Photograph — waha-international.org

On the 1st of August this year, six Nigerians were selected as winners of the 2018 British Council Future Leaders Connect cohort. A global fellowship where exceptional young people from around the world will come together for a number of days and link to the UK Houses of Parliament, meet with inspiring leaders and policymakers and discuss the most significant global issues facing the next generation globally.

In an interview with Ventures Africa, two of the winners, Edwin Akpotor and Mary Dinah, give insights into their policies and plans.

EDWIN AKPOTOR

How dangerous is childbirth for women in Nigeria? Enlighten us on the statistics and dangers women in Nigeria face during childbirth?

EDWIN AKPOTOR (EA): Pregnancy and childbirth are supposed to be a joyous phase in the life of every woman. In Nigeria however, many women are faced with many dangers during this stage of life. According to the most recent Nigeria National Demographic and Health Survey (NDHS), about 111 women and girls of reproductive age die daily (i.e. 5 women die per hour) due to preventable pregnancy and childbirth related complications. With approximately 600 maternal deaths per 100,000 live-births, Nigeria seems to be one of the worst places on earth to deliver a baby. The childbirth dangers are enormous-ranging from inadequate skilled birth attendant to unavailability of essential delivery kits-a lot of efforts need to be done by government and other stakeholders to strengthen the Nigeria health care system.

Most problems are really as a result of our health systems. What in your opinion should be done to revamp the health system in the country?

EA: Increased, adequate funding, timely release of allocated funds and judicious use of the released funds. This is the solution to our health system. In 2001, Africa Head of States met in Abuja, Nigeria and committed to allocate at least 15% of their annual budget to the health sector. This commitment was called “the Abuja declaration”. While some countries have achieved and surpassed the 15% allocation to the health sector, Nigeria is yet to allocate even 10% to the health sector. In 2014 (5.63%), 2015 (5.78%), 2016 (4.23%), 2017 (4.7%) and 2018 (3.9%). If we can fix the three key issues around health sector funding (allocation, the timely release and efficient utilization), I believe about 95% of our health problems will be solved.

There is an exodus of doctors, health workers from the country, how much will this affect progress in reducing child and maternal deaths?

EA: Health sector brain-drain will worsen the currently unacceptable neonatal, infant, child and maternal mortalities. There is an urgent need for the government is incentivizing health care services in Nigeria to pull a plug on the ongoing mass exodus of health professionals from the country.

What is the greatest challenge in enacting policies to manage childhood pneumonia and diarrhoea?

EA: Nigeria don’t have issues enacting policies, it is the political will to implement enacted guidelines is the major albatross. According to the most recent NDHS, Childhood Pneumonia and Diarrhoea are responsible for about 23% of under-5 years’ death in Nigeria. The 2017 Multiple Indicator Cluster Survey (MICS) conducted by the Nigeria National Bureau of Statistics, Pneumonia has overtaken malaria as the single biggest killer of U-5 years’ children in Nigeria. In 2010, Nigeria was the co-chair of the United Nations Committee on Life Saving Commodities. The committee recommended that countries revise their Childhood Pneumonia and Diarrhoea and other maternal policies in other to improve access to health care and reduce MNCH mortalities. Nigeria signed the UN commitment in 2010. It was until 2016 before our country adopted (despite signing the agreement in 2010) the Childhood Pneumonia and Diarrhoea policies. My organization the Pharmaceutical Society of Nigeria (PSN) with support from the Bill & Melinda Gates Foundation (BMGF) funded Partnership for Advocacy in Child and Family Health (PACFaH) provided technical support to Nigeria FMOH to fully adopt the global policy for the management of Childhood Pneumonia and Diarrhoea in 2016.

There is a need for concerted efforts by government and other relevant stakeholders to implement the enacted childhood Pneumonia and Diarrhoea policies to save our children. Another challenge to implementing these new policies is funding constraints.     

Enlighten us on the progress you have made in your work so far and what you envision with your work in the near future?

EA: Apart from supporting the government to mainstream the management of Childhood Pneumonia and Diarrhoea with the use of the newly (2016) adopted policies, I am working on supporting the government to increase access to life-saving contraceptives through the private health sector, which are mainly Community Pharmacies (CPs) and Patent Medicines Shops (PMS). According to the NDHS, 60% of Nigerians visit the CPs and PMS for their health needs. Only 30% of Nigerians visit the public health facilities (according to the NDHS).

On the Childhood Pneumonia and Diarrhoea work, we have been able to support FMOH to disseminate the new policies to all States of the Federation for domestication and implementation. You know in Nigeria, health is on the concurrent list; thus, each State of the Federation has the right to legislate on health matters. FMOH cannot force policies on the States; FMOH can only disseminate the policies and encourage the States to adopt, domesticate and implement. We completed the dissemination of the new Pneumonia and Diarrhoea policies across Nigeria in September 2018. We plan to support “willing and available” States to adopt, domesticate and implement the national Childhood Pneumonia and Diarrhoea.

On supporting the government increasing access to family planning information and services through CPs and PMS, we have advocated and obtained approvals from the government to implement a pilot project in Kaduna and Lagos States. We hope the result from this pilot will lead to the revision of current FP policies that prevent CPs and PMS from providing expanded contraceptive information and services in Nigeria.

MARY DINAH

Can you talk us through the statistics of violence against women? How worrying are these numbers?

MARY DINAH (MD): United Nations statistics shows that 1 in 3 women worldwide has experienced either physical or sexual intimate violence at one point in their lives. These figures are worrying because of the lasting effect sexual violence has on women. Amongst many other ills, sexual harassment and violence against women often result in depression, HIV in some parts of the world, unemployment, abortion, suicide. Worst still, it is reported that most of the perpetrators are past or present husbands, boyfriends and family members. The close nature of these relationships ending in violent conduct creates a very deep scar in the lives of women and it has to stop.

What in your opinion are the direct effects of gender inequality on African women especially?

MD: Gender inequality has adverse effects on social development across the board. Reduced access to quality education, low income and wage brackets, discrimination against women attaining leadership positions, limited access to quality healthcare for women all hamper the growth of our societies by a 50% factor which is roughly the ratio of women to men in most African countries. As Mandela said ‘we cannot move forward if half of us are held back’.

For something arguably so entrenched in our society, how do you plan to use your policy to battle the causes of violence against women?

MD: Society norms were formed over time and are very much subject to change. Three keys areas must be addressed to improve the situation. Firstly, more data on sexual violence must be gathered through surveys in order for the analysis to be shared and the knowledge disseminated. Secondly, women must be encouraged to share their experiences and seek help through counselling. Thirdly, laws must be updated to meet inter-nation standards and recommendations in order to have more successful trials in this area. Through my foundation –POWA which is Power to Women Association – we have launched an open email line where victims of sexual harassment can anonymously share their experiences while we connect them to proper counselling. This will also form the basis of data gathering which will be used as cases in lobbying the Senate to pass appropriate bills into law. 

You say you have a vision to live in a world where there is gender inclusion and women’s rights are protected. Do you believe this can come about in your lifetime? How close are we to this?

MD: I believe we can achieve this to a great extent by 2030 in line with the United Nations Women’s goals and timelines. One of the key catalysts of this rapid change in mindset is technology. Women in both urban cities and rural areas now have access to the internet through smartphones and can see for the first time the quality of life women in the developed world have. This includes freedom, financial security and liberty they enjoy as women. This wave undoubtedly has already gotten far in certain parts of the world and is moving very quickly to Africa. 

How much is the law helping women battle sexual violence? Can you enlighten us on laws women should be familiar with in order to enforce change?

MD: The UK is a great example of a nation where laws are very quickly updated and new laws are passed through parliament in an exemplary manner. For example, this year a new law called Upskirting was passed which means anyone who takes a picture of a ladies undergarments by placing a phone or camera under her skirt will be guilty of Upskirting, a crime punishable by 2 years in prison. With this new amendment, many more people have been convicted of this crime. Therefore, multiple laws are needed in the area of sexual harassment which is not yet in place in Nigeria. Nigeria still operates mainly under the Violence against Persons Act for all sexual harassment offences. However, multiple crimes fall under this which needs to be identified and passed as law otherwise perpetrators will be easily acquitted.

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