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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 commissions Borno’s projects, says Zulum’s performance exceptional
Tinubu commissions Borno’s projects, says Zulum’s performance exceptional
By: Michael Mike
President Bola Ahmed Tinubu on Saturday commissioned three newly constructed mega schools and a fleet of 620 fully electric vehicles and tricycles delivered by the governor of Borno State, Professor Babagana Umara Zulum.
During the commissioning ceremony, which was performed separately, President Tinubu commended Governor Zulum for his transformative leadership.

The president said: “I congratulate the Governor and the people of Borno State for this transformation. Government is all about people, and Professor Zulum is doing a very good job of caring for people.”
The president highlighted the projects as tangible evidence of effective governance and a blueprint for holistic state development.
The commissioned schools include Mafoni Day Secondary School, Bola Ahmed Tinubu Government Day Secondary School and Mafoni Primary School.
They are part of Governor Zulum’s ambitious 104 Mega School Initiative designed to drastically improve access to quality education and rebuild the sector after over a decade of insurgency.
Each of the facilities is equipped with modern classrooms, laboratories, libraries, sports facilities and an administrative complex to create a conducive learning environment.

The president also commissioned the international terminal of the Muhammadu Buhari International Airport, Maiduguri, in preparation for the commencement of international operations.
Governor Zulum, in his response, expressed gratitude for the federal government’s support and reiterated his administration’s commitment to rebuilding Borno’s infrastructure, economy and human capital.
The event was attended by federal and state officials, traditional rulers and community leaders.

President Tinubu concluded his state visit by attending the wedding ceremony of former Borno State Governor Sheriff’s son, conducted at the Maiduguri Central Mosque.
Tinubu commissions Borno’s projects, says Zulum’s performance exceptional
News
Between Imperialism and Military Rule: The Choiceless Political Reality in West Africa
Between Imperialism and Military Rule: The Choiceless Political Reality in West Africa
By Chukwuemeka B. Eze and Jeggan Gray Johnson
West Africa stands today at a troubling crossroads where democratic aspirations collide with deep geopolitical tensions, failing institutions, and a new wave of military interventions- raising legitimate questions of the region’s democratic trajectory fifty years after its formation. Have we plateaued or plummeted into the age of the erosion of established normative procedures and democratic institutions, or is the regional experiment in a stage of reflection of deeper, ongoing challenges? Are citizens confronting systems that they perceive as imperial impositions and using whatever means available to them to resist? Or are they facing a crisis of democracy itself, a legitimacy crisis stemming from civil rule that often masks authoritarian tendencies? Why are military coups predominantly re-emerging in Francophone countries? Is this a coincidence, or does it reveal unresolved histories of external influence, entrenched political economies or distinctive patterns of state–society relations in these contexts? In whose name and under whose mandate do political elites continue to hold power? Why are we so quick to dismiss the military as being outside of the political system when, in fact, it is an institution shaped by the same social, economic and political dynamics as the rest of society? To what extent does our discourse artificially separate civilians from soldiers, rather than examining the broader governance ecosystem that produces both?
Citizens increasingly find themselves trapped between three unappealing forces—the entrenched culture of ‘electoral despotism’, external imperial influence and internal military domination. The trilateral dilemma has produced a disturbing condition: a choiceless choice, where none of the options seem incapable of delivering stability, dignity, peace and security or even genuine sovereignty.
The Long Shadow of Imperialism: More than six decades after independence, imperial legacies remain deeply embedded in West Africa’s political and economic structures. Former colonial powers continue to exert influence through aid conditionalities, control of extractive industries, military cooperation agreements, and political alliances that safeguard their strategic interests. In countries like Mali, Niger, Burkina Faso and Benin, resentment toward external interference; particularly from France has grown into a widespread political sentiment.
Economic dependence, currency constraints (such as the CFA franc), and foreign troops stationed on African soil reinforce the perception that the region’s sovereignty remains compromised. This has created fertile ground for anti-imperialist rhetoric, often championed by populist actors and military juntas who exploit these grievances to gain legitimacy.
The Return of Soldiers to Politics: The last decade has seen a resurgence of military takeovers in the region. Coups in Mali, Guinea, Burkina Faso, Niger, representing a largest coup belt in the world, and recently attempted interventions in Benin- a socio-political enigma and Guinea Bissau- the region’s narco-state, reflect a collapse of public trust in democratic systems perceived as kleptocratic, ineffective, and elite-controlled. Many West Africans, frustrated by insecurity, poverty, and government failure, initially welcomed soldiers as “corrective forces.” But military rule often replaces one form of authoritarianism with another and characterised by restricted freedoms, politicized security apparatus, uncertain transition timelines, limited economic vision and opportunity, heavy reliance on foreign military partners (Russia, Turkey, Gulf states) and debt, overshadowed by a youth bulge threatening to burst at the seams. e. Thus, the promise of liberation from imperialism frequently gives way to new dependencies and domestic authoritarianism, and ultimately, policy incoherence, confusion and instability.
The Choiceless Choice: The tragedy is that citizens are forced to choose between very difficult and perhaps inferior alternatives: Imperialism, which undermines sovereignty and reinforces structural inequalities, the electoral despotism- where power remains concentrated within a cabal or small host of elites, and Military rule, which suspends constitutional order and democratic rights. All option addresses the core issues driving instability: weak governance, unemployment, fractured national identities, extremist threats, and the absence of economic diversification. In this vacuum, West Africans face a situation where every available choice feels imposed, not freely made.
The Geopolitical Chessboard: Part of the crisis stems from the region’s growing importance in global geopolitics. West Africa has become a stage for competition among major powers: France and the EU seek to preserve influence, The United States prioritizes counterterrorism, Russia positions itself as an anti-West alternative, China expands via infrastructure loans, and the eventual confiscation of strategic minerals anchored in the blue and green economies, Gulf states and Turkey enter with economic and military interests and the list continues to expand. These competing agendas pull governments in different directions, leaving citizens with little say over the region’s strategic direction.
The Decline of Democratic Credibility: Democracy in West Africa is in crisis not merely because of coups, but because a leadership pandemic. The region has a critical and morally bankrupt leadership. of Manipulated constitutions, electoral fraud, corruption scandals, and impunity have hollowed out institutions. When democratic governments fail to deliver development or justice, the military’s rhetoric of “rescue missions” becomes appealing. Yet these interventions ultimately produce another cycle of disillusionment.
What Real Sovereignty Requires: Breaking this cycle demands a new political imagination—one rooted in African agency, not external dictates or military paternalism. A pathway to genuine sovereignty includes: Strengthening democratic institutions beyond elections, economic independence, especially through value-added industries, regional security cooperation less reliant on external forces, civic education and accountability systems, that are citizenry driven, that restore public trust, as well as a pan-African political consciousness capable of resisting both imperial pressure and internal authoritarianism. The future depends on reclaiming democracy as a tool of liberation, not a façade for elite capture.
Conclusion: West Africa’s tragedy is not that it lacks alternatives, but that the region’s political trajectory has become trapped between two dominant and deeply flawed forces. Imperialism continues to shape its geopolitics and economy, while military rulers exploit public frustration to consolidate power. Together, they create a choiceless political reality where citizens struggle to find a path that protects both sovereignty and freedom. Yet within this crisis lies an opportunity: the chance to articulate a new political vision grounded in bold leadership, accountable governance, and regional solidarity. Reimagining democracy means going beyond periodic elections. It means nurturing institutions that are stronger than individuals and ensuring that power remains accountable to the people. It means prioritizing people’s power over that of statesmen, strengthening judicial independence, fortifying the institutions meant to protect democracy and ensuring that the exercise of power after elections truly serves citizens. Only then can West Africans move beyond the suffocating binary of imperialism and soldiers—and reclaim the right to choose their own future.
Chukwuemeka B. Eze is the Director for Democratic Futures in Africa and Jeggan Grey Johnson, Advocacy Advisor at the Open Society Foundations
Between Imperialism and Military Rule: The Choiceless Political Reality in West Africa
News
New drug test policy for schools will cut down substance abuse among youth – Marwa
New drug test policy for schools will cut down substance abuse among youth – Marwa
By: Michael Mike
Chairman/Chief Executive Officer of the National Drug Law Enforcement Agency (NDLEA) Brig. Gen. Buba Marwa (rtd) has said that the newly launched drug test policy for schools in Nigeria will discourage illicit substances abuse by young Nigerians especially those aspiring for higher education.
Marwa stated this weekend when he received the Vice Chancellor of the Taraba State University, Professor Sunday Bako who led a team of his management staff to seek partnership with the anti-narcotics agency on the fight against substance abuse and illicit drug trafficking.
The NDLEA boss, said: “We’re glad to work and partner with you, your university and the Taraba state government on this matter and it’s a good thing that what you’re doing aligns with the new national policy for tertiary institutions that includes compulsory and random drug integrity tests for students. This initiative is a joint effort between the Federal Ministry of Education and the National Drug Law Enforcement Agency (NDLEA) to combat substance abuse among young people in schools across the country.

“At the NDLEA, we have been pushing for this and we’re happy we have a dependable partner in the Minister of Education and members of his team who worked with us and supported us on this. This is not in anyway punitive but a strategic push that will largely discourage our youths from going into substance abuse because they know at every stage of their education, they will face compulsory drug test.
“We are fully prepared to work with all schools to ensure the success of this great initiative that will make positive impact on youth development, security and national productivity in line with the renewed hope agenda of President Bola Tinubu.”
He commended the VC for leading the pack by establishing a full Directorate of Narcotics and Drug Abuse Prohibition in the institution, with a promise to support his efforts through capacity building training and other areas of collaboration.
In his remarks, Bako commended the Marwa leadership of NDLEA for its professionalism, openness and collaborative spirit, which has earned the agency both national and international accolades.
He said: @We are particularly pleased to visit at a time when your excellent and unwavering commitment in the fight against drugs and illicit substances abuse/trafficking earns you another five years of tenure renewal. Your relentless efforts in combatting substance abuse have contributed significantly to protecting our youths and preserving the future of our nation.”
He noted that his visit was borne out of his concern about the challenge of drug and substance abuse among young people, which poses serious threat to academic excellence, moral values, and national development.
The VC said: “This visit seeks to strengthen the relationship between Taraba State University, Jalingo and the National Drug law Enforcement Agency which started way back since 22nd August, 2024 during the inauguration of the Directorate of Narcotics and Drug Abuse Prohibition and the launch of WADA by the NDLEA Taraba state command, as well as the TSU Drug Free Club patrons/officials.
“We firmly believe that effective drug control and prevention require a multi-sectoral approach involving law enforcement agencies, academic institutions, and the wider society.
In this regard, Taraba State University is eager to partner with your agency in areas such as collaborative research on drug abuse and substance use disorder, policy-oriented studies, public enlightenment and sensitization programmes, capacity building training, student internship opportunities, and community outreach initiatives within Taraba state and beyond. Partnership with the NDLEA will further strengthen our institutional policies and programmes in this critical area.”
New drug test policy for schools will cut down substance abuse among youth – Marwa
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