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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
The High Cost of Silence: Why President Tinubu Must Sign the Federal Audit Service Bill
The High Cost of Silence: Why President Tinubu Must Sign the Federal Audit Service Bill
By Paul Dasimeokuma
Nigeria currently manages a staggering ₦68.32 trillion budget through an audit framework that is effectively a colonial relic.
The Audit Ordinance of 1956, which remains the primary reference for federal audit reports, technically ceased to be part of Nigerian law in 1990 and is conspicuously absent from the 2004 Laws of the Federation of Nigeria (LFN).
This creates a legal lacuna, a dangerous, silent void where the nation’s financial watchdog is forced to bark using the authority of an obsolete law that has no place in a modern republic. As President Bola Ahmed Tinubu navigates the Renewed Hope agenda, the Federal Audit Service Bill, already passed by the National Assembly, represents a low-hanging fruit for structural reform that can no longer be ignored.
The current auditing function in Nigeria has devolved into a frustrating exercise in report writing without consequence. Under the present system, the Auditor-General for the Federation (AuGF) produces an annual report, which is then sent to the Public Accounts Committees (PACs) of the National Assembly.
The PACs conduct hearings, invite heads of agencies, and eventually produce their own recommendations. Yet, despite this high-level activity, the cycle of financial felonies and misdemeanors continues unabated.
Evidence shows that audit recommendations are treated with levity by Ministries, Departments, and Agencies (MDAs), and follow-ups are virtually non-existent despite clear Financial Regulations.
The result is a culture of impunity where the same infractions: unvouched expenditures, missing assets, and unremitted revenues—appear in reports decade after decade.
This Bill is the structural answer to this stagnation. It seeks to move Nigeria from a limited, department-based audit model to a modern Supreme Audit Institution (SAI) structure, consistent with global best practices. By transforming the office into a Service, the Bill ensures that auditing is a core pillar of national economic security.
The Bill provides for the establishment of an autonomous Federal Audit Service and a Federal Audit Board. This Board will fundamentally strengthen the independence of the AuGF, particularly concerning recruitment, promotion, and discipline.
Currently, the AuGF relies on the Federal Civil Service Commission for staffing, which often leads to a mismatch in specialised skills. An independent Board ensures the office is shielded from political interference and staffed by professionals answering only to the standards of their craft.
For the first time, the Bill explicitly empowers the AuGF with the power of the purse and the power of sanction. It authorises the AuGF to surcharge public officers for expenditures not duly brought into account and, more importantly, to withhold the emoluments of any person who refuses to reply to audit queries within 30 days. This closes the long-standing accountability gap where audit findings were merely advisory.
In the past, an MDA could simply ignore a query with no personal consequence. Under the new Bill, silence carries a direct financial penalty, providing the legal teeth necessary to compel compliance with financial discipline.
Beyond internal accountability, the Bill is a crucial signal to the international community.
Nigeria was successfully removed from the Financial Action Task Force (FATF) grey list in October 2025, a hard-won victory for the nation’s financial reputation. However, this victory must be protected. The FATF framework explicitly monitors audit oversight of public funds as part of its financial integrity assessments. Maintaining a 70-year-old framework that technically does not exist in our current laws risks signaling to global monitors that Nigeria’s anti-corruption reforms are superficial.
Similarly, the International Monetary Fund (IMF), in its June 2025 Article IV Consultation, called for strong expenditure management and transparent reporting. Assenting to this Bill is an act of economic diplomacy. It tells the World Bank and foreign investors that Nigeria is serious about the transparent implementation of its record-breaking budget.
It aligns the country with the Lima Declaration, which mandates that Supreme Audit Institutions must have the functional independence necessary to perform duties without executive overreach.
The reform window is rapidly closing. With the 2027 election cycle approaching, administrative bandwidth for such structural changes will contract. Transitioning from the 1956 framework and constituting the Federal Audit Board requires significant lead time.
Assent in 2026 gives this implementation a fighting chance to take root. President Tinubu has frequently spoken about the need for courage in governance. Signing the Federal Audit Service Bill is an act of such courage. Nigeria cannot build a 21st-century economy on 1950s paperwork. The time for the Audit Act is now.
Paul Dasimeokuma – Centre for Social Justice
The High Cost of Silence: Why President Tinubu Must Sign the Federal Audit Service Bill
News
Zulum: Borno Will Deliver Tinubu, APC Candidates in 2027 Elections
Zulum: Borno Will Deliver Tinubu, APC Candidates in 2027 Elections
By: Our Reporter
Borno State Governor, Professor Babagana Umara Zulum, has reaffirmed the commitment of the people of the state to support President Bola Ahmed Tinubu and all candidates of the All Progressives Congress (APC) in the forthcoming 2027 general elections.
Governor Zulum made the commitment on Monday during the All Progressives Congress, APC, Senatorial District Primary Election for Borno Central, in Maiduguri.
The governor also commended President Tinubu for choosing Senator Kashim Shettima as Vice President of the Federal Republic of Nigeria, describing the decision as a great honor to the people of the state.
“Let me begin by extending a profound appreciation to the President of the Federal Republic of Nigeria, President Bola Ahmed Tinubu, GCFR, for all the support that he has been rendering to our great party and indeed the government and people of the state and for him to choose one of our own, Senator Kashim Shettima, as the Vice President, we remain eternally grateful to him,” Zulum stated.
He assured the President of overwhelming support from Borno State ahead of the next presidential election.
“Insha Allah, the people of Borno State will vote for President Bola Ahmed Tinubu for a second term,” the governor declared.
Zulum also endorsed Senator Kaka Shehu Lawan for another term as Senator representing Borno Central Senatorial District in 2027.
“Today, it has been affirmed that Senator Kaka Shehu Lawan will return as Senator for Borno Central come 2027, Insha Allah,” he said.
The governor called on party supporters and the electorate to remain united and to support APC candidates at all levels.
Chairman of Borno State Senatorial District Primary Elections Committee, Jones Ode Erue, hailed the rancor-free process of all the primary elections conducted in the state.
He commended Governor Babagana Umara Zulum for providing a level playing field and ensuring the exercise was conducted smoothly.
According to him, since the candidate for Borno Central senatorial district, Senator Kaka Shehu Lawan, is unopposed, his candidacy was affirmed by voice vote.
“We have a single candidate, so what we will do is affirmation in compliance with the electoral Act and the APC Constitution,” Esue said.
“By the powers vested in me as Chairman of Borno State Senatorial District Primary Election Committee, I,
Prophet Jones Ode Erue, hereby declare, affirm, and present Senator Kaka Shehu Lawan, having satisfied the constitution of the APC, as the duly returned candidate for Borno Central District,” he declared.
Senator representing Borno Central and APC Senatorial candidate, Senator Kaka Shehu Lawan, SAN, accepted the party’s candidacy and promised his constituents that he would serve diligently.
He thanked Governor Babagana Umara Zulum for the tremendous support and for allowing him to be the party’s sole candidate.
“I hereby accept the candidacy bestowed on me by the party and promised to serve my constituents without affection or ill will,” Kaka Shehu stated.
Officials from INEC and the Security Agencies monitored the exercise.
The event was attended by the APC Deputy National Chairman North, Hon. Ali Bukar Dalori; serving and newly elected candidates for the House of Representatives; the APC state chairman; APC National and State officials; the Secretary to the State Government; the Acting Chief of Staff; Commissioners; and other senior government officials.
Zulum: Borno Will Deliver Tinubu, APC Candidates in 2027 Elections
News
Cuba Accuses US of Building ‘False Case’ for Possible Invasion Amid Rising Tensions
Cuba Accuses US of Building ‘False Case’ for Possible Invasion Amid Rising Tensions
By: Michael Mike
The Cuban government has accused the United States of fabricating allegations against Havana as a pretext for possible military aggression, following reports that Washington is increasingly concerned about Cuba’s alleged drone capabilities and growing ties with Russia and Iran.
Cuban Foreign Minister, Bruno Rodríguez Parrilla, alleged that the United States was “manufacturing a fraudulent case” against Cuba in an attempt to justify tougher sanctions and heightened pressure on the Caribbean nation.
The accusation followed recent reports in American media suggesting that U.S. intelligence agencies were assessing what they described as an emerging security threat linked to Cuba’s acquisition of military drones.
According to reports, U.S. officials fear that Havana may be strengthening military cooperation with countries considered strategic rivals of Washington, including Russia and Iran.
Cuba, however, dismissed the allegations as politically motivated and part of a long-standing campaign aimed at isolating the communist-led island nation.
The development marks a fresh escalation in already strained relations between United States and Cuba, amid worsening economic hardship in Cuba and renewed geopolitical rivalry involving major global powers.
Analysts say tensions between both countries have intensified in recent months following stricter U.S. sanctions, worsening fuel shortages in Cuba and increased diplomatic hostilities.
The Cuban government has repeatedly accused Washington of fueling economic suffering on the island through decades-old embargoes and restrictive measures, while the U.S. maintains that its policies are targeted at promoting democracy and human rights.
The latest dispute emerged after reports claimed that Cuba may have expanded its drone programme with external support, raising security concerns in Washington over possible threats near strategic U.S. facilities, including the Guantanamo Bay naval base.
Havana strongly denied any hostile intentions, insisting that the allegations were exaggerated to create fear and justify additional punitive actions against the country.
Observers note that the war of words comes at a delicate moment in international relations, with growing global polarization between Western powers and countries aligned with Russia and China.
Cuba Accuses US of Building ‘False Case’ for Possible Invasion Amid Rising Tensions
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