The United Nations Population Fund (UNFPA) does a lot more than its name suggests. Working in 150 countries across the world, the UNFPA works to promote “the right of every woman, man and child to enjoy a life of health and equal opportunity”.
Key to this is the provision of population data in support of programmes targeted at its main areas of work around maternal and reproductive health, and gender equality and women’s rights.
In this respect, the UNFPA, now led by former Nigerian health minister Babatunde Osotimehin,works on areas that many have highlighted as core issues during Nigeria’s elections.
The Nigerian government has failed to meet commitments on health funding made under the Abuja Declaration, and although working hard to correct the problem, maintains a poor record in maternal, child and newborn health outcomes. TV election campaigning has highlighted the fact that no federal hospital has been built in the country in recent years, while politicians seek healthcare overseas. The anticipated population boom in Nigeria intensifies many of the challenges facing the country, most notably employment and education - the latter a core campaign topic itself. “Gross inequalities” pervade the education system, which is so dysfunctional at primary level that many urban poor send children to private schools due to the strikes that cripple the under-funded state education system. Girls – particularly of the Hausa ethnicity - make up the large majority of the 7 million children not attending school.
This plays into another key area of work for the UNFPA, gender equality. Gender is not been trumpeted as a major source of issues in the run-up to elections. But while they rarely receive the attention they deserve in Nigeria or elsewhere, gender issues remain of significant concern: in addition to girls being disadvantaged in education, half of Nigerian women experience gender-based violence, and, although the numbers are improving, women are under-represented in politics.
Bannet Ndyanabangi, the Deputy Representative of the UNFPA Nigeria, answered Think Africa Press’ questions:
What does the UNFPA Nigeria do, and how do its areas of work link up?
The UNFPA has been in Nigeria since 1974. Our main areas of work include improving maternal health to reduce maternal morbidity and maternal mortality, and working on population and development. We try to support the government to get appropriate data for planning, and we have supported censuses and surveys such as the demographic health survey, which gives information for health and development planning. We also work on gender, trying to fight gender discrimination, gender-based violence and promoting gender equality. In this, we focus a lot on the issue of education for girls, through, for example, combating early marriage to ensure girls stay in school.
In terms of maternal health, Nigeria lags behind other countries in outcomes. What are the key areas of your work and what progress have you made?
The approach now in terms of reducing maternal mortality and morbidity is an approach of strengthening health systems. What does this entail? There are about seven key components, key among which is strengthening human resources. An example of this is the government-led midwifery scheme which uses Millenium Development Goal Debt Relief Funds - we work with the National Primary Health Care Development Agency in terms of training, as in the case of the more than 2,000 midwives who have been deployed as part of the Midwifery Service Scheme. The key pillars of reducing maternal mortality are three: one is family planning, to ensure that women who need contraceptives have access; the second is skilled attendants, so every woman who is giving birth is attended to by a skilled person, usually midwives; the third pillar is emergency obstetric care, when women need to access a doctor, or in some cases a midwife, who can do a caesarean section to get the baby out safely and save the woman’s life. UNFPA has been working with government and civil society to strengthen these areas.
I think the main challenge in Nigeria is that it is a very big country both in terms of population and landmass, and the infrastructure really needs to be developed: when you are talking about access to services you need roads and ambulances, and Nigeria has not really invested well in these areas of infrastructure and resources. But the government is aware of this, and the Midwifery Service Scheme can be highlighted as an example of Nigeria trying to address these issues.
And Nigeria has failed to meet commitments on health spending under the Abuja Declaration?
The idea of the Abuja Declaration was to get governments to put at least 15% of gross domestic product towards health. Many countries have to catch up. Nigeria hasn’t reached there, but we are advocating and hoping that the next Abuja summit should be held here. We are really pushing and hoping that the government can get close to the committed amount.
But the government should also be credited. In terms of family planning, for the first time there is a budget line for buying contraceptives, which is very positive. They will be supplied to health facilities, and the government has now removed the fee so women will no longer have to pay for contraceptives.
What is the situation in Nigeria with HIV/AIDS, and what work do you do on it?
Nigeria’s HIV prevalence is around 4.2%, which has come down from 5%, which is good news. But because it is such a big country, you find that it joins India and South Africa as the countries with the highest number HIV-infected people around the world, and therefore mother-child transmission is also high in these countries. So, if you compare it with Southern African countries, where HIV prevalence is above 10%, Nigeria could be said to be doing better. But if you look at the population mass then there are a lot of HIV-infected people who need treatment, and efforts are underway to do that and prevent mother-child transmission. This does link in to the expected population boom, and there are certainly big challenges.
Our main focus is prevention: among young girls, preventing women who are HIV positive from getting pregnant - which is about access to contraceptives - and also once HIV positive women get pregnant we work with government and other partners to ensure that they have access to prevention of mother-to-child transmission.
What are the key issues in terms of women’s rights and gender equality that need addressing in Nigeria?
There are many areas including gender-based violence and economic empowerment, but the main issue as we go forward is education. We all know that if a young girl goes to school and stays at school, then many of the challenges are addressed: they stay at school, they don’t get pregnant early and the chances of them dying while giving birth are lower, they have a higher use of contraceptives and a lower infection rate of HIV/AIDS. So, women’s empowerment starts with girls’ education.
Do you feel that gender issues are somewhat ‘off the radar’ in Nigeria in comparison to other issues?
There is a need for more affirmative action around gender issues, because women need to be heard more at political, advocacy and policy-making levels. If you look at parliament in Nigeria, representation of women is low, and if you compare that with other countries like Uganda and Rwanda, they have many more women in parliament and they are more able to advocate on women’s empowerment issues. For me that is one of the main problems. We need to combine girls’ education with affirmative action, and get women heard in parliament, government and political parties. If we can do that it would result in a decrease in violence against women – women who are better educated and able to cater for themselves would not stand having their rights violated and would leave, because they can look after themselves. If they are in parliament and cabinet they can bring these issues up and legislation can be made, while men would also respect them more. If it is just men running the affairs of politics, these issues can tend to become off the radar and men tend not to take these issues seriously.
What are the drivers of the huge population growth Nigeria is set to experience? Is it coming from any particular section of the population?
The issue of population is not affected by religion or tribe – it is a resource issue. We are aware that in countries that have managed to reduce population growth the main issue has been investing in human resources, in terms of education and availability of resources. As a result people have more things to do, they are in school, they have jobs, and consequently they don’t have as many children. This is clearly documented: Iran has one of the best family planning programmes and it is a Muslim country. It’s policy issues, it’s resources, it’s education. So, Nigeria, once it strengthens those areas - ensuring equitable resources are available, ensuring girls go to and stay in school - then these things can be addressed. Nigeria has a very young population where 60% of the population is under 30-years-old, so there needs to be investment in young people: they need jobs, they need to be at school, they need to have vocational training. Otherwise it will be a big challenge for the country.
But it is also a challenge for us and affects the work we do. UNFPA is about quality of life, saving lives and equality, really. If people don’t have a right to choice, for example in the number of children they have due to lack of access to contraception, then that affects out work. So we are working with the government to ensure that people’s rights are protected in terms of how they want to plan their families.