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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
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Nigeria: MSF/Borno Govt. Vaccinates 350,000 Children Against Diphtheria in Maiduguri
Nigeria: MSF/Borno Govt. Vaccinates 350,000 Children Against Diphtheria in Maiduguri
By: Our Reporter
The humanitarian medical organization Médecins Sans Frontières (MSF) and the Borno State Ministry of Health have successfully completed a vaccination campaign against diphtheria targeting children up to 14 years old in Maiduguri Metropolitan Council (MMC), Borno State, northeast Nigeria.
The campaign began with a first round from 9 to 15 February 2026, which reached 490,000 children, far exceeding the initial target of 387,000. A second round was conducted from 9 to 15 April 2026, targeting 360,000 children reached during the first round to strengthen immunity. Despite the high number of children reached, limited vaccine availability constrained the scale of response.
Nigeria is grappling with one of its most severe diphtheria epidemics in history, with the National Centre for Disease Control (NCDC) reporting 65,759 suspected cases and 2,229 deaths as of 22 March 2026 since May 2022 and officially declaring an outbreak in 2023. In Borno State, one of the most affected areas, MSF has treated more than 7,400 suspected cases since 2023, with 4,200 treated in the past year alone. Furthermore, MSF is treating thousands of people suspected or confirmed to have diphtheria across the country, in close collaboration with state Ministries of Health, and currently supports activities in Bauchi, Borno, Kano, and Sokoto states.
Diphtheria is an acute infectious disease that spreads primarily through respiratory droplets or contact with infected wounds. Symptoms include a sore throat, fever, swollen lymph nodes, and a thick grey membrane in the throat that can obstruct breathing. In severe cases, the bacterial toxin can damage the heart, nerves, and kidneys, potentially leading to complications such as paralysis. For unvaccinated persons without proper treatment, diphtheria can be fatal in around 30% of cases, with young children at higher risk of dying.
MSF supported the Borno State Ministry of Health to run the vaccination campaign, providing comprehensive logistical support including vaccine storage, transportation, and remuneration for vaccination teams; health promotion and awareness activities; and program supervision. The Ministry of Health provided the vaccines used in the campaign. This collaborative effort ensured high coverage, with communities responding enthusiastically to outreach efforts across both rounds.
“This vaccination will help to significantly boost immunity levels of children below 14 years old in Maiduguri, the area responsible for most of the diphtheria cases we saw in our treatment center. This proactive step is essential to controlling and preventing the disease,” said MSF emergency coordinator for the project, Nao Muramoto.
In addition, MSF supported the diphtheria treatment unit (DTU) at Maiduguri Teaching and Training Hospital in collaboration with the Ministry of Health. The DTU saw a surge in suspected cases during the campaign, reflecting heightened awareness and improved referrals by community health workers during the vaccination efforts.
“Sustained routine immunization against diphtheria, improved access in volatile areas, and tackling vaccine hesitancy remain essential to prevent future surges of vaccine-preventable diseases like diphtheria. “Access to more vaccines is needed, as efforts to reach the children of Borno State should remain a priority to avoid further contaminations, to cut the transmissions, and to save lives,” concludes Nao Muramoto.
Beyond its support to diphtheria treatment and vaccination, MSF also supports the Comprehensive Emergency Obstetric and Newborn Care (CEmONC) in Maiduguri, a 60-bed referral maternity and obstetric emergencies hospital with an intensive care unit (ICU) and neonatal ICU, and the Shuwari Primary Healthcare Centre and the Nilefa Kiji nutrition hospital, where our teams treat children under five suffering from severe and moderate acute malnutrition with medical complications.
Nigeria: MSF/Borno Govt. Vaccinates 350,000 Children Against Diphtheria in Maiduguri
News
Fiscal Storm: ActionAid Slams ₦34trn Revenue Deductions, Calls for Transparency
Fiscal Storm: ActionAid Slams ₦34trn Revenue Deductions, Calls for Transparency
By: Michael Mike
ActionAid Nigeria has called for an urgent forensic audit of Nigeria’s revenue management system following revelations that more than ₦34 trillion was deducted from federal earnings before allocation to the three tiers of government.
The organisation said the scale of the deductions—accounting for over 40 per cent of federal revenue in recent years—points to systemic weaknesses in public financial management and poses a serious threat to fiscal stability and development financing.
In a statement issued on Thursday, ActionAid said findings by the World Bank confirmed that a significant portion of government income is being absorbed through pre-distribution charges, including cost-of-collection frameworks and agency remittances, with limited transparency on their composition and utilisation.
“These findings reinforce long-standing concerns about Nigeria’s widening fiscal constraints and rising debt burden,” the group said. “The persistence of large-scale revenue leakages represents both a governance failure and a missed opportunity to strengthen fiscal stability.”
According to the organisation, the deductions—estimated at more than ₦34 trillion—have continued to rise alongside government revenues, leaving federal, state, and local governments with significantly reduced resources to fund public services.
ActionAid warned that the trend is worsening Nigeria’s reliance on borrowing, citing projections by the International Monetary Fund that the country’s debt-to-GDP ratio could climb to 33.1 per cent by 2027.
“The widening gap between gross revenue and distributable income is constraining development financing and increasing dependence on debt,” the statement added.
The group expressed particular concern over what it described as “opaque and fragmented” revenue channels, noting that substantial portions of national income pass through multiple layers before reaching the Federation Account.
It said the lack of public disclosure around these deductions—including their justification, structure, and end-use—raises critical accountability questions.
“There is limited transparency on how these funds are managed,” the organisation stated. “This opacity weakens fiscal oversight and undermines public trust in governance.”
ActionAid also pointed to broader implications for national development, warning that reduced public revenue is limiting government capacity to invest in essential sectors such as healthcare, education, security, and social protection.
The Country Director of ActionAid Nigeria, Andrew Mamedu, said the consequences are already being felt by millions of Nigerians.
“For citizens grappling with rising inflation, declining purchasing power, and economic hardship, the continued reduction in available public resources means fewer investments in essential services,” he said.
He added that weakening fiscal capacity is also exacerbating insecurity, as economic pressures fuel crime, displacement, and social instability.
“At a time when livelihoods are becoming more fragile, the erosion of public revenue further limits the government’s ability to respond effectively to these challenges,” Mamedu said.
The organisation further criticised the lack of transparency surrounding major public expenditures, citing concerns over projects such as the Nigeria Revenue Service building, where cost details and procurement processes have not been publicly disclosed.
“Citizens have a right to know how public funds are utilised,” the group said, stressing that accountability must extend beyond revenue collection to expenditure.
ActionAid warned that without urgent reforms, Nigeria risks entrenching a system where public resources are consistently depleted before they can deliver meaningful impact.
“The continued expansion of unchecked deductions poses a direct threat to equitable development, fiscal stability, and public trust,” it said.
To address the issue, the organisation called on the Federal Government to undertake a comprehensive and transparent review of all revenue deduction frameworks, with a view to ensuring accountability and efficiency.
It also demanded the immediate publication of detailed breakdowns of all deductions, strengthened independent oversight of revenue-generating agencies, and reforms to eliminate systemic leakages.
In addition, ActionAid urged the National Assembly to intensify its oversight role through public hearings and scrutiny of deduction structures, while calling on state governments, civil society, and the media to increase pressure for transparency.
“An independent forensic audit of all deduction mechanisms is critical to restoring public confidence,” the organisation said.
ActionAid added that Nigeria’s development trajectory depends not only on revenue generation but on how effectively public resources are managed and deployed.
“This is not just a fiscal issue; it is a matter of justice,” Mamedu said. “Every naira that fails to reach essential services denies Nigerians access to healthcare, education, and dignity.”
Fiscal Storm: ActionAid Slams ₦34trn Revenue Deductions, Calls for Transparency
News
Troops rescue two kidnapped victims in Benue
Troops rescue two kidnapped victims in Benue
By: Zagazola Makama
Troops of Sector 1 under Operation Whirl Stroke (OPWS) have rescued two kidnapped victims in Ukum Local Government Area of Benue State.
Security sources said the incident occurred at about 3:50 a.m. on April 15 when troops deployed at Kyado responded to a distress call on kidnapping activities in the area.
According to the sources, the troops swiftly moved to the scene, prompting the kidnappers to abandon their victims and flee.
The sources added that the troops successfully rescued the two victims and reunited them with their families.
Security operations have been intensified in the area to track down the fleeing suspects and prevent further incidents.
Troops rescue two kidnapped victims in Benue
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