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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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Lake Chad Basin Commission appoints Amb. Ibrahim Babani as Executive Secretary

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Lake Chad Basin Commission appoints Amb. Ibrahim Babani as Executive Secretary

By: Zagazola Makama

The designation of Amb. Ibrahim Babani as the new Executive Secretary of the Lake Chad Basin Commission (LCBC) has sparked fresh expectations for stronger regional cooperation, environmental recovery and security stabilisation across the Lake Chad region.

Babani’s appointment was announced at the 71st Ordinary Session of the Council of Ministers of the LCBC, held on March 6, 2026, in N’Djamena, Chad, where ministers and commissioners from member states deliberated on strategies to address the region’s pressing challenges.

The meeting, chaired by Mr Passale Kanabe Marcelin, Chad’s Minister of Water and Energy Resources and current Chairman of the LCBC Council of Ministers, brought together representatives of the commission’s member states, including Nigeria, Niger, Cameroon, Chad and the Central African Republic.

Nigeria was represented by Prof. Joseph Terlumun Utsev, Minister of Water Resources and Sanitation and First Commissioner of Nigeria to the LCBC, alongside Mrs Bianca Ojukwu, Minister of State for Foreign Affairs and Second Commissioner.

The Lake Chad Basin Commission remains one of Africa’s most important regional bodies, responsible for coordinating water resource management, environmental restoration and socio-economic development among countries sharing the Lake Chad Basin.

The basin supports more than 40 million people across the five member states, whose livelihoods depend largely on fishing, farming and pastoral activities linked to the shrinking lake.

Over the past decades, however, the region has faced severe environmental degradation, climate change impacts and the devastating effects of the ISWAP/Boko Haram insurgency, which has displaced millions and disrupted economic activities. These complex challenges have made the role of the LCBC increasingly strategic in driving recovery, stabilisation and resilience across the basin.

Stakeholders believe Babani’s emergence as Executive Secretary comes at a critical time when the commission is intensifying efforts to implement several large-scale regional programmes.

These include the Regional Strategy for Stabilisation, Recovery and Resilience (RS-SRR) for areas affected by Boko Haram violence, as well as projects aimed at ecological restoration and socio-economic reintegration of vulnerable populations.

During the meeting, commissioners reviewed progress in implementing the strategy and emphasised the need to accelerate key initiatives, including the development of a regional transitional justice policy and improved coordination of stabilisation interventions.

They also recommended the organisation of the sixth edition of the Governors’ Forum in Niger, alongside meetings of traditional rulers and civil society organisations to strengthen community-based recovery efforts.

Prior to his appointment, the incoming Executive Secretary of the LCBC, Amb. Ibrahim Babani, served as Director of External Affairs (DEA) at the Office of the National Security Adviser (ONSA) and also doubles as Head of Mission (HoM) of the Multinational Joint Task Force (MNJTF), bringing extensive security and diplomatic experience to his new role.

Babani’s leadership will therefore be critical in coordinating these initiatives and ensuring that they translate into tangible benefits for affected communities. Another priority expected to dominate Babani’s tenure is the restoration of the Lake Chad ecosystem, which has shrunk drastically over the past half century due to climate change, drought and unsustainable water use.

At the session, commissioners reviewed progress on the Inter-Basin Water Transfer Project, a major initiative designed to replenish the lake by transferring water from other basins.

The Council of Ministers commended the LCBC Executive Secretariat for successfully mobilising funding from the African Development Bank for the project and urged faster implementation of technical support programmes aimed at restoring the lake’s ecological and economic functions. Environmental experts believe that restoring the lake is crucial for reducing poverty, preventing conflicts over natural resources and addressing some of the root causes of insecurity in the region.

The Ministers also reviewed progress on the Lake Chad Region Recovery and Development Project (PROLAC) and encouraged continued engagement with the World Bank to secure financing for a second phase of the initiative.

Similarly, they called for further advocacy with the African Development Bank to support the second phase of the Project to Support the Socio-Economic Reintegration of Vulnerable Groups in the Lake Chad Basin (PARSEBALT).

Both initiatives focus on rebuilding infrastructure, supporting livelihoods and reintegrating vulnerable groups affected by years of insurgency and displacement. These programmes complement military efforts against extremist groups by addressing the social and economic conditions that fuel instability.

Despite its strategic importance, the LCBC continues to face financial constraints that could hamper implementation of its programmes.

During the session, commissioners raised concerns about the accumulation of unpaid contributions by member states and urged governments to settle their arrears and ensure regular payment of statutory dues.

They also mandated the chairman of the Council of Ministers to escalate the issue to the highest political authorities within member states to guarantee sustainable funding for the commission’s activities.

The council approved the commission’s 2026 Annual Work Plan and Budget, estimated at 15.13 billion CFA francs, with over 12.63 billion CFA francs allocated to development programmes and 2.50 billion CFA francs for operational costs.

The meeting also adopted key annexes to the Lake Chad Basin Water Charter, including frameworks governing the management of water infrastructure and procedures for notification of planned measures affecting shared water resources.

Commissioners further endorsed a Five-Year Investment Plan and directed the Executive Secretariat to organise a donors’ roundtable to mobilise international support.

Babani’s leadership comes at a time when the Lake Chad region is at a crossroads. While military operations have significantly weakened insurgent groups in recent years, millions of people still face humanitarian challenges, environmental degradation and fragile livelihoods.

The effectiveness of the LCBC in coordinating development, environmental restoration and stabilisation initiatives could determine whether the region moves toward lasting peace and prosperity.

The Council of Ministers concluded the meeting by expressing appreciation to development partners for their continued support and announcing that the next budgetary session will be held in Bangui, Central African Republic.

For many stakeholders in the Lake Chad Basin, the appointment of Babani represents not only a change in leadership but also a renewed opportunity to accelerate recovery, strengthen regional cooperation and secure the future of one of Africa’s most vital ecosystems.

Zagazola is a Counter Insurgency Expert and Security Analyst in the Lake Chad regional

Lake Chad Basin Commission appoints Amb. Ibrahim Babani as Executive Secretary

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ECOWAS Court Raises Alarm Over Gender Violence, Low Compliance With Judgments

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ECOWAS Court Raises Alarm Over Gender Violence, Low Compliance With Judgments

By: Michael Mike

The President of the ECOWAS Court of Justice, Claudio Monteiro Gonçalves, has called for stronger regional action to combat gender-based violence and ensure justice for women and girls across West Africa, warning that many victims still suffer in silence.

Gonçalves, who was represented by the Acting Deputy Registrar of the ECOWAS Court of Justice, Mrs. Marie Sanie, made the call in Abuja during the court’s celebration of International Women’s Day, organised by the CCJ Women Forum under the theme “Rights, Justice, Action for All Women and Girls,” with a sub-theme urging stakeholders to “Break the Silence: End Gender-Based Violence Now.”

He said the protection of women’s rights remains central to the court’s mandate of advancing the rule of law and safeguarding fundamental human rights across the Economic Community of West African States.

According to him, the court has, through its judgments, played a significant role in challenging discrimination, addressing sexual and gender-based violence and providing remedies for victims across the region.

“These groundbreaking decisions have not only delivered justice to individuals but have also set important legal precedents that reinforce the dignity and protection of women and girls throughout the region,” he said.

Among the landmark rulings highlighted by the court president was the 2008 case of Hadijatou Mani Koraou v Republic of Niger, which addressed slavery practices in Niger, and the 2017 case of Dorothy Chioma Njemanze & 3 Ors v Federal Republic of Nigeria that condemned discrimination and degrading treatment against women.

Other notable cases cited include WARDC & IHRDA (Mary Sunday) v Federal Republic of Nigeria on domestic violence, WAVES & 1 Or v Republic of Sierra Leone on discrimination based on pregnancy, Adama Vandi v Republic of Sierra Leone on rape and the failure to provide effective remedy for victims, and Forum Against Harmful Practices (FAHP) & 2 Ors v Republic of Sierra Leone concerning female genital mutilation.

Gonçalves stressed that gender-based violence remains a major obstacle to equality, justice and sustainable development across the region.

“Too often, survivors suffer in silence due to stigma, fear or lack of support to seek justice. Today we affirm that silence must end and justice must be translated into action,” he said.

The court president also expressed concern over the low level of compliance with the court’s rulings by member states, revealing that only about 20 per cent of its judgments have been fully implemented.

He warned that the low enforcement rate could undermine the authority and credibility of the regional court if not addressed urgently.

To tackle the challenge, he said the court recently carried out bilateral engagement missions to several member states, including Sierra Leone, Nigeria and Guinea-Conakry, as part of activities marking the 50th anniversary of the Economic Community of West African States.

The missions, he explained, were aimed at encouraging governments to implement the court’s decisions and fulfil their treaty obligations.

Gonçalves also noted that the court regularly conducts awareness and outreach missions across member states to educate citizens on how to access the court and seek redress for human rights violations.

He emphasised that justice would only be fully realised when citizens are aware of their rights and governments ensure that court judgments are respected and implemented.

While celebrating the achievements of women working within the ECOWAS Court, he acknowledged that challenges remain, particularly in ensuring greater representation of women in leadership positions and creating supportive work environments that promote work-life balance.

Despite the challenges, he reaffirmed the court’s commitment to strengthening legal protections for women and girls in the region.

“As we celebrate the achievements of women today, we reaffirm our commitment to delivering justice, advancing the rule of law and building a region where every woman and girl can live in safety and dignity,” he said.

Meanwhile, the Patron of the ECJ Women Forum, Justice Dupe Atoki, has called for stronger commitment to protecting the rights of women and girls, stressing that legal protections must go beyond promises to ensure real justice and equality.

Atoki made the call during the celebration of International Women’s Day at the ECOWAS Court of Justice in Abuja, where officials, diplomats and legal practitioners gathered to discuss the role of justice systems in safeguarding women’s rights across West Africa.

Speaking on the global theme for this year’s commemoration, the judge said the theme serves as both a reminder and a call to responsibility for governments, institutions and society at large.

She emphasised that the rights of women and girls should never be treated as privileges granted at convenience but as fundamental human rights that must be respected, protected and fulfilled.

According to her, although progress has been made globally in advancing gender equality, many women and girls still face barriers that limit their opportunities, silence their voices and restrict their participation in social, political and economic life.

“The emphasis on rights reminds us that the rights of women and girls are not privileges to be granted at convenience, but fundamental human rights that must be respected, protected and fulfilled,” she said.

Atoki noted that justice systems have a critical responsibility in addressing discrimination, violence and exclusion against women, adding that courts and legal institutions must remain accessible, impartial and responsive to the realities women face.

She said effective justice mechanisms are essential in ensuring that laws protecting women are properly enforced and that perpetrators of abuse are held accountable.

“The call for justice highlights the vital role of laws, institutions and courts in safeguarding equality and dignity. Justice must be accessible, impartial and responsive to the realities faced by women and girls,” she stated.

Atoki also stressed that achieving gender equality requires more than commitments and declarations, noting that deliberate action is necessary to dismantle structural barriers that hinder the progress of women and girls.

According to her, governments and institutions must translate policy commitments into practical measures that create safe and supportive environments for women to thrive.

“The call for action reminds us that commitments alone are not enough. Real progress requires deliberate steps through policies, institutions and collective effort to dismantle structural barriers and create environments where women and girls can thrive,” she said.

She urged stakeholders across the region to renew their commitment to advancing women’s rights, strengthening access to justice and ensuring that gender equality becomes a lived reality rather than a distant aspiration.

Atoki concluded by calling on governments, civil society organisations and legal institutions to work together to ensure that the promise of rights, justice and action is realised for all women and girls across the West African region.

ECOWAS Court Raises Alarm Over Gender Violence, Low Compliance With Judgments

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NHRC Takes Rights Campaign to Grassroots, Holds Women’s Day Town Hall in Abuja Community

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NHRC Takes Rights Campaign to Grassroots, Holds Women’s Day Town Hall in Abuja Community

By: Michael Mike

The National Human Rights Commission (NHRC) has intensified advocacy for the protection of women and girls by organising a community town hall meeting in Bwari as part of activities marking the 2026 International Women’s Day.

The sensitisation programme brought together traditional rulers, youth leaders, women groups and other community stakeholders to discuss the need for stronger action against discrimination and violence affecting women.

Executive Secretary of the Commission, Tony Ojukwu, said the annual commemoration of International Women’s Day provides an important opportunity to celebrate the achievements of women while drawing attention to the obstacles that still limit their full participation in society.

Ojukwu, who was represented at the event by the Director of the Commission’s Women and Children Department, Ngozi Okorie stressed that the theme of the 2026 celebration, “Rights. Justice. Action. For All Women and Girls,” calls for practical and sustained efforts to remove barriers confronting women in many communities.

He noted that despite growing awareness of gender equality, women and girls continue to face gender-based violence, discrimination, limited access to justice and socio-economic inequalities.

According to him, addressing these challenges requires the collective commitment of government institutions, community leaders and citizens.

“The rights of women and girls are fundamental human rights. Protecting them demands deliberate and sustained action from all stakeholders,” he said.

The NHRC boss reaffirmed the Commission’s determination to promote and safeguard the rights of all Nigerians, particularly vulnerable groups such as women and children.

He explained that the Bwari town hall meeting was designed to deepen public awareness of human rights and provide a platform for dialogue on practical measures that could strengthen the protection of women and girls at the grassroots.

Traditional rulers who attended the forum commended the Commission for bringing the conversation on human rights closer to local communities.

The Esu of Bwari, represented by Mai Anguwa of FCDA Quarters, Zakwoi Ibrahim, described the initiative as timely, noting that such engagements would help educate residents about their rights and responsibilities.

Also speaking, Youth President of Bwari Area Council, Comrade Dr Awoyi Bwari, praised the NHRC for organising the programme, saying it would boost awareness on human rights issues among both men and women in the community.

Representatives of women’s organisations, including faith-based groups and market associations, also participated in the meeting and pledged their support for efforts aimed at promoting and protecting the rights and welfare of women and girls.

NHRC Takes Rights Campaign to Grassroots, Holds Women’s Day Town Hall in Abuja Community

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