Article by: Dr Aminu Magashi (Source: http://healthinteractive.wordpress.com)
On Tuesday 27th August 2013 I published an article titled ‘Key Highlights from Global Review of ICPD + 20’. It was in connection with the just concluded African Regional Conference on Population and Development tagged ‘Harnessing the Demographic Dividend: the Future We Want for Africa’ that took place from 30 September – 4October 2013 in Addis Ababa, Ethiopia. The conference provided an opportunity for member states to have a common position on the draft report and recommendations of the regional review of the ICPD PoA for Africa. (International Conference for Population and Development Programme of Action) and agreed on the linkages between the outcomes of the Africa regional review and the post-2015 development agenda.
As part of the preparation for the conference member states wrote and submitted country reports on progress detailing events and actions since 1994 when the conference took place in Cairo. In Nigeria through a facilitation of Plan/CEDPA, civil society organisations had held a meeting to review progress in line with the global review and came up with a shadow report to press demand and exert strategic pressure on the Nigeria government to respond to critical issues of population and development. I chaired the initial committee of 4 persons that wrote the 1st draft shadow report which was shared widely and consulted with other relevant civil societies to produce a final copy of the report.
In this article I will lay more emphasis on the aspect of the report that dwelled more on health matters. The report observed that currently, the population is estimated at slightly above 172 million placing it as the 7th largest in the world, just after Pakistan and above Bangladesh. Nigeria contributes about 2.5 percent to world population with an annual growth rate of 3.2, and has almost doubled within 22 years (1991-2012). Nigeria remains the most populous country in Africa, structurally young with the male population slightly more than the female, and is among the very few countries whose population is still growing. The rapid population growth rate can be attributed to the high Total Fertility Rate (TFR) of 5.7, fuelled by a large proportion of women in the reproductive age group (51 percent of the total population of women), with a low contraceptive prevalence rate of 15 percent for all methods and 10 percent for modern methods and an unmet need of 20 percent for family planning. The life expectancy at birth for women and men is estimated at 47.1 years and 46 years, respectively. Maternal mortality ratio stands at 545/100,000 live births, while 75 children per 1,000 live births die before their first birthday and 157 children per 1,000 live births or one child out of six, die before reaching age five.
At the 1994 ICPD sessions held in Cairo, Nigeria was among the delegates from the governments of 179 countries, among other groups and representatives who met and came up with firm commitments and agreed to a 20-year PoA for Population and Development. Before the ICPD in 1994, Nigeria had a National Policy on Population tagged “National Policy on Population for Development, Unity, Progress and Self-reliance”. It was reviewed 15 years later to accommodate emerging issues and realities presented by the 1991 census result, reflect the ICPD PoA and other international agreements, declarations, and obligations including the launch of the MDGs in 2000. All these informed and prompted the review which produced the current policy titled “National Policy on Population for Sustainable Development” in 2004, with most of its targets aligned with those of the ICPD PoA and the MDGs.
In addressing ICPD issues regarding the national context during the last five years (2007-2012), Nigeria has put in place several programmes, strategies and institutional entities backed up with budget allocation for implementation, but evidence have shown that overall progress was behind schedule.
In addressing the needs of Adolescents and Youths, 3 major policies are put in place to guide the implementation of programmes and activities designed to address the needs of adolescents and youths. The key institutions concerned with addressing the needs of this segment of the population constitute the Federal Ministry of Youth Development (FMoYD), Federal Ministry of Health (FMoH) and the National Planning Commission (NPopC).
The report observed that Nigerian government has not made much progress in the provision of comprehensive and integrated sexual and reproductive health services for adolescents and young people. Despite the availability of all the supporting policies and guidelines, the availability and accessibility to youth friendly health services remains critically low. It also observed that nationally, there is very limited availability of data on adolescent sexual and reproductive health issues and an absence of a coordinated clearing house for data on adolescent and youth issues.
Nigeria has made some progress in its effort to eliminate mother-to-child transmission of HIV and treatment for improving the life expectancy of HIV-positive mothers. However it was observed that there is poor integration of HIV/AIDS services with other Sexual Reproductive Health Services.
In a separate 2 page call to action that was circulated to Nigerian delegates at the regional conference, the following are recommended;
- The Nigerian Government should give full attention to meeting the reproductive health needs of young people, with full respect for their privacy and confidentiality and to provide them with Comprehensive Sexuality Education.
- The Nigerian Government to prioritize sexual and reproductive health services and to strengthen health systems by ensuring access to integrated services.
- The Nigerian Government to ensure that all young people have information and access to the widest possible range of safe, effective, affordable and acceptable methods of family planning.