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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
Zulum meets 56 state-sponsored doctors, approves training fund, others
Zulum meets 56 state-sponsored doctors, approves training fund, others
By: Our Reporter
Borno State Governor, Professor Babagana Umara Zulum, has approved a special training fund for the 56 medical doctors currently undergoing residency training under the state’s sponsorship.
The governor granted the approval during an interactive meeting with the resident doctors at the Government House in Maiduguri on Thursday.

The meeting was convened at the governor’s instance to assess the progress of the doctors’ training and address any challenges hindering their seamless progression in their various places of primary assignments.
Beyond approving the training fund, Zulum also approved the immediate implementation of promotional benefits for all resident doctors due for career progression.
He directed that the promotions be implemented with immediate effect and that all arrears be paid to the beneficiaries, dating back to the effective date of their promotions.
The governor also directed the Borno State Hospital Management Board to organise a similar interaction with other medical doctors in the state who are not undergoing residency training.

He reiterated that the welfare of all health workers in the state remained a top priority for his administration, stressing that a motivated workforce is essential for delivering quality healthcare services to the people of Borno.
“My administration is committed to creating an enabling environment for our health professionals. We understand that without their dedication, we cannot achieve the needed health coverage we desire for our citizens,” the governor stated.
The meeting was attended by key stakeholders in the health sector, including the Commissioner for Health, Professor Baba Mallam Gana; the chairman of the State Hospital Management Board, Dr Joseph Jatau; and the Chief Medical Director, Professor Abubakar Kullima.

Also in attendance were the acting Chief of Staff, Dr Babagana Mustapha Mallumbe; the Chief Adviser to the Governor, Dr Mairo Mandara, the Executive Director, Borno State Primary Healthcare Development Board, Professor Arab Alhaji Mohammed and the Chief Medical Director of the Kashim Ibrahim University Teaching Hospital, Prof. Ibrahim Musa Kida.
Zulum meets 56 state-sponsored doctors, approves training fund, others
News
Ebizi Unreliable, Adulterous Conduct Modelling Around Lokpobiri Over Deputy Office – Kolga Group Alleges
Ebizi Unreliable, Adulterous Conduct Modelling Around Lokpobiri Over Deputy Office – Kolga Group Alleges
The Kolga Youth Progressive Alliance has raised perturbing concerns of Mrs Ebizi Brown Ndiomu, member representing Sagbama Constituency || desperateness for consideration as Deputy Governor of Bayelsa State.
The state lawmaker rumoured for possible nomination, consideration for the replacement of the departed deputy governor, has been modelling around the Honorable Minister of State for Petroleum Resources (Oil), Senator Heineken Lokpobiri in Abuja.
A statement issued on Friday by the group spokesman, Comrade Tony Alazigha, the group described Mrs Ebizi Brown adulterous demeanor to be ascribed as desperate measures for consideration, and replacement of the departed deputy governor.
According to the group, Ebizi who shares a good working relationship with the Governor, Senator Douye Diri had ought to concentrate on the established relationship with the governor rather than adulterously running around Heineken Lokpobiri.
The adulterous, scandalous conduct of the honorable member modelling around politicians for consideration of the office of the deputy governor, will dent the image and reputation of the governor and the government.
The group spokesman demanding the general public to be watchful, stated that Kolga leaders who are relations to Mrs Ebizi Brown, are the people desperately pushing for the nomination of the lawmaker to deputize the Governor, Senator Diri.
He said the Kolga leaders pushing for Mrs Ebizi nomination as deputy, are leaders whom Governor Douye Diri has munificently made billions, but not satisfied because they want to control the government, and the leadership structure of the state.
The group cautioned Senator Douye Diri to dismiss the consideration of the Sagbama lawmaker for the replacement of the departed deputy governor, Mr Lawrence Ewhrudjakpo.
“The office of the deputy governor demands capacitated individual of reliability, trustworthy, hardworking, resourcefulness, competence, and not adulterous character displayed by the lawmaker from Sagbama.
“Is it the honorable minister working for governorship ambition that will nominate her or the governor whom she share good working relationship.
“Even in Sagbama local government area, there more competent, reliable individuals working closely with the governor that are worthy to deputize Governor Diri, and definitely not adulterous, unreliable Ebizi Brown.
The group urged Senator Diri to look inward in Sagbama for competent, dependable, trustworthy individual that will prioritize Bayelsans before personal interest to deputize him.
Ebizi Unreliable, Adulterous Conduct Modelling Around Lokpobiri Over Deputy Office – Kolga Group Alleges
News
Zulum okays N12.9b to sponsor Borno indigenes on aeronautics/engineering degrees
Zulum okays N12.9b to sponsor Borno indigenes on aeronautics/engineering degrees
By: Our Reporter
Borno State Governor, Professor Babagana Umara Zulum, has approved a N12.9 billion scholarship scheme to sponsor 54 indigenes of the state to study aeronautics and engineering with various professional certifications, at the Isaac Balami University of Aeronautics and Management (IBUAM).
The training programme covers basic pilot training, with 10 beneficiaries specialising in Aerospace Engineering, 11 in Electrical and Electronic Engineering, 11 in Mechatronics Engineering, 12 in Software Engineering, and 10 in Systems Engineering.

At a brief ceremony held at the Government House in Maiduguri on Thursday night, Zulum presented a cheque for N2.5 billion to the institution, covering the annual tuition and associated expenses, with the 5-year total package valued at N12.9 billion.
Addressing the beneficiaries, Zulum charged them to remain focused and dedicated to their studies. He emphasised that the selection process was deliberately designed to ensure equity across the state, with two students chosen from each of Borno’s 27 Local Government areas.

“What matters most is not just gaining admission, but how focused you will be in your studies. I advise you to remain dedicated and become good ambassadors of our state,” the governor stated.
In addition to funding their education, the governor announced an immediate financial support package of N500,000 per student to cover resumption logistics and other incidental expenses.

Giving an overview of the selection process, the State Commissioner for Education, Engr. Lawan Abba Wakilbe revealed that the scholarship attracted interest from across the state. He disclosed that the ministry received over 3,000 applications.
According to the Commissioner, this large pool was initially shortlisted to 1,200 candidates, who were then subjected to a written examination, and the final 54 successful candidates emerged.
“These programmes reflect Governor Zulum’s commitment to human capital development, youth empowerment and investment in education,” Engr Wakilbe said.

The founder of IBUAM, Isaac Balami, an indigene of Borno State, commended Governor Zulum for the initiative. He assured the government that the students would receive world-class training, expressing confidence that they would be among those who would eventually build the first made-in-Nigeria aircraft.
Zulum okays N12.9b to sponsor Borno indigenes on aeronautics/engineering degrees
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