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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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Burkina Faso’s reckless violation of icao rules over emergency landing exposes AES hostility toward Nigeria

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Burkina Faso’s reckless violation of icao rules over emergency landing exposes AES hostility toward Nigeria

By: Zagazola Makama

The seizure of 10 Nigerian Air Force personnel by Burkina Faso’s military regime after an emergency landing has ignited anger across diplomatic and aviation circles, with experts condemning the move as vindictive, unprofessional, and a direct breach of globally recognised ICAO safety procedures.

The Nigerian C-130 Hercules aircraft, which made an emergency landing in Bobo-Dioulasso on Monday, had already obtained clearance before entering Burkina Faso’s airspace, contrary to AES claims. Aviation sources confirmed that the crew followed all required procedures after encountering an in-flight technical distress, including declaring an emergency and requesting the nearest available runway.

Under ICAO international law, which supersedes regional disagreements, an aircraft facing distress has the unrestricted right to land anywhere, including in hostile territory or active war zones. Emergency procedures clearly state that: Pilots must transmit “MAYDAY” or “PAN-PAN” depending on the severity, all air traffic units must grant priority, maintain radio silence, and provide safe landing guidance, no country is permitted to deny landing rights to a distressed aircraft, regardless of political tension or military status and any obstruction or punishment of an emergency landing is treated as a serious violation of international aviation law.

Yet, despite these established global norms, Burkina Faso’s junta responded with hostility, detaining impounding the aircraft while issuing inflammatory statements through the Confederation of Sahel States (AES).

Multiple diplomatic sources say Burkina Faso’s behaviour was not about airspace violation, but about frustration and anger over Nigeria’s role in foiling the recent coup attempt in Benin Republic. The junta in Ouagadougou has openly aligned itself with regimes in Niger and Mali and views Nigeria-led ECOWAS as an adversary.

Burkina Faso, Mali and Niger, having withdrawn from ECOWAS to form the AES, have taken increasingly confrontational postures. The failed coup in Benin Republic would have added a fourth member to their alliance. Nigeria, working with Beninese authorities, helped abort the mutiny, an outcome that allegedly angered Ouagadougou. It was believe this political grievance drove their irrational and provocative treatment of the Nigerian Air Force crew.

Ironically, while Burkina Faso claimed “sovereignty violation,” the Nigerian Air Force and the Nigerien Air Force, both on opposing sides of the ECOWAS–AES political divide continue to operate jointly on the border. Niger and Nigeria have been conducting joint operations against ISWAP in part of North East.
This exposes the immaturity and isolationist attitude of Burkina Faso’s junta, which has adopted a policy of hostility even toward partners with whom they still maintain diplomatic ties.

Despite withdrawing from ECOWAS, Burkina Faso continues to operate its embassy in Nigeria. This makes its hostile action even more illogical and diplomatically inappropriate. If they expect safe operations and immunity for their missions on Nigerian soil, they must uphold reciprocal commitments under international law.

Contrary to AES propaganda, the Nigerian aircraft: had prior clearance, followed ICAO emergency protocols, declared distress, and was compelled to land for safety reasons. Aviation experts noted that aircraft transponders may switch off during emergencies, which is normal and never justifies detention of crew members.

If every country were to behave as Burkina Faso did, global aviation would collapse into chaos. Officials warn that: Burkinabè aircraft could one day face emergencies and require landing in Nigerian airspace. If Nigeria were to apply the same hostile logic, lives could be lost unnecessarily. Aviation safety is built on mutual trust, not political revenge.

A senior aviation specialist described Burkina Faso’s action as: A reckless display of ignorance and political bitterness. Emergency landing protocols are universal. Detaining crew members for saving their aircraft is unacceptable and unlawful.”

Although the Nigerian government has not publicly commented, highly placed sources confirm that quiet diplomatic pressure is being applied at the highest level to ensure the immediate release of the personnel and aircraft.

Burkina Faso’s reckless violation of icao rules over emergency landing exposes AES hostility toward Nigeria

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AT PRESIDENT QUATTARA’S INAUGURATION:

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AT PRESIDENT QUATTARA’S INAUGURATION:

** VP Shettima Reaffirms Nigeria’s Commitment To Regional Stability, Peace

** As World Bank hails Nigeria’s reforms, pledges more partnership in energy, job creation, gender empowerment

By: Our Reporter

Vice President Kashim Shettima on Monday witnessed the inauguration and swearing-in ceremony of President Alassane Ouattara for another term in office as President of Côte d’Ivoire in Abidjan, where he reaffirmed Nigeria’s continued commitment to regional peace and stability.

This is just as the World Bank has applauded the reform policies of the administration of President Bola Ahmed Tinubu, pledging to heighten its partnership with the nation on energy, job creation and gender empowerment initiatives.

At the presidential inauguration that brought together West African leaders and international dignitaries in Abidjan, VP Shettima who represented President Bola Ahmed Tinubu also conveyed the warm congratulations of the Nigerian leader to President Ouattara on his swearing-in.

The inauguration took place at the Presidential Palace, where President Ouattara took the oath of office, pledging to prioritise national reconciliation and economic stability as he begins another term leading the West African nation.

Speaking on behalf of President Tinubu, the Vice President expressed confidence in President Ouattara’s continued leadership and wished him success in his new mandate.

Senator Shettima reaffirmed Nigeria’s commitment to deepening the strong partnership between both nations and working together to advance peace, stability, security, and prosperity across the West African region.

The Nigerian Vice President noted that both countries will further strengthen their economic ties through agriculture and trade relations.

In his inaugural address, President Ouattara thanked all visiting leaders who came to show solidarity and friendship with the I’voirans, promising to continue to work for the well-being of his citizens and engage more robustly in diplomatic relations for mutual benefits.

Other leaders who attended the event include the Presidents of South Africa, Liberia, Senegal, Gambia, Angola, Ghana amongst others, and former Nigerian President, Dr. Goodluck Jonathan.

The United States was represented by a Presidential Delegation led by Under Secretary of State for Economic Affairs, Jacob Helberg. High-level personalities and delegates from ECOWAS and other nations also graced the occasion.

Meanwhile, the World Bank has applauded the reform policies of the administration of President Bola Ahmed Tinubu, pledging to heighten its partnership with the nation on energy, job creation and gender empowerment initiatives.

The global financial institution stated this on Monday in Abidjan, Cote d’Ivoire, when Vice President Shettima received in audience the Managing Director, Operations, of the World Bank Group, Ms. Anna Bjerde, on the sidelines of the presidential inauguration.

He told Ms Bjerde that the administration of President Bola Ahmed Tinubu, from inception, had to contend with negative impact of the oil subsidy regime on the economic growth of the country, just as he outlined the positive results of the administration’s bold reforms.

The VP further told the World Bank Director that the ongoing tax reforms of the Tinubu administration has yielded positive result, saying “we have crossed the Rubicon.”

He pointed out that though the impact of the reforms may have been painful at the initial stage, it has started showing the dividends, even as he said in order to turn the demographic bulge into demographic dividends, the administration is focusing on gender empowerment initiative, investments in the digital economy and agriculture for enhanced productivity.

The Vice President commended the World Bank team for being supportive to Nigeria.

Earlier, the Managing Director, Operations, of the World Bank Group, Ms. Bjerde, commended Nigeria for taking pragmatic initiatives to position the country on the right path.

Noting that the World Bank is willing to partner more on energy, she said, “First, on energy, we’re stepping up on a number of possibilities to ensure that about four million people are connected.”

Ms. Bjerde also revealed that her group will encourage and enhance upliftment and education of the girl-child in Nigeria.

AT PRESIDENT QUATTARA’S INAUGURATION:

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Workshop for SAs reflects administration’s commitment to effective leadership—Governor Buni

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Workshop for SAs reflects administration’s commitment to effective leadership—Governor Buni

By: Yahaya Wakili

Yobe State Governor Hon. (Dr.) Mai Mala Buni CON has revealed that the training workshop for Special Advisers reflects the administration’s commitment to effective leadership and quality service delivery.

Governor Buni started this while launching a four-day training workshop for special advisers in Kano. Adding that the training workshop aimed at boosting efficiency and promoting good governance.

The governor, ably represented by his deputy, Hon. Idi Barde Gubana (Wazirin Fune), said that the event was crucial for deepening governance effectiveness and improving policy coherence.

According to him, the workshop will also enhance service delivery across the executive team, particularly for those serving as key policy and strategic aides, and he noted that the special advisers play a vital role in policy formulation and implementation.

“The training will address practical areas, especially conflict management, collaborative engagement, communication strategy, ethical leadership, and teamwork among advisers.” Gov. Buni said.

The Secretary to the Yobe State Government, Alhaji Baba Mallam Wali mni, ably represented by the Permanent Secretary, Administration and General Services, Alhaji Madu Gashu’a, revealed that the program aims to enhance collaboration between political and administrative officers.

The training workshop is expected to enhance the participants’ effectiveness and contribute to the overall success of the administration.

Workshop for SAs reflects administration’s commitment to effective leadership—Governor Buni

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