‘Nigeria has no up-to-date policy on adolescent health’

What is the exact situation of adolescent health in Nigeria?  Most of the issues raised by the commission are not strange to me. The opinion that the experts came up with more or less synchronizes with the opinions that the experts in Nigeria generally have. Since 2006 I have been the chair of Nigeria’s Technical […]

What is the exact situation of adolescent health in Nigeria?
 Most of the issues raised by the commission are not strange to me. The opinion that the experts came up with more or less synchronizes with the opinions that the experts in Nigeria generally have.
Since 2006 I have been the chair of Nigeria’s Technical Working Group on Adolescent Health. I have also led in the development of a policy around young people.

What is the opinion?
On all sides, Nigeria is still battered with all kinds of adolescent health problems. That is why the commission rightly classified us as a high burden country. The data in country also reflects that is where we are in our trajectory of adolescent development. 
Nigeria is a multi-burden country, in other words, we are battling with some old existing traditional problems which are very high, particularly issues around reproductive health. Our teenage pregnancy level for example is very high.  As the Nigerian Demographic Health Survey has shown, almost a quarter of our young people are getting pregnant, and it is almost 40 percent in some parts of the country.
Unfortunately in Nigeria many of them are not just young people getting pregnant but those getting pregnant in marriage.
HIV is another issue, the level is not  quite high in terms of  prevalence rate,but because we have a huge population of young people in Nigeria, our HIV picture comes next after South Africa, so we have a huge burden of HIV.
We also have issues with early sex and sexually transmitted infections, because that goes together with pregnancy and HIV.
We are also battling with traditional issues about infection, like malaria for instance; next to children, adolescents have the highest burden not because they get as sick but because the number of adolescents in this country is huge. The adolescents in this country constitutes about 23 percent of our population.
If our population is about 189 million, that is over 30 million adolescents.
There are countries classified in that report as injury high burden countries because of suicide, and transport problems. Nigeria is also beginning to increase very much in that area. Infact the burden of the problem now is even high than that of Sexually Transmitted Diseases.
Okada (motorcycle) riding has become the job for millions of our young people because there is no work, as a result of this , we are beginning to get a high level of injury. Our roads are terrible. People are still buying driving license from home, people still drive carelessly on the road. There are laws regulating this but no one applies the law. We are getting increased rate of accidents and injury among young people.
Furthermore there are countries classified in that report as non-communicable disease high countries. As a country we are also included in that area.
Obesity is increasing because junk food is increasing in our country, every  angle has one fast food joint or the other and people are patronizing and using a lot them.
Young people do not exercise any longer, everybody drives to school,  so we are battling the  traditional problems and witnessing increase in injury, and non-communicable diseases.

In what way is the report of help to us?
The report also itemized for us some of the things we need to do to reduce the problem. Let me state emphatically, it is not as if we have not done some things. But there are three major problems about what we have done.
Number one, a lot of things we have done that need to go to scale have not gone to scale. In other words, the coverage of some of our interventions have been so low and few, for example we do the family life and HIV education in the country which is supposed to cover all citizens but today less than a fifth of our students have been covered.
Two, there are things we are doing that evidence don’t support , like interventions, programmes and adverts that are not solidly based on science, and as such are not producing  the kind of results they should.
 Three, there are things we could have done more that we have not done at all or that evidence has shown can work but we have not tried at all.

The report said there should be urgent and continued investment in adolescent health. Specifically, what should government do urgently in the area of adolescent health?
We must ensure that a great proportion of our young people go to school and not just primary school. Let us invest and make sure that most young people get a minimum of secondary school education that is of good quality.
More so, our schools shouldn’t be just places to learn arithmetic and mathematics. But  a place for influencing the development of young people.
 Another investment is to get our health system to recognise how important it is to work with young people in a friendly way. There is also need to invest in our health system to be more responsive to the agenda around young people.
The other thing we need to do is to invest in our laws. There are laws we need to review. As I talk to you now, today there is no extant policy around young people’s lives in Nigeria. We developed a policy in 2007 , that policy was supposed to take us to 2012 but we said let’s push it to 2013. That policy needs to be reviewed urgently. We had an Action Plan 2010 to 2012, that action plan has not been revised. Our National Youth Policy that I am anchor has also expired. Now UNFPA is trying to get the ministry of youth to review it. Even in terms of our policy on young people, we don’t have an up to date policy.
For example, in our universities they said professors can now  retire at 70 years. If they do this, are they not taking the jobs that young people should have taken?  They didn’t think around this policy in terms of creating space for young people, and that is the challenge we are having, we are not thinking through our young people and what tomorrow means for them.
(The Lancet Commission group was established under the leadership of adolescent health specialists at the University of Melbourne, Australia, The London School of Hygiene and Tropical Medicine  and two other universities,  and has 30 members from 14 countries spanning  six continents)