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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
Tinubu: The FCT Verdict and Inevitability of 2027
Tinubu: The FCT Verdict and Inevitability of 2027
By Jude Obioha
The 2027 presidential election may still be months away, but its contours are already visible to anyone willing to read the signs. Politics, like history, leaves clues. And the recent Federal Capital Territory (FCT) Area Council elections, alongside parallel electoral exercises in parts of Rivers and Kano States, have provided more than clues. They have offered a preview.
The message from the FCT was neither ambiguous nor accidental.
The All Progressives Congress (APC) secured five of the six chairmanship seats, flipping the Abuja Municipal Area Council (AMAC), Bwari, and Kuje from the Peoples Democratic Party, leaving the opposition with only Gwagwalada. In AMAC, the most populous and politically symbolic council in the nation’s capital, the APC did not merely win; it dominated, polling over 40,000 votes, more than triple the tally of its closest challenger. In Nigeria’s political heartbeat, voters spoke with clarity.
This was not just a council election. It was a temperature check. And the temperature suggests that President Bola Ahmed Tinubu’s political machinery is not only intact but also expanding.
Those who dismiss local elections as inconsequential misunderstand Nigerian political dynamics. The FCT is not just any territory; it is the seat of power, the melting pot of Nigeria’s elite and grassroots political currents. When the ruling party strengthens its grip there, it signals organisational discipline, voter mobilisation capacity, and strategic coherence. It also reveals something more uncomfortable for the opposition: fragmentation. What even makes the victory more compelling is that APC has never won AMAC in Council or the FCT in Presidential elections. But just as it flipped in 2026 for AMAC, this could be the trajectory in 2027, not only in the Nation’s Capital but across the country.
While the APC consolidates, the opposition continues to splinter. Personal ambitions eclipse collective strategy. Coalition talks rise and collapse in cycles of distrust. Meanwhile, key political figures across party lines quietly align with Tinubu’s centre of gravity. Today, more than 30 governors, including some outside the APC fold, are considered allies of the President. In Nigerian politics, that is not a coincidence. It is architecture.
Tinubu did not arrive at this moment by accident. For over two decades, he has cultivated alliances, mentored political actors, built networks that transcend ethnicity and region, and demonstrated a rare capacity for long-term strategy. From Lagos to the national stage, he has shown an ability to think beyond electoral cycles. His 2023 victory was the product of patience and preparation. His governance since then reflects consolidation.
Critics predicted collapse when he removed fuel subsidies and unified the exchange rate. They foresaw a political implosion as reforms tightened liquidity and global inflation surged. Yet, against a backdrop of inherited fiscal strain and near-monetary instability, the administration has steadied the ship of macroeconomics. The Naira has shown signs of recovery. Food prices, while still sensitive, have begun to ease in several markets. Investor confidence is cautiously returning. None of this suggests perfection. But it does signal resilience.
Politics rewards resilience. The FCT results, therefore, are not merely about council chairpersons. They are about perception. Voters in the capital had an opportunity to register a protest. Instead, they reinforced the ruling party. That reinforcement carries symbolic weight. It suggests that, at least for now, the reform pain has not translated into wholesale rejection.
Beyond Abuja, similar patterns in Rivers and Kano further underscore a broader national trend: the ruling party is organised; its rivals are reactive.
If elections were solely about sentiment, 2027 might still be unpredictable. But elections are about structure: polling units, ward agents, coalition discipline, voter databases, and resource mobilisation. On those metrics, the APC appears several steps ahead.
One might even argue, cautiously but realistically, that the next presidential contest is shaping up less like a battlefield and more like a procession, with the final destination a “coronation” of President Bola Ahmed Tinubu for his second term.
This is not to diminish the democratic imperative of competition. Democracy demands opposition. It thrives on alternatives. But effective opposition requires coherence, not cacophony. At present, Nigeria’s opposition landscape is characterised more by internal recalibration than collective mobilisation.
Tinubu, meanwhile, continues to consolidate elite consensus while maintaining grassroots engagement. His style may be deliberate, sometimes opaque, but it is rarely impulsive. He understands the arithmetic of power: governors influence state machinery; state machinery influences turnout; turnout influences outcomes.
That arithmetic is already aligning. Therefore, to describe his anticipated re-election as a “coronation” may sound dramatic. Yet politics often moves long before ballots are cast. Momentum, once built, acquires its own inevitability. The FCT elections were not the cause of that momentum; they were evidence of it.
Could unforeseen variables emerge? Certainly, Nigerian politics is famously dynamic. Economic shocks, security challenges, or breakthroughs in coalition dynamics can quickly reshape landscapes. But as of today, the trajectory is unmistakable.
President Tinubu has outmanoeuvred rivals before. He has demonstrated the patience to endure criticism and the strategic instinct to expand alliances. With a consolidated ruling party, cross-party gubernatorial alignment, and early electoral signals tilting in his favour, 2027 increasingly appears less a question of “if” and more a question of margin.
History often whispers before it announces. The FCT has whispered. And if the opposition continues on its present course: divided, reactive, and organisationally thin, then the 2027 presidential election may well confirm what these early signals already suggest: that President Bola Ahmed Tinubu’s second term is not merely probable, but politically inevitable.
Obioha is the Director of Strategy at the Hope Alive Initiative (HAI), a group dedicated to good governance in Nigeria.
Tinubu: The FCT Verdict and Inevitability of 2027
News
ECOWAS Parliament Pushes Stronger Public Engagement, Private Sector Role
ECOWAS Parliament Pushes Stronger Public Engagement, Private Sector Role
By: Michael Mike
The ECOWAS Parliament has called for deeper public engagement, stronger youth participation and greater private sector involvement in regional affairs as part of efforts to strengthen trade and democratic integration across West Africa.
The call came as the regional legislature unveiled a series of year-long initiatives to commemorate its 25th anniversary, with officials stressing that the success of regional integration under the Economic Community of West African States (ECOWAS) depends largely on how effectively citizens, entrepreneurs and young people are involved in shaping the bloc’s future.
Speaking during a press conference in Abuja announcing the activities, officials said the silver jubilee celebrations will be driven largely by private sector-led programmes aimed at promoting trade opportunities, entrepreneurship and broader citizen engagement across the region.
According to them, the initiatives are designed to highlight the parliament’s contributions to peacebuilding, democratic governance and economic integration since its establishment while also opening new spaces for dialogue between policymakers, businesses and the public.
They noted that while governments have traditionally driven regional policies, the next phase of West Africa’s integration must actively involve the private sector and civil society to unlock trade opportunities and accelerate development.
The anniversary activities will therefore feature a range of engagements including business forums, youth-focused initiatives, public policy dialogues and media collaborations intended to broaden awareness about ECOWAS programmes and encourage citizens to take greater ownership of the regional project.
Officials emphasised that young people, who form the majority of West Africa’s population, must be placed at the centre of regional economic strategies, particularly in areas such as innovation, digital trade and entrepreneurship.
Delivering a vote of thanks at the event, the Chief Communications Officer of the ECOWAS Parliament, Uchenna Duru-Nwaotule, commended journalists for their role in strengthening democratic accountability and public awareness across the region.
She said the presence of the media at the event underscored their critical role in promoting transparency and fostering citizen participation in regional governance.
“As we mark twenty-five years of the ECOWAS Parliament’s contribution to regional integration and peacebuilding through parliamentary diplomacy, the partnership of the media remains indispensable in ensuring that citizens across West Africa are informed and actively engaged in this milestone celebration,” she said.
Duru-Nwaotule noted that the commemorative initiatives reflect a growing recognition that regional integration cannot be driven solely by governments and institutions.
Rather, she stressed, it requires the active participation of businesses, organised civil society groups and the media working together to advance the shared vision of a prosperous and united West Africa.
She urged journalists to continue amplifying initiatives that promote youth engagement, economic development and inclusive dialogue across the ECOWAS region, adding that the anniversary offers a platform for citizens, entrepreneurs and innovators to contribute meaningfully to the bloc’s integration agenda.
The ECOWAS Parliament, established in 2000, serves as the legislative arm of the regional body and plays a key role in promoting democratic governance, conflict resolution and policy harmonisation among member states.
Officials said the 25th anniversary celebration will not only highlight the institution’s achievements over the past quarter century but will also set the stage for renewed collaboration aimed at advancing the goals of regional prosperity and unity under the ECOWAS long-term development framework.
ECOWAS Parliament Pushes Stronger Public Engagement, Private Sector Role
News
Nigeria Promotes 70,000 Paramilitary Officers, Deploys High-Tech Immigration Centre to Tighten Border Control
Nigeria Promotes 70,000 Paramilitary Officers, Deploys High-Tech Immigration Centre to Tighten Border Control
By: Michael Mike
In a sweeping show of reform across Nigeria’s internal security architecture, the Federal Government has promoted more than 70,000 paramilitary officers within three years and launched a technology-driven Integrated Operating Centre to track immigration violators in real time.
Minister of Interior, Olubunmi Tunji-Ojo, announced the twin developments in Abuja while declaring open the 2026 Sectoral Performance Retreat for agencies under the Ministry of Interior. The retreat, held at the Nigeria Army Conference Centre, was themed “Accountable Leadership, Measurable Impacts: Reviewing Results, Renewing Commitments.”
Tunji-Ojo described the mass promotion exercise as unprecedented, saying it reflects the commitment of President Bola Tinubu’s administration to improve morale and restore professionalism across the paramilitary services.
“Only yesterday, I approved the 2026 promotion of personnel across all agencies under the Ministry. By April and May, the implementation will commence,” the minister said, urging officers to reciprocate government’s support with discipline, patriotism and improved service delivery.
In what observers see as a major shift toward data-driven border management, Tunji-Ojo disclosed that the Nigeria Immigration Service (NIS) has inaugurated an Integrated Operating Centre (IOC) equipped with sophisticated surveillance and data harmonisation tools.
According to him, the centre provides real-time intelligence on foreigners who have overstayed their visas, with historical data covering up to a decade.
“With the kind of sophisticated gadgets and equipment now in place, the Immigration Service has become a strong internal security enabler. The Service will go after those who have overstayed. It is no longer business as usual,” he declared.
The minister said the deployment of advanced analytics and harmonised databases has placed persons of interest squarely on government radar, reinforcing efforts to secure Nigeria’s borders and sanitise its migration system.
As part of ongoing reforms, he revealed that seven new Forward Operating Bases (FOBs) have been established to strengthen border surveillance and migration management nationwide. He commended the Comptroller-General of the NIS, Kemi Nanna Nandap, for what he described as visionary leadership in modernising the Service.
The minister also applauded the efforts of the Nigeria Security and Civil Defence Corps (NSCDC), the Nigeria Correctional Service (NCoS), and the Federal Fire Service (FFS), but warned that commendation must not breed complacency.
He tasked the NSCDC with intensifying protection of critical national infrastructure, including oil pipelines, solid mineral sites, schools and hospitals, stressing that the corps “cannot be run like a volunteer service.” He urged its Commandant-General, Prof. Ahmed Audi, to submit a clear operational roadmap following his reappointment.
On correctional reforms, Tunji-Ojo insisted that efforts must go beyond custodial management to ensure rehabilitation and reintegration, warning that repeat offending signals systemic failure.
“If offenders complete their sentences and return to crime, then we have not succeeded,” he said.
Permanent Secretary of the Ministry, Dr. Magdalene Ajani, described the retreat as a critical platform for reviewing stewardship and aligning performance with national priorities. She said the Ministry carries enormous responsibility in border management, citizenship administration and internal security, all of which directly affect the daily lives of Nigerians.
Ajani stressed the need to align operations with the Renewed Hope Agenda of President Tinubu, encouraging openness to constructive criticism and innovative thinking.
She expressed confidence that the retreat would produce a concrete roadmap to guide the Ministry’s agencies in delivering measurable results in the year ahead.
The dual announcement of mass promotions and high-tech border surveillance signals a government intent on pairing welfare reforms with operational efficiency — a strategy officials say is essential to strengthening Nigeria’s security framework in an era of complex internal and cross-border threats.
Nigeria Promotes 70,000 Paramilitary Officers, Deploys High-Tech Immigration Centre to Tighten Border Control
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