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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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Three chadian nationals feared dead as canoe capsizes in Gamboru-Ngala, Borno

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Three chadian nationals feared dead as canoe capsizes in Gamboru-Ngala, Borno

By: Zagazola Makama

Tragedy struck on Sunday evening in Gamboru-Ngala, Borno State, when a canoe carrying eight passengers capsized while crossing the river bordering Nigeria’s Gamboru town and Fotokol in Cameroon, leaving three persons feared dead.

Zagazola Makama gathered that the incident occurred at about 6:30 p.m. when the canoe, operated by one Mamman Nur Abbagana of Kasuwan Katako, Gamboru, overturned midstream with all passengers thrown into the water.

Security sources confirmed that all eight passengers were Chadian nationals travelling from Jos, Plateau State, en route to N’Djamena, Chad Republic.

Five passengers, whose identities were yet to be confirmed at press time, were rescued alive.

However, a woman identified as Alphosine Makebu Beboroum, 34, and her two daughters Centich Mamajibe, 3, and Mamajilem Bebaroum, 10 months, all Chadian nationals, drowned and had not yet been recovered as of Monday morning. The search and rescue mission is still ongoing.

Meanwhile, Police authorities also confirmed the arrest of the canoe paddler for violating the Borno State Government’s directive mandating the use of life jackets by all canoe and boat operators.

The command said preliminary investigations were ongoing.

Three chadian nationals feared dead as canoe capsizes in Gamboru-Ngala, Borno

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How Nigeria’s rapid military intervention in Benin reshaped West Africa’s anti-coup momentum

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How Nigeria’s rapid military intervention in Benin reshaped West Africa’s anti-coup momentum

By: Zagazola Makama

The failed coup attempt in Benin Republic is far more than an isolated disturbance in West Africa. It is a political earthquake whose tremors are being felt all the way from Cotonou to Bamako, Niamey and Ouagadougou.

For the military juntas entrenched in the Sahel, Sunday’s events were a nightmare scenario a decisive blow to their hope of expanding the “putschist club” across the region.

President Patrice Talon’s firm, composed address to the nation late Sunday night delivered the final stamp of legitimacy. But what many are now acknowledging is this: Nigeria’s swift and disciplined intervention was the game-changer.

In the early hours of the crisis, as coup plotters seized the National TV station and attempted to entrench themselves, the Government of the Republic of Benin activated its mutual defence channels with Abuja. Within minutes, Nigeria’s Chief of Defence Staff, General Olufemi Oluyede, acting under the directive of President Bola Ahmed Tinubu, activated a rapid-response military operation.

The Nigerian Air Force fighter jets were ordered into Beninese airspace to dominate the skies, neutralise hostile positions, and support loyalist forces. Simultaneously, Nigerian ground forces mobilised and crossed into Benin under Benin-led coordination, providing reinforcement to secure key installations and restore constitutional order.

This single act of regional leadership changed the trajectory of the coup, shattered the momentum of the plotters, and halted what could have become a prolonged national crisis.
ECOWAS was already mobilising, but Nigeria’s decisive action set the tone and provided the operational backbone that ended the coup within hours. It was a clear demonstration that Abuja remains the stabilising anchor of West Africa politically, diplomatically, and militarily.

As Talon spoke last night, the fear in junta capitals was visible. Social media networks aligned with the juntas scrambled to spin the failure: “It’s not over yet!” “Talon is bluffing!” “Stay vigilant!”

But beneath the bravado was panic. Their long-held dream to expand military rule into coastal West Africa had collapsed and Nigeria’s intervention made that collapse irreversible.The night became a theatre of desperation, with fake democrats, pseudo-intellectuals and Pan-African opportunists trying to salvage their ideological embarrassment. They resorted to tired diversionary tactics, attacking ECOWAS, questioning its motives, and searching for excuses.

But the truth was undeniable: The coup failed because the region, led by Nigeria, refused to allow another country to fall. But expected, some Nigerians, often those who do not follow security operations, took to social media asking: “Why didn’t Nigeria use this same energy against terrorists and bandits?”

An absurd question. It is as if these people have never seen the daily reports of: Dozens of terrorists neutralised across Zamfara, Katsina, Kaduna and Borno, mass destruction of ISWAP and Boko Haram enclaves, bandit kingpins eliminated, thousands of kidnapped victims rescued, large quantities of weapons recovered, aerial bombardments carried out week after week

Nigeria has been fighting terrorists with unmatched intensity, To compare the two operations, one a cross-border rapid-intervention mission lasting hours, and the other a domestic counterterrorism war spanning over 15 years is intellectually dishonest. What happened in Benin was not “energy Nigeria never shows.” It was a different type of mission a rapid, high-precision, multinational constitutional defence operation and Nigeria executed it flawlessly.

The larger significance of the failed coup is now evident. It has: exposed the weakness of the Sahel juntas, halted their push to expand military authoritarianism southwards, sent a message that ECOWAS has finally adapted and will no longer tolerate illegal takeovers and reaffirmed Nigeria’s decisive role in shaping regional security outcomes.

The supporters of the juntas are terrified and they should be. Because Sunday marked the beginning of a new countdown. The ideological project of the Sahel military regimes is weakening, and their attempt to export instability has backfired spectacularly. The next months will be critical. The Sahelian juntas, already struggling with insecurity, economic collapse, and public frustration, now face an emboldened regional order.

Nigeria’s leadership, demonstrated so clearly in Benin, has restored confidence that democratic stability in West Africa can and will be defended.

The failed coup in Benin did not only preserve a nation’s democracy. It reset the balance of power in the region. And Nigeria stood at the centre of that pivotal moment.

The clock is ticking for the putschist regimes.
History has resumed its rightful course.

Zagazola Makama is a Counter Insurgency Expert and Security Analyst in the Lake Chad Region

How Nigeria’s rapid military intervention in Benin reshaped West Africa’s anti-coup momentum

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“Road Home is Open”: Zulum Brings Hope to 12 000 Nigerian Refugees in Cameroon

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“Road Home is Open”: Zulum Brings Hope to 12 000 Nigerian Refugees in Cameroon

By: Our Reporter

Borno State Governor, Professor Babagana Umara Zulum, has reaffirmed his administration’s commitment to restoring the dignity of victims of insurgency, including Nigerian refugees in the neighbouring countries of Cameroon, Chad, and Niger.

Governor Zulum gave this assurance while addressing refugees at the Minawao camp in Cameroon’s Far North region, as part of government efforts to repatriate those who remain. Over 12, 000 Nigerian refugees from Kirawa, Ngoshe, Ashigashiya and surrounding communities in Gwoza Local Government Area have been living in the camp for more than a decade.

The governor’s visit provided a significant relief and renewed optimism as he interacted with the refugees. For many, his presence signalled that the long road home was finally opening, describing the moment as their “first real assurance”.

Governor Zulum informed the refugees that adequate security arrangements have been put in place in their home communities, following years of expanded military operations and civilian security initiatives across Gwoza and other parts of Borno.

“The welfare of refugees, internally displaced persons, and returnees remains a priority for us,” Zulum said, noting that rebuilding the lives of insurgency survivors is a core pillar of his administration’s humanitarian and development agenda.

The governor also announced cash support for shelter rehabilitation for those willing to return, a measure designed to help returnees begin reconstructing their homes. In addition, he pledged to drill boreholes for the refugees.

“Borno State in partnership with the federal government will provide a cash assistance of N500 000 to each refugee that is willing to return home, while women households will be given N100,000 each,” Zulum announced.

The governor of the Far North Region, Cameroon, Mijinyawa Bakari, praised Governor Zulum’s unwavering commitment, describing his continued support for displaced Nigerians in Cameroon as exemplary and deeply humanitarian.

“Borno State Governor has consistently demonstrated genuine concern and responsibility for his people, even beyond Nigeria’s borders,” Bakari stated.

He acknowledged the sustained humanitarian assistance, particularly the governor’s long-standing interventions in the Minawao Refugee Camp.

“Zulum’s physical presence and hands-on support has not only provided relief to the refugees but has also strengthened cooperation between Nigeria and Cameroon in addressing displacement and regional stability,” he added.

During his visit, Governor Zulum also toured farmlands allocated to the refugees by the Cameroonian government, which have become their primary source of livelihood.

While assessing the fields, he commended the refugees’ resilience and the host authorities’ generosity. He assured farmers that his administration would support their agricultural activities by providing irrigation kits and water sources to boost productivity.

“Empowering refugees to maintain their livelihoods is central to restoring dignity and ensuring a smooth transition back into their communities,” Zulum stressed.

The governor was accompanied by the senator representing Borno South, Senator Mohammed Ali Ndume; the member of the House of Assembly representing Gwoza, Hon. Abdullahi Buba Abatcha; commissioners, the Chairman of Gwoza Local Government, and other officials.

“Road Home is Open”: Zulum Brings Hope to 12 000 Nigerian Refugees in Cameroon

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