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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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Kashim Shettima: Of Betrayal, Power, and Survival.

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Kashim Shettima: Of Betrayal, Power, and Survival.

By: Inuwa Bwala.

“March has returned, and with it the Ides. Beware the men who call you brother.”
Julius Caesar was perhaps Rome’s most trusted general. He crossed the Rubicon for Rome, conquered Gaul for Rome, and pardoned enemies for Rome.

Yet it was neither Gaul nor Pompey: his avowed rivals, that killed him. It was Brutus: his friend, and confidant yet his protégé, who was described as “the noblest Roman of them all.”

Julius Caesar did not slump and died because the daggers were too many, rather, bacause he noticed the person he least expected could betray him amongst those stabbing him: Brutus. In utter shock and disbelief, Caesar slumped, but not before he uttered the word,”And you too Brutus?”.

There is no doubt that, Kashim Shettima was Borno’s most tested governor. He walked into boiling areas, when others fled the state. He rebuilt schools bombed by Boko Haram. He chose to stay in Maiduguri when Abuja offered comfort.
As Vice President, he has carried himself as a true statesman abs the face of the Tinubu administration at national and international meets.

He always speaks of “the sanctity of human life” and calked for swifter and total mobilisationagainst terror.
Yet today, whispers from Borno and Abuja suggest the daggers are not in the bush like that of Boko Haram, they are in the hands of his kinsmen, those he hold family meetings and political meetings with.

Those who could read between the line, may be able to tell, when Shettima gave an anecdote at a recent public function, about the visit by his kinsmen to his boss, Bola Ahmed Tinubu, just three months into the life of the administration.

Like Brutus and the conspirators of the Shakespearean fame, who claimed they did not hate Caesar, but loved Rome more, those who visited Tinubu claimed to love Nigeria more and her President, abd not brcause thry hated Shettima.
Brutus in particular played on a so-called republican pride and his fear of tyranny, which he used in convincing himself that betrayal was patriotism. He struck to “save” Rome.

Shettima’s own “Brutuses” use a different script, relying on Shetyima’s perceived ambition and the attendant battle to keep himself in the balance of power as an alibi.
And in the face of contending forces, they recruited people to plsy out the cards, while remaining in the shadows. The charges may appear different with that if Caesar, but the intents are same. And while still smarting from the Muslim-Muslim debacle, Shettima had hradly setyled in office when they began to spread rumours of him, being too Borno, not enough to be a northerner. Too ambitious, fetish, independent minded and growing too popular. One thing they could not take away from him though us the fact that Shettima is intelligent, shrewd and a master schemer, which his boss knows too well.

I had cause to warn of this years ago seeing Shettima’s passive refusal to pick between kinsmen in place of statesmen to work with him.
I could see through the plots to denigrate a fine emergent nationalist by linking him with Boko Haram, painting him as fetish, portraying him as a religious and ethinic checkbox, all in a bud to undo him. The weapon when he was govetnor was insurgency, but the weapon now is political naivity and stereotyping . The tactic includes convincing his Kanuri kinsmen to fight him, so that “when Kanuri fights Kanuri, others will win. But beyond that, even his Kanuri brothers seem to have an axe to grind with him.
The painful truth remains, that, Caesar’s killers were senators in the Capitol, but Shettima’s challengers may be his own kinsmen: some of whom, he nentored snd no one can ever convince him that, they could ever work against him. In both cases, the dagger is dipped in familiarity.
It cuts deeper because the hands holding it, are either those he mentored or once broke bread with him.

Caesar died because he ignored omens. Not even Calpurnia, his wife’s dream could deter him. He ignored the soothsayer, and shunned the Senate’s mood, thinking goodwill was a good sheild and armor.

Shettima’s March 2027 is loaded with omens too, arising from fresh attacks by vested interests, intrigues amongst political players, betrayal by kinsmen, espionage by aides and attachees, dissertion by hitherto close allies, manipulations in the media, ethnic or religious profiling, clandestine meetings that without communiqués, but with lethal intents, contending forces in the party who whisper that 2027 needs a “new pairing.” indeed, the ides are here, because a second term is near, and second terms birth daggers.

As governor, perhaps Shettima survived by moving rather faster than conspiracy. He outrun, those who want to either even scores or shake off his dominace, and those people have remained at daggers drawn with him
How Shettima Survives, will definitely be a refrence point in power struggles in Nigeria.
But unlike Caesar who never learnt, Shettima is a good student of Robert Greens 48 Laws of Power, and must have drawn lessons from the falls of others before him.

To survive, Shettima must learn to trust, but audit the Praetorians. Caesar trusted Brutus with his life. Shettima cannot afford blind trust. The INEC database compromise and probe shows how insider access kills. Shettima must do what he did as governor: forensic audits, no sacred cows. As I earlier said, he must have his own policy, which must not be changed simply because some people want to determine its content.
He must learnt to keep the people, his own trusted people, and must not loose, as Caesar lost Rome due to his belief in his personal prowess and capacity. Shettima still owns Borno’s streets and still conttols the larger and more lethal political forces in the North.

He should be able to name the Brutus, but should not become an Antony, whom at Caesar’s funeral sparked civil unrest. Shettima cannot afford chaos. He should have a machinery on ground that will expose the plot, without burning the Forum. He should expedite action in uniting the North, and rally the support of kinsmen, even as a counterforce, or risks allowing the real enemies to win.

Importantly, he should bear in mind, that, the parabolical March is not the end, the ides pass. For Caesar, it ended at Pompey’s statue, but for Shettima, March can end with a stronger alliance. He must do what he told the nation: “We choose light over shadow, and hope over despair”.
The Verdict of History, had
Brutus dying on his own sword, muttering, “Caesar, now be still.” Betrayal did not save the Republic, rather it buried it.
Shettima’s kinsmen face the same choice. They can strike and wait for the verdict of history, or they can sheathe the dagger and remember: the real enemy still sleeps someehere else.

Twelve years ago, I wrote that Shettima’s ides would test Borno. In 2026, I state without fear of contradiction, that, they will test Nigeria.
Caesar ignored the soothsayer because he was in so much hurry. Shettima, as always, may not be in a hurry, but should he decide to, that hurry may yet save him.

Kashim Shettima: Of Betrayal, Power, and Survival.

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FACT CHECK: No School Attack, No Student Abduction in Kautikari — What Really Happened During the ISWAP Raid

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FACT CHECK: No School Attack, No Student Abduction in Kautikari — What Really Happened During the ISWAP Raid

By Zagazola Makama

A wave of alarming reports circulating across social media and some online platforms has claimed that Boko Haram insurgents attacked a school and abducted students in Kautikari community of Chibok Local Government Area, Borno State.

The claims, predictably amplified by emotionally charged references to the 2014 Chibok schoolgirls’ abduction, have generated anxiety among Nigerians following developments in the troubled region.

However, a detailed fact-check by Zagazola Makama, based on assessment from field sources, and video evidence from the scene, has found the claims to be entirely FALSE.

According to sources, the incident occurred at about 7:30 p.m. on June 13 when ISWAP terrorists launched an attack on a hunters’ patrol base located within the premises of a disused primary school in Kautikari.

The facility being used by the hunters was not functioning as a school at the time of the attack, nor were students present at the location. Rather, local hunters had established a patrol outpost within the structure, using some of the classrooms as temporary accommodation and operational shelters while supporting troops of Operation HADIN KAI’s efforts in the area.

The terrorists specifically targeted the hunters’ base and not a school populated by students as widely claimed. Initial resistance by the hunters successfully repelled the first assault.

However, the terrorists later regrouped in larger numbers and launched a second attack, forcing the hunters to temporarily withdraw after running low on ammunition.

Military sources disclosed that reinforcement teams comprising troops of the 117 Task Force Battalion from Kwada, supported by a Quick Response Force, local hunters and vigilante personnel, rapidly mobilized to the scene and engaged the terrorists. The coordinated response eventually overwhelmed the attackers and forced them to retreat.

No Student Was Abducted

Contrary to viral claims, there is no evidence that any student was abducted during the attack. Operational reports from the scene recorded no missing students, no reports of schoolchildren being taken away, and no indication that the terrorists targeted an educational institution in session.

Security sources confirmed that accountability checks conducted after the attack found no cases of student abduction.

In fact, the only confirmed casualties were one civilian who was reportedly struck by a stray bullet fired by the terrorists and one member of the Civilian Joint Task Force (CJTF) who sustained a gunshot wound to the arm.

Sources said also that the terrorists set fire to clothing and personal belongings belonging to the hunters stationed at the outpost. No troops were killed or injured during the engagement.

Further undermining the false reports is video footage obtained by Zagazola Makama from the aftermath of the attack. In the footage, one of the affected hunters is seen showing the damaged facility and burnt belongings while lamenting the destruction caused by the terrorists.

The hunter can be heard explaining that the location served as their place of accommodation and operational base.

“This is where we sleep,” he says while pointing to the affected section of the building.

The footage clearly supports military accounts that the target was a hunters’ outpost and not an occupied school hosting students.

The confusion likely arose because the hunters’ base was situated within the premises of a primary school building.

Photographs and videos showing damaged classrooms were subsequently circulated online without context, leading some platforms to incorrectly conclude that a school had been attacked and students abducted.

The result was the rapid spread of misinformation that failed basic verification standards.

Given Chibok’s painful history, any report involving schools and abductions naturally attracts national and international attention. This makes accurate reporting even more important.

FACT CHECK: No School Attack, No Student Abduction in Kautikari — What Really Happened During the ISWAP Raid

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Police Foil IED Attack, Destroy Explosive Device in Zamfara

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Police Foil IED Attack, Destroy Explosive Device in Zamfara

By: Zagazola Makama

The Zamfara State Police Command says it has successfully foiled a planned attack after its Explosive Ordnance Disposal (EOD) unit discovered and safely destroyed an Improvised Explosive Device (IED) in Tsafe Local Government Area of the state.

The Command said the operation was carried out on Friday at about 4:15 p.m. along the Kunchin Kalgo axis following credible intelligence received through community engagement efforts.

According to a statement issued by the Command, operatives of the Violence Crime Response Unit (VCRU), in collaboration with the EOD team, swiftly mobilised to the area after receiving information about a suspected explosive device planted by bandits.

Preliminary findings indicated that the device was strategically planted along the road with the intent of causing mass casualties among commuters and other road users.

The statement added that the timely response of the operatives led to the safe detection, evacuation and controlled destruction of the explosive device before it could cause any harm.

The Command commended the vigilance and cooperation of local residents, describing community support as critical to ongoing security operations in the state.

It further assured residents that efforts were ongoing to identify, arrest and prosecute those responsible for planting the device.

The police also disclosed that patrols had been intensified across vulnerable areas to prevent similar incidents and ensure the safety of road users.

The Commissioner of Police, A.M. Bello, reiterated the Command’s commitment to sustained operations against banditry and other violent crimes in Zamfara State.

Police Foil IED Attack, Destroy Explosive Device in Zamfara

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