Nigeria
Nigeria is Africa’s most populous country and experiences the highest maternal and infant mortality rates in the world. One of the largest oil exporters in the world, Nigeria is rich in natural and human resources, yet most of its population lives in poverty. The LDM program focused mainly in Northern Nigeria, which is characterized by a predominantly Muslim population and a large Hausa population who practice Islamic Shar’ia law. The general socio-economic context of Northern Nigeria is one characterized by persistent problems of poverty, overpopulation, ethnic crisis, gender- based exclusion, and a magnitude of uneducated and unemployed youth.
The political context continues to be shaped by poor use of democratic structures and a policy making environment which is yet to be fully participatory. The past years have shown some overall improvements, as Nigeria has made progress in combating corruption, increasing transparency, and fostering economic reforms.
Stagnant Reproductive Health Outcomes
Against this background, the appalling reproductive health profile of the country remains unchanged. The 2008 Nigeria Demographic and Health Survey’s preliminary findings show that total fertility rates in 2008 remain the same as that of 2003 and are only slightly lower than the rate in 1990. Interestingly, total fertility rates at the two ends of the age spectrum, 15-19 and 40-45, have increased.
The Health Survey’s findings on the use of modern methods of contraceptives suggest little or no positive change in the contraceptive prevalence rates, particularly in the North. In the Northern states of Katsina and Jigawa less than 1% of women report using modern methods of contraceptives.
Policymakers seem receptive to advocacy on gender and reproductive health issues but are hampered from following through on commitments by issues of capacity, disagreement on the Islamic position on reproductive health and family planning, and the failure of civil society and the media to keep up the pressure.
New Approaches
The Federal Ministry of Health designed a new and inclusive approach to address the reproductive health problems in Nigeria. The new approach coincides with the end of the vertical reproductive health and family planning programs and the commencement of a new era of integrated neo natal and maternal health programming. The new approach is anchored on two key documents:
- The Maternal and Neonatal National Policy
- The Situation Analysis and Action Plan for New Born Health in the Context of Integrated Maternal Health
Catalyst for Change
Most development partners perceive leadership development as a catalyst capable of transforming conservative forces in the political decision making structure and propelling them to take responsibility for the substandard reproductive health and family planning profile of Northern Nigeria. Evaluations of leadership development interventions which targeted traditional and religious leaders as well as political decision makers suggest that these initiatives have been creating champions for change from an otherwise conservative force in society.
Supporting Leadership
LDM Nigeria developed a core group of 200 Leadership Fellows from within civil society, the traditional and religious establishment, as well as public sector. Approximately half of these Leadership Fellows were female. Leadership Fellows were supported by the LDM program through workshops, conferences, mini-grants, and mentoring to expand their work at community, facility, and regional levels in reproductive health and family planning.
Leadership Fellows established networks with strong links to viable organizations, including the network of Islamic scholars linked to Sukul; the network of Leadership Fellows working on girl child education and adolescent reproductive health linked to Gumel Youth Association; the network of leadership master trainers linked to the College of Technology, Markafi.
The LDM program supported five members of the network of Islamic scholars to make a keynote presentation and lead a discussion on reproductive health as Islamic enlightenment at the National Meeting of Muslim Professionals in Dawah in November 2008. With mini-grant support, the adolescent reproductive health and girl child education network developed a project to air a series of radio programs to encourage girl child education and reduce the age of marriage, and the Islamic scholars’ network is using radio programs to reach a wider audience on the Islamic position on family planning and women’s health.
Leadership Fellows now occupy strategic positions at the helm of the Federal Ministry of Health, the National Primary Health Development Agency, the National Agency for the Control of HIV/AIDS, and several state level agencies throughout Northern Nigeria. Leadership Fellows have leveraged funds from other funding agencies to scale up their projects and have been recognized in their regions for their life saving skills.
Sources:
- The World Bank (2009)
- Nigeria Demographic and Health Survey, USAID (2008)
- Population Reference Bureau (2009)