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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
News
VP Shettima: Borno Attack Will Not Break Nigeria’s Resolve
VP Shettima: Borno Attack Will Not Break Nigeria’s Resolve
By: Our Reporter
Vice President Kashim Shettima has condemned in strong terms the bomb explosion that claimed about five lives and left several others injured at a Mosque in Gamboru Market, Maiduguri, Borno State, describing the attack as a despicable assault on innocent citizens and the peace of the nation.
The Vice President said President Bola Ahmed Tinubu has ordered an immediate intensification of security operations in Borno State following the incident.
In a statement on Thursday, the Vice President condemned the attack, assuring that the Federal Government is deploying additional tactical teams to the area to track down and apprehend those responsible for the terror attack.
“The Federal Government will not tolerate any attempt to undermine the peace and security of our nation. Our security agencies are working round the clock to ensure that the perpetrators of this heinous crime are brought to justice immediately,” he said.
Senator Shettima expressed confidence that the security architecture currently in place would not only apprehend the perpetrators but also unravel the full circumstances surrounding the incident.
“We sympathize with the Government of Borno State, residents, and families who have lost their loved ones in this attack. The Federal Government is confident that those responsible for this despicable act of terrorism will face the full weight of the law,” VP Shettima said.
He assured Nigerians that the Tinubu administration’s commitment to national security, anchored in constitutional duty, remains unwavering.
“Since President Bola Ahmed Tinubu assumed office in 2023, this administration has consistently reaffirmed its unyielding commitment to safeguarding the security, unity, and stability of our nation.
“This commitment remains steadfast under God and the Constitution of the Federal Republic of Nigeria. We will continue to provide our security agencies with all necessary resources and support to decisively defeat terrorism in all its forms,” he affirmed.
The Vice President added that the Federal Government is working closely with state authorities and local security agencies to ensure protection of vulnerable communities and critical infrastructure across the North East and other regions.
VP Shettima: Borno Attack Will Not Break Nigeria’s Resolve
News
Zulum-“Protect Our Sacred Bond,” Celebrates Peaceful Year in Christmas Message
Zulum-“Protect Our Sacred Bond,” Celebrates Peaceful Year in Christmas Message
By: Our Reporter
With profound gratitude to God for sparing our lives one full year to another Christmas celebration, Borno State Governor, Professor Babagana Umara Zulum felicitate with the Christian community across the state on the occasion of Christmas.
The Governor is currently engaged in a four-day security and resilience building tour across Northern Borno. The tour includes visits to military formations to boost their morale, and to communities affected by the insurgency, where he is working to build their confidence and provide tangible democratic benefits.
In a message by his Spokesperson Dauda Iliya, Governor Zulum expressed gratitude to God Almighty for the return of relative peace in the state.
“For us in Borno State, the period between the 2024 to the 2025 Christmas celebrations has been one full year of celebrating enviable all-encompassing reconstruction and recovery,” Zulum stated.
“The progress is not only in terms of physical infrastructure, but also in terms of the peace and forbearance, mutual goodwill and harmonious coexistence among the Muslim and Christian communities, which our beleaguered state very critically desires to launch itself back to prosperity and glorious past,” he added.
“I feel obliged to express my most heartfelt gratitude to God for enabling me to preside over the state one full year, witnessing a gladdening restoration and maintenance of these required peace, mutual goodwill and harmony between the the Muslim and Christian communities which bonded us tightly together as a solid people, but which the over a decade Boko Haram insurgency threatened to completely destroy.
“A noteworthy part of the Muslim-Christian harmonious coexistence and goodwill reconstruction and maintenance was my recent high-level consultation meeting with the leadership of Jama’atu Nasril Islam (JNI) and Christian Association of Nigeria (CAN), focused on strengthening collaborative efforts between the state government and religious bodies to combat the lingering threat of insecurity and foster lasting peace in Borno State.
“At that meeting, I underscored the critical role of religious leaders in promoting tolerance, unity and peace across the state because Borno, like many states, has unique and beautiful family composition dynamics.
“It is common to find under one roof, brothers and sisters, uncles and aunts, who profess different faiths. We share meals, we celebrate festivities and milestones, we grieve losses together, as one family, bound by blood and love that transcends religious labels. This is our reality.
“I stressed that our enviable strength emanates from this reality. I will still, therefore, stress that we must protect this sacred bond within our homes and allow it to define our individual, as well as intra- and cross-community engagements.
“In sustenance of my tradition of just, fair and equitable treatment of both communities in festive seasons, I have, also, this year, I announced support to the Christian community and non indigenes, which includes free transportation to non-indigenes to different parts of the country, humanitarian support to over 6,000 vulnerable Christians, cash gifts to widows and orphans, sponsorship of Christian pilgrimage and other interventions.
I am always disposed to rendering such support, and even more, whenever the need arises.
Governor Babagana Zulum urge every citizen of the state, irrespective of faith, to come together in the collective search for lasting security, peaceful and harmonious coexistence as the most-critical foundation for true reconstruction, recovery and prosperity.
Zulum-“Protect Our Sacred Bond,” Celebrates Peaceful Year in Christmas Message
News
Gov. Zulum condemns Christmas Eve explosion in Borno
Gov. Zulum condemns Christmas Eve explosion in Borno
By: Bodunrin Kayode
About five people are feared dead yesterday evening as a suicide bomber detonates improvised explosive devices (IEDs) strapped to his body in a Maiduguri mosque in the popular Gamboru market, which is visited by traders from all over the country, including bordering countries.
The deaths, which were as a result of a suicide explosion, occurred at a mosque inside Gomboru Market, where the suspect had sneaked into a mosque, disguised as a faithful during “Magrib prayer.”

Sources within the market community said he was not a regular at the mosque, and they could also not explain how he lined up with the others or how he came to the community unnoticed to cause such a damnation.
As of the time of writing this report, the explosion had left several residents within the market community injured, while the most fatal ones have been rushed to nearby general hospitals for immediate treatment to stop the bleeding, which usually escalates the bleeding.

As of the time of writing this report, the military and police authorities had confirmed that about five people had died from the attack, which caused a lot of people to scamper for safety, causing massive gridlock around the customs area.
Reaction of the military
Reacting to the incident, the military said that about 32 civilians sustained all manner of injuries from the incident.
In a release signed by Lt. Col. Sanni Uba, it went on to state that the incident occurred at about 6pm yesterday at a mosque located within Gamboru Market in Maiduguri Metropolitan Council (MMC), while Muslim faithfuls were observing evening prayers.
“Preliminary findings indicated that the incident was caused by a suspected Boko Haram Terrorist (BHT) suicide bomber, who detonated an improvised explosive device, killing himself and 2 civilians on the scene.

“Troops, in conjunction with the Nigeria Police Explosive Ordnance Disposal (EOD) team, other sister security agencies, the Borno State Government, and NEMA, responded promptly, secured, and cordoned off the affected area to prevent further harm and ensure public safety.
“Casualties were immediately evacuated to the General Hospital and the Teaching Hospital in Maiduguri for prompt medical attention.
“A total of 32 civilians sustained varying degrees of injuries. Regrettably, 2 of the injured civilians were later confirmed dead at the hospital, while 2 others are currently in critical condition. The remaining injured persons are stable and receiving appropriate medical care.
“Troops and other security agencies have since intensified surveillance and security measures within Maiduguri and surrounding areas.
“Members of the public are advised to remain calm and security conscious, especially during the yuletide season. The public is also urged to be on the lookout for teenagers with suspicious looks.
“It is advised to avoid crowded places and maintain extra vigilance at religious places, especially churches during the yelutide period. Citizens are urged to promptly report any suspicious persons or activities to the nearest security post.
“OPHK commiserates with the families of the deceased and assures the public of its continued commitment to safeguarding lives and property.”
Zulum Condemns Maiduguri Mosque Suicide Attack, Calls for Vigilance in Worship, Public Places
Meanwhile, Governor Babagana Zulum has condemned, in strong terms, the suicide explosion at the Gomboru market mosque in Maiduguri metropolis Wednesday evening.
Governor Zulum, conveying his profound condolences from the frontline in northern Borno through his Special Adviser on Media, Dauda Iliya, called for increased vigilance and heightened security measures, particularly in places of worship during the festive period.
“I am deeply saddened by the Gamboru mosque suicide attack, which occurred on Wednesday evening when worshippers were performing Maghrib prayer, killing 5 people and injuring 35 others. The act is utterly condemnable, barbaric, and inhumane.
“Attacking a place of worship is a desecration of the sanctity of the mosque at a time when Muslim faithful are performing acts of worship.
“I wish to express my condolences to the families of all those that lost their lives in the attack and pray for the repose of their souls and for the speedy recovery of those injured,” he stated.
The governor further assured that adequate measures have been taken to forestall any security breach during the festive period and beyond.
IEDs have been a major challenge in the 16-year-old insurgency war, which has been fought by Nigeria in the Northeast theater of operation, Hadin Kai.
Meanwhile, residents went about their activities in peace hours after the gridlock was eased between customs and the international route leading to Gamboru Ngala and out of the country.
Gov. Zulum condemns Christmas Eve explosion in Borno
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