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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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International Police Academy – UNIPOL Appoints Joseph Icha, as Director International Counter Narcotics Training Nigeria Section

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International Police Academy – UNIPOL Appoints Joseph Icha, as Director International Counter Narcotics Training Nigeria Section

By: Bodunrin Kayode

The international Police Academy (UNIPOL) has Appointed Deputy Commander General (DCG) Joseph Icha,
Director Training and Manpower Development, National Drug Law Enforcement Agency (NDLEA) as Director International Counter Narcotics Training Nigeria Section.

A statement from the academy’s management stated that “the academy proudly announces the appointment of
DCG Joseph Icha, Director Training and Manpower Development, NDLEA as Director International Counter Narcotics Training Nigeria Section.

“This appointment recognizes
DCG Joseph Icha, Director Training and Manpower Development, NDLEA. exceptional contributions to national security, law enforcement leadership, and international cooperation.”

Icha has served the Agency in various Senior Management capacities as Principal Staff Officer, Assistant State Commander, Assistant Director, State Commander, and Deputy Director among others, with commendations.

The new international counter narcotics boss has attended several law enforcement courses on Drug Supply Suppression and Drug Demand Reduction within and outside the country.

“He is a Master Trainer with the United Nations Office of Drug and Crime (UNODC) in Drug Law Enforcement intelligence led investigation strategies and Criminal Intelligence. ” said the statement.

Joseph Icha has facilitated training programmes on behalf of UNODC to various law enforcement agencies in the country.

DCG Joseph Icha is a Law Enforcement Operative, mentor, curriculum designer, and advisor per excellence.

He is also a member of several international professional Organizations and currently is the Director Training and Manpower Development of NDLEA.

This important appointment was pronounced under the leadership of Dr. Alexander Jan M (Hany El Zahar), Executive Director, Founder, and CEO of the International Police Academy – UNIPOL, and IPA President (Rtd.) Senior Superintendent of Police Shuaib Adam HSC OLY VJ, International Director of Law Enforcement, Police, and Military, with the support of Prof. Yuval Binstoc (IPA) and Sir Junustia Brecen.

International Police Academy – UNIPOL Appoints Joseph Icha, as Director International Counter Narcotics Training Nigeria Section

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Plateau State Complied with the deadline for 2024 Audited financial Reports…. Manset

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Plateau State Complied with the deadline for 2024 Audited financial Reports…. Manset

By: Bodunrin Kayode

Plateau State Accountant General Naanret Manset has said that it was not true that Plateau state has refused to comply with the deadline given to states for the submission of 2024 audited financial statements.

Reacting to a report published recently, the accountant general in a statement noted that “the attention of the Office of the Accountant-General of Plateau State has been drawn to a publication by the Foundation for Investigative Journalism (FIJ) titled ‘It’s Past Deadline, 5 States Fail to Publish 2024 Financial Statements’, which wrongly lists Plateau State as one of the defaulters.”

Naanret Manset maintained that “For the record, Plateau State fully complied with all statutory timelines for the preparation, audit, and publication of its 2024 audited financial statements

“Submitted same to the Auditor-General in May, 2025 which is within the stipulated period of 6 months.

“Audit completed in June, 2025 and forwarded to the House of Assembly which is also within the stipulated period of 3 months.

“Approved by the House of Assembly
Published online on 27 July 2025, below the legal timeline of 9 months.
The audited report is publicly available here:

“We urge FIJ to promptly correct their publication and remove Plateau State from the list of non-compliant states.
Plateau State remains committed to transparency, accountability, and timely financial reporting.” It noted.

The FIJ had recently published that six Nigerian states are yet to publish their audited financial statements for the 2024 fiscal year.

It revealed that five of such erring states have already past their statutorily implied deadlines which Plateau is saying is not true as it applies to them.

The publication had said that ” erring states are Akwa Ibom, Kaduna, Ogun, Oyo, Plateau and Rivers.

“In Akwa Ibom’s case, its amended 2021 audit law gives the auditor general up to nine months to publish the report online after submitting it to the House of Assembly.

“The Accountant General has six months to present the books, followed by a 90-day audit and submission period.

” In the other five states, audit laws differ in the year they were enacted or updated, but the process is similar.

“The Accountant General must submit the financial documents to the audit office within three months after the financial year ends.

” The Auditor General is then required to audit the report, send it to the House of Assembly and publish it immediately.

“The Ogun State Audit Law (2021), Rivers State Audit Law (2021, as amended), Akwa Ibom State Audit Law (2021), Oyo State Audit Commission Law (2021) and Plateau State Audit Law (2021) all set out these requirements.

” In Rivers, however, publishing the audit is left to the discretion of the Auditor General.

“In past years, these states have published their audits between June and August. Some have also been ranked among the lowest in transparency.

” The CJID Openness Index, released in July 2024, placed all six in the bottom tier along with 10 others.”

Recently, FIJ reported Akwa Ibom’s repeated disregard for budgetary transparency despite binding provisions in its Fiscal Responsibility Law.

The FIJ report maintained that two states Yobe and Ekiti, scored above average for transparency and accountability in 2024, with 73 per cent and 54 per cent, according to the Sub national Audit Efficacy Index, published by the Paradigm Leadership Initiative.

The report noted that the annual assessment, which measures financial transparency and policy adoption across Nigeria’s state governments, shows a familiar trend: “stagnation or decline.”

Plateau State Complied with the deadline for 2024 Audited financial Reports…. Manset

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Prof. Ribah clarifies stance on dialogue, says he does not support ransom or levies to bandits

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Prof. Ribah clarifies stance on dialogue, says he does not support ransom or levies to bandits

…cautions against misrepresentation of position on dialogue with bandits…

By: Zagazola Makama

Prof. Abubakar Usman Ribah, a peace advocate and member of the Peace Committee, has cautioned social media users against misrepresenting his views on dialogue with bandits as a strategy for sustaining peace in the troubled North West Zone.

Ribah, in a video made available to newsmen on Wednesday, said his comments on dialogue had been twisted and circulated on Facebook, TikTok and X (formerly Twitter), in ways that fuel misunderstanding and hostility.

He urged users to “fear God and stop changing the narrative to suit their own views,” stressing that selective quoting of his remarks was misleading and unfair.

“Social media users should fear God and stop changing the narrative that goes contrary to our own views. You are quoting a segment that suits your narratives, leaving out the rest, and continue to circulate it. That is misrepresentation,” Ribah said.

He explained that his position on dialogue was not in support of paying levies or ransoms to bandits but in favour of a government-led engagement that addresses the root causes of the conflict.

“We believe that fighting with guns only prolongs crises. For 10 years, it has not yielded results, and that is why we wanted to end it through dialogue.

“And the dialogue we are seeking is not the one where villagers go on their own to negotiate with bandits, pay levies in order to farm, or pay ransom to release family members. That type of dialogue is not sustainable. It is betrayal.

“The dialogue we support is the one led by government, where authorities can solve the pressing issues between farmers and herders, and address the needs and demands of all conflicting parties,” he said.

Ribah clarified that his advocacy for dialogue predated the current administration and had been consistent for more than seven years.

“This did not start with this government. I have been engaging in dialogue for over seven years. You can go through my pages. War cannot end war, but dialogue will, if both conflicting parties agree. This is what we are talking about,” he said.

The peace advocate dismissed allegations that he and other members of the Peace Committee were shielding or supporting bandits.

“Some are accusing us of supporting bandits, some are accusing us of giving them protection. But how can we protect bandits that are killing people? No way. What we want is to stop the bloodshed, where everyone will be allowed to go about his normal life,” he stressed.

Ribah further accused some social media commentators of being “conflict entrepreneurs,” whom he said benefitted from circulating negative reports of attacks.

“Some people benefit from telling negative stories of attacks. They are conflict entrepreneurs. We want them to focus on telling positive stories instead of dwelling on negativity,” he added.

The North West Zone, particularly Zamfara, Sokoto, and Katsina States, has for years been plagued by banditry, mass killings, abductions, and forced displacement, with government and stakeholders divided over the most effective approach to peacebuilding.

Prof. Ribah clarifies stance on dialogue, says he does not support ransom or levies to bandits

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