Health
Faith leaders urged to confront beliefs, family decisions driving maternal deaths in Kano
For many women in Kano, the risks associated with childbirth begin long before labour.
Cultural beliefs, religious misconceptions, financial hardship, delayed antenatal care and reliance on traditional remedies can prevent pregnant women from reaching health facilities when they need care.
These barriers were highlighted at a two-day interfaith workshop in Kano, where religious leaders, health professionals, government officials and development partners examined how communities can help reduce maternal deaths.
The workshop, titled “Save Lives: An Interfaith Workshop on Reducing Maternal Mortality”, was organised under the Advocacy and Implementation of Maternal, Newborn, Child Nutrition and Health (AIM-MNCNH) project and held on Monday in Kano State.
Participants examined the “three delays” associated with maternal deaths and findings from community dialogues in Gaya Local Government Area of Kano State.
The discussions showed that access to care is often determined by more than the availability of health facilities. Decisions by husbands and older family members, transport difficulties and beliefs about childbirth can all determine whether a woman receives timely care.
‘People listen to religious leaders’
Speaking on the role of religious leaders, Adeniyi Ogunbanwo, Secretary of the Christian Association of Nigeria (CAN) in Kano State, said they could play a significant role because of the trust communities place in them.
Mr Ogunbanwo said churches could use sermons, weddings, naming ceremonies and other gatherings to educate families about maternal health.
“Religious leaders, in terms of being realistic, people listen to us. So, we have a lot to play, and mostly by speaking,” he said.
He said churches could also support women who struggle to pay medical bills, noting that some churches have maternity wards.
However, Mr Ogunbanwo warned that religious beliefs should not be used to discourage women from seeking professional medical care.
He said some women interpret biblical references to childbirth as meaning they should be able to deliver without medical assistance.
According to him, CAN had been engaging the Kano State Primary Healthcare Board and other government structures on maternal health and would develop a sermon guide for churches across the state.
Family decisions
Beyond religious teachings, the discussions also highlighted the influence of family members on women’s decisions about seeking care.
Speaking on the findings from community engagements, Maryam Danjuma, Community Engagement Officer with Pathfinder International, said many pregnant women were not the final decision-makers when it came to seeking antenatal or delivery care.
Ms Danjuma said women often depended on their husbands, while husbands could themselves be influenced by mothers-in-law and older women in their communities.
She said some older women who had delivered at home in the past sometimes considered women who preferred health facilities to be lazy.
Ms Danjuma recalled a case discussed during a town-hall meeting in which a woman died after her relatives opposed her husband’s decision to take her to a health facility.
She also recalled a contrasting case in which a husband insisted that his wife register for antenatal care despite her initial refusal.
Transport and harmful practices worsen delays
Speaking further on the barriers identified during the community dialogue, Ms Danjuma said distance and transportation costs compounded the problem, particularly for women living in remote communities.
She said some communities were far from health facilities and lacked affordable transport.
She also raised concerns about “ruwan naƙuda”, a substance some women take during labour, sometimes mixed with herbs or pills.
According to her, the practice is deeply rooted in some communities and can cause complications.
Ms Danjuma said the challenges require community actors to work together rather than treating religious leaders as the only solution.
She said Pathfinder was therefore engaging men, health workers, traditional birth attendants and other influential community members.
Speaking on the role of traditional birth attendants, she said they could be part of the solution by referring women to health facilities, particularly when complications arise.
She added that some community meetings were also held inside health facilities to familiarise women with the environment and address concerns about privacy and treatment.
JNI challenges misconceptions about hospital care
The need to address misconceptions about medical care was also emphasised by Muhammad Gwagwarwa, Chairman of Jama’atu Nasril Islam (JNI) in Kano State.
Mr Gwagwarwa said religious leaders had a responsibility to challenge beliefs that discourage women from seeking medical care.
He said the organisation was invited to bring Islamic scholars together to discuss ways of reducing maternal deaths during and after childbirth.
Speaking on the scale of the problem, Mr Gwagwarwa said the figure presented at the workshop showed Nigeria accounts for 27 per cent of global maternal deaths.
He said some families believe seeking hospital care is unnecessary because childbirth is ultimately determined by God.
However, he stressed that Islam encourages people to seek treatment from medical professionals.
“Islam has established that people should seek healthcare and go to those who are experts in the field of health.
“Therefore, staying at home, refusing to go to the hospital and relying on fate has also contributed to these deaths,” he added.
Mr Gwagwarwa also attributed some of the challenges to the decline in experienced traditional birth attendants, saying those who previously assisted women had acquired considerable knowledge through years of practice.
He said JNI would take maternal health messages beyond mosques to schools, marriage ceremonies, Qur’anic learning centres, Maulud gatherings and Islamiyyah schools.
Responsibility extends beyond families
While the discussions focused strongly on beliefs and family decisions, Habiba Mijin-Yawa, Ameera of the Federation of Muslim Women of Nigeria, Kano State chapter, said responsibility for reducing maternal deaths extends beyond families.
Ms Mijin-Yawa said families, communities, government and health facilities all had roles to play.
She identified beliefs, irresponsible husbands and women’s attitudes among the challenges.
However, she, said the government and health facilities must also address gaps that discourage women from seeking care.
“This is not only on the husband, but also the government and even the hospitals,” she said.
Pathfinder seeks measurable change
Speaking on the expected outcome of the workshop, Olufemi Ibitoye, Technical Adviser, MNCH at Pathfinder International, said the initiative was designed to move religious leaders beyond advocacy towards measurable action.
Mr Ibitoye said Kano was selected because of its high burden of maternal mortality, with religious leaders drawn from high-burden local government areas.
He said participants had developed action plans for taking maternal health messages into their communities.
“What we are doing here is actually to save lives, an interfaith workshop to reduce maternal mortality in Kano State,” he said.
The project is funded by the Gates Foundation through a consortium led by ACEPHAP, with Pathfinder International, CCSI and American Women’s Association of Nigeria as supporting partners.
Mr Ibitoye said a sermon guide had also been developed to help religious leaders address antenatal care, danger signs and skilled birth attendance.
According to him, the initiative will use existing structures to track whether the intervention is producing results.
He said health promotion and advocacy officers at the LGA level would work with religious and community leaders to monitor antenatal attendance, facility deliveries, complications and maternal deaths.
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A total of 10,494 Nigerians are listed among staff in the United Kingdom’s National Health Service (NHS), according to data shared by NHS Million, a UK campaign organisation focused on NHS staff.
Nigeria ranked sixth overall on the list, behind the UK/British, India, the Philippines, Ireland and Poland, making Nigeria the largest African nationality represented in the breakdown.
The data shared by NHS Million showed that more than 1.1 million NHS workers identified as British or UK nationals, while Indians accounted for 32,117 staff and Filipinos 25,423.
It also showed that Zimbabwe had the second-highest number of African nationals working in the NHS, with 4,780, followed by Ghana with 3,395, Egypt with 2,895 and South Africa with 1,829.
The figures highlight the significant contribution of Nigerian professionals to the UK health system, but also come amid persistent concerns over the shortage of health workers in the country.
Nigeria loses thousands of health workers
The 2025 State of Health of the Nation Report, released by the Federal Ministry of Health and Social Welfare, showed that over 20,000 Nigerian health workers relocated abroad within one year.
The figure included 3,919 doctors, 7,487 nurses and midwives, 6,861 medical laboratory professionals, 702 pharmacists, 658 physiotherapists and 274 dentists, among other health professionals. The report also showed that Nigeria has 95,456 registered doctors, but only 60,551 currently hold active practising licences.
The workforce shortage is further worsened by the uneven distribution of health professionals across the country, with several northern states recording particularly low doctor densities.
UK remains major destination
The United Kingdom is one of the major destinations for Nigerian health professionals.
Data from the UK’s General Medical Council showed that 4,691 Nigerian-trained doctors joined the UK medical register between May 2023 and April 2026, according to a Punch report.
The data also showed that 15,896 Nigerian-trained doctors were licensed to practise in the UK.
READ ALSO: PT Health Watch: How laboratory tests can help detect colorectal cancer early – Expert
The 2025 State of Health of the Nation Report identified external migration as one of the factors affecting the availability of health professionals in Nigeria.
Migration policy yet to be fully implemented
The federal government has introduced several measures aimed at increasing the health workforce and addressing migration.
Nigeria also approved a National Policy on Health Workforce Migration in August 2024, aimed at managing health worker migration, improving retention and strengthening workforce planning.
However, the 2025 State of Health of the Nation Report said that although the implementation plan had been finalised, full implementation had not commenced.
The report said an additional 23,000 frontline health workers were trained in 2025, bringing the number trained between 2024 and 2025 to 78,146, or about 65 per cent of the national target of 120,000.
The policy is intended to improve working conditions, support career progression and establish a more coordinated approach to health worker migration and retention.
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Colorectal cancer, which affects the colon and rectum, is one of the most common cancers globally, yet it can remain unnoticed for a long time because some people have no symptoms in the early stages.
The World Health Organisation (WHO) estimates that 1.9 million new cases of colorectal cancer and more than 900,000 deaths occurred globally in 2022.
The agency said symptoms, when they occur, may include blood in the stool, persistent changes in bowel habits, abdominal pain, unexplained weight loss and fatigue.
Because some people may not notice any warning signs, screening can provide an opportunity to identify possible abnormalities before the disease becomes advanced.
What happens before a diagnosis is confirmed?
Laboratory investigations are an important part of that process, as medical laboratory scientists examine samples that can provide clues about what is happening in a patient’s body.
Speaking with PT HEALTH WATCH, Adedoye David, a medical laboratory scientist, said laboratory testing contributes to the investigation of colorectal cancer through the examination of biological samples, including stool, blood and tissue.
One of the investigations is the Faecal Occult Blood Test (FOBT), which detects blood in stool that may not be visible to the naked eye.
Another is the Faecal Immunochemical Test (FIT), which uses antibodies to detect human haemoglobin in stool.
These tests can help identify people who may require further assessment, but Mr David stressed that detecting blood in stool is not the same as diagnosing cancer.
“Stool-based tests are very important for detecting hidden blood in stool. It could be reliable if the test investigation is carried out using the right and standard operating procedures.
“But as much as it can be reliable in detecting hidden blood, it might not be totally reliable in the diagnosis of colorectal cancer,”he said.
Where further investigation is necessary, Mr David said a patient may be referred for procedures such as colonoscopy, during which abnormal areas can be identified and tissue samples taken for laboratory examination.
A biopsy can then help determine whether the abnormal tissue is cancerous.
Why symptoms should not be ignored
The distinction between screening and diagnosis is important because colorectal cancer does not always announce itself with obvious symptoms.
A person who feels healthy may therefore not consider testing necessary, while another may receive a negative stool test and conclude that further medical attention is unnecessary.
Mr David said both assumptions could be misleading.
He urged people to seek medical advice when they experience persistent symptoms rather than waiting for them to become severe.
He also advised people with a family history of colorectal cancer or long-term inflammatory bowel disease to discuss their risk with healthcare professionals and determine whether they require earlier or more frequent screening.
WHO identifies family history of colorectal cancer and certain inflammatory bowel diseases among factors that can increase a person’s risk of developing the disease.
Although colorectal cancer is more common with increasing age, it is not exclusively a disease of older people. WHO has also reported a rising incidence among younger adults in several countries.
Screening is only useful when people can complete it
The challenge, however, is not simply persuading people to undergo screening. The health system must also be able to support them when a test produces an abnormal result.
Evidence from Nigeria illustrates this point.
A Nigerian community-based study involving more than 2,000 adults found that FIT screening was feasible. However, the researchers also highlighted challenges with follow-up colonoscopy after positive results.
This means that detecting a possible problem is only one part of the process. Patients must be able to access the additional investigations required to establish what the abnormal result means and, where necessary, begin treatment.
Mr David identified limited facilities capable of carrying out some key investigations and the cost of available services as major challenges facing colorectal cancer testing in Nigeria.
For people who may already be hesitant about testing, the cost and availability of diagnostic services can make early detection even more difficult.
READ ALSO: Hot tea, coffee linked to higher risk of oesophageal cancer — Study
Mr David also urged Nigerians to overcome the embarrassment that may come with providing stool samples for laboratory examination.
“There is nothing to be ashamed of producing a stool sample. It is just like any other medical sample and it is needed for us to carry out informed diagnosis,” he said.
Ultimately, a stool test is not a verdict on whether a person has cancer. Rather, it can be one step in a process that helps health professionals decide who may need further investigation.
For Mr David, improving colorectal cancer outcomes therefore requires both public awareness and access to appropriate laboratory and diagnostic services, so that people can seek help early and abnormal findings can be properly investigated.
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