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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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2027 Elections: UN Asks Political Parties to Focus Campaign on Policies and Ideas

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2027 Elections: UN Asks Political Parties to Focus Campaign on Policies and Ideas

By: Michael Mike

As Nigeria gears up for season of electioneering, the United Nations has called on political parties to focus their campaigns on policies and ideas, not insults or divisive rhetorics.

During a speech at the Roundtable on Hate-Free Politics in Nigeria on Monday in Abuja, the United Nations Resident and Humanitarian Coordinator in Nigeria, Mr. Mohamed Fall said as we head to the 2027 elections. “Allow me to share some recommendations. First, political parties must lead by example. Campaigns should focus on policies and ideas, not insults or divisive rhetoric.

“Second, parties should commit to codes of conduct that reject hate speech and promote information integrity. Third, cooperation with media and digital platforms is essential to ensure that harmful content is not amplified, while factual, reliable information reaches voters.

“Above all, we must remember that elections are about people, their dignity, their rights, their future. Hate speech strips people of their dignity and undermines the very foundation of democracy. As leaders, you have the power and the responsibility to set the tone, to show Nigerians that politics can be conducted with respect, truth, tolerance, and integrity.”

Fall added that: “On this International Day of Democracy, I call upon you today: let us work together to make democratic participation in Nigeria free from hate and grounded in information integrity and respect for human rights. Let us affirm that words matter and that in choosing our words carefully, we choose peace, unity, and progress for Nigeria. Let us act collectively to strengthen and protect democracy in and beyond Nigeria.”

He stated that this International Day of Democracy with theme “Democracy and Inclusion in an Age of Insecurity” should remind us that democracy is not only about holding elections, but about ensuring inclusion, pluralism, and public participation of everyone in a respectful and inclusive manner.

He noted that: “When falsehoods spread unchecked, especially during elections, they weaken public trust, mislead citizens, and undermine democratic choices. Promoting information integrity means ensuring that Nigerians can access reliable information, that public debate is grounded in facts, and that voters are empowered to make informed choices free from manipulation.”

He insisted that: “In Nigeria, the stakes are high. Vibrant political discourse and engagement should be moments of ‘no gree for anybody’, unity, and pride. But they can be harmful if hateful language and hostile narratives are allowed and accepted; it can incite hostility and result in violence. We know from history that hate speech has been a precursor to some of the worst atrocities, including genocide.

“The Rabat Plan of Action, endorsed by the United Nations, reminds us that advocacy of national, racial, or religious hatred that incites discrimination, hostility, or violence must be prohibited by law and that these laws must comply with international human rights standards, including the right of association, expression, and assembly.

“This is a cornerstone of democracy. Restrictions must be lawful, necessary, and proportionate, never a pretext to silence debate. The challenge before all of us here today is to strike the right balance: engaging in open political discourse while safeguarding freedom of expression and protecting Nigerians from the harms of hate speech.”

On his part, the Executive Secretary of National Human Rights Commission (NHRC), Dr. Tony Ojukwu noted that since the return to civilian rule in 1999, Nigeria has made notable progress in democratic development.

He said: “We have witnessed successive electoral cycles, the strengthening of civil society, and the expansion of political space. Yet, our democracy remains a work in progress. Challenges such as low voter turnout, weak internal democracy in political parties, electoral violence and malpractices, weak institutional accountability, and limited inclusion of women, youth, and persons with disabilities and harsh political climates continue to undermine public trust and democratic consolidation. Above all of these, our democratic and political processes including communication have often come under immense challenges of poor values, deep-seated hate-filled and divisive rhetoric threatening the core foundation of our nationhood.”

He noted: “The National Human Rights Commission has been at the forefront of efforts to promote ethical and hate-free politicsin Nigeria. In the 2023 elections.”

Ojukwu stated that hate speech is intricately related to human rights, either in its form or outcome, adding that: “To the person spreading hate speech, it is about right to freedom of expression, opinion, speech or belief. To the recipient of hate speech, it is a violation of the rights to dignity of human person and the freedom from discrimination based on religious belief, political, ethnic, gender, cultural or other affiliations, amongst many other human rights.

“When applied to politics, hate speech and unethical communications breed political divisions that facilitate violence, weak voter electoral participation, stifles plurality and social cohesion.”

He said: “As we count down to the 2027 General Elections, the NHRC is alarmed at the high level of hateful politics and unethical practices that seemed to have taken the centre stage with some of our political actors. Achieving a culture of responsible and value-laden political process continues to remain a challenge for Nigeria. From the independence of the election management body to unethical actions of political parties, their candidates and agents to the inappropriate use of security and law enforcement agencies.

“Vote buying and inducements of various sorts during past and recent elections have become worrisome indicators of the fragility of the Nigerian electoral culture with severe consequences on the freedom of association and the right to participation.”

He noted that: “The Roundtable on Ethical and Hate-Free Politics in Nigeria which we are convening today in partnership with the United Nations is aimed at forging a shared understanding of the drivers, patterns, and impacts of hate speech and unethical political communications in Nigerian electoral and democratic processes and to secure practical, rights-based commitments from key actors to promote ethical politics, reduce hate speech and protect pluralism and inclusive participation—especially for women, youth, persons with disabilities, and minority communities in the electoral processes leading to the 2027 elections and beyond.”

2027 Elections: UN Asks Political Parties to Focus Campaign on Policies and Ideas

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Eight ISWAP fighters including two Commanders killed in clash with troops in Borno

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Eight ISWAP fighters including two Commanders killed in clash with troops in Borno

By: Zagazola Makama

At least eight Islamic State of West Africa Province (ISWAP) fighters, including two field commanders and a sector leader, have been killed by Nigerian troops in Borno.

Intelligence sources told Zagazola Makama that the insurgents were neutralised in an encounter with troops along the Maiduguri–Baga highway on Monday morning.

According to the sources, the clash occurred near Garin Giwa, close to Cross Kauwa, when the terrorists laid an ambush on troops on patrol.

“During the engagement, eight terrorists were killed, including two ‘Munzirs’ (field commanders) and one ‘Qaid’ (sector leader).

“They were identified as Modu Dogo, a Munzir from Dogon Chukun; another unidentified Munzir; and Abu Aisha, a Qaid from Tumbun Mota,” one of the sources said.

The source added that several other fighters were wounded, especially those who fled on foot after abandoning 14 motorcycles recovered by the troops.

The incident is the latest setback for ISWAP fighters operating around the Lake Chad basin.
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Nigerian troops neutralise armed bandit, recover AK-47 in Katsina

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Nigerian troops neutralise armed bandit, recover AK-47 in Katsina

By: Zagazola Makama

The troops of Operation FANSAN YANMA have neutralised an armed bandit and recovered an AK-47 rifle during an operation in Turare Forest.

Zagazola Makama learnt that the operation, conducted in collaboration with other security agencies, was based on credible intelligence received about the presence of bandits in the forest.

“The operation, which took place at about 3:00 a.m., on Monday led to the killing of an armed bandit. One AK-47 rifle was recovered from the suspect,” he said.

The sources added that patrol and monitoring activities in the area have been intensified and would be sustained to prevent further criminal activities.

Nigerian troops neutralise armed bandit, recover AK-47 in Katsina

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