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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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BOTMA: The agency will not tolerate underage driving in Maiduguri

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BOTMA: The agency will not tolerate underage driving in Maiduguri

By: Bodunrin Kayode

The general manager of the Borno State Traffic Management Agency (BOTMA), Eng. Baba Tijani, has said that his agency will not tolerate “underaged” kids driving keke napep in Maiduguri and environs.

The GM warned that the brazen display of wrongdoing by Keke Napep was becoming alarming, especially with lots of underage kids being caught committing such crimes.

The Borno traffic management agency boss vowed to bring owners of such erring Keke napeps to book to check their reckless behavior on the streets of the Maiduguri metropolis and beyond.

Tijani, who spoke exclusively during the 2025 Federal Road Safety Corp RS12.2 Borno special marshals sectoral workshop, said that his management is aware of the dangerous excesses of the Keke Napep riders in the town and has never taken it lightly with them.

“I can assure you that we have details of all the excesses of the Keke Napep drivers in the city, and we are not joking with them. As long as we have their details, we can trace and deal with them, and the rest is history.

“I can assure you that there is no keke that is not registered by us regardless of their high numbers. For as long as they are registered in our data bank, we know how to trace them. Even if the keke is used for robbery, I assure you, we know how to sanction them for as long as they are within the state.

“By the way, it is not true that we are not capable of handling them in spite of their numbers and the enormous nature of their offenses. We do not overlook the misdemeanor of Keke Napep drivers in Maiduguri no matter how small they are.”

He told this reporter that under his watch kids who are under 18 were totally forbidden from driving keke napeps in Maiduguri metropolis, adding that residents should also avoid such keke napeps because they are obviously a death trap for commuters.

Eng. Tijani stressed that unless drivers are 18 years or above, they are not permitted to drive a keke napep in the entire Borno state, adding that only stable adults are registered as drivers of napep in their data bank used to sanction erring ones.

Tijani noted that for the remaining part of the year, his men will monitor the main roads in the metropolis thoroughly during the yuletide period to force the napep boys to conform to expected norms and behavioral patterns.

On staff strength, he added that the agency has been making use of what it has, hinting that “we have over 300 personnel in MMC and Jere alone, and we are trying to do our best with what we have even with the confusion at the Custom and Gamboru axis of the town.”

“We are aware of the challenges in many areas, and we believe that very soon the customs area will be handled. We are aware that the area is heavily congested in terms of traffic because the tunnel from one side to the other is not used, but I wish to assure commuters that all this will become history soon.

On the misbehavior of some of his staff, he noted that checks and balances have been placed within the system by management, adding that their provost marshals in white caps are out to oversee the erring staff and will send feedback to us on the next step.

Eng. Tijani called on the general public to cooperate with him and his management team by reporting erring marshals as and when wrongs were committed, adding that as soon as they are reported, action will be taken against such officials.

To press his point home, the GM revealed that about 30 erring marshals have been sacked so far from the agency, stressing that management does not drop their guards when it concerns portraying them in a bad light.

Speaking on the welfare of his staff, the GM agreed that there was an urgent need to boost the salaries of his marshals, as they are quite lower than the current minimum package.

He, however, announced that he was not leaning on his oars concerning their welfare because the matter has been tabled before the executive, and the governor is about to work on it, thereby taking care of his people.

Tijani regretted that they do not have a board that would assist them in putting their challenges on the front burner but is grateful to the media for doing justice to the plight of his people.

BOTMA: The agency will not tolerate underage driving in Maiduguri

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Nigeria: No casualties after US bomb rocks Jabu Village in Sokoto

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Nigeria: No casualties after US bomb rocks Jabu Village in Sokoto

By: Our Reporter

Residents of Jabu village in Sokoto state, Northwest Nigeria reported that there are no casualties following US bomb that rock the village on Christmas Day targeting bandits terrorists.

A video surface Monday morning showing some residents carrying heavy metal, which is said to be the bomb shell fired by US into the area.

Although there are no official comments yet to what happened in the Northwest, some residents believed that some targeted areas may have yielded most results.

NEWSng observed that following the reported US military targets on terrorists enclaves in the Northwest, top islamic clerics and certain individuals known to be marking comments in defense of the bandits and Fulani militias activities have been usually quiet.

When ABC NEWS contacted few clerics to speak on the attacks, they decline comments stating that they are also waiting to hear what the government would say with regard to the claimed by US President Trump.

“This involve US and Nigeria. I also heard but I was not there not can establish facts to what happened on Christmas Day in Sokoto. ” One of the cleric, who pleaded not to be mentioned in print said.

Another clerics, Malam Usman Tukur simply said “No comments.”

Also another who refuses to speak at all holds his lips in declining comments.

Nigeria: No casualties after US bomb rocks Jabu Village in Sokoto

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Why US–Nigeria counter-terrorism cooperation remains critical to defeating insurgency

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Why US–Nigeria counter-terrorism cooperation remains critical to defeating insurgency

By: Zagazola Makama

The ongoing United States–Nigeria counter-terrorism operations are critical not only to degrading terrorist networks, but also to helping the international community, particularly the U.S., better understand the scale, complexity and human cost of Nigeria’s long-running war against terrorism.

Nigeria has battled multiple terror and extremist groups for over a decade, with attacks spanning the North-East, North-West and North-Central zones, claiming thousands of lives, displacing millions and overstretching security and humanitarian resources.

Therefore, deeper operational cooperation allows the U.S. to see firsthand the terrain, tactics and evolving threat environment Nigerian forces contend with daily from suicide bombings and IED warfare to cross-border terrorism, banditry and extremist collaboration.

Joint operations provide a clearer picture of what Nigeria is passing through. It is different from reading intelligence reports. When partners operate together, there is a better appreciation of the sacrifices, the operational difficulties and the resilience required to fight terrorism in this environment.

Though, nothing new in what the Nigeria Air Force was already doing but the cooperation, will enhanced intelligence sharing, surveillance, training and technical support, while also improving Nigeria’s capacity to disrupt terrorist logistics, communication and financing networks.

Nigeria brings critical advantages to the partnership, including local knowledge, community structures and long-term operational presence, while the U.S. contributes advanced intelligence, surveillance and reconnaissance capabilities, precision strike support and global counter-terrorism experience.

This synergy will help narrow intelligence gaps, improve early warning systems and strengthen the ability of Nigerian forces to respond to threats more proactively. Beyond military gains, the partnership helps place Nigeria’s security challenges in proper global context, correcting misconceptions that often underestimate the intensity of terrorist violence in the country.

The collaboration helps the U.S. and other international partners understand that Nigeria is not facing isolated incidents but a sustained, multi-front war. That understanding is essential for sustained diplomatic, technical and humanitarian support, rather than the rhetoric being purported about the conflict.

The partnership also sends a strong message to terrorist groups that Nigeria is not isolated in its fight, and that attacks on civilians and security personnel attract international attention and consequences.

However, counter-terrorism cooperation must go beyond kinetic operations. Those executing these operations must put emphasized on the importance of civilian protection, community engagement and post-conflict stabilisation, as lasting peace cannot be achieved through force alone.

Why US–Nigeria counter-terrorism cooperation remains critical to defeating insurgency

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