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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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EU, UNODC, ECOWAS Back Nigeria’s New Drug Control Plan, Warn of Rising Threats

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EU, UNODC, ECOWAS Back Nigeria’s New Drug Control Plan, Warn of Rising Threats

By: Michael Mike

International partners including the European Union (EU), the United Nations Office on Drugs and Crime (UNODC), and the Economic Community of West African States (ECOWAS) have pledged continued support for Nigeria’s efforts to combat substance abuse and illicit drug trafficking under the proposed 2026–2030 National Drug Control Master Plan (NDCMP).

The commitment was made on Monday during the opening of a two-day NDCMP Consultative Forum organised by the National Drug Law Enforcement Agency in Abuja, where stakeholders commended the agency’s achievements while warning against complacency amid evolving drug threats across Africa.

Speaking at the forum, Deputy Head of the EU Delegation to Nigeria and ECOWAS, Mr. Zissimos Vergos, said the European Union remained committed to strengthening collaboration with Nigeria in addressing the transnational nature of drug trafficking and substance abuse.

According to him, Nigeria’s stability and Europe’s security are interconnected, stressing that the impact of drug abuse and trafficking extends beyond national borders.

“Our presence here today is that of partners who have walked this uphill and rough road ourselves, and we continue doing that,” he said.

“What affects the youth of Maiduguri or the streets of Ibadan does not stay within Nigerian borders. Drug trafficking is a transnational challenge, and the master plan laid before this forum is Nigeria’s contribution to a transnational response.”

Vergos noted that the EU had also updated its own drug strategy and action plan with stronger emphasis on international cooperation, adding that the bloc was ready to work with Nigeria in translating the new master plan into practical outcomes.

He also praised the leadership and personnel of the NDLEA for their dedication and commitment to drug control efforts.

Also addressing participants, UNODC Country Representative, Mr. Cheikh Ousmane Touré, warned that the global drug landscape was rapidly changing, driven by the rise of synthetic drugs, increasingly sophisticated trafficking networks, and the growing use of technology to facilitate illicit markets.

He said Nigeria was at the centre of these emerging threats, making it imperative for the country to adopt a comprehensive, data-driven, and forward-looking strategy.

Touré reaffirmed UNODC’s commitment to supporting Nigeria through technical assistance, institutional strengthening, evidence-based prevention and treatment programmes, and enhanced international cooperation.

“As we look ahead, we see this master plan as an opportunity to deepen impact, strengthen data systems, reinforce institutions across all levels of governance, and ensure that the response is people-centred, inclusive, and sustainable,” he said.

Chairman/Chief Executive Officer of the NDLEA, Mohamed Buba Marwa, said although Nigeria had recorded significant progress over the past five years, the country must confront a more complex and evolving drug threat.

Citing projections by the UNODC, Marwa said drug use in Africa could rise by 40 per cent by 2030, while West Africa continued to serve as a major corridor for cocaine trafficking between Latin America and Europe.

He further identified the growing abuse of synthetic substances, prescription drugs, new psychoactive substances, and the increasing digitalisation of the illicit drug trade through encrypted platforms and dark web operations as major concerns.

“As Africa’s most populous nation and largest economy, Nigeria cannot afford to be a passive observer. The risks to our youth, our workforce, and our national security are too high,” Marwa stated.

He explained that the proposed 2026–2030 master plan would introduce new strategic pillars, including alternative development and sustainable livelihoods to address the socio-economic drivers of the drug trade, as well as the disruption of illicit drug economies through financial intelligence.

Marwa urged stakeholders at the forum to think boldly and propose innovative solutions that would shape Nigeria’s drug control strategy over the next five years.

Also speaking, ECOWAS Commissioner for Human Development and Social Affairs, Dr. Daniel Amankwaah, described Nigeria’s master plan as critical to the regional bloc, noting that several ECOWAS member states often draw policy direction from Nigeria’s framework.

He assured the NDLEA of ECOWAS support, not only in finalising the plan but also during implementation.

Minister of State for Education, Suwaiba Said Ahmad, commended the NDLEA for its sustained advocacy, enforcement, rehabilitation, and stakeholder engagement efforts.

She stressed the need for a holistic and multi-sectoral response involving education, healthcare, law enforcement, community participation, and social support systems to effectively address the root causes and consequences of drug abuse.

Other dignitaries at the event included representatives of the Senate Committee on Drugs and Narcotics and the National Orientation Agency.

EU, UNODC, ECOWAS Back Nigeria’s New Drug Control Plan, Warn of Rising Threats

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CSOs Press Tinubu to Sign Federal Audit Service Bill, Warn Delay Weakens Anti-Corruption Fight

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CSOs Press Tinubu to Sign Federal Audit Service Bill, Warn Delay Weakens Anti-Corruption Fight

By: Michael Mike

A coalition of leading civil society organisations has intensified pressure on President Bola Ahmed Tinubu to grant assent to the long-awaited Federal Audit Service Bill, warning that continued delay threatens Nigeria’s anti-corruption drive, fiscal transparency reforms, and public finance management system.

The coalition, comprising Centre for Social Justice, ActionAid Nigeria, Paradigm Leadership Support Initiative, Accountability Lab, Africa Network for Environment and Economic Justice, BudgIT and others, said presidential assent to the bill would mark a major turning point in Nigeria’s efforts to strengthen accountability and curb corruption in public institutions.

In a detailed joint statement issued on Monday, the organisations described the proposed legislation as a critical governance reform designed to modernise Nigeria’s outdated audit system, improve oversight of public spending, and close longstanding legal gaps in the nation’s financial accountability framework.

The groups noted that the bill, which has already been passed by the National Assembly and forwarded to the President for assent, seeks to repeal the obsolete Audit Ordinance of 1956 and establish a new Federal Audit Service with expanded powers and institutional independence.

According to the coalition, Nigeria has operated for decades without a comprehensive and modern federal audit law, despite constitutional provisions establishing the Office of the Auditor-General for the Federation.

The organisations argued that the 1956 Audit Ordinance, often cited in federal audit processes, was no longer part of Nigeria’s extant laws, having not been reproduced in the Laws of the Federation of Nigeria in either 1990 or 2004.

“As such, there is a lacuna in that area of the law,” the statement noted, adding that even if the old audit law were assumed to still exist, it had become outdated and incapable of addressing contemporary governance and accountability challenges.

The coalition said the proposed Federal Audit Service Bill would strengthen the “last mile” of public finance management and support the Federal Government’s anti-corruption agenda by granting broader operational and investigative powers to the Auditor-General for the Federation.

Among the major reforms highlighted in the bill are the establishment of an autonomous Federal Audit Service and Federal Audit Board, transparent procedures for appointing the Auditor-General, mandatory fair hearing provisions before removal from office, and significantly expanded audit responsibilities.

The bill also broadens the scope of audits beyond traditional financial reviews to include forensic audits, value-for-money audits, performance audits, investigations into public-private partnerships, subsidies, grants, loans, disaster funds, and classified expenditures.

Under the proposed law, the Auditor-General would also be empowered to summon individuals, compel the production of documents, investigate fraud, impose surcharges for unaccounted public funds, and collaborate with anti-corruption agencies including the Economic and Financial Crimes Commission and the Independent Corrupt Practices and Other Related Offences Commission.

The coalition stressed that one of the most transformative provisions in the bill is the requirement that audit reports become public documents accessible online after submission to the National Assembly.

According to the organisations, this would significantly improve transparency, support investigative journalism, and empower citizens and civil society groups to monitor public spending more effectively.

The statement further observed that the proposed legislation introduces, for the first time, strict timelines for the submission and review of audit reports by ministries, departments and agencies (MDAs), the Accountant-General, and the National Assembly.

The groups argued that the absence of such timelines under the current framework had contributed to delayed audits, weak enforcement, and the repeated recurrence of financial infractions across government institutions.

The coalition also pointed to the creation of offences and penalties for audit violations as a major innovation capable of ending what it described as a cycle of impunity in the management of public funds.

“Available evidence shows that audit recommendations are treated with levity by MDAs,” the statement said.

“Despite the provisions of the Financial Regulations, there is hardly a follow-up on the recommendations. This sets the stage for the year-after-year reoccurrence of the same set of financial felonies and misdemeanours by MDAs.”

The civil society groups argued that signing the bill into law would deliver significant economic, governance, and institutional benefits to Nigeria, including reducing revenue leakages, improving value-for-money in public spending, strengthening investor confidence, enhancing debt management, and aligning the country with global standards in public financial management.

The statement referenced international principles such as the Lima Declaration of Guidelines on Auditing Precepts adopted by the International Organisation of Supreme Audit Institutions (INTOSAI), which emphasises the importance of independent audit systems in safeguarding public resources and detecting financial misconduct early.

The coalition warned that refusal or continued delay in assenting to the bill could undermine Nigeria’s anti-corruption efforts, weaken fiscal discipline, and limit the country’s ability to meet international accountability benchmarks.

It also cautioned that the existing legal vacuum in federal auditing would persist if the bill is not signed into law.

As part of its recommendations, the coalition urged President Tinubu to not only assent to the legislation immediately but also ensure rapid implementation through the constitution of the Federal Audit Board within 90 days.

The organisations further called on the Attorney-General of the Federation to publish a simplified public summary of the law to enhance public understanding and confidence.

They also urged the Federal Government to communicate the reform to international development partners including the International Monetary Fund, World Bank, and AFROSAI-E as evidence of Nigeria’s commitment to governance reforms under the Renewed Hope Agenda.

The renewed push for the audit bill comes amid increasing concerns over revenue leakages, weak institutional accountability, rising public debt, and persistent allegations of financial mismanagement within government agencies.

Analysts say the proposed law could become one of the most consequential public finance reforms in Nigeria in decades if fully implemented.

CSOs Press Tinubu to Sign Federal Audit Service Bill, Warn Delay Weakens Anti-Corruption Fight

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Climate Beyond Borders Caravan Begins in Abuja, Targets Youth-Led Climate Action Across Africa

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Climate Beyond Borders Caravan Begins in Abuja, Targets Youth-Led Climate Action Across Africa

By: Michael Mike

The Federal Ministry of Youth Development has thrown its weight behind the Climate Beyond Borders Caravan, a continental climate advocacy initiative aimed at mobilising young Africans to champion grassroots climate solutions and sustainable development across 17 African countries.

Speaking at the opening ceremony of the caravan in Abuja, the Honourable Minister of Youth Development, Ayodele Olawande, represented through a goodwill message, described Nigerian youths as “resourceful but underutilised,” stressing that they possess the creativity, resilience and innovative capacity required to tackle the growing climate crisis.

The initiative, organised by the People, Planet and Peace Foundation, is themed: “From Awareness to Action: Mobilizing Resourceful Nigerian Youth for Grassroots Climate Solutions.”

According to the minister, the Climate Beyond Borders Caravan will traverse 17 countries across West, East, Central and Southern Africa to promote climate advocacy, eco-tourism and community-driven environmental action.

He commended the organisers for choosing Nigeria as the starting point of the campaign, noting that climate change has evolved from being a distant environmental issue into a daily reality affecting millions of Nigerians.

“The North is experiencing desertification and drought, while the South is grappling with flooding and coastal erosion. Food prices continue to rise as changing weather patterns disrupt agriculture. The effects of climate change are now present in our homes, markets and communities,” the minister stated.

He, however, maintained that climate change also presents economic opportunities, particularly for young people, through green entrepreneurship, renewable energy, sustainable agriculture, waste management and climate-smart innovation.

The minister highlighted ongoing government interventions under the Renewed Hope Agenda of President Bola Ahmed Tinubu, including the establishment of the Youth Migration and Climate Action Resilience Department within the ministry.

He also referenced the ministry’s Circular Economy Youth Empowerment Initiative, popularly known as Waste to Wealth, which aims to create employment opportunities for 37,000 youths by converting waste into eco-friendly products and valuable resources.

Emphasising the importance of collective responsibility, the minister said practical actions such as planting trees, clearing drainage systems, recycling plastic waste and community participation remain critical in mitigating climate change.

He expressed optimism that the caravan’s activities, including the Abuja capacity-building programme, engagements in Ogun State and a climate walk in Lagos themed “Keep It Clean, Keep It Green: Our Environment, Our Responsibility,” would inspire grassroots mobilisation and long-term environmental consciousness.

“As this caravan journeys across Africa, it sends a powerful message that young Africans are not waiting for others to solve our problems. We are taking ownership of our future,” the minister added.

Also speaking at the event, Dr. Joseph Omoniyi of the Federal Ministry of Innovation, Science and Technology described the caravan as a strategic continental tour designed to identify local technologies capable of addressing climate-related challenges in different African countries.

According to him, the initiative seeks to build a database of indigenous technologies and lifestyle innovations that can be adapted by youths across participating countries to address environmental problems and support national climate commitments.

“The attempt is to find technologies that are peculiar to those countries and create a library of local solutions that can be harnessed by the youth,” he said.

Dr. Omoniyi further expressed hope that the exercise would culminate in a broader African climate summit where findings from the caravan would be harmonised to strengthen Africa’s contribution at global climate negotiations, particularly the United Nations climate conferences.

A Kenyan climate advocate and founder of Roots of Hope, Mariam Abdreshi, said the caravan was necessary because climate change continues to affect communities across Africa, especially women.

She noted that women remain central to community development and are often disproportionately impacted by environmental crises.

“As youth, we know we are responsible for building a better generation, but elders also have knowledge to guide us. This caravan is important because it connects communities and helps us grow a greener Africa,” she said.

The co-organiser and caravan leader, Olatunji Olayiton-Francisco, said the capacity-building sessions were specifically designed to equip young people with practical knowledge and advocacy skills needed to confront climate-related challenges in their local environments.

He explained that after Nigeria, the team would continue to countries including Benin Republic and Togo, alongside other selected African nations where climate champions have already been mobilised.

“Our expectation is that after empowering the youth, they will return to their communities and champion climate advocacy and environmental responsibility wherever they are,” he said.

Private sector stakeholders also pledged stronger support for climate action during the event.

Founder of Artuno and CarbonScope360, Ayo Ogunlowo, stressed the need for sustained advocacy, incentives and government-backed policies to drive youth participation in climate action.

He argued that climate interventions must go beyond awareness campaigns and produce tangible economic and social benefits for communities.

“We need advocacy, commercialization and governance working together. Climate action should not just be about ticking boxes; people must benefit from it,” Ogunlowo said.

He further advocated for locally developed innovations tailored to African realities instead of overdependence on imported solutions.

Ogunlowo revealed that Artuno recently launched a N100 million climate innovation fund to support environmentally sustainable businesses.

According to him, the first phase of the intervention had already supported three businesses involved in reusable sanitary pads production, alternative energy solutions and paper recycling initiatives aimed at reducing open burning.

He added that his organisation is also sponsoring more than 200 schoolchildren while supporting women-focused environmental empowerment programmes across communities.

Climate Beyond Borders Caravan Begins in Abuja, Targets Youth-Led Climate Action Across Africa

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