Events

Nigeria Beyond the Headlines: Population, Health, Natural Resources, and Governance

April 25, 2012 // 8:30am5:30pm
Event Co-sponsors: 
Maternal Health Initiative
Africa Program
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“Nigeria is a country of marginalized people. Every group you talk to, from the Ijaws to the Hausas, will tell you they are marginalized,” said Peter Lewis, director of the African Studies Program at the Johns Hopkins University School of Advanced International Studies.

Youth make up the bulk of society and yet are sidelined by a disproportionate unemployment rate. The vast majority of Nigerians (84.5 percent) live on less than $2 a day as the country’s growing wealth is concentrated in fewer and fewer hands. A changing climate, minimal services, and Boko Haram destabilize the country’s north, while environmental degradation, corruption, and resource mismanagement impede progress in the south

Unmet Demographic Expectations

“Thirty years ago there was an expectation of better progress on demographic transition for Nigeria,” said Scott Radloff, the director of USAID’s Population and Reproductive Health Office. In 1982, he said, the United Nations Population Division estimated that total fertility rates (TFR) would fall from 6.8 children per woman to 4.7 by 2010, and that infant mortality rates would fall from 132 deaths per 1,000 live births to just 57 over the same time period. In reality, TFR fell to just 5.6, while infant mortality slid to 97.

For family planning in particular, Radloff said, “there’s been little to show for [the international community’s] investment. Modern contraceptive prevalence was measured in 2008 at just 10 percent, which is not very different from where it was 20 years ago, or 30 years ago for that matter.”

The country’s population growth will further strain its resources in the coming years, said Bolatito Ogunbiyi, an Atlas Fellow with Population Action International. Nigeria is already 1 of 15 sub-Saharan countries suffering from water shortages, she said, and climate change and population growth are projected to further constrain supply while boosting demand.

Those twin pressures will also make food security efforts more difficult as more people will have to feed themselves with less land and less reliable access to natural resources. “Looking at the effect of climate change with population growth…the situation could get worse in the future,” said Ogunbiyi.

“A Very Important Contradiction”

In recent years, an economic boom has accompanied Nigeria’s population boom, making it one of the fastest growing economies in the world, said the World Bank’s Volker Treichel. On the one hand, that growth is contributing to a small but growing middle class in the country, on the other, there remains “a very important contradiction in Nigeria” between greater prosperity and growing unemployment. 

“While there is impressive GDP growth…that growth is not being distributed evenly through the economy,” said Anthony Carroll, vice president of the business consulting firm Manchester Trade, Ltd. “Growth is concentrated in fewer and fewer hands.” 

While the boom benefits Nigeria’s wealthy, the country’s youth suffer disproportionately from rising unemployment, said Treichel, with more than 40 percent of the 15- to 24-year-old cohort unemployed. In order to get one of the few formal sector jobs available, youth “keep going back to school and adding another bachelor’s degree, another master’s degree,” he said, “and that’s so difficult, because those jobs just don’t keep growing at the pace that is necessary.” 

Adolescent Reproductive Health and Family Planning

“Poverty predisposes adolescents to high risk behaviors and pushes parents to marry off their daughters,” said Adenike Esiet, executive director of Action Health Incorporated in Lagos. Further, “socially prescribed gender roles undermine young women’s agency and their ability to protect themselves.” Such perceptions must be altered she argued, if the country’s human resources are to be full realized. 

“These are the young people who will govern Nigeria, with no education, and for the women, limited agency and a [limited] means of managing their own fertility.” 

“When we say adolescent sexual and reproductive health, we mean the physical, mental, emotional well-being of young people – that includes the freedom from unwanted pregnancy, unsafe abortion, maternal death, sexual transmitted infections (including HIV), and every form of sexual violence and coercion,” she said.

In the north, more than two-thirds of girls marry before the age of 20, according to Esiet. “This violates the rights of these young women, because they can’t be consenting if they are minors. These girls are marrying men who are far older than them [and] who have multiple partners,” placing them at risk of contracting sexual diseases and leading to loss of schooling and livelihood opportunities, she said. For every one adolescent boy who is HIV positive in Nigeria, there are three girls.

In addition, “teenage mothers are twice as likely to die from pregnancy-related causes,” Esiet said, yet more than half of Nigerian girls bear their first child before the age of 20. These newborns are also more likely to die during infancy. “Teenagers are typically physically, emotionally, and economically, unprepared to take care of children because they are still children themselves.”

“A major driver [of poor health outcomes] continues to be the denial amongst adults of the fact that young people are not asexual,” said Esiet. “In the midst of all of these negative sexual and reproductive health indicators, adults will still rather believe that young people should not have access to services or information.” 

“What people need is information to take more informed decisions,” said the Nigerian Urban Reproductive Health Initiative’s Kabir Abdullahi. “Incidentally, that is not what is provided.” 

A dearth of facilities, transport, and family planning services, as well as the low priority this area receives in the government budget, has resulted in a shocking maternal mortality rate of 545 women per 100,000 live births, according to Abdullahi. 

With a total fertility rate of almost six children per woman and a population set to double over the next 25 years, huge expansions in the health sector are needed even just to maintain the current level of services, he said. 

Abdullahi, using data about correlations between wealth, geography, contraceptive use, fertility rates, gender preferences, and birthing practices asserted that improving services will require focusing on the most vulnerable.

He recommended making health insurance available to those at the community level and focusing on changing “the norm of secrecy around family planning” by encouraging traditional community and religious leaders to reflect on the impact of poor maternal health on their communities. 

“Religious leaders have tremendous power of speech,” Abdullahi said. “Because they speak the same language, they understand them, they know them, [and] they have trust in them.”

Accounting for Diversity and Maintaining Commitments 

Dr. Zipporah Kpamor, chief of party for the NGO Management Sciences for Health, said the extensive sub-national diversity in Nigeria is an important factor in the lack of progress on demographic and health indicators

Kpamor explained that a large portion of national health funding is commonly allocated to high profile projects in teaching hospitals and major centers. These projects, she said, fail to benefit the diverse majority of Nigerians. 

“The primary key,” said Esiet, “is understanding that when we say adolescents or young people, we’re talking about a diverse population. We have resources and we know what needs to be done, it’s the management of those resources that continues to draw us back as a country.”

All of the speakers explained at length that health solutions require a comprehensive approach, better information, better services, higher quality infrastructure, and a serious focus on gender relations. Yet, the heart of the problem is that the pledges being made have not converted into action. 

“We like to say that Nigeria would sign every funky policy, any beautiful policy that comes up – we’re the first to sign,” said Esiet. However, “sticking by the letters of the documents we signed…truly becomes an issue.”

“The truth of the matter is that there’s progress that’s been made in Nigeria, it’s just that progress is just too slow.”

Youth and Conflict

In the coming years, Nigeria’s cohort of unemployed youth has equal potential to “be converted into either a religious or a regional clash, as certain youths get opportunities and other youths do not,” said Pauline Baker, President Emeritus of the Fund for Peace.

Youth in the troubled Niger Delta offer a case in point. Judy Asanti, executive director of Academic Associates PeaceWorks, a Nigeria-based conflict resolution NGO, said that the 2009 amnesty program the government enacted to disarm militants has, paradoxically, incentivized violence among the country’s marginalized youth as they struggle to establish livelihoods for themselves. Seeing the government pay former militants monthly stipends in exchange for disarming, marginalized youth are now motivated to take up arms against the state with the expectation that it will then have no choice but to pay them for peace. 

Conflict in the country extends far beyond Niger Delta, however, and is motivated by a number of factors beyond opposition to the oil industry and its negative impact on local development. “Violence in Nigeria is unfortunately quite regular, quite intense, but also quite varied in its motives, in its scope, and in its direction,” said Peter Lewis. 

“There is not a single fault line, north-south, Christian-Muslim, Yoruba-Hausa, or any other such simple division that would explain…the majority of violence in Nigeria.”

There is nonetheless a set of “critical issues” that are reflected across the country’s main centers of conflict, said Baker. In the delta regioncentral Nigeria, and northern Nigeria, “population issues, health issues, and natural resource issues are all critical,” she said. 

Land and Climate Challenges

With so much at stake in an already unstable region, Anthony Nyong, head of gender, climate change, and sustainable development at the African Development Bank, said climate change exacerbates insecurity.

“Nigeria…is not immune to the threat of climate change,” he said. “We have seen Lake Chad dry up, we have seen people lose their livelihoods, and we’ve seen the migration that has come out of Lake Chad into Nigeria.”

How do you plan for this? The answer, Nyong said, is in figuring out how to “sustain green growth in the face of poverty alleviation.” The upcoming Rio+20 meetings will be an important forum for exploring alternatives, he argued. “We cannot continue on the development paradigm that we have chosen.”

George Akor, senior program manager at the Women Environmental Programme, pointed out the specific gendered impacts of environmental stress. “Climate change impacts, such as water scarcity, and falling agricultural productivity, may disproportionately affect women and girls,” he said, drawing from the 2010Nigerian Millennium Development Goals Report

“Women make up some 60 to 80 percent of [the] agricultural labor force in Nigeria – they play a very important role in this sector,” said Akor. Yet they rarely own the land because it is largely a patrilineal society. This disconnect reduces the capacity of Nigeria’s communities to adapt to challenges such as population pressure, severe erosion, uncontrolled logging, land subsidence, flooding in the coastal and riverine states, and drought and desertification in the north, he said.

“Water, land, and biodiversity are under severe pressure,” and that stress is manifested in crop failure, declining yields, and increased work time required for less food and less income. Women’s livelihoods are directly affected by these issues, said Akor. 

The urban environment also faces pressure from poor land management, shoddy construction, and the continued growth of slums in major cities. 

Industrial activities, such as illegal mining in the north-west, which received media attention after the discovery of widespread lead poisoning, and oil pollution from spillage and gas flares, are also serious environmental issues, Akor said. 

Water Mismanagement and Government Opacity

“Water and sanitation isn’t really a hot topic in Nigeria,” said Ameto Akpe of Nigeria’s BusinessDaynewspaper. Yet, “every year, almost 200,000 kids under the age of five die from drinking unsafe water[and] many more fall terribly sick from water related diseases like cholera, dysentery, and typhoid fever.” Akpe described challenging authorities on the lack of safe water and routinely receiving answers that were evasive and nonchalant. “It’s something you see over and over again,” she said. 

“The water sanitation crisis…is less about the lack of the resource, or even the lack of funds, and more about poor and faulty management failures that have dramatic consequences,” said Akpe. She pointed to a project in the city of Makurdi on the banks of the river Benue, where tens of millions of dollars have been spent on a new water treatment facility in an area that lacks the infrastructure to actually distribute the water to residents. 

How could such an oversight occur? The reasons are complex, but corruption and a lack of transparency in government financing are major issues, she said. Despite government promises that 75 percent of Nigerians will have access to clean drinking water by 2015, the water budget has been repeatedly slashed since 2010. It is now 65 percent of what it used to be, Akpe said.

Reasons for Optimism in a Rising Civil Society

The growing rift between Nigerians and their government spilled into the open in January when thousands protested the end of the government’s long-standing fuel subsidy, which caused prices for food, fuel, and transportation to skyrocket overnight. Although there have been protests in response to oil price hikes in the past – notably in 1988 and 2000 – this round was markedly different, said Akwe Amosu, an Africa policy analyst with the Open Society Foundation

The mood of the January protests was encapsulated by a student quoted in Reuters, said Amosu. “He said, ‘the bottom line is we don’t trust the government to do what they say anymore.’” Paired with the unequal distribution of recent growth, that distrust is reorienting public opinion and galvanizing civil society. Within weeks, the protests prompted the government to reign in the cutbacks and simply reduce, rather than repeal, the subsidy.

“There is a rising level of expectations that…is changing the way that people think,” said Amosu. “People are beginning to feel more acutely the difficulties around poverty, around jobs, around lack of services.” Those rising expectations are contributing to a level of discourse on governance that is unparalleled in the country’s recent history, and which, if sustained, could help brighten the country’s future. 

“Nigeria’s never been this divided since the civil war, and yet the country has never been this united in protest in its history,” she said, quoting ActionAid’s Hussaini Abdu. “And I think that speaks to the idea that people are getting a handle on the idea that they are a critical part of holding the nation to account.”

Drafted by Kate Diamond and Stuart Kent, edited by Schuyler Null.

Photo Credit: Lagos slums, courtesy of flickr user smagdali (Stefan Magdalinski).

 
Event Speakers List: 
  • Professor and Director of Environmental Studies, Ohio University; Former ECSP Director
  • Senior Scientist and Director, PMA2020, Bill & Melinda Gates Institute for Population and Reproductive Health
  • Atlas Fellow, Population Action International
  • Lead Economist, Operations and Strategy, World Bank
  • Vice President, Manchester Trade, Ltd.
  • Lead Technical Officer, Office of Population and Reproductive Health, U.S. Agency for International Development
  • Peter Lewis // Fellow
    Associate Professor and Director of the African Studies Program, Johns Hopkins University, School of Advanced International Studies
  • Director, Academic Associates PeaceWorks
  • Africa Policy Analyst, Open Society Institute
  • President Emeritus, Fund for Peace

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