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

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
News
US Says Latest Visa Decision Against Nigeria Unconnected to BRICS, Venezuelan Refugees

US Says Latest Visa Decision Against Nigeria Unconnected to BRICS, Venezuelan Refugees
By: Michael Mike
The United States Mission has explained that recent reduction in visa validity for Nigerian nonimmigrant travellers is not tied to Nigeria’s position on BRICS nor the Venezuelan deportees.
US President Donald Trump had threatened to impose tariffs on “Any country aligning themselves with the Anti-American policies of BRICS”
Trump made the statement few days ago while BRICS leaders and associates
met in Rio de Janeiro, Brazil for the 2025 summit.
The Minister of Foreign Affairs, Amb. Yusuf Tuggar had on Thursday on one of the National Televisions during his reaction to recent stringent visa regime to Nigerian travellers by the American government noted that it may be as a result of non acceptance of Venezuelan deportees, insisting that the country has trouble of its own
Tuggar said: “We already have over 230 million people,” and cannot add to our headache.
The US Mission in Abuja while clarifying the latest visa validity decision on Friday noted that the decision was rather based on a global security and technical review.
The mission in a statement on Facebook also reaffirmed its commitment to bilateral cooperation with Nigeria and expressed willingness to work with Nigerian authorities to meet the necessary criteria.
The statement read: “The U.S. Mission Nigeria wishes to address misconceptions about the recent reduction in visa validity for most nonimmigrant U.S. visas in Nigeria and other countries. This reduction is not the result of any nation’s stance on third-country deportees, introduction of e-visa policies, or affiliations with groups like BRICS.
“The reduction in validity is part of an ongoing global review of the use of U.S. visas by other countries using technical and security benchmarks to safeguard U.S. immigration systems.
“We value our longstanding partnership with Nigeria and remain committed to working closely with the Nigerian public and government officials to help them meet those criteria and benchmarks, thereby ensuring safe, lawful, and mutually beneficial travel between our nations.”
US Says Latest Visa Decision Against Nigeria Unconnected to BRICS, Venezuelan Refugees
News
Six community guards killed, others feared abducted in Zamfara bandit attack

Six community guards killed, others feared abducted in Zamfara bandit attack
By: Zagazola Makama
At least six members of the Community Protection Guards (CPG) in Zamfara State have been killed and others feared abducted following a deadly ambush by armed bandits in Bungudu Local Government Area.
Zagazola Makama report that the attack occurred at about 12:30 p.m. on Thursday as the CPG members were travelling from Bungudu to Yar Katsina in Kekun Waje District to condole with the family of one of their colleagues who was killed by suspected bandits a day earlier.
According to sources, the group was ambushed along the route by heavily armed attackers who opened fire on them, killing six CPG personnel on the spot.
The assailants also reportedly made away with several pump-action rifles belonging to the victims and one motorcycle.
Shortly after the incident troops of Operation FANSAR, were deployed to the scene. However, the attackers had already fled into the bush before their arrival.
The remains of the slain guards have been transported to Bungudu Town for burial rites, while efforts are underway to trace and rescue other victims suspected to have been abducted during the attack.
Six community guards killed, others feared abducted in Zamfara bandit attack
News
Suspected gunman dies after clash with police in Kogi, officer injured

Suspected gunman dies after clash with police in Kogi, officer injured
By: Zagazola Makama
A suspect linked to unlawful possession of firearms has died following a violent clash between his gang and police operatives in Idah, Kogi State.
The incident began on July 8, when detectives from the State Criminal Investigation Department (SCID) in Lokoja visited Aija area in Idah to arrest the suspect, simply identified as Enemi. Upon sighting the police, the suspect reportedly fled by jumping over the fence of his residence and had remained at large.
However, on July 10, fresh intelligence on his whereabouts prompted the Divisional Police Officer in Idah to mobilize a team of operatives, led by Inspector Ojumu Rokan, to effect his arrest.
While attempting to apprehend him, the team came under sudden attack from members of the suspect’s gang, who allegedly tried to disarm and mob the officers.
In the process, the suspect was shot in the leg while trying to escape, but was quickly whisked away from the scene by his accomplices.
During the confrontation, a police officer, PC Usman Kebiru of the Area Command, Idah, sustained multiple injuries after being attacked with machetes, cutlasses, and stones.
He was rushed to the General Hospital in Idah for treatment.
Subsequent reports reaching the division later confirmed that the injured suspect died at his family residence in Idah.
Security across the area has since been heightened, with all formations placed on red alert. Intensive patrols are ongoing to prevent further unrest and track down members of the fleeing gang.
Suspected gunman dies after clash with police in Kogi, officer injured
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