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By Damiete Braide
Every Nigerian state that screens pregnant women for hepatitis B eventually confronts the same problem. The test kits arrive, the programme begins and women are screened.
But sustaining that service requires something more permanent: a way to pay for it year after year.
Dr. Elohor Oborevwori, a physician and public health specialist, set out to solve that second problem. In Delta State, her solution is now routine policy within a contributory health scheme covering nearly 2.9 million enrolled residents.
The medical case for screening was already established. International guidance recommends testing pregnant women for hepatitis B, with hepatitis C screening also incorporated into antenatal services in some health systems.
The challenge Oborevwori addressed was implementation: how to make screening routine and sustainably financed rather than dependent on temporary programmes or external funding.
While serving as a Public Health Physician in the Delta State Ministry of Health, Oborevwori proposed building screening into two systems the state already operated: routine antenatal care to deliver it and the state’s contributory health insurance scheme to finance it. Her proposal brought the clinical rationale, delivery pathway and financing mechanism together.
The state adopted it.
A directive issued on 2 November 2023 by the Delta State Contributory Health Commission instructed medical directors of accredited facilities to implement hepatitis B and C screening for pregnant women covered by the scheme and adjusted the scheme’s tariff to cover the service. Commission records show 2,886,555 residents enrolled as of April 2026.
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Delta State’s Commissioner for Health said proposals of this kind often reach government as requests for stand-alone programmes with separate budgets and outside funding, arrangements that can become difficult to sustain when funding ends. Oborevwori’s proposal arrived with the delivery and payment mechanism already worked out. According to the Commissioner, that completeness contributed to its approval.
Beyond Delta
The significance of the problem Oborevwori addressed is increasingly evident beyond Delta State.
The Commissioner said the Delta approach has been presented to counterparts from other states and discussed at national health forums, where financing sustainable antenatal screening is a shared concern. He described the approach as transferable to other jurisdictions operating contributory health-insurance schemes.
Across Nigeria, governments are already incorporating hepatitis screening into maternal-health systems through different mechanisms.
Lagos provides hepatitis B and C screening through public health facilities, including general hospitals, its teaching hospital and designated primary health centres. Kano is implementing a triple-elimination strategy that incorporates hepatitis B screening alongside HIV and syphilis interventions for pregnant women.
Antenatal hepatitis screening has also been documented in health facilities in other parts of the country.
While states have adapted the approach to their own health systems and financing structures, the underlying implementation principle is increasingly reflected beyond Delta: integrating hepatitis screening into established maternal-health services and creating a defined mechanism to sustain its delivery.
Its emergence across independently administered health systems demonstrates that the implementation approach first demonstrated in Delta has relevance and application well beyond the state.
That distinction matters in assessing Oborevwori’s contribution. She did not discover hepatitis screening or develop the clinical evidence supporting testing during pregnancy. Her contribution lies in implementation and health-systems design: developing a mechanism through which an established intervention could become routine care supported by an existing domestic financing system.
Dr. Ejiro Orhewere said the significance of implementation work is demonstrated not simply when an intervention succeeds in its original setting, but when the solution addresses a problem shared across health systems and proves capable of adoption or adaptation elsewhere.
The recommendation to screen belonged to everyone. Oborevwori’s contribution was demonstrating how one Nigerian state could make that recommendation routine and sustainably financed.
Evidence that the approach is subsequently adopted or adapted by independently administered health systems would take that contribution one step further: from a solution demonstrated in Delta State to one with documented application beyond it.
