Dr. Michael Olawuyi, Abuja
Nigeria. The ‘giant of Africa’. But can this giant lead the way on sustainable development?
In 2015, Nigeria signed up to the UN’s Sustainable Development Goals (SDGs); a “blueprint to achieve a better and more sustainable future for all” by the year 2030. But there is a growing concern among experts and leaders that the country will not be able to meet these targets.
Economic recession, a humanitarian crisis in the north east of Nigeria, infrastructural deficits, technology gaps and the unpredictable value of crude oil, are just some of the barriers to achieving the SDGS, according to a review conducted by the Federal Government of Nigeria in 2017. The current situation resulting from Covid-19 only exacerbates these challenges.
Yet, with an annual population growth rate of 2.6%, the Nigeria population is forecasted to grow to 410 million by 2050, from the current estimate of 193 million, according to the United Nations Population Fund (UNFPA).
This raises the question: Can Nigeria ever attain sustainable development?
I believe the answer is ‘yes’. Having worked in Nigeria’s health sector for more than a decade, I strongly believe that the answer to helping Nigeria achieve sustainable development is ‘Childbirth Spacing’ (also known as family planning). By increasing access to voluntary family planning services, the positive benefits can have an impact far beyond the health sector, including economic growth and human capital development.
Family planning, if prioritized, has been found the world over to have a positive impact on the demographic dividend of a country. ‘Demographic dividend’ is defined by UNFPA as “the economic growth potential that can result from shifts in a population’s age structure, mainly when the share of the working-age population (15 to 64) is larger than the non-working-age share of the population (14 and younger, and 65 and older). Simply put, family planning has the potential to optimize Nigeria’s population-age structure, such that the working population is more than the dependent population. This means increased productivity, reduced poverty (SDG 1) and economic growth (SDG 8).
Family planning can also save money for the government. According to the Guttmacher Institute, for every $1 spent on family planning, around $2.20 is saved by the health system. This is because, for every unwanted pregnancy averted by family planning, the costs associated with maternal and childcare, such as ante-natal care, delivery, post-natal care and immunizations, are saved. These savings could be spent on other health needs and education, contributing to achieving SDG 3 on health and wellbeing and SDG 4 on quality education.
At the household level, well-spaced out pregnancies allow couples to invest in their family’s future. The income earned by the couple can be used to improve the family’s nutritional status (SDG 2) and educational attainment (SDG 4).
Family Planning has been described as the antidote to maternal mortality. Nigeria has one of the worst maternal mortality rates in the world, accounting for 20% of global maternal deaths, according to World Health Organization. The current average total fertility rate is 5.3 children per woman, while some states have a fertility rate of up to 8.5. Family planning can prevent unwanted pregnancy thus avoiding unsafe abortions and reducing high fertility rates. By increasing access to family planning information and services, Nigeria’s maternal deaths could be reduced drastically, and women could be given the opportunity to live a healthier and more prosperous life.
But in order to see these benefits, the government needs to allocate adequate funds.
In 2019, the allocation of funds at federal level for family planning was reduced by 90%, from ₦2.9 billion in 2018 to ₦300 million. The federal government is the sole supplier of family planning commodities to all states in Nigeria, therefore the budget cuts resulted in acute shortages nationwide. This led to an increase of unwanted pregnancies and unsafe abortions, especially among young people.
The government needs to prioritize funding for family planning in order for Nigeria to accelerate progress towards achieving the SDGs.It is not enough to rely solely on donor funding to finance these services. This cannot be relied on in the future. Dramatically increasing uptake of voluntary family planning requires the government to provide resources for; procurement of commodities and consumables, training, and capacity building of health workers on the provision of modern contraceptives and communicating quality information to the Nigerian population. According to USAID HP+ Program, achieving Nigeria’s family planning goals (including a contraceptive prevalence rate of 36%) required ₦190 billion (603 million USD) between 2013 and 2018. Lagos state, in south west Nigeria requires about ₦18 billion to finance family planning over a five-year period. Jigawa state, in north west Nigeria requires about N5billion to achieve its family planning goals
Once resources have been allocated, funds need to be disbursed on time. The UKAid-funded Women’s Integrated Sexual Health (WISH) programme, found that in some states, none of the annual budget have been disbursed for family planning services by June 2020. Governments at the federal and state level are responsible for distributing funds on time. An uninterrupted family planning service could reduce the burden on an already over-burdened health system in Nigeria.
The government could also leverage financing mechanisms such as the National and State Health Insurance Schemes and the Basic Healthcare Provision Fund to help provide and fund family planning services. Including family planning services in the health insurance benefit package could reduce financial barriers to uptake of family planning services, especially for the poor and vulnerable.
Nigeria has a golden opportunity to live up to its reputation as “the giant of Africa” by achieving the Sustainable Development Goals. A simple and low-cost pathway to attaining sustainable development in Nigeria is the prioritization of family planning services!
WISH- Women’s Integrated Services for Health is a UKAid funded program jointly implemented by Marie Stopes International, Options, Planned Parenthood Federation of Nigeria, Ipas and Think place.
Dr. Michael Olawuyi is National Sustainability Lead, WISH Program