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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
Army trolls in Adamawa arrest major drug supplier to terrorists
Army trolls in Adamawa arrest major drug supplier to terrorists
By: Zagazola Makama
Troops of Operation Hadin Kai (OPHK) have arrested a suspected major drug supplier to Boko Haram and ISWAP terrorists operating across parts of Borno and Adamawa.
The suspect, identified as Zubairu Muhammad, 45, was arrested at about 6:30 a.m. on Tuesday by troops of 232 Battalion (Tactical), Uba, Adamawa State.

Sources told Zagazola Makama that Muhammad is believed to be one of the major suppliers of cannabis sativa and crystal meth (popularly known as ICE) to terrorists through the Askira-Uba, Chibok, Michika and Damboa corridors.
According to the source, the troops recovered 14 blocks of cannabis sativa valued at over N1 million, and 43 grams of ICE, valued at more than N3 million, from the suspect.
He was also found with two Army camouflage T-shirts, which he allegedly used while delivering illicit substances to terrorists.

The source said preliminary investigation had been concluded, and that the exhibits would be handed over to the National Drug Law Enforcement Agency (NDLEA), Yola Command, for further action.
Army trolls in Adamawa arrest major drug supplier to terrorists
News
Stop rascally behavior and reckless driving on maiduguri roads…Gubio warns keke napep riders
Stop rascally behavior and reckless driving on maiduguri roads…Gubio warns keke napep riders
By: Bodunrin kayode
Chairman Borno State Civil Service Commission Dr Bulama Gubio has called on young people in the state to reduce their irresponsible actions with keke NAPEP during weddings and related ceremonies which makes them over excited and drive recklessly in the streets of maiduguri.
Dr Gubio is miffed about the excesses of the younger generation mostly keke napep drivers who use the tricycle as an excitement toy driving with reckless abandon sometimes killing themselves in the process without fear of reprimand.
Gubio who is a member of the Borno state traditional council and secretary of the elders forum in the state called on the federal Road Safety Corp (FRSC) to work on the annoying excesses of the Keke napep riders who have caused a lot of trouble for commuters in the state capital adding that they operate with a lot of impunity which is not found in the pattern of the government drivers whom he said were better behaved.
Dr Gubio asked the FRSC to increase the enlightenment of even the resident commuters on the use of the commercial keke riders even as they entrust their lives into the hands of the the reckless riders among them because some of them are definitely on induced substances before they come into the roads breaking traffic and driving very roughly even contesting the major roads with bigger cars and sometimes killer trailers.
Dr Gubio actually made these remarks during the 2025 special marshals sectoral workshop, RS12.2 of the Borno state command held this week at the Elkanemi Hall of the State owned Ramat Polytechnic in Maiduguri.
Also admonishing the gathering on the use of Borno roads, Sector Commander of the FRSC Usman Mohammed condemned the behavior of some of the keke napep riders in the state capital describing them as down right recalcitrant elements.
He regretted that in their obstinate posture towards any form of control, a lot of them have fallen under the hammer of stiff fines sometimes as high as N50,000 for offenses yet they continue to repeat the same charges even when driving passengers.
Mohammed told this reporter that with the increased security in the state capital, his team will continue to do their lawful best to reduce the unnecessary carnage on the major roads of the Maiduguri metropolis and even the adjoining highways to the zones.
He decried the lingering excesses of the Keke napep riders within the Maiduguri metropolis adding that most of them are just stubborn and would not take instant correction which is why he sometimes had to stop traffic himself, arrest erring ones and give them on the spot education and correction for their offenses.
The Sector Commander said that because of their high number in terms of population, his men are on high alert with other collaborating agencies to stem the tide of these numerous excesses of these riders with a view to reduce same to the barest minimum.
On the alleged sluggishness of the union leaders to control their erring members, he maintained that they have been doing their best because some of them even boy-cut registration to avoid being caught making it an endless litany of woes coupled with the burden of facing another new set of wrong doers mobilizing into the highways each new day which is really tedious.
He added that it was not true that the excesses of the riders was due to the unenlightened nature of the leaders as posited by road watchers adding that the leaders are enlightened, but its just that the riders are recalcitrant by the way they go about driving their tricycles recklessly in the town.
“Since we cant get all of them at the same time, what we do is to stop four or five of them at the same time. I have stopped many in that pattern to talk to them and they listen to my lectures on their wrong doings and some do repent.
“Without mincing words, just recently, we arrested over seven of them because of unnecessary over loading etc. We have brought out a time schedule to make them fall in line to see how we can correct some of these excesses. So we are doing a lot to sort out these challenges.
” As a matter of fact, some of their union officials have come to commend us that they are very happy with the way we are going about handling the recalcitrant ones among them.
On enlightenment of the officials,” you see they are home based, they have limits with which they can handle these keke napep members who are committing all these offenses on our roads, however, we have been having enlightenment campaigns on these riders and we do hope to get there one day.
Speaking during the opening ceremony of the workshop, the State Coordinator, special marshal RS12.2 Borno sector command, Mohammed Dahaya commended road users in the society for gracing the 2025 Special Marshals bi-annual Sectoral Workshop adding that their presence, despite the economic and security challenges coupled with their regular tight schedule is a testimony of their love for the FRSC as well as their commitment to safety of lives and properties on our roads.
He said that the Special Marshals were a group of Volunteers, established under section 10(1) of the FRSC statute, as defined in the FRSC establishment Act 2007 adding that the roles and constitutional responsibilities of Special Marshals include Advocacy and support, Patrol Operations, Enforcement and Education in all ramifications of human activities without any pecuniary interest, meaning they are not paid for the services rendered to the society.
Special Marshals he noted believe that the beauty of life doesn’t depend only on how happy you are but how happy you make others which is why, the most impactful thing to do in life is to help someone in need stressing that the worth of life is not in its duration but in its donations to humanity.
”we still need the support of all, morally and financially to be able to achieve our desired goals and objectives for efficient and effective services to humanity.
Your labour of love will not be in vain.” He concluded.
Present at the occasion were several dignitaries including the representatives of the Ministry of Transport And Energy, Aliyu Buba, The General manager, Borno Express Transport Corporation, Grema Kyari, The Vice Chancellor Kashim Ibrahim University, Prof. Babagana Gutti, Special Marshal Engr. Shettima Abdullahi and The Chairmen NARTO Borno State Council Jidda Bishara.
Stop rascally behavior and reckless driving on maiduguri roads…Gubio warns keke napep riders
News
FCT Designated for Implementation of NESREA / UNEP Innovative Waste Management Pilot Project
FCT Designated for Implementation of NESREA / UNEP Innovative Waste Management Pilot Project
By: Michael Mike
The National Environmental Standards and Regulations Enforcement Agency (NESREA) with the support of the United Nations Environment Programme (UNEP) has began the process of reforming the waste management system in the country.
Also, the Federal Capital Territory, FCT has been designated as the pilot state for the implementation of the reforms.
In order to put the necessary frameworks in place to achieve this, the agency hosted two separate two-day consultative workshops with relevant stakeholders.
The first workshop aimed to consolidate report on recommendations for Legislative and Institutional Reforms in the Waste Management Sector in Nigeria, whilst the second workshop looked at the specific measures on the better inclusion of informal structures and workers in the reforms.
The workshops are part of the UNDA-funded Project on Environmentally Sound and Safe Waste Management Frameworks in Africa, being implemented by UNEP in collaboration with other UN agencies across three African countries Guinea-Bissau, Nigeria, and Sierra Leone.
Director General of NESREA, Prof. Innocent Barikor in his remarks described the project as timely, coming at a time when Nigeria is implementing the circular economy with a view to promoting resource efficiency and the creation of green jobs.
He disclosed that under the project, the Federal Capital Territory, FCT has been designated as the pilot state for the implementation of the reforms, noting the vital role of the waste management sector in safeguarding public health, ensuring environmental sustainability and enhancing the quality of life in communities.
He said: “Over the years, waste management has remained one of the key environmental and developmental challenges in Nigeria. Despite efforts to develop policies and plans, Nigeria continues to face significant challenges in managing waste, including inadequate infrastructure, insufficient funding, and lack of public awareness. to address this, NESREA, in collaboration with the United Nations Environment Programme under the Montevideo Programme V for the Development and Periodic Review of Environmental Law, is implementing this pilot project in Abuja.”
Barikor disclosed that the objective of the project was to strengthen the waste management framework with the aim of promoting environmentally sound and safe management of waste in Nigeria, while ensuring better inclusion and protection of informal workers and structures; as well as the integration of waste segregation.
He expressed the belief that the National Waste Marketplace Programme recently unveiled by NESREA, and the implementation of the Extended Producer Responsibility (EPR) Programme would further boost effective waste management in line with global best practices.
He noted that: “The Marketplace intends to link waste pickers, collectors, recyclers in an innovative manner that provides benefits and allow stakeholders to interface. It will give room for financial support, insurance support and incentives. Cooperatives will also be on the space. The direction is to move towards entrenching global best practices.”
Representative of UNEP, Aphrodite Smagadi in a goodwill message said the success of the reforms depend to a large extent on meaningful engagement and integration of all stakeholders including governments institutions, the private sector, civil society, as well as the informal sector.
While thanking NESREA for convening the forum, the Director, Climate Change, Federal Ministry of Environment, Dr. Iniobong Abiola-Awe said despite the challenge posed by waste management, it represents an opportunity to turn waste into wealth, pollution into innovation and environmental risk into green enterprise.
Represented by a Chief Scientific Officer, Uduak Ekpa, Dr. Abiola-Awe added, “Nigeria generates over 32 million tonnes of solid waste annually comprising a wide range of waste types, including, food waste, plastics, paper, textiles, metals, glass and hazardous materials such as electronic and medical waste. These waste streams pose distinct challenges and require tailored approach for collection, treatment and disposal.”
The workshops had participants drawn from Ministries, Departments and Agencies of government including Federal Ministry of Environment, Abuja Environmental Protection Board, Ministry of Labour and Employment, Ministry of Youth Development Waste Pickers Association of Nigeria, Women Environmental Programme, as well as recyclers.
Participants analyzed best practices from the different parts of the world and made recommendations.
FCT Designated for Implementation of NESREA / UNEP Innovative Waste Management Pilot Project
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