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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
How propaganda and exaggerated genocide narratives triggered punitive international actions against Nigeria
How propaganda and exaggerated genocide narratives triggered punitive international actions against Nigeria
By: Zagazola Makama
Recent United States visa restrictions and mass deportation measures affecting Nigerian nationals have reopened debate on how sustained propaganda, misinformation and alarmist narratives about insecurity in Nigeria shaped international perceptions and policy responses against the country.
While Nigeria continues to face real security challenges including terrorism by ISWAP, Boko Haram, AlQaeda, banditry, farmer–herder clashes and transnational jihadist infiltration, the framing of these conflicts as an organised, state-backed “Christian genocide” has increasingly been questioned by Nigerians.
Yet, for several years, a powerful campaign driven largely by Nigerian activists, politicians and diaspora-based pressure groups portrayed Nigeria as the world’s epicentre of religious extermination, with claims that were grossly exaggerated, unverifiable or outright false.
The agitations grew domestic grievance to international propaganda. Between 2021 and 2024, a wave of advocacy emerged accusing the Nigerian state of deliberately sponsoring or protecting jihadists allegedly engaged in the daily slaughter of Christians. Some campaigners claimed that 1,500 Christians were being killed every day, a figure that would translate to more than 540,000 deaths annually, a number exceeding fatalities recorded in most active war zones globally.
One widely circulated narrative claimed that between 2010 and October 2025, 185,000 people were killed on account of their faith, including 125,000 Christians and 60,000 Muslims, allegedly based on reports from Intersociety, one of the NGO created to push the false claims.” The same narrative alleged that 19,100 churches had been burned and 1,100 Christian communities completely seized and occupied by jihadists supposedly backed or shielded by the Nigerian government.
However, independent verification of these figures consistently failed. No global conflict-monitoring organization, including ACLED, UN agencies, or major international human rights bodies as well as official bodies like Police, DSS, and the NHRC, corroborated such numbers. Nigeria’s total population stands at approximately 240 million, making such casualty claims statistically implausible without triggering global humanitarian emergency responses on the scale of Gaza, Syria or Ukraine.
Zagazola Makama report that while religiously motivated attacks occur, Nigeria’s violence landscape is far more complex, driven by criminal banditry, resource conflict, insurgency, arms proliferation, climate stress and weak border control, affecting Muslims, Christians, Pagan, traditionalist and adherents of other faiths alike.
Despite the lack of empirical grounding, these activities keep weaponizing faith to internationalise pressure. The genocide narrative gained traction in U.S. political circles, evangelical advocacy groups and sections of Western media. Some Nigerian politicians amplified these claims at international forums, urging sanctions, arms embargoes and even military intervention against their own country.
The expectation among agitators was that Trump’s administration would deploy American forces or impose targeted sanctions against Nigerian officials and groups like Miyetti Allah, Boko Haram, Bandit and those that once push for Shariah laws. Instead, the policy response took a different and far more consequential direction. Rather than physical military intervention, Washington opted for strategic intervention with the armed forces of Nigeria through technical support while in their country they opted for tougher penalties like border control, immigration enforcement and visa restrictions, citing insecurity, terrorist activity, document integrity issues and vetting challenges.
Nigeria was subsequently placed under partial U.S. travel restrictions, with the U.S. government explicitly referencing the activities of Boko Haram and ISWAP, and difficulties in screening travellers from affected regions.
The unintended security backlash
Ironically, following persistent framing of Nigeria’s violence as a religious war produced outcomes opposite to what campaigners claimed to seek. Rather than protecting Christians, the rhetoric emboldened extremist groups to carry even more deadlier attacks.
Terrorist organisations, including ISWAP, JAS and al-Qaeda-linked JNIM elements now infiltrating North-Central Nigeria, capitalised on global narratives portraying Nigeria as a battlefield of faith. By attacking churches, clergy and Christian communities, these groups sought to validate the propaganda, provoke sectarian retaliation and trigger a broader religious conflict. This strategy mirrors jihadist doctrine across the Sahel: manufacture sectarian violence, polarise society, delegitimise the state and attract recruits.
Security intelligence from Kwara and Niger States, for instance, shows JNIM’s Katiba Macina exploiting communal tensions along the Benin–Nigeria corridor, recruiting Fulani youths while framing attacks as resistance against “tyranny” language deliberately aimed at feeding international narratives of persecution.
The U.S. Department of Homeland Security has since justified its tougher posture using data-driven assessments: visa overstay rates, terrorism risks, weak civil documentation systems and law-enforcement information gaps.
For Nigeria, these translated into: Partial visa suspensions for B, F, M and J categories, increased scrutiny of Nigerian travellers, inclusion in broader immigration enforcement actions, Indirect reputational damage affecting trade, education and diplomacy
Meanwhile, The Department Homeland Security announced record deportations and self-removals, over 2.5 million exits since January 2025, a development that disproportionately affects nationals of countries portrayed as high-risk, Nigeria included. Crucially, those most affected are ordinary Nigerians students, professionals, families and entrepreneurs, not terrorists, bandit leaders or militia commanders.
The Fulani bandit in the forest has no interest in a U.S. visa. It is the Nigerian student, pastor, doctor and trader who bears the cost.
Notably, as sanctions and restrictions took effect, the loud genocide rhetoric largely faded from public discourse. The activists who once dominated international media cycles have grown quieter, perhaps confronted by the reality that the consequences fell on Nigeria as a whole, not on imagined perpetrators. This pattern point to a broader lesson in strategic communication: when a nation’s internal crises are exaggerated into existential falsehoods, external actors respond not with rescue but with containment.
A cautionary lesson for national discourse is that; Nigeria’s security challenges are real and demand sustained reform, diplomatic support, and international cooperation. But weaponising religion, spreading unverifiable casualty figures and lobbying for foreign punitive action against one’s own country undermines national security rather than strengthening it. More dangerously, it feeds extremist propaganda, deepens communal mistrust and invites external decisions based on distorted perceptions.
When internal challenges are projected internationally without context or factual balance, foreign governments respond not with solidarity but with restrictions, sanctions and containment. In this environment, propaganda even when framed as advocacy, erodes diplomatic goodwill and inflicts long-term harm on citizens whose lives and opportunities are shaped by external policy decisions.
False alarms and absolutist narratives fracture social trust, embolden extremists and inflame the very fault lines terrorists seek to exploit. Ultimately, propaganda however emotionally persuasive does not protect communities; it weakens national resilience and leaves society more vulnerable to the forces it hopes to defeat.
Zagazola Makama is a Counter Insurgency Expert and Security Analyst in the Lake Chad region
How propaganda and exaggerated genocide narratives triggered punitive international actions against Nigeria
News
Gunmen kill soldier, abduct 13 passengers on Okene–Auchi highway
Gunmen kill soldier, abduct 13 passengers on Okene–Auchi highway
By: Zagazola Makama
Suspected kidnappers disguised in military uniforms have killed a serving soldier and abducted 13 passengers during coordinated attacks on two commercial vehicles along the Okene–Auchi Federal Highway.
Zagazola Makama report that the incident occurred at about 5:35 p.m. on Dec. 16 when unknown gunmen intercepted a green Toyota Sienna, conveying nine passengers from Abuja to Delta State.
The source said six passengers were abducted from the vehicle, while three others were rescued.
According to the source, the attackers also stopped a white Toyota Hiace bus, conveying 11 passengers from Delta State to Abuja, during the same operation.
“Seven passengers were abducted from the Hiace bus, while four were rescued,” the source said.
Tragically, the source said a serving Non-Commissioned Officer of the Nigerian Army, who was among the passengers and had identified himself as a soldier, was shot by the attackers.
“He sustained gunshot injuries to his legs and thighs and was later confirmed dead,” the source added.
Both vehicles were recovered and towed to a police station for safe keeping, while five empty shells of 7.62mm ammunition suspected to be from an AK-47 rifle were recovered at the scene as exhibits.
The corpse of the deceased soldier was deposited at the Okengwe General Hospital mortuary for autopsy, while statements were obtained from the rescued victims to aid investigation.
It was gathered that troops have launched joint rescue operations, including bush combing and intensive surveillance along the highway, with a view to rescuing the abducted passengers and arresting the perpetrators.
The authorities assured motorists that measures were being intensified to secure the Okene–Auchi corridor and prevent further attacks.
Gunmen kill soldier, abduct 13 passengers on Okene–Auchi highway
News
Bandits kill one, abduct several in Zamfara
Bandits kill one, abduct several in Zamfara
By: Zagazola Makama
Armed bandits have killed a young man and abducted several others during an attack on a store area in Bungudu Local Government Area of Zamfara State.
Zagazola report that the incident occurred at about 12:30 a.m. on Dec. 16 when gunmen, carrying AK-47 rifles and other sophisticated weapons, launched a sporadic shooting spree in Karakkai district.
The source said one Lukman Rabe, aged 21, was shot dead during the attack, while an unspecified number of people were abducted and taken to an unknown location.
Army troops in collaboration with joint Police, and local hunters, were immediately mobilised to the scene to secure the area.
Sources said that efforts are ongoing to rescue the abducted victims and apprehend the fleeing suspects, while residents have been urged to remain vigilant and report any suspicious activity to security agencie
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