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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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Zulum Visits Frontline Troops in Mairari, Inspects Dilapidated FGC Monguno

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Zulum Visits Frontline Troops in Mairari, Inspects Dilapidated FGC Monguno

By: Our Reporter

Borno State Governor, Professor Babagana Umara Zulum, on Tuesday, visited the Forward Operating Base (FOB) in Mairari to bolster the morale of troops on the frontline.

Mairari, a strategic town in the state, endured two insurgent attacks in December. On both occasions, the assaults were successfully repelled by troops, averting a significant security breach.

Governor Zulum, who is currently on a resilience-building tour of Northern Borno, commended the officers and men for their bravery and sacrifice, describing them as the backbone of peace and stability in the state.

“Your resilience and commitment inspire confidence in our people,” the Governor stated. “I want to assure you that my administration will continue to provide all necessary logistics and welfare support to boost your morale and enhance your operational effectiveness. Mairari will not fall.”

He emphasised that the state government, in collaboration with the Federal Government and military high command, would ensure a steady supply of operational logistics, mobility support, and welfare packages to keep troops combat-ready.

The Commander of Sector 3, Operation Hadin Kai, Major General Suleiman Saidu Tilawan, commended the Governor for his consistent and proactive support.

“The support we receive from the Borno State Government and the Theatre Commander has been exceptional,” he said. “It has translated into improved logistics, enhanced morale, and renewed confidence among our troops to confront threats head-on.”

Governor Zulum also interacted with residents of Mairari, listening to their concerns and commending their courage. He described the community as a symbol of resilience and announced cash assistance to those affected by the recent attacks to ease hardships and support recovery.

…Zulum Inspects Dilapidated FGC Monguno

Earlier in the day, Governor Zulum conducted an inspection of the abandoned Federal Government College in Monguno.

He assessed extensively damaged classrooms, vandalized laboratories, and deteriorating staff quarters, tangible reminders of the insurgency’s impact on public institutions.

The Governor said the purpose of the visit was to assess the damage and identify practical steps for the college’s full rehabilitation. “Education is the foundation upon which any peaceful, prosperous, and resilient society is built,” Governor Zulum stressed. “Rebuilding schools is central to the long-term recovery and stability of our dear state.”

He assured that his administration would spare no effort in restoring the school, with the ultimate goal of ensuring children from Monguno and neighbouring communities can access quality education.

During the inspection, Governor Zulum encountered widows who are taken refuge in some of the abandoned structures and provided them with cash assistance and facilitated the admission of some of their qualified daughters into the Monguno College of Nursing and Midwifery, offering them a pathway to education and future self-reliance.

Zulum Visits Frontline Troops in Mairari, Inspects Dilapidated FGC Monguno

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Yuletide: NSCDC Deploys 55,000 Operatives Nationwide, Intensifies Intelligence to Tackle Insecurity

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Yuletide: NSCDC Deploys 55,000 Operatives Nationwide, Intensifies Intelligence to Tackle Insecurity

By: Michael Mike

The Nigeria Security and Civil Defence Corps (NSCDC) has deployed over 55,000 operatives across the country to ensure public safety and protect critical national assets and infrastructure during the Christmas and New Year festivities.

The Commandant General of the Corps, Prof. Ahmed Audi, ordered the nationwide deployment as part of measures to strengthen the nation’s security architecture before, during and after the yuletide period.

Audi said the decision became imperative in view of the tendency of criminal elements to exploit festive periods to carry out acts of banditry, kidnapping, terrorism, insurgency and other crimes.

He stressed that many security threats could be effectively curtailed if citizens embraced the culture of providing credible and timely intelligence to security agencies. According to him, proactive intelligence-sharing would aid early intervention and lead to the arrest of individuals who pose threats to national security.

“To prevent crimes rather than react to them, it is imperative for members of the public to trust and collaborate with us by providing credible and timely information that will enable swift action,” the NSCDC boss said.

Audi directed Zonal Commanders to closely monitor formations under their jurisdiction, while State Commandants are to coordinate Area Commands, Divisional Offices and other operational units to ensure effective coverage.

He explained that the deployment involves both covert and overt operations, with full mobilisation of personnel aimed at guaranteeing maximum human security and safeguarding government assets nationwide.

Reaffirming the Corps’ commitment to national peace and stability, the NSCDC helmsman assured Nigerians of enhanced collaboration with sister security agencies to ensure a safe environment conducive to development.

He said: “Our unwavering commitment is to ensure a safe and secure environment, and this can only be achieved with the active support of the public.”

The assurance was contained in a statement signed by the National Public Relations Officer of the Corps, Afolabi Babawale.

Yuletide: NSCDC Deploys 55,000 Operatives Nationwide, Intensifies Intelligence to Tackle Insecurity

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Military arrest policemen on VIP escort duty in violation of President Tinubu’s directive

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Military arrest policemen on VIP escort duty in violation of President Tinubu’s directive

By: Zagazola Makama

The military has arrested four police officers for allegedly providing unauthorised escort services to a VIP in contravention of the presidential directive on the withdrawal of policemen from VIP protection duties.

Police sources told Zagazola Makama that the arrest occurred on Dec. 17 at about 9:30 a.m., while the officers were reportedly on escort duty.

Those arrested were identified as ASP Musa Waziri and Insp. Jeremiah Achimogu both attached to 45 Police Mobile Force (PMF), Abuja; Insp. Awipi Terry of 21 PMF; and Insp. Hassan Baba of 50 PMF, Abuja.

According to security sources, the officers were arrested by military personnel after allegedly flouting the presidential order withdrawing police personnel from VIP escort duties.

The sources further disclosed that the policemen were dressed in uniforms similar to that of the Nigeria Security and Civil Defence Corps (NSCDC), allegedly in an attempt to evade detection and deceive enforcement personnel.

The arrested officers have since been detained, while disciplinary procedures have been initiated against them in line with extant regulations.

The Federal Government had earlier directed the immediate withdrawal of police personnel from unauthorised VIP protection duties to redeploy manpower to core policing and internal security operations across the country.

Military arrest policemen on VIP escort duty in violation of President Tinubu’s directive

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