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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
Justice Must Be Affordable, Accessible for Women, Says UN
Justice Must Be Affordable, Accessible for Women, Says UN
By: Michael Mike
The acting UN Resident and Humanitarian Coordinator in Nigeria, Elsie Attafuah, has called for urgent action to reduce the financial, social and institutional barriers preventing women and girls from accessing justice in Nigeria.
Attafuah made the call in Abuja on Friday during the launch of “The Cost of Justice: Women’s Voice of Resilience in Nigeria,” an anthology documenting the experiences of women who have navigated the country’s justice system in pursuit of accountability.
The event, held at the United Nations House in Abuja, was organised by the South Saharan Social Development Organisation in collaboration with UN Women and Ford Foundation as part of activities marking International Women’s Day 2026.
Speaking at the gathering, Attafuah said the anthology serves as a powerful reminder that behind policy debates on justice are real human stories of struggle, resilience and courage.
She noted that many survivors of violence face significant financial burdens when seeking justice, including the cost of transportation, medical reports, legal representation and repeated court appearances.
According to her, these expenses can make the pursuit of justice extremely difficult for many women already facing economic hardship.
She also highlighted the lengthy and complex legal processes survivors must navigate, noting that court proceedings often take months or even years to conclude. During such periods, victims may face pressure from families or communities to withdraw their cases or reconcile with perpetrators.
Attafuah further pointed to the social cost of seeking justice, explaining that survivors frequently encounter stigma, victim-blaming and pressure to remain silent.
She stressed that access to justice is a critical component of global development efforts, particularly under Sustainable Development Goal 16 and Sustainable Development Goal 5, which focus on building inclusive institutions and ending violence against women and girls.
The UN coordinator reaffirmed the commitment of the United Nations system in Nigeria to work with government institutions, civil society groups and development partners to strengthen legal frameworks, expand survivor support services and promote social norms that uphold the dignity and rights of women and girls.
Also speaking at the event, the UN Women Representative to Nigeria and ECOWAS, Beatrice Eyong, said the anthology highlights the persistent challenges women face in accessing justice, particularly survivors of sexual and gender-based violence.
She noted that despite progress in legal reforms and awareness campaigns, many women continue to face financial constraints, stigma and limited access to legal support.
Eyong said the publication documents the experiences and resilience of women who have sought justice, emphasising that justice is not only about laws and institutions but also about protecting dignity and ensuring survivors can seek accountability without fear or hardship.
She commended the organisers and partners supporting the initiative, including the Ford Foundation, for advancing efforts aimed at promoting gender equality and strengthening protection for women and girls.
In a goodwill message delivered on behalf of the Attorney-General of the Federation and Minister of Justice, Lateef Fagbemi, Chief State Counsel at the Sexual and Gender-Based Violence Response Unit of the Federal Ministry of Justice, Habiba Ajanah-Hamza, reiterated the Federal Government’s commitment to improving access to justice for survivors.
She said the ministry remains focused on strengthening coordination among institutions involved in addressing gender-based violence, supporting effective investigation and prosecution of cases, and ensuring that victims are treated with dignity and sensitivity throughout the legal process.
According to her, achieving meaningful access to justice requires sustained collaboration among government institutions, development partners, civil society organisations, the legal community and the media.
Ajanah-Hamza added that initiatives such as the anthology contribute to raising public awareness and strengthening advocacy for reforms that make justice systems more accessible and responsive to the needs of women and girls.
The anthology launch also featured discussions aimed at identifying practical solutions and partnerships that can help reduce the cost of justice and improve survivor-centred responses across Nigeria.
Participants at the event stressed that the voices documented in the publication should serve as a call to action for stakeholders to work collectively toward building a justice system that ensures protection, accountability and dignity for every woman and girl.
Justice Must Be Affordable, Accessible for Women, Says UN
News
Zulum Moves to Fix Rural Health Gap in Borno, Approves 473 Medical Workers and 100% Allowance for Doctors
Zulum Moves to Fix Rural Health Gap in Borno, Approves 473 Medical Workers and 100% Allowance for Doctors
By: Michael Mike
Borno State Governor, Prof. Babagana Zulum has approved the recruitment of 473 medical personnel and introduced a 100 per cent rural posting allowance for doctors in a major push to strengthen healthcare services in underserved communities across Borno State.
The dual intervention is aimed at addressing the shortage of skilled health workers in rural areas and improving access to quality medical care for residents outside the state capital.
The Chief Medical Director of the Borno State Hospital Management Board, Abubakar Kullima, disclosed the development on Thursday in Maiduguri, noting that the governor had approved the immediate employment of doctors, nurses, pharmacists, laboratory scientists and community health extension workers.
Kullima explained that the recruitment also includes specialised health personnel and support staff such as perioperative care nurses and primary eye care workers who will be deployed to newly established and existing health facilities across the state.
According to him, the new workforce will be distributed across general hospitals and primary healthcare centres in the three senatorial zones to strengthen service delivery at both secondary and grassroots levels.
He said the move is part of broader reforms by the Zulum administration to rebuild and expand healthcare services in the state following years of conflict that strained public health infrastructure.
Beyond recruitment, the governor has also directed the immediate implementation of a 100 per cent rural allowance for doctors and a 40 per cent allowance for nurses serving in remote communities.
The incentive, approved through a memo to the hospital management board, is designed to attract qualified medical professionals to rural postings where harsh working conditions and limited facilities often discourage deployment.
With the new policy, doctors who accept rural postings will have their remuneration significantly increased, a step officials say is necessary to address the persistent shortage of medical personnel outside major towns.
Health sector observers say the initiative could significantly boost the availability of healthcare workers in rural communities where residents often travel long distances to access medical services.
The recruitment and incentive scheme form part of a series of healthcare reforms undertaken by Governor Zulum, including the approval of special training funds for resident doctors and the commissioning of specialised health facilities such as eye and dental hospitals.
Officials say the latest measures are expected to improve staffing levels in public hospitals, strengthen service delivery and expand access to essential healthcare across communities in Borno.
Zulum Moves to Fix Rural Health Gap in Borno, Approves 473 Medical Workers and 100% Allowance for Doctors
News
Breaking News: Cuba Signals Readiness for Dialogue With U.S., Insists on Sovereignty and Respect
Breaking News: Cuba Signals Readiness for Dialogue With U.S., Insists on Sovereignty and Respect
By: Michael Mike
Cuban President, Miguel Díaz-Canel has reaffirmed his country’s willingness to engage in dialogue with the United States in an effort to address long-standing disputes, while stressing that any engagement must be anchored on equality, mutual respect and full recognition of national sovereignty.
Speaking during a high-level meeting with members of the Political Bureau, the Secretariat of the Central Committee of the Communist Party of Cuba, and the Executive Committee of the Council of Ministers on Friday in Havana, the Cuban leader revealed that officials from both countries have recently held discussions aimed at easing tensions and identifying practical solutions to contentious bilateral issues.
Díaz-Canel said the talks form part of the historic diplomatic approach that has guided the Cuban Revolution since its inception—one that supports dialogue while firmly defending the island’s independence and political system.
According to him, the discussions were designed to examine areas of disagreement between the two nations and determine pathways for resolving them through negotiation. He noted that the exchanges also seek to gauge whether both governments are prepared to take concrete steps that would improve relations and deliver tangible benefits to their citizens.
The Cuban president added that another key objective of the engagement is to explore possible areas of cooperation, particularly in addressing shared challenges that affect regional security and stability across Latin America and the Caribbean.
He cautioned against speculation surrounding the talks, emphasizing that the Cuban leadership traditionally refrains from responding to public conjecture about sensitive diplomatic processes.
“This is a complex and delicate process that must be handled with seriousness and responsibility,” Díaz-Canel said, noting that rebuilding understanding between the two countries requires sustained effort and careful diplomacy.
The Cuban government, he said, has consistently maintained that any progress in relations must be based on strict adherence to international law, reciprocity, and respect for the sovereignty and self-determination of the Cuban state.
Relations between Havana and Washington have long been marked by political tension and ideological differences. However, the latest engagement suggests a cautious attempt by both sides to reopen channels for dialogue and possibly chart a less confrontational path forward.
Breaking News: Cuba Signals Readiness for Dialogue With U.S., Insists on Sovereignty and Respect
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