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Why pregnant women with previous CS shouldn’t use PHCs for antenatal care

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Maternal health experts have urged pregnant women with a history of two caesarean sections to register and receive antenatal care in secondary and tertiary health facilities rather than in Primary Healthcare Centres.

They noted that pregnant women with such a history have a high-risk pregnancy and need expert care and facilities that the PHCs do not have.

The gynaecologists, in separate interviews with PUNCH Healthwise, emphasised that early antenatal registration at the appropriate centre would help to prevent delays and complications, which could be life-threatening for both mother and baby.

The reproductive health experts also urge expectant mothers with hypertension, diabetes before or during pregnancy or a history of miscarriages to register and attend antenatal care in higher-level facilities such as general and tertiary hospitals.

They urged every pregnant woman to register and attend antenatal care in registered hospitals to ensure they receive the best care and prevent avoidable complications and deaths.

PUNCH Healthwise reports that pregnant women should register and begin antenatal care as soon as pregnancy is confirmed with a positive test, ideally within the first eight to 12 weeks.

PUNCH Healthwise also reports that expectant mothers who have undergone two caesarean sections should not attempt vaginal birth to prevent the rupture of the uterus and bleeding.

Severe bleeding after childbirth is the leading cause of maternal mortality worldwide, according to the World Health Organisation.

High blood pressure disorders during pregnancy, infections and complications from unsafe abortions are contributors to maternal deaths.

The 2018 National Demographic and Health Survey puts Nigeria’s maternal mortality rate at 512 deaths per 100,000 live births.

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Speaking with PUNCH Healthwise on the matter, a professor of Obstetrics and Gynaecology at the University College Hospital, Ibadan, Oyo State, Chris Aimakhu, explained that while low-risk pregnancies could be safely managed at primary healthcare facilities, women with high risk pregnancies, including those who have previously undergone caesarean deliveries, need specialist care, which is available in general and tertiary healthcare centres.

Aimakhu said, “Every pregnant woman should access antenatal care. But those with high-risk conditions such as previous CS, hypertension or diabetes must be managed in facilities that can handle emergencies. A primary health centre does not have the capacity to perform a caesarean section. If such women are booked there, it puts both mother and child at serious risk.”

He noted that many primary healthcare centres, especially in rural communities, are poorly staffed and often run without doctors, midwives or round-the-clock services, leaving them unequipped to handle obstetric emergencies.

“In situations where a woman with a previous CS registers in a PHC, and complications arise, delays in referral may lead to avoidable maternal or neonatal deaths,” the don added.

The gynaecologist further asserted that antenatal care was not optional, lamenting that Nigeria still records high maternal mortality due to preventable causes such as postpartum bleeding and pregnancy-induced hypertension.

The maternal expert, however, clarified that not all pregnant women need to register at teaching hospitals, stating that women who register in PHCs and are in need of specialist care should be immediately referred to the appropriate centres.

“Low-risk patients can safely receive care in PHCs or secondary hospitals if those centres know what they can handle. But once a patient has a history of caesarean deliveries, she belongs to the high-risk category.

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“The key is not only access but timely access. If a facility knows it cannot handle a case, it must not keep the woman until it is too late,” Aimakhu asserted.

Also, the president of the Association for Fertility and Reproductive Health, Professor Preye Fiebai, dispelled the notion that all pregnant women must seek antenatal care in tertiary hospitals, stressing that well-equipped primary health centres can effectively manage uncomplicated pregnancies.

“Antenatal care doesn’t have to be in a tertiary hospital. If we have good primary health care, you can start from there. Ideally, the essence of primary care is to identify those who require higher care and then refer them, but most people go straight to the teaching hospital. However, you can still receive good antenatal care if the setup of your primary healthcare system is good and you have qualified people to run it, and you can start from there.

“Mind you, some people go to private hospitals also and if you can afford it, why not?” the reproductive health expert said.

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Ohanaeze disowns installation of Igbo king in S’Africa

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The Ohanaeze Ndigbo Worldwide has rejected the controversial installation of an “Igwe Ndigbo na East London” in East London, South Africa.

It stated that the title is not recognised and lacks legal backing.

The PUNCH had earlier reported that violent unrest broke out on Monday in the Eastern Cape Province of South Africa following protests against the coronation, with demonstrators torching vehicles and looting shops owned by foreign nationals.

Video evidence shared on X showed protesters setting several vehicles and buildings allegedly belonging to foreigners ablaze, as security forces intensified efforts to restore order.

The outrage has continued to grow, with foreign-owned properties becoming primary targets.

However, in a statement by its National Publicity Secretary, Ezechi Chukwu, the group expressed concern over tensions triggered by the development, noting reports of attacks on innocent persons and destruction of property.

The statement read, “We express deep concern over the resulting disturbances, condemn the unwarranted attacks on innocent persons and destruction of property and call on relevant authorities to take necessary steps to prevent further escalation.”

The organisation condemned the violence and urged South African authorities to act swiftly to prevent further breakdown of law and order.

Ohanaeze stressed that the Igbo are globally known for their peaceful disposition, enterprise and respect for the laws of their host communities, as it dissociated itself from any conduct that contravenes local customs and traditions.

It clarified that the purported installation in East London “only amounts to a mere nominal observance since it is not backed by any law.”

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The group further noted that, in line with the position of the South East Council of Traditional Rulers, it did not recognise the conferment of the “Eze Ndigbo” title outside Igbo land.

Ohanaeze advised Igbo communities in the diaspora to adopt non-kingship titles such as “Onyendu” for internal coordination to avoid misrepresentation.

It also urged Igbo residents abroad to conduct themselves with discipline and respect for the laws of their host countries, while calling on the South African government and citizens to uphold peaceful coexistence.

The group appealed for calm, mutual respect and constructive engagement among all parties involved.

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Political titans, Dangote attend El-Rufai mother’s burial

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On Sunday, dignitaries from different political divides were present at the Central Mosque, Abuja, in honour of Hajiya Umma El-Rufai, the deceased mother of the former governor of Kaduna State, Mallam Nasir El-Rufai.

From his residence in Abuja to the mosque and lastly to the Gudu cemetery, both members of the opposition parties and the ruling party were present to offer condolences.

Specifically, his successor, Governor Uba Sani, the National Security Adviser, Mallam Nuhu Ribadu, were present in his house and at the funeral prayers.

The two had parted ways politically with El-Rufai, though they were mutual friends before.

Also present were former Vice President Atiku Abubakar, 2023 Labour Party presidential candidate, Peter Obi, former governor of Rivers State, Rotimi Amaechi, former governor of Sokoto State, Aminu Tambuwal, and ex-Adamawa State governor, Jibrilla Bindow.

All Progressives Congress governors were also in attendance, including Governors Babagana Zulum (Borno) and Mohammed Bago (Niger); former national chairman of APC, Abdullahi Ganduje; former Minister of Interior, Abdulrahman Dambazau, among others.

The 16th Emir of Kano, Lamido Sanusi, a former Zamfara State governor, Abdulaziz Yari, Senator Shehu Sani and billionaire businessman, Aliko Dangote, were also present.

At the interment of Hajiya El-Rufai at the Gudu Cemetery, Abuja, on Sunday, the former Minister of Communications and Digital Economy, Isa Pantami, held the two estranged friends (El-Rufai and Sani) by their shoulders and spoke a few words capable of melting the hardest of hearts.

Looking across his shoulders, he said, “Let us focus on the things that unite us because they are more than the things that divide us.

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This life and everything it contains will end, and the grave is our end. No matter how you strive, you won’t get anything until Allah (God) grants it to you.”

Atiku had earlier announced his attendance in a post on his verified  X handle, saying, “Today, I joined family, friends and associates of Mallam Nasir El-Rufai and the extended El-Rufai family at the Janazah (funeral prayer) of the matriarch of the family, Hajiya Umma El-Rufai.

“May God continue to comfort the family and all who mourn her. And may Allah grant her Aljannah Firdaus. Amin.”

Prominent Nigerians, including President Bola Tinubu, had earlier paid tributes to the deceased.

Tinubu, in a statement signed by his spokesman, Bayo Onanuga, commiserated with El-Rufai, urging him to find the strength to move on in the absence of his beloved mother.

“Nasir, please accept my heartfelt condolences on the passing of your beloved mother, Hajiya Umma, which happened today (Friday) in Cairo. As someone who had also lost an old mother, I share in your grief,” Onanuga wrote on behalf of President Tinubu.

Sani also earlier extended condolences on behalf of the Kaduna State Government and its people, describing the late Hajiya Umma as “a devoted mother and matriarch, a woman of rare grace, moral clarity, and quiet strength,” who embodied faith, patience, generosity, and community reconciliation.

“On behalf of the government and people of Kaduna State, I extend my deepest condolences to His Excellency, Mallam Nasir El-Rufai, and the entire El-Rufai family on the passing of their beloved mother, Hajiya Umma El-Rufai,” Sani said.

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The National Chairman of the APC, Prof Nentawe Yilwatda, visited El-Rufai and his family, urging them to put their faith in God at all times.

He posted, “I visited the home of Mallam Nasir El-Rufai to commiserate with him and the entire family on the painful loss of his beloved mother, Hajiya Umma El-Rufai, who passed away yesterday (Friday).

“The death of a mother is a deeply personal and irreplaceable loss. It is a moment of profound grief not only for the immediate family, but also for all who understand the priceless role of a mother in the life of her children and family.

“Mama lived a fulfilled life and, by the grace of God, leaves behind a legacy through her children, family and all those whose lives she touched.

“At this difficult time, I pray that Almighty Allah forgives her shortcomings, grants her Aljannatul Firdaus, and comforts Mallam Nasir El-Rufai, the entire El-Rufai family, and all loved ones she left behind. May Allah grant the family the strength, patience and fortitude to bear this painful loss,” the APC Chairman wrote.

Also, the immediate past governor of Ekiti State and former Chairman of the Nigerian Governors’ Forum, Dr Kayode Fayemi, expressed deep sorrow over the passing of Hajiya Umma.

In a statement issued on Sunday by the Fayemi Media Office, the ex-governor described her death as a profound loss, not only to the El-Rufai family but also to all who were touched by her life of humility, faith, and service.

He noted that the late Hajiya Umma lived a life defined by strong moral values, devotion to family, and commitment to community—qualities he said are reflected in her son’s life and public service.

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“I received with deep sadness the news of the passing of Hajiya Umma El-Rufai. Her departure is a painful loss, but we take solace in the exemplary life she lived and the legacy she leaves behind,” Fayemi said.

The death came at a time when El-Rufai was in the custody of the Independent Corrupt Practices and Other Related Offences Commission following his arrest over allegations of corruption and money laundering.

He was arraigned before a Federal High Court in Kaduna on March 24 on a 10-count charge, with the case adjourned until March 31, 2026, for hearing of pending applications, including his bail request.

He was released temporarily from the ICPC custody, reportedly to witness the burial rites of his mother.

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Veteran Filmmaker, Wale Adenuga Reveals Why He Sacked And Recalled Papa Ajasco

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According to Adenuga, the actor was initially removed from the role due to serious misconduct, including attempts to claim ownership of the Papa Ajasco brand.

Veteran filmmaker Wale Adenuga has revealed the reasons behind the removal and subsequent return of Abiodun Ayoyinka in his role as Papa Ajasco.

According to Adenuga, the actor was initially removed from the role due to serious misconduct, including attempts to claim ownership of the Papa Ajasco brand.

The conflict reportedly began when Ayoyinka organised a tour using the Papa Ajasco name without informing the production team.

The situation escalated after the Nigerian Copyright Commission discovered that he had tried to register the brand under his name, even though the producers already held the legal rights.

Adenuga, in an interview with Punch, described this act as a betrayal that led to the actor’s dismissal.

Despite the controversy, Ayoyinka was later brought back to the role, a decision Adenuga said was based on practicality and the actor’s talent rather than personal feelings.

He noted that while talented actors can be challenging, their skills sometimes make them indispensable.

The producer also discussed changes in the entertainment industry, mentioning that his productions have adapted to digital platforms.

Shows like Akpan and Oduma are now distributed mainly on YouTube, while WAPTV maintains an online presence and mobile app to reach audiences.

On the topic of royalties and actor welfare, Adenuga said the current system needs reform and that responsibility should not rest solely on producers.

He suggested that a well-structured industry could ensure fair compensation and long-term support for actors, reducing the burden on individual production teams.

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He said, “That level of betrayal led to his dismissal. I understand the psychology of actors. Sometimes the most talented can also be the most difficult. As a producer, you sometimes have to choose between talent and temperament. Despite everything, I would still work with him because he is a good actor. Our content is now on social media.

“Some productions like Akpan and Oduma are distributed primarily on YouTube, while WAPTV also has an online presence and app. I agree that actors should benefit more in a structured system. It is not the sole responsibility of producers to manage long-term welfare. A proper industry structure would ensure that everyone is taken care of.”

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