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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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International Alliance Group Call on Government to Ensure Schools are Safe for Students

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International Alliance Group Call on Government to Ensure Schools are Safe for Students

By: Michael Mike

Moving Minds Alliance (MMA) has called on the federal government to tackle insecurity in schools headlong and ensure that schools are safe for Nigerian students.

Speaking on the background of Monday’s abduction of at least 25 children and a teacher at a boarding school in north-western Nigeria’s Kebbi state, the Interim Director of the Moving Minds Alliance (MMA), Katie Murphy on Wednesday in Abuja at the First National Consultative Meeting on Early Childhood Development (ECD) in Crisis, a two-day dialogue aimed at strengthening support systems for young children affected by conflict, displacement, and other emergencies, said the abduction was a sad narrative that should not be allowed to happen again.

The Moving Minds Alliance (MMA) is a funders collaborative and network focused on scaling up support for young children and families affected by crisis and displacement. They aim to improve coverage, quality, and financing of early childhood development services in emergency contexts.

Speaking at the event, Katie Murphy, stressed the urgency of securing innovative and sustainable domestic financing to safeguard the holistic development of Nigeria’s youngest children.

Murphy noted that while Nigeria receives substantial global support for ECD in crisis settings, most of the funding is channelled into health and nutrition, leaving critical areas such as early learning, responsive caregiving, and psychosocial support largely underfunded.

“This gap presents both a warning and an opportunity,” she said. “If we fail to invest now, the long-term wellbeing of children living through conflict and displacement will be at risk. But with coordinated action, Nigeria can champion a strong national commitment that inspires global momentum.”

She added that the meeting aims to review ongoing interventions, identify policy and financing solutions, and build a unified advocacy roadmap “led by Nigeria, for Nigeria’s children.”

She noted this at the national consultative meeting on children in crisis and development in Nigeria, a 2-day dialogue with Government and Early Childhood Development (ECD) stakeholders and also launch of it strategy and unveiling, “Reimagining early years crisis response strategy 2025-2030” in Abuja.

She said Nigeria can play a vital role in shaping a bold national commitment that inspires global action and includes a specific focus on children affected by crisis and displacement.

“Over the next two days, we are here to reflect on existing efforts to strengthen ECD for children affected by crisis and displacement, identify the policy and financing pathways that can accelerate progress, and begin to work together to shape a coordinated advocacy agenda led by Nigeria, for Nigeria’s children,” she said.

Also, the Early Childhood Care Development and Education (ECCDE) desk officer at the Ministry of Education, Confidence Okonkwo represented by the Director Basic Education, FME, Dr Folake Olatunji-David assured that the Federal Government of Nigeria is committed in ensuring that every Nigerian child is given adequate care in terms of nutrition, in terms of health, in terms of education.

” Nigerian Government has extended collaboration to private sector development for support because government do not have all the resources to cater for challenging issues in the education sector in the country, ” she said.

Representing the Federal Ministry of Education, Director of Basic Education, Dr. Folake Olatunji-David,, reaffirmed government commitment to ensuring that every child receives adequate nutrition, healthcare, and learning opportunities. She explained that the government is deepening partnerships with the private sector, acknowledging that public resources alone are insufficient to tackle the growing challenges in the education system.

Current national data paints a stark picture, showing that 3.6 million people in Nigeria are displaced as of October 2025, including over 3.57 million internally displaced persons (IDPs) and 142,557 refugees and asylum-seekers, with more than half of the displaced population are children.

It also showed that 1.8 million children face the threat of severe acute malnutrition, and over 18 million Nigerian children are currently out of school—many due to insecurity and displacement.

Children in these environments often miss out on nurturing care, early learning, mental health support, and other foundations essential for lifelong wellbeing. Without strategic action, experts warn that Nigeria risks falling short of national development targets and the 2030 Sustainable Development Goals.

Although Nigeria ranked among the top global recipients of ECD funding in crisis contexts in 2023—$27 million in humanitarian aid and $270 million in development assistance—funding patterns remain uneven. With the OECD forecasting a 30% drop in global aid, Nigeria could lose up to $89 million in ECD-related support by 2027, heightening the importance of domestic investment.

At the consultative meeting organised by the Moving Minds Alliance, the Federal and state ministries, including Education and Women Affairs; UN agencies such as UNHCR; Philanthropic organisations; International and local NGOs; Refugee- and community-led groups from Borno, Cross River, and Benue and media, researchers, and advocates These states were selected for their large populations of refugees and IDPs.

The event also marked the official launch of MMA’s 2025–2030 strategy: Reimagining Early Years Crisis Response.

According to the organisers, after the meeting, a national ECD coalition will be activated to coordinate efforts through 2029, leading up to global advocacy milestones such as the ECD Financing Summit in 2027.

International Alliance Group Call on Government to Ensure Schools are Safe for Students

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Nigerian Army neutralizes 239 terrorists, recovers weapons in Kaduna and Niger states

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Nigerian Army neutralizes 239 terrorists, recovers weapons in Kaduna and Niger states

By: Zagazola MAkama

Troops of the Nigerian Army under the command of 1 Division, Sector 1 Operation FANSAN YANMA, have successfully neutralized 239 violent extremists and insurgents while recovering a significant cache of weapons and ammunition across Kaduna and Niger states, a top military officer has disclosed.

Maj Gen Abubakar Sadiq Muhammed Wase, during the operational briefing to the Chief of Army Staff, Lt Gen Waidi Shaibu, said the successes were part of sustained clearance operations, patrols, ambushes, raids, and anti-kidnapping missions aimed at denying terrorists freedom of action in the sector.

The operations, he said, led to the recovery of 185 assorted weapons and 5,860 rounds of ammunition from identified insurgent enclaves and hideouts. “Our offensive and non-kinetic operations continue to degrade terrorist capabilities and disrupt their operational networks,” Maj Gen Wase said.

He highlighted that the Division’s area of responsibility, which covers Kaduna, Kano, Jigawa, and Niger states, is characterised by rugged terrain, dense forests, and underdeveloped infrastructure, which terrorists exploit as hideouts. Despite these challenges, he said the coordinated use of mobile combat units, light mobility platforms such as motorcycles and gun trucks, and aerial surveillance have restricted insurgent movements and enhanced operational coverage.

Maj Gen Wase also noted the recovery of over 1,091 life-support items, 364 vehicles and motorcycles, and the rescue of 563 kidnapped victims since the Division assumed operational control. He attributed the success to a combination of kinetic operations, intelligence-led targeting, and inter-agency collaboration, which have strengthened the Division’s capacity to dominate its area of responsibility.

He noted that the Nigerian Army has strengthened its commitment to community development and civil-military cooperation with the completion and commissioning of a new primary school in Tudun Biri, Kaduna State.

The unveiling of the Chidambere Community Primary School was part of a broader initiative by 1 Division, Sector 1 Operation FANSAN YANMA, to complement military operations with developmental interventions aimed at winning the hearts and minds of local communities.

Maj Gen Abubakar Sadiq Muhammed Wase, who briefed the Chief of Army Staff, Lt Gen Waidi Shaibu, said the project was commissioned and handed over to the Kaduna State Government as part of the Division’s ongoing non-kinetic engagements.

He explained that the Army’s engagement in education, healthcare, and infrastructure is designed to enhance civilian confidence, reduce community vulnerability to terrorist influence, and strengthen local cooperation with security agencies. “The school will serve as a symbol of the Nigerian Army’s commitment to peace, stability, and sustainable development in conflict-affected communities,” Maj Gen Wase said.

The commissioning follows a series of non-kinetic initiatives, including medical outreaches in Tutunbiri, Amarabanjoz, and other affected communities, aimed at ameliorating humanitarian challenges created by prior security operations and air component strikes.

He noted also that as part of ongoing efforts to reduce insurgent influence and promote peace, the Nigerian Army has successfully facilitated the surrender of several terrorist groups operating in Kaduna State, Maj Gen Abubakar Sadiq Muhammed Wase has disclosed.

The surrenders were achieved through a reconciliation and engagement team constituted in collaboration with the Kaduna State Government and the Office of the National Security Adviser. Targeted localities included Chukun, Egebi, Ndiwa, and Birnin Gwari LGAs, where terrorists were encouraged to lay down arms and accept government amnesty.

Maj Gen Wase revealed that 16 notorious terrorist groups, including Dogo Gide, Yelo Jamboros, Kolo Meri, Alhajilabi, Bilia, Gwamna, and Kabiru Boderi, expressed willingness to surrender. Weapons and ammunition were recovered during the process, and 142 kidnapped victims were released without ransom, including Dr. Daniel Okuola, a medical doctor who had been abducted in 2023 from the National Eye Center, Kaduna.

The GOC emphasised that these non-kinetic engagements do not reduce the intensity of ongoing kinetic operations. Rather, they complement military efforts by isolating terrorists from vulnerable communities, gathering intelligence, and strengthening civil-military relations.

He noted that the Division’s integrated approach of reconciliation, civil engagement, and targeted operations has strengthened public confidence in the military and supported the broader aim of restoring peace and security across the sector.

Maj Gen Wase said the Division remains committed to sustaining dialogue with repentant elements while continuing offensive operations against those who reject government amnesty.

Nigerian Army neutralizes 239 terrorists, recovers weapons in Kaduna and Niger states

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COAS tasks troops on mentorship, confidence in training, combat readiness

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COAS tasks troops on mentorship, confidence in training, combat readiness

By: Zagazola Makama

The Chief of Army Staff (COAS), Lt.-Gen. Waidi Shaibu, has charged soldiers of the Nigerian Army to uphold the highest standards of professionalism by relying on their training, embracing mentorship, and demonstrating confidence during operations.

Lt.-Gen. Shaibu gave the charge while addressing troops at 1 Division during an operational visit, on Wednesday.

He emphasised that proper mentorship and leadership by example remain critical to building a combat-ready Army capable of responding decisively to national security challenges.

“You must be mentored properly to do your job,” the COAS told the troops. “Mentorship means leading by example. Listen to your officers. I have spoken to them they will lead you well so that together we can do our job properly.”

Shaibu assured the troops that the Nigerian Army Headquarters would continue to provide necessary resources, logistics and welfare support to enhance their operational efficiency.

“Note that the resources of the state will be used to provide everything that you require. That will be done,” he said.

The Army Chief urged soldiers to apply the skills acquired during basic and advanced military training, stating that competence in weapon handling and combat manoeuvres is essential for battlefield survival and mission success.

“Put the skills you have been taught to practice whenever you are deployed. Have confidence in your training. On hearing a gunshot, you should dash to the nearest cover and return fire,” he said.

According to him, a soldier must not only fire but “aim and kill” when confronted by hostile threats. He said the Army will intensify emphasis on martial principles, marksmanship, and weapon proficiency drills to enhance the fighting capability of the force.

“You have all gone through this training, and we will continue to deepen it. We are strengthening weapon handling and core combat principles to get the proper soldiers to do their job,” Shaibu added.

The visit also created an opportunity for troops to engage the COAS directly, as he opened the floor for questions and clarifications.

“If you have any questions, feel free to ask me. I am here with some of my staff,” he said, accompanied by the Chiefs of Operations, Logistics, Military Intelligence, and Personnel Management.

The COAS reiterated his commitment to strengthening operational leadership across formations, emphasising that officers must lead with courage and responsibility, while soldiers must uphold discipline and confidence in their operational duties.

COAS tasks troops on mentorship, confidence in training, combat readiness

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