It was the death in childbirth of a dear friend that spurred Adepeju Jaiyeoba, then a young lawyer in Lagos, Nigeria, to take action. It was 2011, and 978 out of every 100,000 Nigerian women — 40,000 a year — were dying from complications during childbirth. Recalling her friend recently, Jaiyeoba said: “She was educated, she had access to one of the best health care facilities in Nigeria, she was informed and was also financially empowered. . . . [It] made me wonder what was happening in rural communities.”

Jaiyeoba, in her late 20s at the time, looked for ways to ensure that mothers and traditional birth attendants were provided both the skills and tools to deliver their babies safely.

Then she launched the Brown Button Foundation — based in Lagos, Nigeria’s business center, and whimsically named after belly buttons. Within four years, it had helped train some 8,000 attendants. To further boost maternal health, in 2013 the foundation launched Mother’s Delivery Kits, which distributes sterile supplies for childbirth. Each kit costs around $5, and the company employs some 85 people.

Since its inception, the company has sold over 50,000 of the sterile kits and had distribution in central and eastern Nigeria, aided by the United States African Development Foundation, a government agency that provides seed capital and technical help to enterprises in underserved parts of Africa.

In 2015, Jaiyeoba landed a Mandela Washington Fellowship and traveled to the US, enabling her to meet President Barack Obama. Two years ago, she bootstrapped a second company, Colourful Giggles Nutrition, with additional support from the US African Development Foundation.

The Brown Button Foundation is sustained by revenue from sales of the delivery kits and children’s cereal, by local and international donors and funds from consulting that Jaiyeoba does on the side. The organization has about 20 permanent staff members and relies on a strong network of volunteers to reach Nigeria’s interior.

Both Mother’s Delivery Kits and Colourful Giggles Nutrition continue to support the goal of the foundation, which is to improve both maternal and child health in Nigeria. With the kits, pregnant women in rural communities and traditional birth attendants now have access to sterile supplies to aide safe delivery during childbirth, while Colourful Giggles Nutrition caters to malnutrition needs of children under five years old in Nigeria.

Maternal and child deaths are still major health problems in the country of 206 million people, Africa’s most populous nation. According to Unicef, child mortality rates have dropped slightly since 2011: In the five years preceding Covid-19, infants were dying at a steady rate of 74 per 1,000 live births (or one infant in 13), and 117 out of 1,000 children were dying before age 5 (or one child in 8).

Jaiyeoba, 38, grew up in Lagos and studied law at Nigeria’s Obafemi Awolowo University before attending the University of Texas, Austin, where she earned a certificate in business management, and the Coady International Institute, in Nova Scotia, Canada, also for classes in business and entrepreneurship. The training she received overseas, she said, has been useful in managing the foundation and its affiliated companies.

In an interview for PassBlue’s Women as Changemakers column, Jaiyeoba talked about her work and her hopes to duplicate it in other parts of Africa. The interview, done in January, has been lightly edited and condensed.

PassBlue: When you started working on maternal health, in Nigeria, were you aware of how severe the problem was?

Jaiyeoba: No, I was not.

PassBlue: What was the most daunting thing you found when you got into the rural communities?

Jaiyeoba: The things we take for granted in the cities were luxuries in those communities. Gloves and [painkillers like] paracetamol were unavailable in many communities. Gloves are so expensive. You start seeing midwives improvise with nylon bags. It was just horrible.

PassBlue: How much impact has the Brown Button Foundation had over the last 10 years?

Jaiyeoba: We have been able to constantly expand the scope of the work around maternal and child health. The causes are a lot, and you find out that one affects the other. All your work goes to waste if the traditional birth attendants you’ve trained do not have access to the [right] supplies. So the side of the foundation that provides support to women in rural communities started making the delivery kits and providing these sterile supplies to communities across Nigeria, to ensure that mothers and infants stay alive during and after childbirth. Then we moved to the other challenge, which is to ensure that those children live to see their fifth birthday. Many times, malnutrition is going to end up taking the child from us — that is also something that affects child and maternal health in rural areas and other parts of Nigeria. So we launched Colourful Giggles Nutrition. It has been constantly evolving for us. We also understand our limitations and know that we cannot solve all the problems.

PassBlue: How helpful is your law degree?

Jaiyeoba: It is about looking at things from the perspective of the end user. That’s the peculiarity that my degree helped bring into the work. While a medical person might focus on the medicine, we consider the patients, or end users. How are they feeling, how are they receiving the things you are bringing to them? How are customs affecting the innovations you are offering? Those are the types of peculiarities that my mind as a lawyer helps to bring to the advocacy. Of course, as a lawyer, you are trained to be analytical — that’s been vital.

PassBlue: What has changed in Nigeria since 2011 in the arena of maternal and child health?

Jaiyeoba: A good number of things, particularly within the communities where we are working. We see that people are more open and receptive to new methods of doing things. One of the major problems in the beginning was that birth attendants often think you want to phase them out and you don’t want them to make money. We are making progress. There is still a lot of ground to cover, but more people are beginning to get awareness. We still don’t have enough people in the space.

Families and mothers are beginning to ask more critical questions. This also stems from awareness. They are beginning to ask important questions at delivery. They are asking what drugs you are giving them, what will you do if this happens; they are asking about bleeding because they have seen someone who died as a result of bleeding. We are beginning to have a safer environment for more holistic discussions when it comes to personal health at childbirth.

PassBlue: Does the Nigerian government pay enough attention to maternal health?

Jaiyeoba: The government is trying its best, and we have seen a little progress, but whether that best is good enough is an entirely different conversation. We interact with the ministry of health in relation to child spacing and family planning issues, which are directly related to maternal health and seem to understand their limitations. They are open to learning. But you know how it is in government. . . . You are subjected to varying opinions as the government changes hands. Having a policy document is important and the willingness to drive the policy document remains an issue. If we really want to change where we are right now on maternal health, we first need to make some fundamental decisions. A lot of it will be in the rural communities, where well over 50 percent of women of child-bearing age live. When mothers die in the cities, it is mostly due to medical negligence, but in these communities, access to health care facilities is an issue. So the government needs to pay more attention to access and staffing those facilities with qualified people, working with the traditional birth attendants, whom the people trust.

Also, the government needs to ensure there are adequate incentives for health workers to stay in rural communities. When communities lack basic amenities like electricity and [clean] water, it becomes difficult to keep health workers. So fix the electricity, make sure there are good roads, provide housing, encourage them to stay, because when they stay lives are saved.

PassBlue: How much attention is Nigeria getting from the international communities regarding maternal mortality?

Jaiyeoba: I think they are trying their best. The United Nations, as well as the World Health Organization, is constantly looking at how best to support on-ground staff and countries, but there is a limit to intervention that a sovereign state can get because you decide what you want or do not want.

PassBlue: Do you think your work can be replicated elsewhere in Africa?

Jaiyeoba: Absolutely! We receive messages from people across Africa . . . because the problem is universal. It is not peculiar to Nigeria. It is a problem of many developing countries, and we continue to look for ways to replicate our models. We have plans to [expand] across Africa, especially our efforts to make nutritious food available to children everywhere. Living to see your fifth birthday should not be dependent on the social class of your parents. It is unjust to have a farmer who produced the maize used to make baby food not be able to afford the same product for his own child.

Damilola Banjo

Damilola Banjo is a staff reporter for PassBlue. She has a master’s of science degree from the Columbia University Graduate School of Journalism and a B.A. in communications and language arts from the University of Ibadan, Nigeria. She has worked as a producer for NPR’s WAFE station in Charlotte, N.C.; for the BBC as an investigative journalist; and as a staff investigative reporter for Sahara Reporters Media.