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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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Army will remain apolitical, committed to defending democracy – COAS

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Army will remain apolitical, committed to defending democracy – COAS

By: Zagazola Makama

The Chief of Army Staff (COAS), Lt.-Gen. Waidi Shaibu, says the Nigerian Army will remain apolitical and steadfast in protecting the nation’s democracy in line with its constitutional mandate.

Shaibu stated this on Saturday at the Passing Out Parade of the Executive Commission Course 2/2025 held at the Nigerian Army School of Infantry, Jaji.

He reiterated that the subordination of the military to constituted civil authority remains the foundation for professionalism, urging officers and soldiers to uphold democratic values at all times.

“We must safeguard this constitutional democratic governance that promotes the values and interests of every well-meaning Nigerian, irrespective of tribe or religion,” he said.

“I charge all Nigerian Army personnel to be proud champions of democracy and remain apolitical in discharging their constitutional duties.”

Shaibu assured Nigerians that the Army remains committed to protecting lives and property across the country, adding that troops are working round the clock to secure the territorial integrity of the nation and support other security agencies.

The COAS commended the Commandant of NASI and the training staff for the successful conduct of the course, noting that the achievements recorded in training and operations were made possible by government support.

He expressed gratitude to President Bola Ahmed Tinubu for his leadership and sustained assistance to the Nigerian Army, reaffirming the loyalty of officers and soldiers to the government and the Constitution.

Shaibu also thanked the Kaduna State Governor, Sen. Uba Sani, and the people of the state for their cooperation and support to Army formations and institutions.

He congratulated the passing-out cadets and their families, wishing them successful careers as they prepare to join units and formations across the country.

“The Nigerian Army awaits you all in the field,” he said.

Army will remain apolitical, committed to defending democracy – COAS

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COAS charges newly commissioned officers to uphold professionalism, loyalty at POP in Jaji

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COAS charges newly commissioned officers to uphold professionalism, loyalty at POP in Jaji

By: Zagazola Makama

The Chief of Army Staff (COAS), Lt.-Gen. Waidi Shaibu, has charged newly commissioned officers of the Executive Commission Course 2/2025 to uphold professionalism, integrity and loyalty as they begin their careers in the Nigerian Army.

Shaibu gave the charge on Saturday during the Passing Out Parade of the course at the Nigerian Army School of Infantry (NASI), Jaji, Kaduna State.

The COAS described the occasion as a significant milestone and congratulated the cadets for successfully completing the rigorous training that qualifies them for the Presidential Commission.

He urged the new officers to remain focused as they take up responsibilities in various operational theatres across the country.

“Your pips will be unveiled shortly, and you will begin individual and collective journeys filled with opportunities, challenges and important decisions,” he said.

“Amidst these, one thing must remain sacrosanct Nigeria must come first in all decisions and actions throughout this new phase of your careers.”

Shaibu emphasised the need for right character, courage, professionalism and resilience, assuring the cadets that the Nigerian Army Officers’ Corps would always stand with them as comrades and brothers-in-arms.

He advised them to rely on the training received at NASI and their experiences in service, stressing that in moments of doubt, their training should remain their guide.

The COAS reminded the officers that leadership required the ability to inspire confidence and make sound decisions.

“A bad plan is better than no plan at all, so ensure that you always have a plan,” he said.

“Always act with the hope for success and not the fear of failure.”

Shaibu highlighted the Army’s efforts to address welfare concerns related to their type of commission, assuring them of measures to support their professional and personal development.

He urged them to pursue continuous improvement through courses and trainings available in the Army, aligning with his Command Philosophy to transform the force into a more professional, adaptable and combat-ready institution.

COAS charges newly commissioned officers to uphold professionalism, loyalty at POP in Jaji

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COAS inaugurates land warfare wargaming centre, says facility will deepen officers’ operational planning

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COAS inaugurates land warfare wargaming centre, says facility will deepen officers’ operational planning

By: Zagazola Makama

The Chief of Army Staff (COAS), Lt.-Gen. Waidi Shaibu, on Saturday inaugurated the newly constructed Land Warfare Wargaming Centre at the Armed Forces Command and Staff College (AFCSC), Jaji, describing the project as a major milestone in strengthening operational training and military education in the country.

Shaibu, who served as Special Guest of Honour at the commissioning ceremony, said the state-of-the-art centre would significantly enhance the capacity of officers to engage in advanced operational planning, mission rehearsal and strategic decision-making.

He said the completion of the project demonstrated the military’s collective resolve to equip officers with the skills required to address contemporary and future security challenges.

“This centre is not only significant to this College but to the Nigerian Army and the entire Armed Forces of Nigeria,” he said.

“The successful completion of this project is a bold statement in our determination to deepen officers’ operational planning capabilities, enhance military education and further prepare our officers for emerging threats.”

The COAS commended the Armed Forces Command and Staff College for maintaining its reputation as a centre of excellence in producing high-quality middle-level officers who contribute to national defence objectives.

“As a proud graduate of this College, I am pleased to remain associated with its continuous transformation,” he added.

Shaibu applauded the progress recorded by the Department of Land Warfare, noting that the execution of several key projects by his predecessors had contributed to improved academic outcomes and a more effective learning environment.

He described the new Wargaming Centre as a necessary complement to the Lt Gen T.Y. Buratai Operations Centre, adding that it would enhance the training of officers in land warfare doctrine and joint operations.

The COAS expressed appreciation to President Bola Ahmed Tinubu for his “unrelenting support to the Nigerian Army,” saying such support made the execution of strategic projects possible.

He also thanked the Commandant of AFCSC, AVM HI Alhaji, for his commitment to improving the college’s infrastructure and training systems, and commended the Director of the Department of Land Warfare, Brig.-Gen. N.U.C. Ogili, for ensuring the timely and quality completion of the project.

Shaibu acknowledged the contributions of the directing staff, administrative officers and college community, noting that they were collective stakeholders in ensuring the effective utilisation and maintenance of the new facility.

He urged students, who are the primary beneficiaries, to make optimal use of the centre to enhance their understanding of operational art, strategic planning and battlefield decision-making.

“I congratulate the Commandant, staff and students of AFCSC on this historic achievement,” he said.

COAS inaugurates land warfare wargaming centre, says facility will deepen officers’ operational planning

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