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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 Raid Illegal Bunkering Site in Bayelsa, Recover Equipment, Stolen Products

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Troops Raid Illegal Bunkering Site in Bayelsa, Recover Equipment, Stolen Products

By: Zagazola Makama

Troops of Sector 2, Operation DELTA SAFE (OPDS), have raided a suspected illegal oil bunkering site at Kpansia general area in Yenagoa, Bayelsa State.

The operation, which took place at about 00:40 hours on 16 June 2026, led to the recovery of two vehicles, one pumping machine, 53 sacks of illegally refined Automotive Gas Oil (AGO) estimated at about 2,650 litres, five empty drums, and two wheelbarrows.

A military source said the troops acted on credible intelligence and stormed the location, disrupting ongoing illegal bunkering activities in the area.

The recovered items and products were evacuated to a safe location for destruction, owing to the densely populated nature of the community.

The source added that operations are still ongoing in the area to track and apprehend other members of the syndicate.

Troops Raid Illegal Bunkering Site in Bayelsa, Recover Equipment, Stolen Products

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Electoral Act 2026: A New Threat to Nigeria’s Democracy

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Electoral Act 2026: A New Threat to Nigeria’s Democracy

By: Victor Emejuiwe

The political environment ahead of the 2027 General Elections presents one of the biggest tests of Nigeria’s democracy since the return to civilian rule in 1999. Unfortunately, this test is taking place amid growing concerns about the shrinking space for political competition and the increasing concentration of political power in the hands of the ruling party.

In recent months, Nigerians have watched a steady movement of opposition politicians and governors into the ruling All Progressives Congress (APC). At the same time, attempts by opposition leaders to build a united front ahead of 2027 have faced legal and judicial obstacles. Internal crises and factional disputes have emerged in key opposition parties, many of which have ended up in court. The recent deregistration of the African Democratic Congress (ADC) by the Federal High Court has only added to public anxiety.

Many Nigerians believe these developments are not mere coincidences but part of a broader strategy to weaken the opposition ahead of the next elections. Whether this perception is correct or not, one thing is clear: the Electoral Act, 2026 has deepened concerns about the future of democracy in Nigeria.

These concerns came to the fore during a stakeholders’ meeting convened to examine the Electoral Act, 2026 and its implications for the credibility of the 2027 General Elections. Electoral experts, legal practitioners, civil society organisations and democracy advocates expressed serious reservations about several provisions of the Act. Among the leading voices were former Resident Electoral Commissioner, Barrister Mike Igini, and political scientist, Professor Abdulmumini Kuna.

Their concern was not simply that the law contains technical flaws. Rather, they argued that some provisions create opportunities for manipulation, weaken accountability and make it more difficult to challenge electoral wrongdoing.

One of the most controversial provisions is Section 60. The section provides that where electronic transmission of election results fails because of communication challenges, the result contained in Form EC8A becomes the primary basis for collation and declaration.

Supporters may argue that this is a practical response to network failures. However, Barrister Igini warned that it reopens the loopholes that electoral reforms were designed to close. The introduction of BVAS and electronic transmission of results was intended to reduce human interference and make election results more transparent. By creating room for manual alternatives whenever network challenges are claimed, the law creates an opportunity for abuse. In highly contested areas, electronic transmission could simply be abandoned on the excuse of technical failure, thereby weakening public confidence in election outcomes.

Section 63(2) raises another serious concern. The provision allows Returning Officers to count ballot papers that do not bear official marks if they are satisfied that such ballots came from materials supplied to the polling unit.

While the provision may have been introduced to address administrative challenges, it places too much discretion in the hands of election officials. According to Barrister Igini, election laws should reduce discretion and increase transparency. Once a Returning Officer is empowered to determine which unofficial ballots should count, the process becomes open to abuse. In a closely contested election, such decisions could influence the final outcome and trigger avoidable disputes. This is why stakeholders called for the repeal of Section 63(2) while retaining Section 63(1).

Another provision that has generated concern is Section 77. The section requires political parties to submit membership registers to INEC at least twenty-one days before party primaries and provides that only those whose names appear in those registers can vote or be voted for during primaries.

While transparency in party administration is important, stakeholders questioned whether the provision could be used to exclude candidates from participating in the political process. Nigerian politics is fluid, with political alignments and alliances often changing close to election periods. The strict timelines imposed by the law may prevent otherwise qualified aspirants from contesting elections simply because their names were not captured in a party register within the required period.

In the same light Professor Abdulmumini Kuna acknowledged that digital membership registers could improve transparency. However, he warned that the requirements may place smaller political parties at a disadvantage and could also affect citizens’ constitutional rights to political participation and freedom of association.

Even more troubling are Sections 137 and 138. Section 137(3) provides that where an election petition involves the conduct of an electoral officer, presiding officer or returning officer, such officials do not need to be joined in the petition. Instead, INEC assumes responsibility for defending itself and its officers.

This provision weakens accountability. Electoral officers are often central figures in election disputes. Their actions can determine whether electoral laws are complied with or violated. Shielding them from direct scrutiny makes it harder to establish responsibility when misconduct occurs. Barrister Igini noted that previous legal frameworks allowed electoral officials to appear before tribunals and provide evidence where necessary. The removal of this safeguard raises concerns about the ability of election tribunals to uncover the truth.

Section 138 creates another major challenge. The provision narrows the grounds upon which elections can be challenged. Under the new law, elections may largely be questioned on the basis of corrupt practices, non-compliance with the Electoral Act or failure to secure the majority of lawful votes cast.

What is particularly worrying is the removal of candidate qualification issues as grounds for challenging election outcomes. In the past, allegations involving forged certificates, false declarations and constitutional disqualifications served as important checks on those seeking public office. By excluding such issues from election petitions, the law weakens one of the key mechanisms for holding candidates accountable.

Professor Kuna warned that this creates a conflict between the Constitution and the Electoral Act. While the Constitution sets qualifications for public office, the Electoral Act appears to limit the ability of citizens and political parties to challenge candidates who do not meet those requirements.

Taken together, these provisions raise serious questions about the direction of Nigeria’s electoral system. Stakeholders warned that the Act could weaken electronic result management, reduce accountability, increase litigation and create opportunities for manipulation. There are also concerns that smaller political parties, women, young people and other underrepresented groups may be disproportionately affected.

Most worrying is the possibility that elections may gradually move away from the ballot box and into the courtroom. Democracy works best when voters determine electoral outcomes. It becomes weaker when legal technicalities become more important than the will of the people.

For this reason, stakeholders called for the repeal of Sections 60(3) and 63(2), stronger protections for electronic transmission of results and the restoration of measures that hold electoral officials accountable for their actions. They also urged citizens and civil society organisations to intensify advocacy for electoral reforms before the 2027 elections.

The defence of democracy cannot be left to politicians alone. Nigerians must demand a review of the controversial provisions of the Electoral Act and insist on a legal framework that promotes transparency, accountability and fairness. There is also a need to challenge questionable provisions in court where they appear to conflict with constitutional rights.

The National Judicial Council should develop clear guidelines for election tribunals to ensure that cases are decided on the basis of justice and the will of the people rather than technical loopholes. Likewise, development partners such as the European Union, the United States, the United Kingdom and the United Nations should engage the Nigerian government and encourage a review of provisions that threaten public confidence in elections.

The time to act is now. Once the electoral process begins, it may become much harder to correct these flaws. Democracy does not collapse in a day. It is weakened gradually when citizens fail to challenge laws and decisions that undermine accountability and the will of the people. Nigerians must ensure that the Electoral Act, 2026 does not become one of the instruments that weakens the foundations of our democracy.

Victor Emejuiwe

Program Manager

Resource Centre for Human Rights and Civic Education (CHRICED)

Writes from Abuja

08068262366

Electoral Act 2026: A New Threat to Nigeria’s Democracy

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KACRAN Hails Buni Over Appointment of New Ngazargamu Emir, Pledges Support for Peace and Development

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KACRAN Hails Buni Over Appointment of New Ngazargamu Emir, Pledges Support for Peace and Development

By: Michael Mike

The Kulen Allah Cattle Rearers Association of Nigeria (KACRAN) has commended Yobe State Governor, Mai Mala Buni, for what it described as a transparent and inclusive process that culminated in the appointment of a new Emir of Ngazargamu.

In a statement issued by its National President, Hon. Khalil Mohd Bello, the association also expressed deep condolences to the government and people of Yobe State, the Ngazargamu Emirate Council, and the royal family over the death of the late Emir, Ahmad Tijjani Ibn Saleh Geidam.

KACRAN described the late monarch’s passing as a great loss to the emirate and prayed for Allah’s forgiveness and eternal reward for his contributions to the development and unity of the people.

The association equally congratulated the newly appointed Emir, Yerima Ibn Mahmud, on his ascension to the throne, describing him as an experienced administrator, accomplished public servant and respected statesman whose wealth of experience would benefit the emirate.

According to KACRAN, the new monarch’s track record in public service, including his tenure as Executive Chairman of Yunusari Local Government Area, member of the Yobe State House of Assembly, Commissioner for Local Government and Chieftaincy Affairs, Special Adviser on Local Government and Chieftaincy Matters, and Commissioner in the Ministry of Livestock Development, positions him well to provide visionary leadership.

The association noted that Governor Buni’s handling of the succession process reflected his commitment to preserving cultural heritage while promoting peace, stability and inclusiveness in the state.

“KACRAN commends Governor Mai Mala Buni for the transparent, peaceful and inclusive process that produced this appointment. By upholding cherished tradition while ensuring stability, the Governor has reaffirmed his deep respect for culture, heritage and the aspirations of the people,” the statement said.

The group further described the emergence of the new Emir as a positive development at a time when the country requires stronger traditional institutions to foster unity, peace and grassroots development.

Reaffirming its commitment to the emirate, KACRAN pledged its loyalty and full support to the new monarch, assuring him of the association’s cooperation in promoting peace, security and socio-economic development across the emirate.

The association expressed confidence that the combined efforts of the new Emir and the Yobe State Government would usher in a new era of harmony, prosperity and sustainable development for the people of Ngazargamu Emirate and beyond.

KACRAN Hails Buni Over Appointment of New Ngazargamu Emir, Pledges Support for Peace and Development

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