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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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Troops Repel Terrorist Infiltration in Kanama, Neutralise Four Insurgents

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Troops Repel Terrorist Infiltration in Kanama, Neutralise Four Insurgents

By: Zagazola Makama

Troops of Operation HADIN KAI have repelled a Boko Haram/ISWAP terrorist infiltration into Kanama town, neutralising four insurgents during a swift response operation in Borno State.

Security sources said the incident occurred at about 6:00 p.m. on April 22 when troops of 159 Battalion, deployed in Kanama, responded to sounds of gunfire within the town.

On arrival, the troops reportedly discovered that terrorists had infiltrated parts of the community.

The troops immediately made contact and engaged the attackers with disciplined fire, forcing them to retreat in disarray.

Subsequent exploitation of the general area led to the neutralisation of four terrorists.

One member of the Civilian Joint Task Force (CJTF) sustained injuries during the encounter and has been evacuated for medical attention.

No military equipment was lost during the operation.

Items recovered from the terrorists include two torchlight mobile phones and the sum of ₦21,000.

Security sources said the general situation across the theatre remains calm but unpredictable, while troops’ morale and fighting efficiency remain high.

Troops Repel Terrorist Infiltration in Kanama, Neutralise Four Insurgents

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UK–Nigeria Trade Mission Deepens Education, Skills Partnership

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UK–Nigeria Trade Mission Deepens Education, Skills Partnership

By: Michael Mike

A high-level United Kingdom trade mission on education and skills has concluded a week-long skills and schools trade mission to Nigeria, laying a solid foundation for expanded collaboration in education and workforce development between both countries.

The mission, which ran from April 19 to 23 in Abuja and Lagos, brought together leading UK private schools, skills providers and education institutions with Nigerian stakeholders, including policymakers, investors and school operators.

Organised by the UK Department for Business and Trade, the engagement is part of the UK’s broader International Education Strategy, which identifies Nigeria as one of five priority markets for global education partnerships. The initiative is being championed by Steve Smith, who is expected to return to Nigeria later this year to sustain momentum.

The mission builds on diplomatic and educational engagements during a recent state visit to the United Kingdom in March, further reinforcing the growing importance of education within UK–Nigeria bilateral relations.

At the heart of discussions was the expansion of in-country delivery of British education, including the establishment of internationally recognised UK schools in Nigeria, as well as the development of industry-aligned skills programmes, particularly in Technical and Vocational Education and Training (TVET).

In Abuja, the delegation held high-level talks with Nigeria’s Minister of Education, Tunji Alausa, securing strong political backing for deeper institutional cooperation. Both sides explored pathways for partnerships that would strengthen Nigeria’s education system while equipping young people with skills tailored to labour market demands.

The delegation also visited several British curriculum schools and colleges in Abuja and Lagos, gaining first-hand insight into teaching standards and operational models already in place within Nigeria.

Speaking at the conclusion of the mission, British Deputy High Commissioner, Jonny Baxter, highlighted education as a key pillar of bilateral engagement.

“The UK and Nigeria share a deep and longstanding relationship, and opportunities in education are one of its most exciting frontiers,” he said, noting that the mission demonstrated “strong appetite on both sides to deepen collaboration.”

He added that connecting UK institutions with Nigerian partners would help build sustainable, in-country education systems, while positioning Nigeria as a regional hub for high-quality learning.

Also reflecting on the mission, Sarah Chidgey described the initiative as a practical demonstration of the UK’s education strategy in action.

According to her, progress in UK–Nigeria education collaboration has grown steadily since her first visit in 2022, with the current mission reinforcing mutual commitment to expanding access, quality, and innovation in the sector.

The delegation included representatives from prominent UK institutions such as Harrow International School, The King’s School Canterbury, Whitgift School, Bedford School, and Pearson, among others.

The mission concluded with a robust pipeline of follow-up activities, including one-on-one engagements, memorandum of understanding (MoU) discussions, and agreed next steps aimed at translating dialogue into tangible partnerships.

Analysts say the initiative signals a shift toward more structured and commercially viable education cooperation between both countries, with potential benefits spanning student mobility, local capacity building, and skills development aligned to Nigeria’s economic priorities.

With sustained engagement expected in the months ahead, stakeholders believe the mission could mark a turning point in positioning Nigeria as a major destination for international education investment in Africa.

UK–Nigeria Trade Mission Deepens Education, Skills Partnership

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Violence in Borno Displaces Over 5,000 as Humanitarian Needs Surge in Pulka

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Violence in Borno Displaces Over 5,000 as Humanitarian Needs Surge in Pulka

By: Michael Mike

A fresh wave of armed violence in northeast Nigeria has forced more than 5,000 people from their homes in Ngoshe, pushing already fragile communities in Gwoza Local Government Area deeper into crisis.

The international medical humanitarian organisation Médecins Sans Frontières (MSF) confirmed it has launched an emergency response in Pulka, where displaced families have sought refuge following deadly attacks on March 3. The assault reportedly left scores dead and many others abducted, triggering mass displacement to the nearby town, located about 15 kilometres away.

Survivors arriving in Pulka described scenes of devastation and hurried escape. Many fled with nothing, leaving behind homes and livelihoods destroyed by violence.

“Our homes were bombed, everything we owned was gone,” said Safiya Mohammed Aga, a displaced resident of Ngoshe told MSF: “We ran for our lives. Some of us arrived here without clothes or anything at all.”

With no formal shelter available, thousands are now sleeping in open spaces and along streets, exposed to harsh conditions and growing insecurity. Women, children and the elderly are among the most vulnerable, facing acute shortages of food, clean water and basic sanitation.

MSF said the lack of essential services is increasing the risk of disease outbreaks, particularly among children. In response, the organisation began a four-week emergency intervention on April 10, targeting the most urgent needs.

So far, more than 900 families have received non-food items such as cooking utensils, sleeping mats, mosquito nets and water containers. Additionally, 884 dignity kits—containing menstrual hygiene supplies, soap and oral care items—have been distributed to vulnerable individuals.

To address water shortages, MSF teams are delivering approximately 16,000 litres of safe drinking water daily, while also rehabilitating sanitation facilities and conducting hygiene awareness campaigns to prevent the spread of disease.

Despite these efforts, MSF officials warn that the scale of the crisis far exceeds current assistance.

“People urgently need food and improved access to water, sanitation and hygiene services,” said Abdoulaye Mahmoudoune, MSF’s emergency field coordinator. “We are responding, but we cannot meet these overwhelming needs alone.”

The crisis in Gwoza reflects a broader pattern of protracted conflict across Borno State, where years of insurgency have repeatedly displaced communities and strained already limited infrastructure. Health facilities remain under pressure, while humanitarian funding continues to decline.

MSF has been supporting healthcare services in the area, including operations at Gwoza General Hospital since August 2025, alongside maternal and child health programmes in surrounding communities and nutrition interventions for malnourished children in Maiduguri.

However, the organisation warns that funding gaps and reduced humanitarian presence are placing life-saving services at serious risk.

MSF is now calling on other humanitarian agencies to urgently scale up assistance in Pulka, particularly in food distribution and water, sanitation and hygiene services. It also appealed to international donors to increase sustained funding for healthcare in northeast Nigeria to prevent further deterioration of an already dire humanitarian situation.

As displacement continues and needs grow, thousands of families in Pulka remain caught in a cycle of violence and survival, with limited support and an uncertain future.

Violence in Borno Displaces Over 5,000 as Humanitarian Needs Surge in Pulka

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