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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
VP Shettima Mourns Borno Terror Attack Victims, Says No Religion Endorses Killing Of Innocent Lives
VP Shettima Mourns Borno Terror Attack Victims, Says No Religion Endorses Killing Of Innocent Lives
By: Our Reporter
Ahead of his trip to Maiduguri, the Borno State capital, Vice President Kashim Shettima , has expressed grief over the death of 25 persons killed in the multiple explosions in different locations across Maiduguri, the Borno State capital on Monday.
He pointed out that no religion sanctions the killing of innocent lives, as the sanctity of human life remains a core tenet of major world faiths.
VP Shettima, who spoke on Tuesday during the closing of the Annual Ramadan Tafsir at the State House Mosque, Abuja, prayed Almighty Allah to grant the souls of those killed in the terror attack in Maiduguri eternal rest, reward them with Aljannah firdaus and give their family the fortitude to bear the irreparable loss.
Praying Almighty Allah to also vanish all agents of terror from the surface of the earth, the VP said, “May the lives of innocent souls – 25 of them – that lost their lives in Maiduguri last evening rest in peace. May Allah grant their souls eternal rest and reward them with His Aljannah firdaus, and may Allah also grant their families the fortitude to bear the irreparable losses.
“May Allah bring this madness to an end. No religion sanctions the killing of the innocent. Whatever that is motivating them, may Allah either guide them on to the right path or May Allah vanish them from the surface of the earth.”
The Vice President emphasised the need for all Nigerians to continue to pray for the country across every sector, as well as pray that the Almighty should continue to grant President Bola Ahmed Tinubu and members of his team wisdom, courage, sincerity and equity in service.
He noted that each season of Ramadan reminds Muslims of a truth that power often tries to hide from man, and that no sit is permanent, just as no office is ultimate and no human being stands above his dependence on his creator.
VP Shettima said, “In the presence of Allah, the distance between the mighty and the unknown vanishes. What remains is character, what remains is accountability, what remains is what we did with the trust placed in our hands.
“This is why gatherings such as this matters. They rescue public lives from arrogance; they retain soul to scale; they teach those entrusted with authority that the nation is not built by policy alone but by conscience; not by proclamation alone but by restraint; not by ambition alone but by fear of Allah.”
The VP called on the Muslim faithful to continue to live in the teachings and lessons of the month of Ramadan, as the final days of Ramadan begins to sleep through their fingers.
“The question before us is not whether Ramadan is ending. The question is whether its teachings will continue to live in us after the moon has changed.
“It is quite easy to cut the head when the atmosphere is charged with devotion. The harder task is to carry it into ordinary days, into the market, into the office, into the home, into the chamber of power, and into the private corners where only Allah sees what we are doing, ” he noted.
While drawing from the lessons of Ramadan, the Vice President said the holy month had thought the Muslim faithful that pity without mercy is noise and worship without service is incomplete.
“So, as we close this year’s Tafsir, let us not return to the habits that weaken our common lives; let us not go back to bitterness, to reckless speech, to indifference dressed as sophistication. A believer doesn’t spend the whole month learning only to become a captive again of anger, greed and division.
“Nigeria needs homes where children encounter good examples before good advice. Nigeria, indeed, needs leaders in every spare who understand that influence is a trust, not a license, ” VP Shettima said.
He paid growing tribute to the Chief Imam of the State House Mosque, Sheikh Abdulwaheed Suleiman Abubakar, and his lieutenant for conducting the Tafsir with wisdom, calm hearts.
Earlier, the Chief Imam prayed for sustainable peace and development of Nigerian and the success of the Tinubu administration’s policies and programmes.
The cleric emphasised the need for leaders at all levels to continue to discharge their responsibilities with the fear of Allah for the process and development of the country.
VP Shettima Mourns Borno Terror Attack Victims, Says No Religion Endorses Killing Of Innocent Lives
News
IGP Visits Maiduguri Bombing Sites, Assesses Security Measures
IGP Visits Maiduguri Bombing Sites, Assesses Security Measures
By: Zagazola Makama
The Inspector-General of Police, Olatunji Rilwan Disu, has visited victims of the recent IED explosions in Maiduguri and assessed the security situation at key attack sites, underscoring the force’s commitment to public safety.
The IGP visited the University of Maiduguri Teaching Hospital (UMTH), where casualties of the bomb blasts are receiving medical attention. He commiserated with victims and their families, assuring them of the Nigeria Police Force’s resolve to identify and dismantle networks responsible for the attacks.

Following the hospital visit, he proceeded to the Maiduguri Monday Market, one of the sites targeted by the terrorists, for an on-the-spot security assessment. The visit included interactions with local security personnel to review operational preparedness and strengthen coordinated response measures.
The IGP also visited the Borno State Government House and the State Police Command Headquarters as part of ongoing engagements to enhance collaboration between federal and state security agencies.

He emphasized that security has been significantly tightened across Maiduguri and its environs, with increased patrols, surveillance, and joint operational deployments aimed at preventing further incidents. Residents were reassured of the force’s commitment to safeguarding lives and property in the aftermath of the attacks.
IGP Visits Maiduguri Bombing Sites, Assesses Security Measures
News
Save us From Heavy Trailers Killing Our People… Muna Garage Residents Cry Out to Zulum
Save us From Heavy Trailers Killing Our People… Muna Garage Residents Cry Out to Zulum
By: Bodunrin Kayode
Residents of Muna axis after customs area in Maiduguri have called on Governor Babagana Zulum to save them from the excesses of heavy duty vehicles who deliberately clog the international highway leading to Gamboru Ngala council area on a daily basis.
Some of the residents who spoke to this reporter after a recent crash which almost killed all the occupants of a commercial “Keke” regretted that the road traffic authorities in the state have not given this international highway the priority it deserves in terms of traffic management due to it’s prominence.
A careless trailer which was parked along the road close to the Alkome police hospital had narrowed the road for another trailer and a Keke nappe which struggled for the little space remaining all driving towards the Muna Garage area when a brush occurred and a sudden bang from the back by a third trailer which almost killed all the occupants of the keke nappe.
Some of the commuters came out alive from the crushed Keke with minor wounds while a particular man had his forefoot crushed almost hanging away from the ball of one of that very foot.
It was a bloody weekend for the commuters as blood from one of them flowed freely into the Keke and on the tarred road leading to Muna while onlookers rushed to see if anyone survived the crash.
Since no security personnel showed up within the first 30 minutes of the crash, the wounded were rushed to a nearby hospital while the trailer cleared from the road to ease traffic movement.
Most of the eye witnesses were enraged by the incident with some blaming it on the Keke riders while others castigated the trailers who insist on parking on the shoulder of this international route which should be free from these kinds of challenges.
Baana, a vulcanizer who says he has spent over three decades on this axis of the town called on Governor Babagana Zulum to as a matter of urgency build a massive modern trailer park for the heavy trucks so that they will stop parking along the road while they wait for clearance in the morning to embark on their journeys to Ngala and beyond.
“Lack of a modern trailer park is the main reason why we keep recording lingering accidents on a daily basis here with countless of people being wounded and are not recorded in the government statistics.” He stressed.
For mallam Isa, a teacher inside the suburb behind Alkome police Hospital, the Governor should as a matter of urgency sign an executive fiat to stop trailers from parking on main roads like this one leading to Mafa,Dikwa and Ngala.
” We are calling on the Governor to invoke an executive order based on section 5 of the 1999 constitution by banning all trailers from parking on the trunk A roads leading to Chad, Niger and Cameroon.
” This is because, apart from endangering the lives of commuters, prolonged stay on the tarred roads cause a lot of damage to the roads which the Governor has dualized after destruction by insurgency.”
Mallam Isa also called on Federal and State Road Safety managers in the state to create a road side emergency station along this route that would be assisting them in clearing accident victims in the road throughout the week and even during the weekend.
“look at this accident that just happened, they are all guilty of one offence or the other. But I equally blame the Keke riders because if they have respect for human lives, they will not be contesting for right of way with heavy duty trailers.
” These trailers are very wicked people. They use their big structures to block and entrap people only to be begging for mercy when the damage has been done.
” Their excesses are as grave as that of the keke napep people. The Federal Road Safety and the Borno traffic management authorities should increase their fines further to serve as deterrent on the rest.
Save us From Heavy Trailers Killing Our People… Muna Garage Residents Cry Out to Zulum
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