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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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Integrated campaign to boost health of 1m children, women in Gombe

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Integrated campaign to boost health of 1m children, women in Gombe

The Gombe State government in collaboration with the Federal Government and the United Nations Children’s Fund (UNICEF), has inaugurated the National Immunisation Plus Days campaign in the state.

The integrated campaign is targeting 1, 046, 553 beneficiaries, comprising 832, 427 children for vaccination against polio and 214,126 pregnant women to be provided multiple micronutrient supplements.

Mr Manassah Jatau, the state’s Deputy Governor while inaugurating the campaign on Friday in Swa community in Balanga LGA of Gombe State said the event also marked the launch of the Maternal Newborn and Child Health Week (MNCHW).

Jatau who was represented by Dr Ahmed Kashere, Chairman of the Governing Council of the Gombe State Primary HealthCare Development Agency described the campaign as crucial towards protecting the health of children and expectant mothers.

He said that the integrated campaign would ensure that children were protected from diseases that threaten their lives.

“This campaign targets 832,427 eligible children and pregnant mothers across 11 LGAs, focusing on polio vaccination for children under five.

“It will ensure vitamin A supplementation for 770,852 children aged 6-59 months, to boost their immune system and prevent night blindness

“Deworming for children aged 12-59 months, to improve their nutritional status and reduce the burden of worm infestation would also be part of the campaign.

“During the exercise, malnutrition screening for children aged 6-59 months, to identify and manage malnutrition early would be carried out.

“Multiple micronutrient supplements would be provided for 214,126 pregnant women, to ensure they have the necessary nutrients for a healthy pregnancy,” he said.

According to him, Sulphadoxine pyrimethamine will be provided for pregnant women, to prevent malaria and its complications.

Jatau stated that the campaign would also feature health education on key household practices, to empower communities across the state with knowledge on healthy living.

He urged all stakeholders, community members, and well-meaning individuals to support the campaign, towards protecting children, pregnant women, while promoting healthy practices in communities.

The deputy governor commended development partners for their continued support and commitment to improving health outcomes in the state while also appreciating community leaders and health workers for their contributions.

Mr Haruna Gambo, the Zonal Technical Officer, National Primary HealthCare Development Agency restated the commitment of the Federal Government to the wellbeing of children and mothers across the state and country.

Gambo said that the collaborative approach through the integrated campaign would strengthen the immunisation system towards improving the health of communities.

In her remarks, Dr. Nuzhat Rafique, Chief UNICEF Bauchi Field Office said that the earlier campaign in the year recorded remarkable success, reaching thousands of children.

Rafique said that the success of the earlier campaign demonstrated what is possible when governments, communities, health workers, and partners unite behind a common goal.

She stated that immunisation remained one of the most powerful tools to protecting children from life-threatening, yet entirely preventable, diseases.

“In Gombe State, the immunisation campaign is being integrated with the MNCHW to ensure that more children and mothers are reached with essential health services.

“As part of our support, UNICEF has provided over 20,000 bottles of Multiple Micronutrient Supplements (MMS) for pregnant women.

“We have also provided over 700,000 doses of Vitamin A to boost the immunity of children and keep them healthy,” she said.

While thanking all donors and governments at all levels, Rafique called on parents, caregivers, community leaders, and partners across all sectors to “help ensure that no child is missed.”

Mothers who came out en masse with their children told our Correspondent that they were appreciative of the government and development partners’ efforts at offering them free vaccines and supplements.

According to them, mothers and their children in their community no longer fall ill as they used to since they embraced health initiatives from the government and donor partners.

Integrated campaign to boost health of 1m children, women in Gombe

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Alaafin Assures NDLEA of Support, Collaboration in Fight Against Illicit Drugs

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Alaafin Assures NDLEA of Support, Collaboration in Fight Against Illicit Drugs

By: Michael Mike

The Alaafin of Oyo, Oba Abimbola Owoade has assured the Chairman/Chief Executive Officer of the National Drug Law Enforcement Agency (NDLEA), Brig. Gen. Buba Marwa (rtd) of support and collaboration in his renewed mandate to curb the scourge of substance abuse and illicit drug trafficking in the country.

The revered traditional ruler gave the assurance when he led two other royal fathers: Oloro of Oro, Oba Joel Olaniyan Olatoye and Olusin of Ijara Isin, Oba Ademola Julius Ajibola, on a courtesy visit to Marwa at the agency’s national headquarters in Abuja on Friday.

He said he is proud of Marwa’s trajectory as Atunluse of Yoruba land.

According to him, “to be kind with you, we are proud of you. Your being in this position at the moment is not just by chance, it’s because of your devotion, your commitment. You have this amiable character. That’s why you are able to govern Borno and Lagos States, and you have always been a performer. Another thing which I can’t forget about you is the legacy of Keke Marwa that you brought to Nigeria.”

Responding directly to the appeal by the NDLEA boss to traditional rulers to support ongoing efforts against drug abuse in the country, the Alaafin assured of his readiness to mobilise his colleagues to work with the agency.

He said: “I’ve heard your message and the same thing with some of my colleagues here and some of my other traditional rulers, we are ready to collaborate with you. I have to tell you, we are at the grassroots, we are close to the community people. We know a lot about what’s going on. So, I’m using this opportunity to tell you that we are ready. We are more than ready to work with you and to give you all the necessary support to make sure that you are successful in this job. We can tell you that anytime you are in need of us, we will always be there for you.”

In his welcome remark, Marwa congratulated the Alaafin for ascending the throne of his forefathers. He charged him and other traditional rulers across the country to leverage on their influence at the local level to work with NDLEA to stamp out substance abuse in communities.

Marwa said: “The drug scourge in Nigeria is at an unacceptable limit and from the drug use survey report of 2018, we find that close to 15 million Nigerians aged 15 to 64 use drugs. It’s a big problem and we have been mandated by President Tinubu, to stand up, fight the drug scourge, arrest those responsible, prosecute them and seize their assets, the traffickers. And on this assignment, we would like to call on the traditional institutions because it’s a very, very important institution.

“Nigerians respect the traditional institutions. Whoever you are in Nigeria, you still come from somewhere. And when you go back to that place, you pay homage to whoever is the leader of the community. And so when the traditional leader speaks, it carries weight. And equally we plead for traditional leaders to also engage the religious leaders in charge of churches and mosques in their domains, they should do serious advocacy against the use of drugs. The NDLEA is always prepared to work with the traditional institution.”

He said the agency will also appreciate getting information about drug dealers in local communities from traditional rulers because of the risk they pose to many youths and their families. “We really appreciate this collaboration and I know for a fact that if we are able to control drug use, even the criminalities will come down because all the people that are kidnappers and the insurgents, terrorists, bandits everywhere, they use drugs first to charge themselves up, to make them high.”

He expressed appreciation to Alaafin for the visit and wished him long successful reign in

good health, peace, development and prosperity in the entire Oyo Kingdom.

Alaafin Assures NDLEA of Support, Collaboration in Fight Against Illicit Drugs

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Mignot: Africa/Europe Ties Destined, Rests on Mutual Respect

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Mignot: Africa/Europe Ties Destined, Rests on Mutual Respect

By: Michael Mike

The European Union (EU) Ambassador to Nigeria and ECOWAS, Gautier Mignot has described the ties between the continents of Europe and Africa as destined and rest on long-term impact, sustainability and mutual respect.

Speaking at a reception organized for African Union and European Union in Abuja, Mignot said “the ties between both continents as a “community of destiny,” adding that Africa’s and Europe’s wellbeing are deeply interconnected.

He emphasized that the partnership rests on long-term impact, sustainability and mutual respect—principles he believes will continue to guide cooperation in the coming years.

The reception which marked the successful conclusion of the 7th African Union–European Union Summit and the 25th anniversary of the AU–EU partnership hosted by the European Union Delegation to Nigeria and ECOWAS, in collaboration with the Embassy of Angola, had in attendance envoys from both European and African countries.

The reception was jointly led by the EU Ambassador and the Ambassador of Angola, José Bamóquina Zau, whose country hosted the summit in Luanda at the end of November.

In his remarks, the EU Ambassador praised Angola for its hospitality, noting that the summit’s success was anchored largely on the commitment and support of the host government and people. He extended the appreciation of all participating delegations to Ambassador Zau and commended Angola for facilitating what he described as “a real sense of community” among nations.

Although President Bola Ahmed Tinubu was unable to attend the summit in Angola due to domestic engagements, Nigeria was represented by Vice-President Kashim Shettima.

The ambassador noted that the strong representation from both African and European sides underscored the significance attached to the partnership. According to him, the joint statement endorsed in Luanda by countries representing about 40 percent of the global community demonstrated unity and shared resolve.

He said the summit reaffirmed a shared commitment to a more inclusive global order and a fairer international financial system capable of addressing the needs of citizens across the two regions. Over the past 25 years, he added, the AU–EU partnership has matured into a platform that drives concrete results across critical areas including peace and security, economic transformation, green and digital transitions, education and regional integration.

Highlighting the Global Gateway Investment Strategy, Mignot noted that more than half of its 264 flagship projects are focused on Africa, with investment commitments of at least €150 billion.

He also cited major initiatives aligned with the AU Agenda 2063, including the €1.2 billion Team Europe programme supporting the African Continental Free Trade Area, and the Africa-Europe Green Energy Initiative targeting the delivery of 50 GW of renewable energy and electricity access for 100 million Africans by 2030.

He noted that despite occasional misconceptions about the strength of the relationship, but stressed that the EU remains Africa’s largest trading partner, leading investor, top provider of development and humanitarian assistance, and the biggest contributor to the African Peace and Security Architecture.

He highlighted youth mobility and women’s empowerment as areas of particular pride for the partnership.

On his part, Ambassador of Angola, José Bamóquina Zau on the event hosted in Angola, said: “Luanda stood up as a platform of hope and a symbol of the African desire to establish continuous relations with Europe in search of benefits of both sides.”

He said hope must be anchored on building channels of dialogue and cooperation in the areas of peace and security, trade and investment, governance, education and health, climate action, and digital transformation.

The envoy said: “We must guide our actions with a spirit of pragmatism, free from the prejudice and bureaucracy that so often hinder the implementation of important decisions taken together.”

He however stated that Africa cannot continue to be dominated by poverty while remaining a major supplier of essential raw materials to the world.

He added that: “We must to build a new, solid, and effective vision between Africa and European financial institutions, with investments in development. This is the most assertive way to avoid the suffocation caused by excessive debt burdens.”

He however said: “Our strategic partnership will only be strong and resilient if it aligns with the African Union’s Agenda 2063, and capable of responding to current global and local geopolitical challenges.”

Mignot: Africa/Europe Ties Destined, Rests on Mutual Respect

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