Video - Nurses strike hits health services in Nigeria

Nurses across Nigeria are protesting poor working conditions. The National Association of Nigeria Nurses and Midwives announced the week-long strike could be extended if its demands are not met.

CGTN Africa

Nigeria takes bold steps toward Hepatitis-free future

Abuja, The World Health Organization (WHO) has collaborated with the Government of Nigeria and hepatitis stakeholders to raise awareness and promote early diagnosis and treatment for World Hepatitis Day 2025. The global event, observed annually on 28 July, raises awareness about viral hepatitis- an inflammation of the liver that can lead to chronic liver disease and liver cancer.

Hepatitis includes five types: A, B, C, D, and E. In the WHO African Region, over 70 million people suffer from chronic hepatitis B or C, but fewer than 10% are diagnosed or treated. Nigeria, with 325,000 new infections in 2022, ranks third globally in hepatitis prevalence.

Chronic hepatitis B and C can lead to liver damage and cancer, even though they are preventable, treatable, and, in the case of hepatitis C, curable.

This year’s theme, ‘Hepatitis: Let’s Break It Down,’ calls for action to remove financial, social, and systemic barriers, including stigma, that prevent hepatitis elimination and liver cancer prevention.

For 2025 World Hepatitis Day, WHO joined the Ministry of Health and Social Welfare and its partners to mark the occasion with a ministerial press briefing at the Federal Secretariat, and launched a three-day hepatitis B screening, on the stop vaccinations for those who test negative, and linkage to treatment programme for those who test positive at the National Assembly Complex in Abuja.

The event at the National Assembly in Abuja brought together health officials, legislators, and the public to address the issue of hepatitis.

Addressing journalists at the press briefing, the Minister of Health and Social Welfare, Professor Mohammed Pate, represented by Dr Godwin Ntadom, Director Public Health Department, FMOH, reiterated Nigeria’s commitment to combating hepatitis.

He noted that the burden and cost of hepatitis treatment in the country is still very high and, as such, has a huge economic impact on the country and called for collective action in eliminating the disease.

Dr Ntadom said, “hepatitis costs Nigeria between ₦13.3 trillion and ₦17.9 trillion annually in direct and indirect costs.
He also announced, ‘Project 365,’ a nationwide campaign aimed at eliminating Hepatitis C and halting Hepatitis B transmission by 2030.

“The project will support the ongoing efforts to eliminate mother-to-child transmission of HIV, hepatitis, and STIs, alongside expanding local pharmaceutical manufacturing through funding, the establishment of the Viral Elimination Fund, tax incentives, regulatory reforms, and legislative support.

Nigeria must no longer hold the third-highest hepatitis burden globally. We have the science, we have the strategy, and we will act together, boldly and urgently, toward a hepatitis-free Nigeria, he said.

WHO’s Acting Representative in Nigeria, Dr Alex Gasasira, represented by Dr Mya Ngon, cluster lead for Universal Health Coverage (UHC) Communicable and Noncommunicable Diseases (NCDs) praised Nigeria’s triple elimination initiative for HIV, hepatitis, and STIs, and emphasized the importance of reducing treatment costs, boosting local production, and expanding screening to achieve healthcare equity.

WHO urges Nigeria and other nations to:
• Ensure hepatitis B vaccination within 24 hours of birth;
• Integrate hepatitis testing and treatment into primary healthcare services;
• Address stigma and misinformation;
• Secure sustainable domestic funding for hepatitis programs; and
• Protect the rights of individuals living with hepatitis, especially in healthcare and employment.

She reiterated WHO’s commitment to supporting Nigeria’s efforts to strengthen its health systems and expand access to affordable diagnostics, vaccines, and treatments.

A beneficiary of the screening, Fash Yommie, 53, from Abuja, shared that he took the test to know his status.

“I took the test to know my status, and I am relieved to have tested negative. I now understand the importance of hepatitis prevention. I will start taking precautionary measures, such as avoiding sharing needles and ensuring proper hygiene with food and water, to protect myself and my loved ones from infection. I encourage everyone to get tested and vaccinated, as early detection is key to preventing this disease.

"Early detection and vaccination are crucial in preventing the spread of hepatitis. Hepatitis B is transmitted through contact with infected blood or fluids, hepatitis C via blood-to-blood contact like sharing needles, and hepatitis A and E through contaminated food or water.

Nigeria has enhanced hepatitis B prevention by adding the vaccine to the national schedule, supported by WHO, Gavi, UNICEF, and partners, to vaccinate all newborns and children and reduce early transmission.

This year’s activities reflect the broader goal of integrating hepatitis services into Nigeria’s primary healthcare system, making screening and treatment more accessible to vulnerable populations.

The National Assembly event is part of WHO's ongoing collaboration with Nigeria to achieve universal health coverage and align with the 2030 Global Health Agenda. Through national and local partnerships, WHO supports Nigeria in reducing the hepatitis burden and improving public health outcomes. The three-day screening serves as a reminder that hepatitis is preventable, and everyone has a role in raising awareness and preventing its spread.

WHO

Nigerian nurses commence nationwide strike today

Nigerian nurses will commence a nationwide strike today to demand improved welfare, fair allowances, and better working conditions for nurses.

The National Association of Nigerian Nurses and Midwives (NANNM-FHI) said the strike action became necessary after a 15-day ultimatum, issued on 14 July, expired without a meaningful response from the federal government or Federal Ministry of Health.

“The strike, starting 12 midnight Tuesday, July 29, will involve total service withdrawal across all federal health institutions.

“Nurses nationwide have been asked to comply fully and stand in solidarity,” the union said in a Monday statement.

The seven-day warning strike is expected to end on 5 August. It will involve nurses in public health institutions across the country and is expected to impact health services in public hospitals.

The NANNM reaffirmed nurses’ central role in healthcare delivery. It said its members contribute 60–70 per cent of hospital services and so deserved improved welfare, fair treatment, and recognition for their essential services.

It rejected a 27 June circular from the National Salaries, Income and Wages Commission (NSIWC) and demanded adjustments to various allowances, including shift, call duty, and retention.

State chapters of the NANNM have already indicated their willingness to join the strike.

The union’s secretary in Oyo, Emmanuel Aina, said in a statement that nurses in Oyo will join the strike. He said the strike action followed a resolution reached at an emergency meeting of NANNM’s National Executive Council and a subsequent directive from the national headquarters.

“I write to notify you that all nurses and midwives across all healthcare institutions, federal, state, and local government, are directed to embark on a seven-day warning strike.

“The strike is scheduled to commence at midnight on Wednesday, July 30, and will run through August 5, 2025,” the statement read.

Mr Aina urged full compliance, adding that official communication regarding the union’s eight-point demand had been sent to relevant authorities.

“This seven-day warning strike is a litmus test for our readiness to pursue a more serious struggle if our demands are not addressed,” he said.

Mr Aina said that among the union’s key demands is the implementation of the new minimum wage for nurses and other staff at LAUTECH Teaching Hospital, Ogbomosho.

He added that the union was also calling for the payment of uniform allowances to all nurses and midwives in the service of Oyo State, in accordance with public service rules.

Other key demands include: Mass recruitment of nurses and midwives into the Hospital Management Board and LAUTECH Teaching Hospital to address severe staffing shortages.

Also, implementation of a 25 per cent CONHESS adjustment circular for nurses and midwives in Oyo State service and implementation of enhanced hazard allowances for those working at the local government level.

Mr Aina emphasised that the strike aimed to draw attention to the urgent need for improved welfare and working conditions for nurses and midwives across the state.

Premium Times

Video - Soaring healthcare costs push Nigerians to traditional medicine

Skyrocketing medical costs are driving patients toward traditional practitioners who offer low-cost alternatives to modern medicine.

CGTN Africa

Over 43m risk river blindness as Nigeria moves toward elimination target

Despite significant progress in eliminating river blindness, also known as onchocerciasis, over 40 million Nigerians remain at risk.

This is as the federal government, in collaboration with the Nigerian Institute of Medical Research, NIMR, yesterday confirmed that transmission of the disease had been interrupted in at least 10 states, including Kaduna, Nasarawa, Anambra and Abia.

Speaking at NIMR’s monthly media chat in Lagos, the Director of Research at NIMR and a leading public health parasitologist, Dr. Babatunde Adewale, stated that children under 10 were now being targeted for blood sampling in endemic communities where treatment had been ongoing for more than a decade.

If these children test negative, it is an indication that transmission has stopped.

Onchocerciasis, transmitted by blackflies, is a major cause of preventable blindness in sub-Saharan Africa.

Nigeria began using Ivermectin through mass drug administration, MDA, in the 1990s to control the disease.

However, due to its effectiveness and growing scientific evidence from countries such as Nigeria, Mali, and Senegal, global focus had shifted from control to total elimination.

“We are no longer just controlling the disease, elimination is now within reach. By 2030, we hope Nigeria will be declared free of onchocerciasis,” Adewale said.

He noted that over 37 million Nigerians had received treatment, adding that using Ov-16 antigen tests on samples collected must show positivity rates below 0.1 per cent to confirm transmission interruption.

NIMR also contributes to public health education and ethics, focusing on neglected tropical diseases that impact rural communities, which are key to Nigeria’s food security.

“These communities are the backbone of our food system,” Adewale said, emphasising that their health must not be overlooked.

He recalled that Nigeria’s success did not happen overnight, stressing that it followed decades of mass campaigns, supported by the World Health Organization, WHO, the federal ministry of health, and other partners, using community-directed treatment with Ivermectin, CDTI. This approach empowers locals to lead the fight by administering the drug themselves.

Onchocerciasis is caused by the Onchocerca volvulus parasite and is the world’s second leading cause of infectious blindness. Nigeria has adopted a phased strategy toward elimination: Phase one is the interruption of transmission; phase two involves post-treatment surveillance for 3–5 years; and phase three, verification by WHO experts.

Challenges remain, particularly insecurity in parts of the country that limit access to some communities. Only Lagos and Rivers States remain officially non-endemic.

Whie expressing optimism about its elimination, Adewale said: “We are doing better than many other African countries. Only Niger has been validated for elimination, and Nigeria is much larger.”

NIMR’s Senior Research Fellow Dr. Kazeem Osuolale, called for stronger community engagement and economic empowerment to improve health outcomes.

“Health interventions must be people-centered,” he said, noting that financially empowered individuals were more likely to comply with treatment.

Also speaking, Mr. Adeniyi Adeneye, a Research Fellow at NIMR’s Department of Public Health and Epidemiology, stressed the importance of health literacy.

He said: “Without public understanding of disease causes and prevention, even the most expensive innovations may fail.’’

By Chioma Obinna, Vanguard

Going door to door to beat diphtheria in Nigeria

On a hot Saturday afternoon in May, Maryam Umar left her small drug store in Bosso Low-Cost, a locality in Nigeria’s Niger state, and headed out into the community. “Visiting [homes] to create awareness of diphtheria disease and to vaccinate children is part of my duty,” she explained.

Umar pushed open a small red gate and was greeted by familiar faces. “They are children I have administered vaccines to,” she said. A few steps on, Umar called out their mothers, requesting the children’s immunisation cards. After reviewing the cards, Umar explained to the mothers the ways diphtheria could sicken their children, and the dangers of not taking the vaccine.

Diphtheria is caused by a bacterium called Corynebacterium diphtheriae, which targets the mucous membranes of the nose, throat and, sometimes, the skin. The disease spreads through infected respiratory droplets, physical contact with an infected individual, or contaminated objects, explained Iyare Osarhiemen, public health physician at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. It’s frequently deadly: even with medical care, one in ten people with respiratory diphtheria is expected to die. Without intervention, as many as half succumb.

But the infection is preventable through vaccination, and the vaccine is available publicly through Nigeria’s routine immunisation programme. While the country has made gains on basic vaccination coverage over the years, movement restrictions and lockdowns during the COVID-19 pandemic, which made it difficult for health workers to reach people, especially those in far-flung communities with vaccines, caused significant and dangerous declines in vaccination rates. Nationwide coverage with the basic diphtheria, tetanus and pertussis-containing vaccine (DTP) dipped from 66% in 2019 to 62% in 2020, at which level it remains.

In pockets of the country, protection levels are far lower still, raising the risk of disease spread. In Niger State, just 43.8% of children had received the necessary three doses of the diphtheria vaccine when the 2023–2024 Nigeria Demographic and Health Survey was conducted, meaning the northern state significantly lagged the national average.

Not coincidentally, over the past three years, Nigeria has been battling its worst diphtheria outbreak in decades. The epidemic, which began in May 2022 and peaked in 2023, had sickened a suspected 44,000 people and caused 1,376 deaths by May 2025. Eleven of those suspected cases occurred in Niger State.

News of those suspected cases prompted quick action in her area, Umar said. “We enlightened [the people] on preventive measures and also [encouraged] them to come for preventive care. The reason for this is to ensure that the rate at which people are infected is reduced,” she added.

To many health workers and parents, diphtheria had become an unfamiliar threat. Between 2003 and 2017, Nigeria recorded no cases of the disease at all, according to World Health Organization data. But decades of suboptimal vaccination coverage, followed by increased vulnerability after COVID-19, meant large populations of susceptible children had accumulated in many places. All that was needed for a major outbreak to begin was a spark: a single infection reaching a group of unimmunised children would set off a wildfire chain-reaction.

One household at a time

The fire is still smouldering, so in communities across the country, including Bosso Low-Cost, health workers like Umar are defending against renewed spread of the disease by redoubling their vaccination efforts. A lot of that has to do with simply making it easier for parents to stay on track.

Every Monday and Thursday, Umar provides routine immunisation services at Bosso Low-Cost Primary Healthcare Centre, where she is based as a community health worker. During the immunisation session, the health facility collects mothers’ information such as name, phone number, and address, principally to help them stay on track with their children’s vaccines. But even with reminders, some families still fall off schedule. Protection against diphtheria requires a full primary series of the vaccine – three doses, spaced weeks apart – so falling off schedule can spell mortal danger.

To get as many children as possible protected, Umar and her colleagues now take vaccines closer to people in their communities every week during outreach, going house-to-house with their vaccine boxes.

Umar said her team visits a minimum of five households at every outreach and in a week, they vaccinate at least 20 children at home. Two-year-old Suleiman Jibrin is one of the children Umar vaccinated. Namana Umar, his mother, says she feels happy knowing her only child has received all three vaccine doses.

“When I see my boy, I feel happy because my child is fully vaccinated. He has been healthy since he took the vaccines [and] I am satisfied,” she said. “This vaccine is for his health so that he can be protected from diphtheria and other diseases.”

Like Jibril’s mother, Happy Nambala, who just had her seven-month-old child vaccinated, said she was confident that vaccines contribute significantly to a child’s health. “Vaccines build children’s immune system; I have never doubted this,” said Nambala, who has had her three children fully vaccinated. “I take health information during outreach very seriously because it has to do with the health of my children.”

Tackling hesitancy

But pockets of resistance to vaccination – often traceable to circulating rumours or traditional beliefs about health – remain, and in those places, efforts to boost vaccination coverage can prove frustrating.

Community health worker Karima Muhammad blames this attitude on lack of awareness and explains that in an effort to tackle that, Niger state outreach workers have made a policy of always showing mothers visual resources, like posters, during visits, to more clearly explain how the disease manifests and how the vaccines work.

“We explain the signs and symptoms to them and we tell them it’s not a spiritual problem,” Hajiya Rabi Yusuf, the director of primary healthcare in Niger State’s Chanchaga local government area, told VaccinesWork. “We explain in their local dialect.”

And in cases where mothers still aren’t convinced, Yusuf said they deploy a “rapid response team”, which might include the local imam, pastor, youth leader, ward health development committee, women leader, security agent and health worker.

“If we have such non-compliance, we go in a team to speak with the person,” she said. “This strategy has helped to deal with diphtheria cases.”

Osarhiemen, the public health physician, adds that besides poor compliance with routine immunisation, the insecurity in the north is also limiting vaccination efforts.

Luckily enough for the families of Bosso, they have Umar, who has taken community engagement and vaccination as a personal, as well as professional, mission. Her reason is simple: “I feel bad when there is mortality due to some [preventable] diseases like diphtheria,” she said.

By Ekpali Saint, VaccinesWork

Video - Nigeria steps up malaria battle with local solutions after U.S. aid cuts

Nigeria is under pressure to enhance its malaria response after reductions in U.S. aid. The country records approximately 55 million malaria cases annually, resulting in around 90,000 deaths. Officials have pledged $200 million and are promoting homegrown health solutions.

CGTN

One death every seven minutes: Nigeria is world's worst country to give birth

At the age of 24, Nafisa Salahu was in danger of becoming just another statistic in Nigeria, where a woman dies giving birth every seven minutes, on average.

Going into labour during a doctors' strike meant that, despite being in hospital, there was no expert help on hand once a complication emerged.

Her baby's head was stuck and she was just told to lie still during labour, which lasted three days.

Eventually a Caesarean was recommended and a doctor was located who was prepared to carry it out.

"I thanked God because I was almost dying. I had no strength left, I had nothing left," Ms Salahu tells the BBC from Kano state in the north of the country.

She survived, but tragically her baby died.

Eleven years on, she has gone back to hospital to give birth several times and takes a fatalistic attitude. "I knew [each time] I was between life and death but I was no longer afraid," she says.

Ms Salahu's experience is not unusual.

Nigeria is the world's most dangerous nation in which to give birth.

According to the most recent UN estimates for the country, compiled from 2023 figures, one in 100 women die in labour or in the following days.

That puts it at the top of a league table no country wants to head.

In 2023, Nigeria accounted for well over a quarter - 29% - of all maternal deaths worldwide.

That is an estimated total of 75,000 women dying in childbirth in a year, which works out at one death every seven minutes.

The frustration for many is that a large number of the deaths – from things like bleeding after childbirth (known as postpartum haemorrhage) – are preventable.

Chinenye Nweze was 36 when she bled to death at a hospital in the south-eastern town of Onitsha five years ago.

"The doctors needed blood," her brother Henry Edeh remembers. "The blood they had wasn't enough and they were running around. Losing my sister and my friend is nothing I would wish on an enemy. The pain is unbearable."

Among the other common causes of maternal deaths are obstructed labour, high blood pressure and unsafe abortions.

Nigeria's "very high" maternal mortality rate is the result of a combination of a number of factors, according to Martin Dohlsten from the Nigeria office of the UN's children's organisation, Unicef.

Among them, he says, are poor health infrastructure, a shortage of medics, costly treatments that many cannot afford, cultural practices that can lead to some distrusting medical professionals and insecurity.

"No woman deserves to die while birthing a child," says Mabel Onwuemena, national co-ordinator of the Women of Purpose Development Foundation.

She explains that some women, especially in rural areas, believe "that visiting hospitals is a total waste of time" and choose "traditional remedies instead of seeking medical help, which can delay life-saving care".

For some, reaching a hospital or clinic is near-impossible because of a lack of transport, but Ms Onwuemena believes that even if they managed to, their problems would not be over.

"Many healthcare facilities lack the basic equipment, supplies and trained personnel, making it difficult to provide a quality service."

Nigeria's federal government currently spends only 5% of its budget on health – well short of the 15% target that the country committed to in a 2001 African Union treaty.

In 2021, there were 121,000 midwives for a population of 218 million and less than half of all births were overseen by a skilled health worker. It is estimated that the country needs 700,000 more nurses and midwives to meet the World Health Organization's recommended ratio.

There is also a severe lack of doctors.

The shortage of staff and facilities puts some off seeking professional help.

"I honestly don't trust hospitals much, there are too many stories of negligence, especially in public hospitals," Jamila Ishaq says.

"For example, when I was having my fourth child, there were complications during labour. The local birth attendant advised us to go to the hospital, but when we got there, no healthcare worker was available to help me. I had to go back home, and that's where I eventually gave birth," she explains.

The 28-year-old from Kano state is now expecting her fifth baby.

She adds that she would consider going to a private clinic but the cost is prohibitive.

Chinwendu Obiejesi, who is expecting her third child, is able to pay for private health care at a hospital and "wouldn't consider giving birth anywhere else".

She says that among her friends and family, maternal deaths are now rare, whereas she used to hear about them quite frequently.

She lives in a wealthy suburb of Abuja, where hospitals are easier to reach, roads are better, and emergency services work. More women in the city are also educated and know the importance of going to the hospital.

"I always attend antenatal care… It allows me to speak with doctors regularly, do important tests and scans, and keep track of both my health and the baby's," Ms Obiejesi tells the BBC.

"For instance, during my second pregnancy, they expected I might bleed heavily, so they prepared extra blood in case a transfusion was needed. Thankfully, I didn't need it, and everything went well."

However, a family friend of hers was not so lucky.

During her second labour, "the birth attendant couldn't deliver the baby and tried to force it out. The baby died. By the time she was rushed to the hospital, it was too late. She still had to undergo surgery to deliver the baby's body. It was heart-breaking."

Dr Nana Sandah-Abubakar, director of community health services at the country's National Primary Health Care Development Agency (NPHCDA), acknowledges that the situation is dire, but says a new plan is being put in place to address some of the issues.

Last November, the Nigerian government launched the pilot phase of the Maternal Mortality Reduction Innovation Initiative (Mamii). Eventually this will target 172 local government areas across 33 states, which account for more than half of all childbirth-related deaths in the country.

"We identify each pregnant woman, know where she lives, and support her through pregnancy, childbirth and beyond," Dr Sandah-Abubakar says.

So far, 400,000 pregnant women in six states have been found in a house-to-house survey, "with details of whether they are attending ante-natal [classes] or not".

"The plan is to start to link them to services to ensure that they get the care [they need] and that they deliver safely."

Mamii will aim to work with local transport networks to try and get more women to clinics and also encourage people to sign up to low-cost public health insurance.

It is too early to say whether this has had any impact, but the authorities hope that the country can eventually follow the trend of the rest of the world.

Globally, maternal deaths have dropped by 40% since 2000, thanks to expanded access to healthcare. The numbers have also improved in Nigeria over the same period - but only by 13%.

Despite Mamii, and other programmes, being welcome initiatives, some experts believe more must be done – including greater investment.

"Their success depends on sustained funding, effective implementation and continuous monitoring to ensure that the intended outcomes are achieved," says Unicef's Mr Dohlsten.

In the meantime, the loss of each mother in Nigeria - 200 every day - will continue to be a tragedy for the families involved.

For Mr Edeh, the grief over the loss of his sister is still raw.

"She stepped up to become our anchor and backbone because we lost our parents when we were growing up," he says.

"In my lone time, when she crosses my mind. I cry bitterly."

By Makuochi Okafor, BBC

‘Difficult choices’: aid cuts threaten effort to reduce maternal deaths in Nigeria

At a UN-run antenatal clinic in a camp for people displaced by Boko Haram, the colours stand out like the bellies of the pregnant women. Abayas in neon green, dark brown and shades of yellow graze against the purple and white uniforms of nurses attending to them in the beige-orange halls of the maternal healthcare facility.

Within the clinic in Maiduguri in north-east Nigeria, midwives and nurses are handing out free emergency home delivery kits, “dignity kits” for sexual abuse survivors and reusable sanitary pads to curb exploitation of young girls who cannot afford them.

A dozen women sit on a mat in the corridor, awaiting the start of a session on reproductive health and doing their best to stay focused in the unwavering 42C heat. Among them is Yangana Mohammed, a smiling 32-year-old mother of seven who knits bama caps for a living.

“I like that the services are free,” she said, holding a yellow medical card while waiting to change her birth control implant. “I’m really glad for this clinic.”

Five years ago, when Mohammed fled jihadist violence in her home town of Gom, she had never heard of family planning. In Muna, a settlement with a couple of thousand residents, down from more than 17,000 at the peak of the insurgency, she found the clinic. It was suggested by her husband, a volunteer for the local vigilante group backed by the state in fighting jihadists, after her last delivery two years ago.

A kilometre away, Aisha, a 25-year-old mother of two, waits her turn at a state-run facility supported by Unicef. Her husband previously barred her from attending antenatal classes, worried that discussing an unborn child with outsiders could harm the foetus. But after losing so much blood in her last pregnancy that five bags had to be transfused into her veins, he quickly changed his mind.

Experts say more resources are needed to sustain such success stories in a region struggling with high maternal mortality, child marriage and female genital mutilation rates. UN global data for 2023, the most recent available, shows that Nigeria recorded 75,000 maternal deaths that year – nearly a third of the total worldwide.

Many of those cases are among north-east Nigeria’s estimated 45 million people. Ritgak Tilley-Gyado, an Abuja-based senior health specialist at the World Bank, said disparities were fuelled by inequities in health systems and socioeconomic and sociocultural status across the country.

“As a result, a woman in the north-east of the country is 10 times more likely to die from childbirth than her counterpart in the south-west … [with] a systems approach that tugs on the right levers, we can turn these abysmal numbers around and improve the wellbeing of mothers,” she said.

The rampant acute malnutrition in the region has worsened things, said Trond Jensen, the head of the UN Office for Coordination of Humanitarian Affairs (Ocha) in Maiduguri.

“At many of [our] stabilisation centres for severely acute malnourished children, the mothers are very young … the risk of maternal mortality increases when you start having children very young and you have inadequate birth spacing, which then leads to complications,” he said.

Across the region, basic infrastructure has been strained or destroyed by a 15-year insurgency spearheaded by Boko Haram and its splinter group Islamic State West Africa Province (ISWAP).

Meanwhile, Nigeria’s federal health budget can hardly match the scale of assistance needed: USAID contributions surpassed Nigeria’s federal allocations for health between 2022 and 2024. In many remote areas cut off by jihadist violence, there is little or no access to health services, forcing nonprofits to sometimes use helicopters to deliver emergency relief.

Aid workers are scrambling to deliver more successes with fewer resources.

For 2024, the UN’s humanitarian response plan of $927m was only half funded. There are fears about bigger funding gaps for this year’s plan since the dismantling of USAID, which paid for 60% of all humanitarian programmes in north-east Nigeria last year. Other donors including the UK, Germany and the Netherlands have also cut down their aid packages or are planning to, in the biggest reshaping of foreign aid in recent history.

“Unfortunately … that has meant that, for instance, 70% of health facilities that we are providing assistance through have been impacted,” said Jensen.

Some providers of humanitarian services are in a state of near panic about the approaching lean season – the period between harvests – which is usually from June to September.

“We have just short of 5 million people who are in need of food assistance … I think the latest estimate is that 23,000 children will be at risk of dying this lean season,” said Jensen, whose agency has begun rigorous cost-cutting and is asking donors to “fund our local partners directly, because that reduces transaction costs”.

“We have to make extremely difficult choices,” he said.

At the clinic, Mohammed has no idea of the behind-the-scenes struggle to keep the free services in place.

“From the knowledge the women here teach me, I pass on [advice about puberty and personal hygiene] to Hafsa, my 16-year-old daughter, who is like my friend,” says Mohammed, who hopes the clinic is around long enough for her daughter to use it.

By Eromo Egbejule, The Guardian

Nigeria's multi-pronged malaria elimination approach gains momentum

Yenagoa, Four months ago, town criers and media in Bayelsa State, notified caregivers of the launch of the malaria vaccination campaign for children under 5-11 months.

The Ministry of Health's message through the Nigeria Primary Health Care Centre, World Health Organization (WHO), Gavi the Vaccine Alliance, UNICEF, and partners was clear: families with eligible children should take their young ones to health centres to bevaccinated against the deadly disease, malaria.

Sherifat Omoniyi, a mother of two, was thrilled that one of her children was eligible. She shared, “When I heard the news, I took my nine-month-old son to the clinic for the vaccine. Since he received it, he hasn't been sick. "

Mrs Omoniyi explained that despite her child receiving the vaccine, she ensures that her household still takes precautionary measures to keep malaria at bay because, during the campaign, the informants reiterated that even with the vaccine, the entire household still needs to ensure the use of other preventive measures to keep malaria at bay.

She said, “We still sleep under the insecticide-treated nets, and ensure we don’t leave our water storage places open. This has significantly reduced the frequency at which my household comes down with fever. We now spend less on malaria treatment”

A matter of urgency

 
Nigeria still faces a concerning malaria burden. Statistics from the 2024 World Malaria Report (WMR) reveal that the country accounts for 27% of the global malaria burden, with 31% of global malaria deaths.

The WHO Global Technical Strategy for Malaria 2016-2030 sets a vision for a malaria-free world by 2030, with specific targets for reducing malaria incidence and mortality and eliminating the disease in at least 35 countries.

The Nigerian government has implemented various strategies such promotion of ongoing use of insecticide-treated nets, seasonal malaria chemoprevention therapy for children under five, preventive care for pregnant women, indoor residual spraying, effective case management, and improved sanitation to reduce mosquito breeding sites in the communities.

Recently, the country commenced a phased rollout of the WHO-recommended (R21) malaria vaccine, targeting children in areas with the highest malaria burden—Bayelsa and Kebbi—to accelerate efforts to reduce malaria among children. More than 140,000 doses have been administered to eligible children from one million doses received from the Nigerian Government and Gavi.

Collective action

Recently, during the commemoration of 2025 World Malaria Day, the Minister of State for Health and Social Welfare, Dr. Iziaq Adekunle Salako, addressed journalists and malaria stakeholders, stating that eliminating malaria is a top government priority, strongly supported by President Tinubu.

Dr Salako appreciated health workers and partners and stressed that achieving a malaria-free Nigeria requires ongoing, united action including tailored actions such as treated nets, preventative medicines for children, larval management, and a phased rollout of the malaria vaccine.

“The government ensures consistent malaria treatment, addresses funding challenges, enhances health systems with improved data, collaborates with the private sector for resources, and encourages preventative measures,” he added.
The minister further encouraged all stakeholders to stay committed to fighting malaria, noting that it requires multisectoral, multi-ministerial, inter-organisational, and community effort.

Pathway to success

With the innovative strategies adopted, the country is on the pathway to eradicating malaria by 2030, said Dr Walter Kazadi Mulombo, WHO Country Representative in Nigeria.

Dr Mulombo noted that the 20225 World Malaria Day, observed under the theme “Malaria Ends with Us: Reinvest, Reimagine, Reignite”, is a rallying revitalised efforts at all levels, from global policy to community action, to renew commitment, rethink strategies and accelerate progress towards malaria elimination.

“This year’s theme reminds us that everyone has a role to play. Reducing malaria by 90% by 2030 could boost the country’s GDP.

However, we are at a crossroads. Climate change, humanitarian crises, resistance to drugs and insecticides, and funding gaps are challenging our gains. But malaria elimination is within reach with strong leadership, innovation, and sustained investment,” he said.

WHO

Related story: Flying Malaria Vaccines Arrive in Nigeria

Restoring trust in Polio Vaccination in Nigeria

Kebbi, April 2025 – In the modest community of Kambaza in Nigeria’s northwestern State of Kebbi, Malan Attahiru Aliyu was once a strong supporter of immunisation.

He actively ensured his children received all routine vaccines and participated fully in every polio vaccination campaign. His trust in the health system stayed resolute right until 2022, when his family for some odd reason was not given treated mosquito nets that help prevent malaria.

That single moment of exclusion planted a deep resentment towards the system. He felt that certain Gwandu Local Government Area (district) officials had deliberately avoided giving him treated mosquito nets that were meant for him and his family.

Feeling abandoned and unvalued, Malan’s frustration turned into a firm decision. He would no longer allow any of his children to receive the Oral Polio Vaccine (OPV), which prevents the highly contagious, crippling, and potentially killer polio disease.

What began as disappointment quietly escalated into dangerous resistance.

The consequences came swiftly and painfully. In December 2023, Malan’s youngest daughter, Maryam, just two years old, contracted a variant form of poliovirus. The diagnosis shook the community, but Malan remained resistant to logic. He stood firm in his decision to reject immunisation for his children. His household became a high-risk pocket of transmission, given that the poliovirus spreads through the oral-fecal route and the household was in neighbourhood with poor sanitation facilities.

Malan became a symbol of how vaccine refusal can threaten entire communities and put the lives of children at risk. Moreover, his refusal was seen across the state, and indeed nationally, as a threat to the Global Polio Eradication Initiative (GEPI).

Launched with the coming together of Heads of State of all United Nations member states in 1988, the Initiative has been working with Governments, partners, and the people themselves to successfully reduce the incidence of polio cases across the globe by 99.9 percent.

Between 1988 and 2021, the Initiative has helped prevent 24 million cases of childhood paralysis due to the poliovirus by vaccinating millions of children with the easy-to-administer Oral Polio Vaccine (OPV). But given how contagious the virus is, even one incidence of polio-affected children anywhere in the world is a danger everywhere.

Malan’s refusal was seen as a major challenge for the State of Kebbi and, indeed, for the whole of Nigeria.

Scores of influential persons visited Malan at this residence to placate him. Prominent personalities, including traditional leaders, tried to convince him to allow his children to take the OPV. Despite all efforts, he barely agreed to allow his youngest polio-affected daughter to take the vaccine so that she would stop shedding the poliovirus through her stool. But for his other children, below the age of five, who were clearly carrying the virus even though not affected by it, he refused to submit to logic.

At one point, all officials had given up on convincing Malan. Instead, a new resolve was made to increase the vaccination dosage of all other children in the community as a booster, protecting them from the crippling virus which Malan’s children were carrying.

But where others might have walked away, Hauwa’u Ubale, a passionate and tireless Volunteer Community Mobilizer (VCM), leaned in. Hauwa’u was one of the over 18,000 VCMs that UNICEF has trained to interact with parents and caregivers of children below the age of five. She is tasked with convincing parents to allow their children to receive OPV during each polio vaccination round.

In a year when there is an active poliovirus outbreak, the number of rounds per year can go up to almost once every month because OPV can only be effective in producing immunity in a child against the poliovirus if it is given to 95 per cent of all children below the age of five in at least three consecutive polio vaccination rounds.

Understanding the complexity of Malan's emotions—hurt, mistrust, and fear—Hauwa'u approached him with empathy and persistence. She did not confront or build pressure. Instead, she listened. She gave space for his anger. And she responded with compassion, facts, and a firm belief that no child should suffer the consequences of misinformation or disillusionment.

With each visit, Hauwa'u gently challenged his beliefs, reminding him that while he could buy mosquito nets, he could not buy immunity from polio. Only vaccines could protect his children from paralysis. Her patience was unwavering, and her conviction unshakeable.

Over time, a breakthrough emerged. Malan saw in Hauwa'u not just a health worker but a voice of truth and a protector of children. He finally agreed to fully vaccinate his two children who were still under the age of five. But the transformation did not end there.

Malan went beyond and became an advocate. Deeply affected by Maryam's illness and moved by Hauwa'u's dedication, he now shares his family's experience as a powerful cautionary tale. He goes door to door in his community, speaking to other hesitant parents—not with blame, but with urgency and empathy: "Don't wait for a diagnosis like mine. Protect your child before it's too late."

Now, he is a public advocate and part of teams that speak individually to parents and caregivers who prevent their eligible children from taking the polio vaccine during campaigns.

Malan and Hauwa’u are the foot soldiers of the Initiative, which is a public-private partnership led by the national governments of all United Nations member states with countless national partners and six global agencies: the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF), Gates Foundation, and Gavi, the Vaccine Alliance.

Malan and Hauwa’u are local heroes, and thousands of community workers like them are empowering a social movement in Nigeria to root out all forms of poliovirus and help the world eradicate this punishing disease.

By Garba Haruna Wara and Priyanka Khanna, Unicef

Flying Malaria Vaccines Arrive in Nigeria

Over 20,000 children across the Federal Republic of Nigeria's Bayelsa state recently gained access to malaria vaccines, bypassing traditional distribution routes.

According to an article published by GAVI on April 22, 2025, approved malaria vaccines arrived by Zipline drone, an unmanned mini-plane carrying parachute-equipped cargo in its belly. This innovative technology can drop packages precisely over targeted facilities.

"So far, this initiative has helped to reach 20,000 people with the first dose of the malaria vaccine in the state," said Chinedu Amah, the Sales and Partnership Director for Zipline in Bayelsa state, in GAVI's article.

"Our drones can make the journey in as little as 45 minutes. So it's been a game-changer for the state in its health system, and we've shown a lot of value creation within the state using our drones," Amah added.

According to the World Health Organization (WHO), despite an annual expenditure of $4 billion, malaria deaths and cases have not shown substantial change over the last decade. According to WHO's latest malaria report, there were an estimated 263 million malaria cases and 597,000 related fatalities worldwide in 2023.

This data represents about 11 million more cases than in 2022.

The WHO African Region shoulders the heaviest burden of malaria outbreaks.

Dr Williams of the Bayelsa State Primary Health Care Board told VaccinesWork, "Our (Nigeria) distribution centre, serving hundreds of health facilities and community sites across a 38,000 square-kilometre radius, has drastically reduced stock-outs to below 1%. Deliveries now arrive within 15–45 minutes, regardless of weather or terrain, significantly improving coverage and timeliness."

As of April 23, 2025, the WHO recommends Mosquirix™ and R21 / Matrix-M™ vaccines to prevent this mosquito-transmitted disease for travelers visiting malaria-endemic countries. These malaria vaccines were added to the WHO's list of prequalified vaccines in 2024.

Currently, 17 African countries have introduced malaria vaccines through routine immunization targeting children.

Vax Before Travel

Nigeria still carries world’s highest malaria burden

Nigeria continues to lead the world in malaria cases and deaths, despite decades of global and domestic investments, according to the latest World Malaria Report 2024 released by the World Health Organization (WHO).

The report draws on 2023 data from 83 malaria-endemic countries, including the territory of French Guiana, while also presenting trends in malaria morbidity and mortality globally and by region.

The report, which highlighted the 2023 global malaria incidence, shows that Nigeria accounted for 26 per cent of global malaria cases, again making it the most malaria-affected nation worldwide.

Out of the estimated 263 million malaria cases recorded globally in 2023, Nigeria accounted for 68 million (68,136,000). DRC Congo followed suit with 33 million cases. Uganda had over 12 million people affected by the disease in 2023, while Ethiopia logged 9.5 million of the global reported cases of the disease.

This shows that the four countries are among the 11 ‘High Burden to High Impact (HBHI)’ countries, a group responsible for 66 per cent of global malaria cases and 68 per cent of deaths in 2023.

Others are Mozambique (9.2 million), United Republic of Tanzania (8.5 million), Angola (8.2 million), Mali (8.2 million), Burkina Faso (8.1 million), Niger (7.9 million), and Côte dʼIvoire (7.8 million).

Nigeria also ranked highest in malaria-related deaths, contributing significantly to the 597,000 global fatalities. The WHO African Region, which includes Nigeria, accounted for 94 per cent of the total global malaria burden and 95 per cent of deaths.

Four African countries accounted for just over half of all malaria deaths globally, with Nigeria having 30.9 per cent, and the Democratic Republic of the Congo having 11.3 per cent. Niger (5.9 per cent) and the United Republic of Tanzania (4.3 per cent) are the two other nations that accounted for 10 per cent of the cases.

While mortality from malaria has declined slightly over the past three years globally, from 622,000 in 2020 to 597,000 in 2023, according to the latest WHO report, Nigeria’s data remain high, especially among children under five and pregnant women.

According to WHO estimates, the country also recorded the largest number of under-five malaria deaths.

By Mustapha Usman, ICIR

Nigeria struggles to rein in a widespread meningitis outbreak that has killed at least 150

Nigerian health authorities are struggling to contain a rapidly spreading meningitis outbreak that has so far killed 151 people across the west African nation, mostly in remote parts of the northern region with children affected the most.

While cases first recorded in October have spread to 23 of Nigeria’s 36 states, nearly half of the deaths, 74, were reported this year, the Nigeria Center for Disease Control said this week, with local partners describing the recent rise in fatalities as “alarming.”

Most deaths from the disease have been mainly due to infected people not going to health facilities or arriving there late with severe complications, NCDC spokesperson Sani Datti told The Associated Press, a common problem in past outbreaks in the country.

The current outbreak has hit Africa’s most populous country as its health sector reels from U.S. aid cuts ordered by the Trump administration in February that have affected multiple countries. Nigeria relied heavily on such aid over the years to help fight similar outbreaks and support its underfunded healthcare systems.

Seasonal meningitis outbreaks are common during the dry season, especially in northern Nigeria. Almost all the worst-hit states are in the north, where health providers have warned the outbreak is rapidly spreading in hard-to-reach areas.

Meningitis, more common during the hot season in Nigeria, affects the protective membranes surrounding the brain and spinal cord. It’s a major public health challenge for a country already grappling with “the world’s highest burden of malaria,” according to the World Health Organization.

Last week, Nigeria received the first batch of more than 1 million vaccine doses from the global vaccine alliance Gavi, described by local officials as a crucial milestone in disease response.

The Nigeria CDC also said it is working with state authorities to scale up disease surveillance with a focus on tracking new cases, laboratory testing, and public sensitization campaigns to curb the outbreak.

Campaigns are also being rolled out, urging residents to take precautionary measures and seek immediate medical attention if they are experiencing symptoms such as high fever, stiff neck and severe headaches.

However, access to hospitals remains a huge problem, local partners say.

“We have seen hundreds of admissions and scores of deaths in just a few weeks. The high fatality rate is due to access (to) care, there are challenges with that and low vaccination coverage,” said Simba Tirima, Nigeria’s country representative for French medical charity Doctors Without Borders, or MSF.

Tirima told the AP that the most vulnerable are residents in remote areas who often arrive late to MSF facilities.

“We know that meningitis progresses rapidly, and patients' (conditions) can deteriorate in 24 hours,” he said, calling for mass vaccination campaigns.

By Dyepkazah Shibayan, AP

Related story: Meningitis outbreak kills 20 students in northern Nigeria

Video - Nigeria’s kidney crisis as experts push for reforms

Chronic kidney disease affects 15 percent of Nigeria's population, with an estimated 45,000 deaths annually due to kidney failure. A new subsidy has however cut dialysis costs by 80 percent in select hospitals.

CGTN

Skin-lightening creams in Nigeria: 'I scarred my six children'

 

At first it seemed to work. The grandmother warmed towards Fatima's children, who were aged between two and 16 at the time.

But then the burns and scars appeared.

Skin-whitening or lightening, also known as bleaching in Nigeria, is used in different parts of the world for cosmetic reasons, though these often have deep cultural roots.

Women in Nigeria use skin-whitening products more than in any other African country - 77% use them regularly, according to the UN World Health Organization (WHO).

In Congo-Brazzaville the figure is 66%, in Senegal 50% and in Ghana 39%.

The creams may contain corticosteroids or hydroquinone, which can be harmful if used in high quantities, and in many countries are only obtainable with a doctor's prescription.

Other ingredients sometimes used are the poisonous metal, mercury, and kojic acid - a by-product from the manufacture of the Japanese alcoholic drink, sake.

Dermatitis, acne and skin discolouration are possible consequences, but also inflammatory disorders, mercury poisoning and kidney damage.

The skin may become thinner, with the result that wounds take longer to heal, and are more likely to become infected, the WHO says.

The situation is so bad that Nigeria's National Agency for Food and Drug Administration and Control (Nafdac) declared a state of emergency in 2023.

It is also becoming more common for women to bleach their children, like Fatima did.

"A lot of people link light skin to beauty or wealth. Women tend to shield, as they call it, their children from that discrimination by bleaching them from childbirth," Zainab Bashir Yau, the owner of a dermatology spa in the capital, Abuja, tells the BBC.

She estimates that 80% of the women she has met have bleached their children, or plan to do so.

Some were bleached themselves as babies, she says, so are just continuing the practice.

One of the most common ways to tell whether someone is using skin-whitening products in Nigeria is by the darkness of their knuckles. Other parts of people's hands or feet get lighter, but knuckles tend to remain dark.

However, smokers and drug users also sometimes have dark patches on their hands, due to the smoke.

So users of skin-lightening products are sometimes mistakenly assumed to belong to this group.

Fatima says that is what happened to her daughters, aged 16 and 14.

"They faced discrimination from society - they all point fingers at them and call them drug addicts. This has affected them a lot," she says.

They have both lost potential fiancés because men do not want to be associated with women who might be thought to take drugs.

I visited a popular market in Kano, where people who call themselves "mixologists" create skin-whitening creams from scratch.

The market has a whole row of shops where thousands of these creams are sold.

Some pre-mixed varieties are arranged on shelves, but customers can also select raw ingredients and ask for the cream to be mixed in front of them.

I noticed that many bleaching creams, with labels saying they were for babies, contained regulated substances.

Other sellers admitted using regulated ingredients such as kojic acid, hydroquinone and a powerful antioxidant, glutathione, which may cause rashes and other side-effects.

I also witnessed teenage girls buying bleaching creams for themselves and in bulk so that they could sell them to their peers.

One woman, who had discoloured hands, insisted that a seller add a lightening agent to a cream that was being mixed for her children, even though it was a regulated substance for adults and illegal to use on children.

"Even though my hands are discoloured, I am here to buy creams for my kids so they can be light-skinned. I believe my hands are this way just because I used the wrong one. Nothing will happen to my children," she said.

One seller said most of his customers were buying creams to make their babies "glow", or to look "radiant and shiny".

Most seemed to be unaware of the approved dosages.

One salesman said he used "a lot of kojic" - well over the prescribed limit - if someone wanted light skin and a smaller quantity if they wanted a subtler change.

The approved dosage of kojic acid in creams in Nigeria is 1%, according to Nafdac.

I even saw salesmen giving women injections.

Dr Leonard Omokpariola, a director at Nafdac, says attempts are being made to educate people about the risks.

He also says markets are being raided, and there are efforts to seize skin-lightening ingredients at Nigeria's borders as they are brought into the country.

But he says it was sometimes hard for law-enforcement officials to identify these substances.

"Some of them are just being transported in unlabelled containers, so if you do not take them to the labs for evaluation, you can't tell what is inside."

Fatima says her actions will haunt her forever, especially if her children's scars do not fade.

"When I confided in my mum about what I did, due to her behaviour, and when she heard the dangers of the cream and what stigma her grandchildren are facing, she was sad that they had to go through that and apologised," she says.

Fatima is determined to help other parents avoid making the same mistake.

"Even though I have stopped... the side-effects are still here, I beg other parents to use my situation as an example."

By Madina Maishanu, BBC

Video - Nigeria raises health worker retirement age to 65 amid exodus of staff abroad

The West African nation has increased the retirement age for healthcare workers to 65, with consultants now able to work until 70. This decision aims to address the growing shortage of healthcare professionals, driven in part by the mass exodus of staff seeking opportunities abroad.

CGTN

Video - Nigeria acts on HIV/AIDS funding as U.S aid halts

Following a sudden pause in U.S. HIV/AIDS aid, Nigeria has allocated 3 million U.S. dollars in emergency funds and set up a committee for long-term domestic funding. Some experts say this kind of move is overdue.

CGTN

Free emergency C-sections lifeline for Nigerian mothers

The Federal Government’s initiative to offer free emergency Cesarean sections (C-section or CS) for poor and vulnerable women in Nigeria who require it is a laudable move to address the nation’s high maternal mortality ratio due to pregnancy-related causes.

Nigeria currently has the fourth-highest maternal mortality rate globally, with a staggering 1,047 maternal deaths per 100,000 live births. This is a figure that is higher than the regional average, putting Nigeria in the category of countries with extremely high maternal mortality rates.

The Coordinating Minister of Health and Social Welfare, Professor Mohammadu Ali Pate, announced this in Abuja during the formal launch of the Maternal Mortality Reduction Innovation and Initiatives, MAMII, project. The initiative aims to alleviate the financial burden associated with C-sections and reduce the high number of maternal deaths in the country.

An emergency C-section is a surgical procedure that is utilised to deliver a baby through incisions in the mother’s abdomen and uterus when there are complications that put the health of the mother or baby at risk. It is generally more expensive than the natural birthing process due to the involvement of major surgery and a longer hospital stay. Surgical procedures require specialised equipment, an operating room, and additional medical personnel, all of which increase the overall cost.

Access is generally limited by high cost, hence most women who require this critical lifesaving procedure either cannot afford it or have to pay a huge sum out of pocket.

In a typical government hospital, a basic C-section can cost between N200,000 and N500,000, although complications and additional care can push the cost up to N1,000,000 or more. In a private hospital, the cost of the same procedure can range from N1,000,000 to N3,000,000, depending on the complexity and additional postnatal requirements.

For many pregnant women, a C-section is a lifesaving procedure, even if it comes with significant financial implications such as additional care, and extended hospital stays, that can push the cost even higher.

Based on the premise that no woman in Nigeria should lose her life simply because she can’t afford a C-section, the new policy has received wide praise essentially because it would remove financial barriers to the life-saving surgical procedure and afford more women access to the much sought-after critical care.

The success of this initiative hinges on its effective implementation and assurance that the women who are eligible are afforded prompt access.

Since only women in public hospitals registered under the National Health Insurance Scheme, NHIS, are eligible, it becomes expedient that the coverage of the NHIS must be extended to more women, particularly in the informal sector.

Long-term sustainability requires a comprehensive approach that addresses the root causes of maternal mortality. This includes prioritising investment in maternal healthcare education, improving healthcare facilities, and increasing the number of skilled healthcare providers.

To avoid running into stormy waters, the broader healthcare challenges that would ensure the initiative’s effective implementation and lasting positive outcomes must be adequately addressed to guarantee the initiative’s sustainability. The Federal government must implement robust strategies to mitigate these requirements and ensure that the successful implementation of the free emergency C-section initiative is a task that must be done.

Vanguard

A mother's mission to help Nigerians with cerebral palsy

Although Babatunde Fashola, affectionately known as Baba, is 22 years old, he is less than 70cm (2ft 4in) tall.

He has cerebral palsy and requires lifelong care. He can neither speak nor walk and is fed via a tube attached to his stomach.

As a baby, he was abandoned by his parents but 10 years ago, he found a home at the Cerebral Palsy Centre in the Nigerian city of Lagos.

"Baba weighs about 12kg [26lb]. He is doing well," the facility's founder, Nonye Nweke, tells me when I visit.

Ms Nweke and her staff work around the clock to support him and other youngsters living with permanent brain damage.

Although there is a lack of official data, cerebral palsy is believed to be one of the most common neurological disorders in Nigeria. In 2017, a medical professor from the University of Lagos said 700,000 people had the condition.

For many of those living with cerebral palsy in the country, their condition was caused by a common phenomenon among newborns - neonatal jaundice.

This is caused by a build-up of bilirubin, a yellow substance, in the blood, meaning the babies' skins have a yellow tinge.

Professor Chinyere Ezeaka, a paediatrician at the Lagos University Teaching Hospital, tells the BBC that more than 60% of all babies suffer from jaundice.

Most babies recover within days. More severe cases need further medical intervention - and even then the condition is easily treatable.

Children are basically exposed to ultra-violet light to dissolve the excess bilirubin in their red blood cells. The treatment lasts a few days depending on the severity.

However, in Nigeria this treatment is often not immediately available, which is why the country is among the five with the most neurological disorders caused by untreated jaundice in the world, according to data from the World Health Organization (WHO).

Any treatment for neonatal jaundice "must occur within the first 10 days of life, else [the condition] could cause permanent brain damage and severe cerebral palsy", says Prof Ezeaka.

To make matters worse, the West African country lacks facilities to care for those with neurological disorders. There are just three cerebral palsy centres, all privately run, in Nigeria, which has a population of more than 200 million.

Ms Nweke - a single mother - set up the Cerebral Palsy Centre after struggling to find support for her own daughter, Zimuzo.

"When I took her to a day-care [centre], they asked me to take her back because other mothers would withdraw their children. As a mum, I must say it was quite devastating," Ms Nweke tells the BBC.

Zimuzo is now 17, and Ms Nweke's Cerebral Palsy Centre provides full-time support for others with similar experiences.

On the day I visit, colourful playtime mats and toys are neatly arranged on the floor. Mickey Mouse and his friends converse on a wide-screen television in the lounge.

Twelve youngsters, some as young as five, gaze at the TV, their bright environment ignored for a moment. They are all immobile and non-speaking.

At lunchtime, caregivers help the youngsters eat. Some take in liquified food through tubes attached to their stomachs.

Carefully and slowly, the carers support their heads with pillows and push the contents of their syringes into the tubes.

The youngsters are fed every two hours and require regular muscular massages to prevent stiffness.

But they are the lucky 12 receiving free care from the Cerebral Palsy Centre, which is funded exclusively by donors.

The facility has a long waiting list - Ms Nweke has received more than 100 applications.

But taking on more youngsters would require extra financial support. The cost of caring for someone at the centre is at least $1,000 (£790) a month - a huge amount in a country where the national minimum wage is about $540 a year.

"As a mum, I must say it's quite overwhelming. You have moments of depression, it gives you heartaches and it is quite expensive - in fact it's the most expensive congenital disorder to manage," Ms Nweke says.

"And then of course, it keeps you away from people because you don't discuss the same things. They are talking of their babies, walking, enjoying those baby moments. You are not doing that. You are sad," she adds.

Ms Nweke explains that she adopted Zimuzo from an orphanage.

A few months after taking her new daughter home, Ms Nweke realised Zimuzo was not developing in the same way as the children around her were. She was assessed at a hospital and diagnosed with cerebral palsy.

Ms Nweke was told she could take Zimuzo, who was then just a few months old, back to the orphanage and adopt another baby instead, but she refused.

"I decided to keep her and I began researching what the disorder was about, the treatment and type of care my child would need - she's my life.

"I was also told by the doctors she won't live beyond two years. Well here we are - 17 years later," says a smiling Ms Nweke.

A lack of awareness and adequate medical support hinders the diagnosis and treatment of neonatal jaundice in Nigeria.

Ms Nweke also says the common local belief that children with congenital disorders are spiritually damaged or bewitched leads to stigmatisation.

Some children with neurological disorders - mostly in Nigeria's rural areas - are labelled witches. In some cases, they are abandoned in prayer houses or cast out of their families.

Ms Nweke is not alone in her mission to dispel myths and improve care.

The Oscar Project - a charity aimed at improving the diagnosis and treatment of neonatal jaundice - recently began operating in Lagos.

The project is named after Vietnamese-born British disability advocate, Oscar Anderson, whose untreated jaundice caused his cerebral palsy.

"We're equipping health facilities at the primary, secondary and tertiary levels with the equipment to treat jaundice, primarily light boxes, but also detection and screening equipment," Toyin Saraki, who oversaw the launch, tells the BBC.

Project Oscar, backed by consumer health firm Reckitt, is training 300 health workers in Lagos. The hope over the first year is to reach 10,000 mothers, screen 9,000 children and introduce new protocols to try and prevent babies with jaundice from developing cerebral palsy.

In a country where the public health system is overstretched, the government has little to say about the disorder, although it lauded the Oscar project's goals.

Treatment for neonatal jaundice is significantly cheaper than the cost of lifelong care, doctors say.

First launched in Vietnam in 2019, Project Oscar has helped about 150,000 children in the Asian country.

Mr Anderson, 22, says he wants to prevent other children experiencing what he has been through.

"People with disabilities are not to be underestimated," he tells the BBC.

He is working to ensure screening for every newborn infant for neonatal jaundice, and, with the support and courage of mums, midwives and medical professionals, ensure there is better understanding and quicker treatment.

However, achieving this is a hugely ambitious goal in Africa's most-populous country, where thousands of babies are born each year with neonatal jaundice.

Regardless, Mr Anderson is determined to defy the odds.

"The work doesn't stop until every baby is protected against neonatal jaundice," he says.

By Nkechi Ogbonna, BBC