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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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3 bandits, 11 community guards killed in bloody clash in Katsina

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3 bandits, 11 community guards killed in bloody clash in Katsina

By: Zagazola Makama

No fewer than three suspected bandits and 11 members of a local vigilante group have been killed in a violent clash between communities and repentant bandits in Jibia Local Government Area of Katsina State.

The incident, which occurred on Tuesday, followed the collapse of a peace arrangement between residents of Falale and Kadobe villages and a group of repentant bandits operating in the area.

Security sources told Zagazola Makama that the confrontation began at about 12:00 p.m. when tensions escalated into a fierce exchange, leading to the killing of three of the bandits.

The development, however, triggered a swift reprisal attack by the armed group, resulting in the deaths of 11 vigilante members drawn from the affected communities.

The Katsina State Police Command confirmed the incident, noting that security operatives were immediately deployed to the scene upon receipt of the report.

Similarly, a joint teams of the troops of Operation FANSAN YANMA, police and other security agencies engaged community leaders and stakeholders to de-escalate the situation and prevent further violence.

“Normalcy has been restored in the area, while investigation into the incident has commenced,” the sources said.

The clash is believed to be linked to a breakdown in trust between the communities and the repentant bandits, amid ongoing efforts by the state government to explore non-kinetic approaches to addressing insecurity in parts of the state.

Residents said the situation remains tense, although security presence has been reinforced to forestall further attacks.

3 bandits, 11 community guards killed in bloody clash in Katsina

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Nigerian Military eliminate 61 terrorists in Malam Fatori, Borno

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Nigerian Military eliminate 61 terrorists in Malam Fatori, Borno

By: Zagazola Makama

The Nigerian Army troops of Operation Hadin Kai (OPHK), in close coordination with, The Nigerian Air Force (NAF), has neutralised no fewer than 61 ISWAP terrorists during a foiled infiltration attempt in Malam Fatori, Abadam Local Government Area of Borno.

Sources involved in the operation disclosed that the terrorists launched the attack in the early hours of Wednesday, advancing on foot and deploying armed drones in a desperate bid to breach the defences of troops at the 68 Battalion location.

The sources told Zagazola Makama that the attack, which came through the frontage of Bravo Company from the Duguri general area, was met with overwhelming firepower and superior coordination between ground forces and air components.

The sources explained that troops, supported by precision air strikes, engaged the insurgents in a fierce battle that resulted in heavy casualties on the side of the terrorists.

According to him, the integration of air and ground manoeuvre ensured that the terrorists were fixed, targeted and neutralised in large numbers.

“Our forces executed four highly effective air interdiction strikes on identified enemy concentrations, decimating their fighting capability. The synergy between air and land forces denied the terrorists freedom of movement and forced a disorderly withdrawal towards the Arege general area after suffering heavy casualties,” he said

The sources noted that additional strike support from allied Nigerien air assets further compounded the pressure on the fleeing insurgents, although battle damage assessment from those strikes was still ongoing.

“The allied forces from neighbouring Niger Republic also conducted rapid strike passes in support of the operation, thereby compounding the pressure on the fleeing insurgents.

“On own casualties, the officer confirmed that four soldiers sustained minor injuries during the engagement and have since been stabilised.

Nigerian Military eliminate 61 terrorists in Malam Fatori, Borno

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VP Shettima Mourns Borno Terror Attack Victims, Says No Religion Endorses Killing Of Innocent Lives

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VP Shettima Mourns Borno Terror Attack Victims, Says No Religion Endorses Killing Of Innocent Lives

By: Our Reporter

Ahead of his trip to Maiduguri, the Borno State capital, Vice President Kashim Shettima , has expressed grief over the death of 25 persons killed in the multiple explosions in different locations across Maiduguri, the Borno State capital on Monday.

He pointed out that no religion sanctions the killing of innocent lives, as the sanctity of human life remains a core tenet of major world faiths.

VP Shettima, who spoke on Tuesday during the closing of the Annual Ramadan Tafsir at the State House Mosque, Abuja, prayed Almighty Allah to grant the souls of those killed in the terror attack in Maiduguri eternal rest, reward them with Aljannah firdaus and give their family the fortitude to bear the irreparable loss.

Praying Almighty Allah to also vanish all agents of terror from the surface of the earth, the VP said, “May the lives of innocent souls – 25 of them – that lost their lives in Maiduguri last evening rest in peace. May Allah grant their souls eternal rest and reward them with His Aljannah firdaus, and may Allah also grant their families the fortitude to bear the irreparable losses.

“May Allah bring this madness to an end. No religion sanctions the killing of the innocent. Whatever that is motivating them, may Allah either guide them on to the right path or May Allah vanish them from the surface of the earth.”

The Vice President emphasised the need for all Nigerians to continue to pray for the country across every sector, as well as pray that the Almighty should continue to grant President Bola Ahmed Tinubu and members of his team wisdom, courage, sincerity and equity in service.

He noted that each season of Ramadan reminds Muslims of a truth that power often tries to hide from man, and that no sit is permanent, just as no office is ultimate and no human being stands above his dependence on his creator.

VP Shettima said, “In the presence of Allah, the distance between the mighty and the unknown vanishes. What remains is character, what remains is accountability, what remains is what we did with the trust placed in our hands.

“This is why gatherings such as this matters. They rescue public lives from arrogance; they retain soul to scale; they teach those entrusted with authority that the nation is not built by policy alone but by conscience; not by proclamation alone but by restraint; not by ambition alone but by fear of Allah.”

The VP called on the Muslim faithful to continue to live in the teachings and lessons of the month of Ramadan, as the final days of Ramadan begins to sleep through their fingers.

“The question before us is not whether Ramadan is ending. The question is whether its teachings will continue to live in us after the moon has changed.

“It is quite easy to cut the head when the atmosphere is charged with devotion. The harder task is to carry it into ordinary days, into the market, into the office, into the home, into the chamber of power, and into the private corners where only Allah sees what we are doing, ” he noted.

While drawing from the lessons of Ramadan, the Vice President said the holy month had thought the Muslim faithful that pity without mercy is noise and worship without service is incomplete.

“So, as we close this year’s Tafsir, let us not return to the habits that weaken our common lives; let us not go back to bitterness, to reckless speech, to indifference dressed as sophistication. A believer doesn’t spend the whole month learning only to become a captive again of anger, greed and division.

“Nigeria needs homes where children encounter good examples before good advice. Nigeria, indeed, needs leaders in every spare who understand that influence is a trust, not a license, ” VP Shettima said.

He paid growing tribute to the Chief Imam of the State House Mosque, Sheikh Abdulwaheed Suleiman Abubakar, and his lieutenant for conducting the Tafsir with wisdom, calm hearts.

Earlier, the Chief Imam prayed for sustainable peace and development of Nigerian and the success of the Tinubu administration’s policies and programmes.

The cleric emphasised the need for leaders at all levels to continue to discharge their responsibilities with the fear of Allah for the process and development of the country.

VP Shettima Mourns Borno Terror Attack Victims, Says No Religion Endorses Killing Of Innocent Lives

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