Professor Yusuf Muhammad Adamu of Bayero University, Kano (BUK), has called on the Nigerian government to integrate medical geographers into the country’s health policy system, warning that decisions made without adequate geographical data could misdirect resources and leave vulnerable communities underserved.
Adamu, a Professor of Medical Geography in BUK’s Department of Geography, Faculty of Earth and Environmental Sciences, made the call while delivering the university’s 63rd inaugural lecture, titled “Putting Health and Disease in Place: My Story and Legacy,” this Thursday, September 24, 2026, at the CBN Centre of Excellence, BUK New Campus, Kano.
He argued that understanding where people live, their environment and their access to healthcare is essential to addressing disease, improving maternal health and ensuring the effective distribution of medical resources.
The professor urged the creation of dedicated medical geographer positions in health ministries, departments and agencies, stressing that geographical evidence and spatial analysis should inform health interventions and public policy.
According to him, the exclusion of geographers from mainstream health research and policymaking has contributed to decisions that overlook high-risk populations and the geographical factors influencing health outcomes.
Drawing on more than three decades of research and teaching, Adamu demonstrated how maternal mortality in Kano State varied significantly between urban and rural communities, showing that a woman’s chances of survival could be influenced by her location and access to appropriate obstetric care.
He cited his research findings showing that the Kano North-West Zone recorded a maternal mortality ratio of 4,477 deaths per 100,000 live births, the highest among the state’s zones in the data presented in the lecture.
He also reported that Kano Central Zone accounted for 68.4 per cent of hospital deliveries captured by his research, highlighting geographical differences in the use of healthcare facilities.
The professor explained that maternal mortality was not a static phenomenon, noting that his findings recorded a maternal mortality ratio of 3,638 per 100,000 live births in 1992, which fell to 1,026 in 1995.
He said the fluctuations demonstrated the need for continuous monitoring of maternal deaths rather than relying solely on isolated annual figures.
Adamu further identified differences in the leading maternal health challenges facing urban and rural Kano. While eclampsia featured prominently in urban areas, anaemia, associated with poverty and malnutrition, was a major concern in rural communities, followed by prolonged and obstructed labour.
He said his research on eclampsia informed an intervention by the Population Council in New York on the use of magnesium sulphate in Northern Nigeria from 2007, adding that the intervention had helped save lives.
The inaugural lecturer also presented a five-stage model explaining how women seek and receive obstetric care, beginning with the recognition of a health problem, followed by family decision-making, treatment at home, obtaining medicines from chemists and, finally, seeking care at a health facility.
He explained that women and their families could initially rely on traditional practices or home treatment before turning to formal healthcare, sometimes delaying access to emergency medical attention.
According to him, 88 per cent of rural maternal deaths examined in his research occurred at home, while 33.9 per cent of urban maternal deaths occurring in health facilities were concentrated in the admission room of Murtala Mohammed Specialist Hospital.
To address these challenges, Adamu recommended interventions targeting families, communities and the health system.
At the family level, he advocated educating households about the normal duration of labour, engaging husbands and fathers-in-law in maternal health decisions, and promoting women’s economic empowerment.
At the community level, he proposed training traditional birth attendants and religious leaders to refer pregnant women to health facilities, regulating chemists as points for identifying and referring patients, and respecting traditional care practices while strengthening links with formal healthcare providers.
For the health system, he called for transparent, prepaid delivery packages, respectful maternity care and stronger feedback mechanisms between communities and health facilities.
The professor cautioned against blaming women for arriving late at hospitals, arguing that interventions must address the social, cultural and economic circumstances shaping their healthcare decisions.
Beyond maternal health, Adamu highlighted the contributions of medical geography to research on diseases, nutrition, immunisation and other health challenges across Northern Nigeria.
He said the research tradition developed at BUK had produced 15 doctoral graduates and more than 200 publications, establishing a foundation for further research into the geographical distribution of health risks.
Adamu called for sustained investment in health and medical geography, including the application of geographic information systems, machine learning, big-data analytics and participatory research methods.
He also emphasised the need to train a new generation of researchers and strengthen collaboration between academics, healthcare practitioners and policymakers.
The lecture culminated in the formal inauguration of the Kano School of Health and Medical Geography, which he described as a multigenerational community of scholars dedicated to using spatial analysis to understand and address health challenges in Northern Nigeria.
Adamu said the school’s future would depend on expanding research into emerging and re-emerging diseases, strengthening policy engagement and extending its geographical reach beyond Kano State.
He maintained that medical geography should be treated as a necessity rather than a luxury, arguing that understanding the relationship between health, disease and place was essential to building a healthier and more equitable Nigeria.
