Nigeria is estimated to account for more than 1 in 4 of all maternal deaths worldwide. Globally, the top five causes of maternal deaths are considered mostly preventable. These include preeclampsia and eclampsia, a form of high blood pressure in pregnancy; postpartum haemorrhage; and severe infection, all seen in MSF’s ICU in Jahun. Yet they are only preventable if they are detected early and people can access skilled care without delay.
For women seeking healthcare in Jahun there are multiple obstacles that affect individuals’ and families’ choices and cause risky delays, according to Theophilus. “People require admission into ICU because they usually come to the hospital late and when things have already gone very bad. For some the villages are very far, so they can't really come to our centre any time.
“If somebody has been in labour since Monday [their family] might […] keep them till Friday, which is market day. They will put the patient into the vehicle that is going to the market, and [only] then be able to bring the patient to the hospital, in a very critical state.”
Thirteen per cent of women giving birth in the maternity department in 2022 were under 18 years of age. Although these teen mothers are often married, decision-making is a challenge for most married women in the culturally conservative communities of northern Nigeria, and especially so for young wives.
“The grandmothers or the mothers have to make decisions for them, or the husband”, say Theophilus. “But we do the best we can and recommend the best that is possible for them.”