By John Paul Akinduro

‘Women empowerment’ is a popular lexicon often used by Nigeria’s power elite to connote their agenda for the womenfolk. If you reside in Nigeria, you must be familiar with the fanfaronade that politicians exhibit when they decide to ‘empower’ women with the usual hair dryers, pepper-grinding and sewing machines and the likes, mostly under the scorching sun. It is easy to berate them as bereft of ideas, if you do not operate within the ecosystem, which has been filled with charlatans in recent times.

While researching this piece, I stumbled on some mind-altering data from the latest BudgIT report that revealed some states spending low on health and education, despite the appreciable increase in Internally Generated Revenue (IGR) and the monthly federal allocation, of which my state of Ondo is unfortunately one but I have decide to be generous with my remarks and make this a soft reminder of the need to do more for our women and girls.

I must say, I am not in any way implying that politicians should not carry out the usual token called ‘women empowerment’ after all, the majority of these women have been impoverished by the political class for far too long.

In the most progressive sense, women’s empowerment has to do with giving women access to opportunities and resources that will enable them to have power to control their own lives and determine their own choices including sexual and reproductive health, which will ultimately lead to economic empowerment, especially for women in low- and middle- income countries like Nigeria.

It is unsettling that in the 21st century, 8.8 million Nigerian women of reproductive age (15-49) have an unmet need for use of modern contraception out of 14 million who want to avoid a pregnancy while there are 770,000 adolescent women (15-19) who have an unmet need for modern methods out of 1.1 million who want to avoid a pregnancy, according to the Guttmacher Institute, in its Adding It Up (AIU) project report of 2019. The case is not different in about 132 low- and middle-income countries (LMICs) and the situation has remained this way over time for lack of political will.

“In low- and middle- income countries, 218 million women have an unmet need for modern contraception, which is a huge component of comprehensive reproductive health services” Doyeun Kim, Global Communications Manager at the Guttmacher Institute, disclosed at the launching of Family Planning Investment Impact Calculator (FPIIC) and the dissemination of Adding It Up (AIU) that brought together top thinkers and practitioners in the reproductive health ecosystem, in Lagos in November and it was organized by the Academy for Health Development (AHEAD) Nigeria.

Adding It Up (AIU) is an ongoing Guttmacher Institute project that estimates the need for, impact of and costs associated with providing essential sexual and reproductive health services and aims to provide advocates, researchers, policymakers and other stakeholders with supportive evidence on the benefits of investing comprehensively in sexual and reproductive health services in low- and middle-income countries.

It is gratifying that the Guttmacher Institute did not just dump these statistics from the AIU project on us to start unbundling or make sense of it but it has done a good job of coming up with what it called the Family Planning Investment Impact Calculator (FPIIC).

Remarkably, this calculator is in the public domain and, on Guttmacher’s website. It allows users to produce data and graphics on the number of women and couples who would receive modern contraceptive care, it shows how increased contraceptive use would avert unintended pregnancies, unplanned births and unsafe abortions, it also displays the number of women’s and girls’ lives that would be saved and cost savings that would be achieved. As demonstrated by Dr Olaitan Oyedun, a Senior Fellow at AHEAD, “every additional US Dollar invested in contraceptive services in low-and middle- income countries like Nigeria would save 3 US Dollars in maternal, newborn and abortion care”. This, the calculator revealed as he input the variables.

“Fully meeting the need for modern contraceptive services and maternal and newborn health care would result in a 68 percent decline in maternal deaths in Nigeria” Adesegun Fatusi, a Professor of Public Health and Community Medicine and founding President of AHEAD, quoted the Gutmaccher Institute as he wrapped up his presentation on investing in sexual and reproductive health.

For a country that has one of the highest maternal mortality rates in the world, if you ask me, this is a big reason to embrace the novel FPIIC, possibly localize it and increase investment in family planning not only in terms of Naira and Kobo but also in the workings and political will. Bearing in mind that most enduring legacies of any public office holder are not assessed by the delivery of brick and mortal projects but in terms of how many lives impacted, especially the vulnerable groups.

Most relatable will be the embarrassingly high number of out-of-school children in Nigeria, which is put at 20 million, by UNESCO as at October 2022 – approximately, a combined population of Denmark, Sweden and the Republic of Ireland. While there may not be enough evidence to link low family planning uptake to high rate of out-of-school children in Nigeria, it is common sense to know this would be a major contributing factor.

“With all the interventions and commitments from the government and partners, there is still a huge gap in the utilization of family planning commodities across the nation” Dr Salma Anas, Director of Family Health in Nigeria’s federal ministry of health, submitted in her remarks at the launch of FPIIC and dissemination of AIU, and according to her, this is so despite “existing policies to ensure citizens have access to quality, free and safe family planning services”.

“The question is, are we spending on sexual and reproductive health the right way?” asked Dr Isaac Aladeniyi, Director of Family Health at the Ondo state ministry of health, who joined other professionals on a panel at the event, which was eloquently moderated by a Professor of Public Health and Community Medicine at the Lagos State University College of Medicine (LASUCOM) Ikeja Lagos, Kikelomo Ololade-Wright.

Aladeniyi argued that there are other factors affecting sexual and reproductive health that must be considered. He suggested community involvement in the design and delivery of family planning programs as a way of improving on the uptake, attributing the success of Ondo Abiye Safe motherhood program to community involvement and ownership.

Other panelists which included the Lagos Chairman of Society of Gynaecology and Obstetrics of Nigeria (SOGON), Prof. Abidoye Gbadegesin, Pharmacist Oluyemi Kolawole and Prof Adesola Olumide, Secretary General of the Society of Public Health Professionals of Nigeria (SPHPN), agreed that public-private synergy, religious implementation of policies, aggressive advocacy and of course, increased funding are a part of complete package to expand access to modern contraceptive services for Nigerian women.

There is no gainsaying that the resultant effect of lack of access to modern contraceptive methods by adolescent women and women of reproductive age is multiplication of generational poverty. Just as I was winding down on this essay, the National Bureau of Statistics (NBS), an agency of Nigeria’s Federal Government, disclosed that no fewer than 133 million out of 218 million Nigerians, are currently living in multi-dimensional poverty, 65 percent of which are children and 29 percent out of school. Sokoto, Bayelsa, Jigawa, Kebbi, Gombe and Yobe are said to be the poorest states. Interestingly, a governor in one of these states built a hospital that is almost the size of the Abuja national stadium while doctors and other healthcare workers are relocating in droves abroad, largely due to poor remunerations, low welfare package, insecurity and poor economy, among other ills bedeviling Nigeria.
Undisputedly, there is a lot to learn from the polio eradication campaign. Notably, the Bill and Melinda Gates immunization leadership challenge – a unique recognition reward system for Nigerian Governors whose states pass a pre-defined threshold to improve routine immunization coverage and ‘kick polio’ out of Nigeria, as the campaign was codenamed. In a nutshell, there is a need to have this illuminating conversation on family planning with the Nigeria Governors’ Forum (NGF), the national and state assemblies and ministries of health across the 36 states of the federation because these are state actors saddled with the responsibility of protecting the health of those without wealth in our society.

It is highly impressive that organizations such as AHEAD is leading the charge in Nigeria by working with local and International partners and funders to push back the limits of knowledge and expand our understanding of sexual and reproductive health over the last 10 years. With a dynamic team of researchers, programmers and communicators, AHEAD is passionately engaging in “various research and dissemination activities, policies, advocacy, capacity building, generating and using evidence for effective programming and policy-making” according to Prof. Olawunmi Fatusi, acting Chief Executive Officer of AHEAD Nigeria.

Adding it up; increased investment in family planning for Nigerian women will increase productivity, reduce cost of maternal and newborn care, crash the country’s infant and maternal mortality rate and of course uphold the rights of women to decide whether and when to have children, experience safe pregnancy and delivery, have healthy newborns, and have a safe and satisfying sexual life.

John Paul Akinduro is a former Special Assistant on New Media and Digital to ex-Ondo governor, Olusegun Mimiko