News
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
Zulum commissions remodelled ‘2nd chance school’ for vulnerable girls
Zulum commissions remodelled ‘2nd chance school’ for vulnerable girls
.Disburses N1bn to SMEs in 5 LGAs
By: Our Reporter
Borno State Governor, Professor Babagana Umara Zulum, on Thursday commissioned a fully remodelled “Second Chance School” for vulnerable girls and women in Biu Local Government Area.

The newly inaugurated facility is part of a strategic initiative designed to offer adult women, including those who missed formal education or dropped out of school due to prevailing challenges, a pathway to self-reliance.
The school’s curriculum is tailored towards providing comprehensive skills’ acquisition, critical digital knowledge and basic literacy, and numeracy training.

With the Biu centre now operational, Zulum’s administration has established three such schools across the state, with existing centres already operational in Maiduguri and Bama.
Meanwhile, Governor Zulum has disbursed N1 billion to small and medium-scale enterprises (SMEs) across five local government areas in southern Borno.
The targeted LGAs include Biu, Hawul, Shani, Bayo and Kwaya-Kusar, with the funds intended to support entrepreneurs and enhance business sustainability.
Zulum explained that the direct injection of capital into the SME sector is essential for driving grassroots development and fostering self-reliance in the post-insurgency recovery phase.
In a related development aimed at tackling youth restiveness and promoting social stability, Governor Zulum has ordered immediate employment of 200 young individuals from the Biu Local Government Area.
After the inauguration, Zulum visited Biu Specialist Hospital where he announced the immediate and automatic employment of a number of dedicated volunteer health workers who have served tirelessly.
He also inspected the 100-unit teachers’ housing estate under construction in Biu town. The estate is part of the Borno State Government’s motivational strategy to attract and retain qualified teaching professionals in public schools.
Governor Zulum has also directed immediate commencement of rehabilitation work on the Borno State Hotel Annexe in Biu.
Zulum commissions remodelled ‘2nd chance school’ for vulnerable girls
News
Environment Minister Calls for Inter-Agency Collaboration to Address Environmental Challenges
Environment Minister Calls for Inter-Agency Collaboration to Address Environmental Challenges
By: Michael Mike
The Minister of Environment, Balarabe Abbas Lawal, has urged enhanced inter-agency collaboration to tackle environmental challenges across Nigeria.
The call was made during a meeting with the Director-General of the National Hydro-Electric Power Producing Areas Development Commission (N-HYPPADEC), Abubakar Sadiq, and his team at the Ministry’s Abuja office.
Highlighting potential areas of cooperation, Lawal emphasized the importance of climate-resilient water supply and sanitation (WASH) programs aimed at ensuring year-round access to safe, reliable, and clean water in communities affected by dam operations. He noted that such collaboration would not only improve access to safe drinking water but also reduce the prevalence of water-borne diseases in these areas.
On energy initiatives, the Minister discussed the distribution of clean cooking stoves to households in hydro-basin communities, stressing that this would significantly reduce household energy poverty, deforestation, and emissions through the adoption of energy-efficient cooking technologies.
Other proposed collaboration areas between the Ministry and N-HYPPADEC include erosion and flood management, ecosystem restoration, climate-resilient afforestation programs, youth and community engagement, job creation, and public awareness campaigns.
In his remarks, Abubakar Sadiq described N-HYPPADEC as a strategic partner of the Federal Ministry of Environment, outlining the commission’s impactful interventions across water supply, sanitation, housing, youth empowerment, water transport safety, and institutional strengthening. He also commended the Ministry for its prompt response to flood-prone areas, erosion challenges, and pollution management.
N-HYPPADEC maintains offices in Lokoja, Birnin Kebbi, Ilorin, Lafia, Jos, Gombe, Jalingo, Makurdi, Kaduna, with its headquarters in Minna, Niger State.
Environment Minister Calls for Inter-Agency Collaboration to Address Environmental Challenges
Health
Health Worker Exodus Deepens as Policy Brief Warns of Systemic Risk to Nigeria’s Healthcare Sector
Health Worker Exodus Deepens as Policy Brief Warns of Systemic Risk to Nigeria’s Healthcare Sector
By: Michael Mike
A new policy brief has warned that unless urgent welfare-focused reforms are implemented, the country risks a deepening crisis that could undermine access to quality healthcare nationwide.
Nigeria’s healthcare system is facing mounting pressure as the steady departure of doctors and nurses continues to erode service capacity, raising concerns about long-term system viability.
According to the policy analysis authored by health policy expert Dr Emmanuel Ejimonu, of the Athena Centre for Policy and Leadership, more than 42,000 nurses left Nigeria between 2021 and early 2024, while thousands of Nigerian-trained doctors have registered to practise abroad, particularly in the United Kingdom. The trend shows no sign of slowing, as survey data cited in the report indicate that nearly three-quarters of medical and nursing students intend to seek employment overseas, with about one in three expressing no plans to return.
The report attributed the exodus largely to domestic welfare and governance challenges rather than professional ambition. Health workers interviewed consistently pointed to low and irregular salaries, unsafe and overstretched working environments, limited opportunities for funded specialist training and weak social protection systems. These challenges, the brief notes, have made emigration a rational choice in the face of institutional uncertainty, especially as global demand for health professionals continues to rise.
Although the Federal Government introduced a National Policy on Health Workforce Migration in 2023 to promote ethical recruitment and retention, the brief argues that its impact has been limited. Implementation gaps, inadequate funding and uneven execution at state and facility levels have prevented the policy from delivering meaningful improvements in working conditions.
The consequences of sustained health worker losses are already visible. Teaching hospitals are reportedly struggling to maintain specialist training and mentorship programmes, while recurring strikes highlight growing mistrust between health workers and government authorities. Economically, the country is losing returns on public investments in training, even as staff shortages compromise care delivery in both urban and rural facilities. Remaining workers also face rising burnout, further fuelling migration intentions.
Drawing on international experiences from countries such as Ghana, Kenya, the Philippines and Cuba, the policy brief stresses that health worker migration cannot be completely stopped. Instead, it recommends managing mobility through welfare-based retention strategies and credible governance structures.
Central to the recommendations is a proposed Welfare-First Retention Package, which prioritises guaranteed and timely payment of salaries, improved workplace safety, funded career progression, fair bonding arrangements and strengthened social protection. The package also calls for disciplined use of bilateral agreements and ethical recruitment frameworks to protect Nigeria’s investment in health worker training.
The brief estimates that, if properly funded and implemented, the proposed measures could reduce short-term health worker attrition by up to one-third within two years, while significantly improving retention over a five-year period.
The report stated that reversing the health workforce crisis will require treating welfare reform as a core economic and governance priority, backed by political will, fiscal discipline and strong institutional coordination. Without such action, the report warns, Nigeria risks the gradual hollowing out of its healthcare system, with far-reaching consequences for public health and national development.
Health Worker Exodus Deepens as Policy Brief Warns of Systemic Risk to Nigeria’s Healthcare Sector
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