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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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Five Militants Killed in Attack Near Ayorou as Local Official Abducted in Niger Republic

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Five Militants Killed in Attack Near Ayorou as Local Official Abducted in Niger Republic

By: Zagazola Makama

At least five local militia members were killed following an attack by suspected Islamic State-linked gunmen in Seno village near Ayorou in Niger Republic’s Tillabéri region.

Local sources said the attack occurred at about 6:00 p.m. on May 17, 2026, when armed militants stormed the village, located approximately six kilometres from Ayorou, and targeted traders and local security volunteers operating in the area.

According to preliminary reports, at least five members of local self-defence groups engaged in securing the community were killed during the assault.

The incident came hours after the reported abduction of a local official identified as Moussa Koukou, said to be the perimeter manager of Diomana.

Sources disclosed that Koukou was kidnapped at about 11:00 a.m. while travelling in a Toyota RAV4 vehicle within the area.

Security sources believe the attack and abduction may be linked to ongoing activities of extremist groups affiliated with the Islamic State operating across the volatile Tillabéri region near the borders with Mali and Burkina Faso.

No official statement had been issued by Nigerien authorities as of the time of filing this report, while monitoring and security operations were said to be ongoing in the affected communities.

Five Militants Killed in Attack Near Ayorou as Local Official Abducted in Niger Republic

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Primaries: Aspirants protest imposition of Reps candidates in Adamawa

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Primaries: Aspirants protest imposition of Reps candidates in Adamawa

The Forum of House of Representatives Aspirants of Numan /Demsa/Lamurde Federal Constituency under the platform of All Progressives Congress (APC) in Adamawa has protested what it described as imposition of candidates in the just concluded primary elections in the state.

Speaking during the peaceful protest in Numan Local Government Area, Adamawa, Vrati Nzonzo, the spokesperson of the Forum said, the committee responsible for the conduct of the exercise and the party officials failed to abide by the rules of the game.

Nzonzo said the rules for electing candidates were through consensus or direct primaries but stressed that none of the rules were observed.

According to him, with what happened, their mandate was stolen and given to someone who did not deserve the candidacy.

“The election was supposed to be Consensus or Direct primaries but we opposed the consensus and there were no direct primaries across the Constituency”, he said.

PNzonzo called on the National Chairman APC and Governor Ahmadu Fintiri to ensure justice and fairness for the victory of the party else they threatened that they won’t vote for the party at the general elections.

Justina Nkon another aspirant also condemned the conduct of the primary election across the constituency.

According to her, the electorate were at the venue of the primaries from 8:00a.m and no officials showed up until 2:00 p.m and later on they said they had conducted the election without seeing any election materials.

She urged Fintiri to live up to the promise he made at the time of his campaign that he would not betray the people in the state.

“It’s now under your watch as the leader of the party we are witnessing the undemocratic process of primary elections by enforcing candidates who have not been elected by the people in the Constituency”, she said.

According to her, the so-called primary elections are unconstitutional, hence the need to conduct a free, fair and credible primary elections.

Usoko ken-Supule, another aspirant, demanded justice and fairness for every aspirant and for the progress of the party in the constituency, state and the country at large.
“We want justice for the progress of the party and without fairness there is no progress, therefore we are respectful party loyalists.

“We are not happy in view of what happened and we are disappointed; we are calling on the party leadership and the state governor to consider the plight of the masses”, he said.

Primaries: Aspirants protest imposition of Reps candidates in Adamawa

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Zulum Assures Immediate Relief Items, Dignified Resettlement of Displaced Persons in Monguno

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Zulum Assures Immediate Relief Items, Dignified Resettlement of Displaced Persons in Monguno

By: Our Reporter

Borno State Governor, Professor Babagana Umara Zulum, has assured displaced communities affected by insecurity that the government is working closely with the Nigerian military hierarchy to provide immediate humanitarian and long-term support.

Governor Zulum gave the assurance when he visited displaced persons in Monguno town on Sunday, reaffirming his administration’s commitment to ensuring dignified resettlement back to their ancestral communities.

While at the IDP camp, the governor interacted directly with displaced families as women, children and elderly residents gathered around him while he listened to their concerns.

“We have examined the situation critically alongside the hierarchy of the Nigerian military, and it has been concluded that we shall provide immediate humanitarian support to these displaced communities, especially in the areas of water, shelter, and sanitation,” Zulum stated.

“Apart from this, we shall also ensure that medium and longer-term sustainable solutions are being adopted, which is acceptable to this community and their ancestral home,” he said.

“We will improve the living conditions of the displaced persons; we will not allow our citizens to endure such hardship without urgent government intervention.”

He also urged residents to cooperate with security agencies by reporting suspicious movements and activities within their communities, noting that sustaining peace and security requires collective responsibility.

“Security is everybody’s business. Communities must continue to support security agencies with timely and useful information,” the governor stated.

Governor Zulum disclosed that there are over 50,000 returnees in Marte, stressing that plans were underway to facilitate the return of more displaced persons to the town as part of the medium and longer-term solution.

He immediately directed the Secretary to the State Government, the Commissioner for Local Government, the Commissioner for Internal Security, and the Chairman of Marte Local Government Area to work out the modalities for implementing the recommendations adopted.

The governor sympathized with the people affected by the recent insecurity and reaffirmed the government’s commitment to supporting them.

As part of the visit, Governor Zulum also met with health workers at the Monguno Eye Hospital, commending them for continuing to provide medical services despite difficult working conditions and limited resources. He announced financial support to improve their welfare and encourage greater commitment to healthcare delivery in the area.

The governor also visited the Commanding Officer of Forward Operation Base (FOB) Mairari for a security brief.

Governor Zulum was accompanied by the Senator representing Borno North, Senator Mohanmed Tahir Monguno; Speaker of Borno State House of Assembly, Rt. Hon. Abdulkarim Lawan, Member Representing Marte, Monguno, Nganzai, Hon. Bukar Talba, Secretary to the state government, Bukar Tijani, Commissioner for Information and Internal Security, Prof. Usman Tar, Commissioner for Local Government and Emirate Affairs, Hon. Sugun Mai Mele, alongside other government officials.

Zulum Assures Immediate Relief Items, Dignified Resettlement of Displaced Persons in Monguno

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