5578 0.0155 I(1)
MMR 2.3463 3.6584 0.3931 3.4448 3.0299 0.0221 I(1)
HEAEXP 2.8941 3.0124 0.0629 5.5107 3.0207 0.0003 I(1)
FERATE 1.7893 2.9604 0.9996 3.2649 3.2152 0.090 I(1)

Source: Author`s Computation (2024)

The findings of  the augmented dickey fuller unit root 
test, with a t-statistic of  4.0878, show that the GDP is 
stationary at first difference because the t-statistic is higher 
than the 5% threshold values and the probability value is 
less than 5%, or 0.0155. MMR is not stationary at level 
since the t-statistics is less than the critical values and the 
probability values are greater than 0.05, but it is stationary 
at first difference because the t-statistic of  3.448 is greater 
than the critical value at 5% of  3.0299 with 0.0221 as 
the probability values. HEAEXP is stationary at first 

difference because the t-statistic of  5.5107 is more than 
the 5% critical value of  3.0207 with the probability value 
of  0.0003, but it is not stationary at level because the 
t-statistic is less than the 5% critical value. However, with 
a 0.0193 probability value, the FERATE is not stationary 
at level since the t-statistics are smaller than the critical 
value of  5%, which is 1.7893 and 2.9604, respectively. But 
FERATE is stationary at first difference as the t-statistics 
of  3.2649 is greater than the 10% critical value of  3.2152. 
however, the probability value is slightly stationary at 5%



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The unit roots examine the stationarity of  the variables, 
as was previously discussed, to avoid erroneous findings. 
The variables are stationary at the first difference of  
analysis, according to the results, fully-modified Ordinary 
Least Square FMOLS will be used for econometric 
analysis.

Cointegration and Bound Test on the Effects of  
maternal mortality in Nigeria and its implications 
for economic development
The results of  the bound co-integration test verified that 
there is an equilibrium long-run relationship between 
the independent variables—Maternal Mortality Rate, 

Fertility Rate, Heath Expenditure and the dependent 
variable, Gross Domestic Product, since the F-statistic 
for the equation is higher than the I(0) and I(1) bounds. 
An overview of  the F-statistic results and approximated 
boundaries is also given in table 2. The determined 
F-statistic value of  5.401157, which is based on the data, 
shows that the dependent variable, sustainable economic 
development, and other independent factors have a clear 
co-integration connection. At the 5% significance level, 
it exceeds the upper and lower bound critical values of  
2.37 and 3.2, respectively.  As a result of  the present of  
Co-integration, this study shall deploy the use of  Fully- 
modified OLS (FOLS) for analysis.

Table 2: F-Bound Test and Co-integration Test
F-Bounds Test Null Hypothesis: No levels relationship
Test Statistic Value Signif. I(0) I(1)

Asymptotic: n=1000
F-statistic  5.401157 10%  2.37 3.2
K 3 5%  2.79 3.67

2.5%  3.15 4.08
1%  3.65 4.66

Source: Author`s Computation (2024)

Table 3: Fully- modified Ordinary Least Squares (FOLS) the Effects of  maternal mortality in Nigeria and its 
implications for economic development
Dependent Variable: GDP
Method: Fully Modified Least Squares (FMOLS)
Variable Coefficient Std. Error t-Statistic Prob.  
MMR -1161102 584663.6 -1.98593 0.0645
HEAEXP -71821.5 85946.03 -0.83566 0.4157
FERATE -746671 45926.96 -16.2578 0
C 12951308 4176522 3.100979 0.0069
R-squared 0.946168 Mean dependent var 370583
Adjusted R-squared 0.936075 S.D. dependent var 214598.6

There exist a cointegration and long-run relationships 
between the variables, this justifies the use of  Fully 
Modified Ordinary Least Squares for analysis. 

Fully- modified Ordinary Least Squares (FOLS) on 
the Effects of  maternal mortality in Nigeria and its 
implications for economic development
The fully-modified OLS (FOLS) table below uses maternal 
mortality rate, fertility rate, and health expenditure 
as explanatory variables and gross domestic product 
as the dependent variable. First, there is a significant 
negative correlation between the dependent variable 
and the maternal mortality rate (MMR) and fertility rate 
(FERATE), with respective co-efficients of  -11611 and 
-74667. This indicates that the dependent variable, gross 
domestic product, falls when the rates of  maternal death 
and fertility rise. Because the p-value of  0.06 slightly 
(above 0.05) indicates that the maternal mortality rate 
significantly contributes to the dependent variable, the 

t-statistic (1.98593) indicates a moderate relationship with 
the dependent variable, but it is statistically insignificant 
at the 5% level. However, the probability value of  0 
indicates a statistical relationship that indicates fertility 
rate is one of  the variables that negatively contributed 
to the dependent variable, and the FERATE t-statistic 
of  -16.2578 has a high value (in absolute terms) that 
indicates a very strong relationship with the dependent 
variable. 
Furthermore, with a co-efficient of  -746671, the health 
expenditure and the GDP, which acts as a stand-in for 
the dependent variable, have a negative relationship. This 
suggests that raising health spending will undoubtedly 
don’t have significant impact on the growth in the GDP. 
With a probability value of  0.4157, health spending 
is statistically negligible in relation to the dependent 
variable. In short, the effect of  health spending on GDP, 
which is used as a stand-in for the dependent variable, is 
not statistically significant and is negligible in this model.



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S.E. of  regression 54257.92     Sum squared resid 4.71E+10
Long-run variance 2.79E+09

Source: Author`s Computation (2024)

Substituted Coefficients
GDP = 1295-1161*MMR -71821.5 * HEAEXP - 746671 
* FERATE
The R-Squared is 0.94, the adjusted R-Squared is 0.93, 

indicating that 93% of  the total variation in the dependent 
variable is explained by variations in the regressors of  the 
model.
Figure 1 displays the results of  the CUSUM Stability 

Figure 1: CUSUM Stability Test and CUSUM squared test for Effects of  maternal mortality in Nigeria and its 
implications for economic development

Test and CUSUM squared test on the recursive estimates 
for effects of  maternal mortality in Nigeria and its 
implications for economic development. The test results 
show that the CUSUM Stability Test and CUSUM 
squared test are stable at the same level of  significance as 
the model, even if  the model is stable at the CUSUM test 
level at the 0.05 percent level of  significance.

Summary of  The Result
The high incidence of  maternal deaths in Nigeria, 
particularly in rural and impoverished areas, is a result 
of  issues with access, quality, and infrastructure of  
healthcare. A high maternal death rate indirectly limits 
GDP growth since it has an impact on workforce 
development, productivity, and population health. The 
modest significance explained by various confounding 
variables in GDP that mask the indirect influence of  
maternal mortality. For instance, the predominance 
of  macroeconomic factors like commerce and oil 
revenue may mask the true impact of  maternal health 
on GDP. Determining the precise impact on GDP may 
be challenging due to the limited significance caused 
by problems with data quality or uneven reporting of  
maternal mortality. In Nigeria, health investment may not 
always result in positive effects because of  inefficiencies, 
corruption, or inadequate resource allocation, even though 
it should theoretically increase productivity and GDP by 
improving workforce health. The low importance may 
suggest that a significant amount of  health spending is 
not directly allocated to rural areas or effective programs, 
restricting its ability to contribute significantly to GDP 
growth. Furthermore, Nigeria’s health spending as a 

percentage of  GDP is still low by international standards, 
which could account for its limited impact on GDP 
growth.
High fertility rates in Nigeria are associated with higher 
dependence ratios (more dependents per working adult), 
which might strain resources and result in lower GDP 
per capita. Savings and investments may decrease due 
to funds being taken away from lucrative endeavors to 
meet the needs of  a growing population. Moreover, 
high fertility rates are often linked to poor female labor 
force participation, which could limit the economy’s 
overall productivity and growth potential. The substantial 
negative impact can also indicate that Nigeria’s economic 
infrastructure and resources are not keeping pace with 
the nation’s rapid population growth, which would lessen 
the benefits of  GDP per capita.

CONCLUSION
This study examines the impact of  maternal mortality on 
Nigeria’s economic development, using maternal mortality 
rate, fertility rate, and health expenditure as independent 
variables, with GDP as the dependent variable. Based on 
the findings, several key recommendations are proposed. 
First, Nigeria should scale up maternal health programs 
by improving access to quality prenatal and postnatal 
care, especially in rural areas. Training medical personnel, 
enhancing infrastructure, and raising public awareness 
are essential steps toward reducing maternal deaths 
and promoting healthier communities, which ultimately 
support economic productivity.
Second, lowering the fertility rate can reduce the 
dependency burden and promote female workforce 



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participation. This can be achieved through widespread 
reproductive health education and better access to family 
planning services. Incentives like tax relief  or subsidies 
may also encourage smaller family sizes.
Third, the government should improve the effectiveness 
and transparency of  health spending. Allocating funds 
directly to health facilities, adopting performance-based 
budgeting, and encouraging private sector investment 
through public-private partnerships can strengthen 
service delivery.
Finally, integrating health and economic policies—by 
aligning healthcare initiatives with sectors like education 
and agriculture—can amplify development outcomes. 
Collectively, these strategies will enhance population 
health and foster inclusive, long-term economic growth 
in Nigeria.

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