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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
Rising tension in Katsina as CJTF personnel fatally shoot father of bandit leader in Malumfashi
Rising tension in Katsina as CJTF personnel fatally shoot father of bandit leader in Malumfashi
By: Zagazola Makama
The fragile peace in Malumfashi Local Government Area of Katsina State has been threatened following the fatal shooting of Alhaji Ibrahim Nagode, 60, by Civilian Joint Task Force (CJTF) personnel.
Nagode, a resident of Na’alma village, is the father of a known bandit leader, Haruna Ibrahim, also called “Fada”.
Sources told Zagazola Makama that the shooting occurred as Fada was returning to his village, following a recently brokered peace accord between bandits and the communities in Malumfashi.
Security sources said the area had been on high alert after intelligence suggested that suspected armed bandits were regrouping in the locality.
In a bid to prevent renewed attacks, the joint troops were deployed to intensify patrols as proactive measure to forestall any hostile activity,” a security source said. However, the operation reportedly resulted in the tragic death of Nagode.
The Department of State Services (DSS) has arrested all CJTF personnel involved in the incident.
Sources said that the authorities are monitoring the situation closely, warning that the death of the bandit leader’s father could escalate tensions in the region.
The sources expressed concern over the potential for retaliation, emphasizing the importance of dialogue and adherence to peace accords to prevent further bloodshed.
Meanwhile security operatives have called on residents to remain vigilant and report suspicious movements in their areas.
Rising tension in Katsina as CJTF personnel fatally shoot father of bandit leader in Malumfashi
News
WFP: Recent Surge in Insecurity Driving Hunger to Level Never Before in Nigeria
WFP: Recent Surge in Insecurity Driving Hunger to Level Never Before in Nigeria
By: Michael Mike
Growing instability across northern Nigeria, including a surge in attacks, is driving hunger to levels never seen before, the United Nations World Food Programme (WFP) has warned.
The warning follows the release of the latest Cadre Harmonisé, a regional food security analysis that classifies the severity of hunger, which found that nearly 35 million people are projected to face severe food insecurity during the 2026 lean season, the highest number recorded in Nigeria.
WFP, in a statement on Tuesday, said attacks by insurgent groups in Nigeria have intensified throughout 2025. Jama’at Nusrat al-Islam wal-Muslimin (JNIM), an al-Qaeda affiliate, reportedly carried out its first attack in Nigeria last month.
Meanwhile, the insurgent group Islamic State in West Africa Province (ISWAP) is said to be pursuing its expansion across the Sahel. Other recent incidents include the killing of a brigadier soldier in the northeast and attacks on public schools in the north, where several teachers and hundreds of schoolgirls remain missing.
“Communities are under severe pressure from repeated attacks and economic stress,” said David Stevenson, WFP Country Director and Representative in Nigeria.
He said: “If we can’t keep families fed and food insecurity at bay, growing desperation could fuel increased instability with insurgent groups exploiting hunger to expand their influence, creating a security threat that extends across West Africa and beyond.”
The statement lamented that Northern Nigeria is experiencing the most severe hunger crisis in a decade with rural farming communities the hardest hit. Nearly six million people in the north are projected to face crisis levels of hunger or worse during the 2026 lean season – June to August – in the conflict zones of Borno, Adamawa and Yobe states.
It added this includes some 15,000 people in Borno State who are expected to confront catastrophic hunger (Phase 5, famine-like conditions). Children are at greatest risk across Borno, Sokoto, Yobe and Zamfara, where malnutrition rates are highest.
It said the dire situation has been compounded by funding shortfalls that diminish WFP’s ability to provide life-saving assistance. In the northeast – where nearly one million people depend on WFP’s food and nutrition assistance – WFP was forced to scale down nutrition programmes in July, affecting more than 300,000 children. In areas where clinics closed, malnutrition levels deteriorated from “serious” to “critical” in the third quarter of the year.
It however assured that despite soaring needs, WFP will run out of resources for emergency food and nutrition assistance in December. Without urgent funding, millions will be left without vital support in 2026, risking more instability and deepening a crisis that the world cannot afford to ignore.
WFP: Recent Surge in Insecurity Driving Hunger to Level Never Before in Nigeria
News
ActionAid Laments the Use of Social Media to Silence Women and Girls in Nigeria
ActionAid Laments the Use of Social Media to Silence Women and Girls in Nigeria
By: Michael Mike
ActionAid Nigeria (AAN) has decried that social media and digital platforms intended to empower, are increasingly exploited to harass, stalk, and silence women and girls. In Nigeria.
AAN in a statement on Tuesday to commemorate the start of the 16 Days of Activism Against Gender-Based Violence with the theme, “UNiTE to End Digital Violence Against All Women and Girls.” signed by its Country Director, Dr. Andrew Mamedu lamented that digital threat compounds the physical dangers girls face in schools amid rising insecurity, creating a dual crisis that demands immediate and collective action.
Mamedu said: “ActionAid Nigeria has long championed safe spaces for women and girls through initiatives such as our Safe Cities project, Women’s Voice and Leadership Nigeria project, the Renewed Women’s Voice and Leadership project, Local Rights Programme and community-based GBV response programs across 21 states and the FCT. In a nation where one in four girls experience sexual violence before the age of 18, the combination of physical and online threats is a crisis that deprives our girls of safety, education, and their future.
“We UNiTE today to break this cycle, fortifying schools against physical violence and abduction, while safeguarding digital spaces from virtual predators.”
He lamented that Nigeria’s education system, intended to be a safe environment for learning, is increasingly under threat. The abduction of 25 students and the killing of a vice-principal at Government Girls Comprehensive Secondary School in Maga, Kebbi State, underscores the fear gripping many northern communities.
He further decried that across the country, schools in Kwara, Niger, Plateau, Bauchi, Kebbi, and 41 Unity schools have closed due to insecurity, forcing children out of classrooms. UNICEF reports that 60% of out-of-school children in northern Nigeria are girls, a figure likely to rise as insecurity persists. Survivors of abductions are often subjected to sexual and domestic slavery, while perpetrators extend their threats online, amplifying fear and intimidation.
He noted that Technology-Facilitated Gender-Based Violence in Nigeria takes many forms, including cyberstalking, non-consensual sharing of intimate images, deepfakes, doxxing, sextortion, and persistent online harassment, insisting that these abuses isolate and shame women and girls, disrupting their education, work, and social participation.
A 2024 UNFPA report indicates that between 16% and 58% of women and girls worldwide experience TFGBV, with Nigeria recording over 6,000 GBV cases in the first five months of 2024 alone.
He said Tech-enabled abuse has real and tangible impacts, particularly on women and girls already marginalised by factors such as ethnicity, disability, or geography. Reports from organisations including Hivos and the Development Research and Projects Centre (dRPC) show that TFGBV intensifies trauma, suppresses voices, and perpetuates cycles of poverty.
H noted that ActionAid Nigeria, alongside women’s rights organisations, survivors, and communities across the country, calls on the Federal Government, State Governments, the National Assembly, law enforcement agencies, regulatory bodies, and international partners to urgently take the following actions:
Domesticate and implement the African Commission Resolution 522 (2023) on protection from internet-based violence; Arrest and prosecute perpetrators of school abductions to reduce insecurity in educational institutions; Establish a National Task Force on Technology-Facilitated Gender-Based Violence to coordinate prevention and response efforts; Allocate specific budget lines for the digital safety of women and girls in the 2026 appropriation; Strengthen survivor-centred reporting and justice mechanisms for both physical and online gender-based violence.
ActionAid Nigeria called on all Nigerians to recognize that the safety of women and girls is the responsibility of every individual, community, and institution, stressing that together, we must act decisively to ensure every girl can learn, live, and thrive free from fear, both online and offline.
ActionAid Laments the Use of Social Media to Silence Women and Girls in Nigeria
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