Challenges in Controlling Hypertension among Pregnant Women in Nigeria

Hypertensive disorders of pregnancy (HDP), encompassing gestational hypertension, pre-eclampsia, eclampsia, and chronic hypertension complicating pregnancy, remain a major contributor to maternal and perinatal morbidity and mortality in Nigeria. Despite established clinical guidelines, effective control of HDP is hindered by multifactorial challenges, including low antenatal care (ANC) coverage and delayed presentation, inadequate facility readiness, inconsistent guideline adherence, limited availability and affordability of essential medications, and sociocultural practices such as reliance on traditional remedies. Patient-level factors, including low health literacy and poor adherence to treatment, further exacerbate adverse outcomes. This review synthesizes recent literature on the prevalence, barriers, and health system gaps affecting HDP management in Nigeria and highlights pragmatic interventions with potential to improve outcomes. Evidence suggests that a coordinated approach integrating early ANC access, facility readiness packages, reliable supply chains, community education, and robust monitoring systems can enhance maternal and neonatal health. Policymakers and healthcare providers must implement context-specific strategies to reduce maternal and perinatal mortality associated with HDP. Keywords: Hypertensive disorders of pregnancy; pre-eclampsia; eclampsia; maternal mortality; antenatal care.