News
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
Scores killed in Boko Haram/ISWAP renewedclashes in Mandara Mountains and Sambisa Forest
Scores killed in Boko Haram/ISWAP renewed
clashes in Mandara Mountains and Sambisa Forest
By: Zagazola Makama
Scores of fighters were reportedly killed in a week-long surge of violent infighting between rival factions of Boko Haram and the Islamic State West Africa Province (ISWAP) across the Sambisa Forest axis of Borno State.
Security sources told Zagazola Makama that the renewed hostilities erupted on Jan. 3, following a coordinated ISWAP raid led by two commanders, identified as Jundullah and Ibn Hataf, targeting camps loyal to the Boko Haram faction around the Ali Ngulde axis of the Mandara Mountains.
The offensive, according to the sources, was met with stiff resistance as Boko Haram elements mounted a counter-ambush under the coordination of a field commander known as Abu-Rijal, also called Ba-Sulhu. Dozens of ISWAP fighters were reportedly killed in the encounter, while many captured alive, with weapons seized by the defending faction.
Footage that resurfaced during the week and said to have been obtained by Zagazola Makama, showed captured ISWAP fighters being executed before other combatants, amid claims of victory by the Boko Haram faction.
While the video reflects the brutality that has characterised inter-group rivalries in the forested enclaves of the Lake Chad in Borno State. Heavy weapons including AK-47 rifles, a general-purpose machine gun (GPMG), an anti-aircraft gun and assorted ammunition, were
recovered during the initial clashes.
However, the balance of power appeared to shift days later. On Jan. 6, ISWAP fighters were said to have launched a retaliatory assault on a Boko Haram stronghold in the Sabil Huda axis, triggering a prolonged exchange of heavy gunfire that lasted several hours.
Sources said ISWAP forces eventually overran the position, killing at least 12 Boko Haram fighters and seizing additional weapons.
The aftermath of the fighting reportedly forced the relocation of Boko Haram families, women and children from contested camps to perceived safe havens around the Yale General axis.
Night operations were also said to have been conducted to track fleeing fighters, though no further confirmed engagements were recorded as of Wednesday.
The renewed clashes are consistent with a long-running rivalry rooted in ideological differences, leadership disputes and competition over territory, resources and fighters. Both factions, according to sources, are re-arming and repositioning for possible further attacks.
Scores killed in Boko Haram/ISWAP renewed
clashes in Mandara Mountains and Sambisa Forest
News
Zulum begins construction of 2 mega schools in Hawul
Zulum begins construction of 2 mega schools in Hawul
By: Our Reporter
Borno State Governor, Professor Babagana Umara Zulum, has commenced the construction of two new mega schools in Hawul Local Government Area on Wednesday.
A 48-classroom High Islamic College is located in Shafa. It will operate under the accredited curriculum of the National Board for Arabic and Islamic Studies (NBAIS), designed to provide a holistic and modern Islamic education.

Zulum explained that the construction of High Islamic Colleges is part of his campaign promise, which will blend formal education with the study of authentic Islamic knowledge and allow learners to study digital knowledge, numeracy, literacy, and vocational skills.
The second mega school project launched by the Governor is situated in Marama and is aimed at expanding access to quality educational facilities across the LGAs by the Zulum administration.
During his visit, Governor Zulum also announced a plan for the recruitment of additional teachers, stating, “I am happy to lay the foundation of a mega school in Marama town. We are going to support you in all ramifications. In line with my campaign promises to deliver and transform the education sector, this government will construct a befitting two-storey building with 36 classrooms, in addition to other facilities.
“Due to a shortage of teachers, we must recruit competent teachers who are indigenes of Marama to teach in this school,” Zulum stated.

Zulum was assisted with the foundation-laying by the Commissioner of Education, Science, Technology and Innovation, Engr. Lawan Abba Wakilbe.
Similarly, Governor Babagana Umara Zulum visited the National Orthopaedic Hospital, Azare, also in Hawul Local Government Area, a facility that was rehabilitated and donated by the State Government to fast-track the take-off of the hospital.
Governor Zulum also commissioned projects executed by Hawul Local Government, including a shopping complex and market stalls.
The Governor was accompanied by Senator Mohammed Ali Ndume (Borno South); former Deputy Governors, Usman Mamman Durkwa and Ali Abubakar Jatau; Hon. Bukar Talba (House of Representatives); the Deputy Speaker, Hon. Abdullahi Musa Askira; members of the State Assembly; commissioners; local government chairmen; and other stakeholders from Southern Borno.
End
News
BORNO MECHANICS’ ASSOCIATION APPOINTS PCC COMMISSIONER AS PATRON
BORNO MECHANICS’ ASSOCIATION APPOINTS PCC COMMISSIONER AS PATRON
By: Our Reporter
The Borno State Motorcycle, Tricycle and Generator Mechanics Association has paid a courtesy visit to the Honourable Federal Commissioner, Public Complaints Commission (PCC), Borno State Hon. Yusuf Adamu in his Office, during which he was formally appointed as the Patron of the Association.
The visit provided an opportunity for a robust and interactive engagement between the leadership of the Association and the Honourable Federal Commissioner. In his remarks, the Commissioner expressed appreciation for the visit and the confidence reposed in him by the Association. He used the occasion to urge members to, with immediate effect, take advantage of the Mechanic Village allocated to them by the Borno State Government by relocating their operations accordingly. He emphasized that the initiative was aimed at enhancing orderliness, professionalism, and safety within the sector.

The Honourable Federal Commissioner further admonished the Association to remain law-abiding and loyal to constituted authority, stressing that peace and progress can only thrive in an atmosphere of respect for the rule of law. He also charged members to uphold the principles of justice, equity, and fair play in the discharge of their duties, and to desist from any form of sharp practices, particularly cheating unsuspecting members of the public.

Responding on behalf of the delegation, the leader of the Association expressed profound gratitude to the Honourable Federal Commissioner for his warm reception, fatherly advice, and willingness to serve as their Patron. He assured the Commissioner that the Association would adhere strictly to his counsel, particularly on relocating to the Mechanic Village and maintaining high ethical standards in their operations.

The courtesy visit was rounded off with special prayers for peace, progress, and prosperity for the Patron, the Public Complaints Commission, and the Federal Republic of Nigeria. The event concluded with the taking of group photographs to commemorate the occasion.
BORNO MECHANICS’ ASSOCIATION APPOINTS PCC COMMISSIONER AS PATRON
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