ENSURING SAFE MOTHERHOOD IN CONFLICT: EVALUATING MATERNAL HEALTH INTERVENTIONS DURING THE BOKO HARAM CRISIS IN BORNO STATE, NIGERIA

Abstract

Pregnant women are disproportionately affected during insurgencies, experiencing
restricted access to maternal healthcare. This study examined how Boko Haram Insurgency (BHI)
constrained maternal healthcare utilisation and how women adapted to challenges in accessing
services in Borno State, Nigeria. Data collection involved administering questionnaires to women
of childbearing age in Dikwa, Gwoza, and Magumeri, as well as conducting interviews with
healthcare providers and community members. Pearson's correlation coefficient was used to
evaluate the relationship between health facility damage and maternal service utilisation. The
analysis revealed that most women were aged 32-49 years (30.6%), had 5-6 children (37.3%),
lacked formal education (36.7%), and were unemployed (60.7%). The insurgency impeded access
to maternal healthcare, with one-third of respondents not receiving adequate antenatal care due to
poor roads, distance, lack of spousal permission, and fear of being attacked. Skilled deliveries at
birth decreased to less than half. Non-governmental organisations were the primary providers of
maternal healthcare in the affected areas, offering antenatal, postnatal, and delivery services. In
conclusion, maternal healthcare utilisation was constrained, and essential services, such as
caesarean sections, were inaccessible due to limited medical equipment. This study recommends
funding rural healthcare facilities, training providers, implementing maternal healthcare services,
including antenatal, emergency obstetric, and postnatal care, and enhancing community outreach
programs to reduce maternal mortality in rural regions.