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Accessing healthcare: An arduous journey for pregnant women in northwest Nigeria

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Accessing healthcare: An arduous journey for pregnant women in northwest Nigeria

By: Michael Mike

In the bustling emergency ward of Jahun General Hospital’s maternity department, the rhythm of activity beats with urgency and determination, like a pulse in the air. In this hospital, Médecins Sans Frontières (MSF) collaborates with the Jigawa state Ministry of Health to provide comprehensive emergency obstetrics and newborn care and fistula care. Since commencing services in 2008, MSF teams have assisted 90,000 deliveries.
Nigeria is the third country in the world, after South Sudan and Chad, where a woman is most likely to die giving birth, according to the World Health Organisation. With an average of more than 1,000 maternal deaths per 100,000 live births each year, Nigeria is far from the global target for 2030 of less than 70 maternal deaths per 100,000 live births, as set under the UN Sustainable Development Goals.
Maternal mortality rates far exceed the country average in northern Nigeria, where more than half of the country’s estimated 200 million people live. In Jigawa state, the most significant factor is the limited access pregnant women have to antenatal care and delivery care for complications in childbirth, which frequently occur.
Unity Enuebuke, MSF Nursing Activity Manager, has been working in Jahun General Hospital for more than 10 years. “We see a lot of women with serious complications, with the most common ones being anaemia, haemorrhage and eclampsia,” she explains. The high number of patients means the maternity wards are often fully occupied, if not over capacity. Unity says, “We regularly have up to two women sharing a bed, and depending on the type of complications we see, things can escalate very quickly.”
Ramatu
Ramatu, a mother of two, suffered life-threatening eclampsia—seizures due to high blood pressure—when she delivered her first baby in Jahun hospital. This is her second time here, overcoming the considerable distance from home. “I live five hours away from Jahun General Hospital. There is no hospital where I live, and the closest one does not open at night,” she explains. In Jigawa state, many of the estimated 749 primary healthcare centres do not have the drugs, healthcare workers and medical equipment to serve the thousands of women of childbearing age, despite efforts from public health authorities, the current healthcare infrastructure does not come close to meeting the needs of the population.
This dire situation leaves pregnant women who want to attend a healthcare facility with limited choices such as giving birth at home, and if complications arise, embarking on a treacherous journey to try to reach one that is functioning.
It is also not enough that healthcare facilities are available, they must also be affordable. The economic reality in this region, worsened by soaring inflation rates, makes it difficult for people to afford hospital fees, drugs or even transportation to health facilities.
The result is that women become hesitant to go to the hospital, preferring to give birth at home with the help of more affordable traditional birth attendants, hence increasing the risk of experiencing complications.
Khadijah
Women have given birth at home for centuries, but mother’s and baby’s survival can hinge on preparing and planning for managing complications, which may also occur without warning. In Jigawa state, health professionals and facility-based delivery rates remain low with up to around 80% of deliveries occurring at home.
Nurse Unity says, “Most times, family members don’t bring the mother to the hospital until they see that the baby is not coming out and the mother herself is having seizures.”
Khadijah, a 58-year-old traditional birth attendant in Aujara community, Jigawa state, understands the value of hospital care if she can’t manage a complication, but has experienced women’s hesitation firsthand. “Some women take my advice when I say they should go to the hospital, while some refuse to go to the hospital because they say that they are used to giving birth at home.”
In many communities in Jigawa state, pregnant women often require permission from their husband or mothers-in-law to visit hospital. This practice is compounded by a trend of early marriage, at an age when women are not fully informed about pregnancy and are not physically ready to carry a child.
Khadijah explains that for some, “it is their husbands that prevent them from going to the hospital. Some men don’t see the relevance of antenatal care, while others don’t want another man to treat their wives.”
1.

What needs to be done?
To tackle maternal mortality, a multitude of factors must be addressed. State authorities and international organisations must scale up their activities and increase funding to healthcare in the region, ensuring that budget allocations for primary healthcare centres are properly utilised and thorough planning and strict implementation processes are in place. In 2023, MSF teams assisted 15,754 deliveries, performed 1,911 caesarean sections and completed 43,785 antenatal consultations. Yet, it is still a drop in the ocean when looking at the needs of women in Jigawa state.
Primary healthcare facilities, which are often the first point where pregnant women seek healthcare, need to be equipped with trained personnel, equipment and resources to manage childbirth-related complications. “Eighty two percent of the cases we receive at Jahun General Hospital are complicated cases that could have been prevented at the primary healthcare level.” says Abdulwahab Mohamed, MSF medical coordinator. “Women, especially those of childbearing age, also have to be informed about their health and wellbeing through health empowerment programmes led by state authorities or other health stakeholders”.
Pregnant women must be encouraged to go for antenatal care where they can be informed about their pregnancy journey and what to expect. Efforts must be made to mitigate cultural practices that hinder women from seeking care in medical facilities. Women should be allowed agency and given freedom to make decisions for their health.
MSF supports the Jigawa state Ministry of Health in providing comprehensive emergency obstetrics and newborn care. Our support started with vesicovaginal fistula repair in 2008, however, the project evolved into a 161-bed facility to care for pregnant women and newborns experiencing complications. MSF teams also provide maternal and neonatal healthcare in the states of Kano, Benue, Cross River, Zamfara and will open a large maternity hospital in Maiduguri in June 2024.

Accessing healthcare: An arduous journey for pregnant women in northwest Nigeria

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2027: TAF-Africa urges INEC, security agencies to ensure inclusive voting

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2027: TAF-Africa urges INEC, security agencies to ensure inclusive voting

By Elizabeth Ogunjobi

TAF-Africa has urged the Independent National Electoral Commission (INEC) and security agencies to ensure accessible and safe voting for Persons with Disabilities (PwDs) in 2027.

Dr Andrew Adaji, Programme Manager of The All-Rights Foundation, made the call in Gombe on Wednesday during a community outreach for PwDs.

Adaji said the agencies must ensure that all eligible voters exercised their constitutional rights without discrimination or unnecessary difficulties.

He said PwDs deserved adequate support to participate in electoral processes, given their population and potential contributions to national development.

He estimated that PwDs constituted about 35 million Nigerians, representing 18 per cent of the country’s population.

Adaji urged INEC to promote priority voting and ensure its officials understood provisions designed to facilitate voting for PwDs.

He also criticised the commission’s alleged neglect of Form EC40H, which documents the participation of voters with disabilities.

“Based on our experience during the off-cycle governorship elections in Ekiti, Anambra and Osun states, most ad-hoc staff were not even aware that the form existed,” he said.

He said observers had to draw polling officials’ attention to the form during the elections.

Adaji urged INEC to incorporate training on Form EC40H into its preparation of ad-hoc staff.

He said this would enable officials to understand its purpose and properly document PwDs participating in elections.

He also called for assistive devices, including magnifying glasses and Braille ballot guides, for voters with visual impairments.

Adaji urged INEC to make polling units physically accessible, stressing that PwDs should exercise their rights independently and with dignity.

“We should not have to carry them into polling units. Instead, the facilities should be designed to accommodate them,” he said.

He expressed optimism that improved accessibility would encourage more PwDs to participate in elections.

Adaji also urged security agencies to prioritise the protection of PwDs during security threats and emergencies.

He encouraged PwDs in Gombe to exercise their voting rights under the priority voting provisions of the law.

He said the provisions included special queues for PwDs, pregnant women and older persons.

Adaji urged Nigerians to support the participation of PwDs in the electoral process.

Alheri Nuhu, Women Leader of the Deaf Association in Gombe State, commended The All-Rights Foundation for organising the outreach.

Nuhu said PwDs had been denied adequate attention during previous elections, despite their constitutional rights.

She lamented discrimination by INEC officials and other voters, saying communication barriers often left deaf voters disenfranchised.

She urged INEC to engage sign language interpreters among its ad-hoc staff to facilitate communication during elections.

Similarly, Malam Sani Abubakar, Chairman of the Lepers Association in Gombe State, called for inclusive voting arrangements.

He said leprosy had affected some members’ thumbs, making thumbprinting difficult despite their faces being captured during previous elections.

Abubakar urged INEC to introduce alternative voting arrangements for affected voters to prevent their disenfranchisement.

NAN reports that The All-Rights Foundation is conducting the outreach in six Gombe communities, targeting 305 PwDs.

2027: TAF-Africa urges INEC, security agencies to ensure inclusive voting

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Borno 2027: The General’s Charge and How Zulum Unleashes Borno’s Heavyweight Political Squad

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Borno 2027: The General’s Charge and How Zulum Unleashes Borno’s Heavyweight Political Squad

By Abubakar M. Kareto

In Nigerian politics, elections are rarely won on auditorium stages; they are decided in the quiet corridors of rural wards and the long queues of remote polling units.

The formal inauguration of the Borno State All Progressives Congress (APC) Campaign Council at the Government House followed by a massive, open-air campaign flag-off at the Sports Centre in Maiduguri represents a calculated departure from routine rally-making toward micro-targeted grassroots mobilization.

By commanding party stalwarts to abandon executive comfort and embed themselves directly within their local communities, Governor Babagana Umara Zulum is deploying a bottom-up doctrine aimed at locking down political legitimacy where it matters most.

At the heart of this strategy is the critical task of maintaining party cohesion after intense internal primaries. Zulum’s explicit instruction for victorious candidates to reach out and heal rifts with aggrieved aspirants reflects a realistic understanding of political arithmetic: internal resentment erodes turnout faster than any opposition campaign. By coupling reconciliation with firm warnings against subversion, the leadership is attempting to forge an unbreakable front out of potentially volatile factions.

The sheer scale of political unity displayed in Maiduguri underscores the formidable nature of this campaign structure. Bringing together political titans including former Governors Senator Maina Ma’aji Lawan and Senator Ali Modu Sheriff, alongside APC Deputy National Chairman Ali Bukar Dalori and the state’s complete senatorial delegation demonstrates an unprecedented level of internal alignment.

This public display of solidarity among historical heavyweights signals organizational stability, minimizing space for opposition inroads while keeping rank-and-file members firmly aligned.

Beyond local dynamics, Borno State occupies a unique position on the national political chessboard as the home state of Vice President Senator Kashim Shettima. In this high-stakes arena, sheer victory is insufficient; the turnout margin itself serves as a barometer of political influence.

Delivering a massive vote tally is therefore both a local objective and a strategic demonstration of national strength, cementing the state’s leverage within the governing alliance.

To turn political influence into actual votes, the campaign relies heavily on record-based persuasion and visible governance dividends. By grounding the campaign pitch in key developmental gains achieved despite severe security challenges and highlighting major federal institutions acquired in Gwoza, Bama, and Azare canvassers are equipped with a tangible policy narrative. Framing voter turnout for President Bola Ahmed Tinubu, gubernatorial candidate Engr. Mustapha Gubio, and all legislative candidates as a direct return on investment gives party workers a clear, evidence-backed story for every doorstep across the state’s 27 local government areas.

A vital strength of this expanded outreach is the deliberate inclusion of women and youth as core engines of voter mobilization. The strong presence of the women’s delegation led by Borno First Lady Dr. Falmata Babagana Umara Zulum alongside the wife of the Deputy Governor and the wives of party candidates highlights an organized effort to engage families and community networks directly. Demanding structured participation across all demographics ensures that campaign directives actively translate into voter registration and turnout.

Deputy Governor Umar Usman Kadafur’s commitment to an issue-based, unit-by-unit campaign outlines the operational mechanics needed to execute this vision. Requiring regular field reports creates a system of measurable accountability across every precinct. In a vast state with complex logistics, such systematic tracking ensures that high-level strategy is actively carried out at every single polling station.

Lastly, the Maiduguri launch demonstrates how strategic discipline, elite reconciliation, and precinct-level focus converge to shape electoral outcomes. In an increasingly competitive political landscape, the Borno APC has laid out a clear blueprint: harness the full weight of a unified leadership squad, but win the election one polling unit at a time.

About the Author
Abubakar M. Kareto is a Public Affairs Analyst and Communications Strategist focusing on governance, policies, economy, and institutional reforms across Nigeria and Africa. He can be reached on X @amkareto and via email at amkareto@gmail.com.

Borno 2027: The General’s Charge and How Zulum Unleashes Borno’s Heavyweight Political Squad

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Two Notorious Terrorist Leaders Haruna Balatoni and Black Neutralised in Plateau Military Offensive Another Fatally Wounded as Six AK-47 Rifles Returned

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Two Notorious Terrorist Leaders Haruna Balatoni and Black Neutralised in Plateau Military Offensive Another Fatally Wounded as Six AK-47 Rifles Returned

By: Zagazola Makama

Troops of the Nigerian Army have recorded major breakthroughs in ongoing offensive operations against armed criminal networks in Plateau State, neutralising two notorious terrorist leaders, critically wounding another and recovering six AK-47 rifles previously seized from security forces.

The latest developments followed sustained military offensives at Dajin Madam in Wase Local Government Area of Plateau State on November 8, 2026.

Security sources disclosed that HUMINT reports received at about 8:53 a.m. on November 9 indicated that the intensity of the military operation had resulted in the neutralisation of two suspected terrorist leaders identified as Haruna Balatoni and Black.

Another notorious figure, identified as Dogo Mai Kunkuru, was reportedly shot in the chest and left in a critical condition, with sources indicating that his chances of survival were slim.

In a significant development on November 10, the sustained military pressure reportedly compelled the terrorist network, through an intermediary identified as Ali-Kwara, to return six AK-47 rifles previously seized from security forces.

The recovered weapons are currently in military custody.
In a related operation, troops of 173 Battalion deployed at Mansur rescued a kidnapped mother and her daughter and recovered 39 cattle.

The developments represent a significant disruption of the criminal network’s leadership, weapons stockpile and capacity to sustain operations in the Wase axis.
The recovery of the six rifles is particularly important as it restores weapons previously lost to the criminal network and provides an opportunity for further intelligence exploitation.

The latest successes underscore the impact of sustained offensive pressure, intelligence-driven operations and military presence in dismantling armed groups operating across Plateau State.

The reported deaths of the terrorist leaders and the condition of Dogo Mai Kunkuru are based on preliminary HUMINT assessments and remain subject to independent military confirmation

Two Notorious Terrorist Leaders Haruna Balatoni and Black Neutralised in Plateau Military Offensive Another Fatally Wounded as Six AK-47 Rifles Returned

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