By Isaiah Owolabi, Project Director & Co-founder, HACEY Health Initiative

“I want to have enough money to visit doctors when I want, and where I want.”

Adeola, 23, is a graduate of HACEY’s Back on Track program at Ibafo, Ogun State, Nigeria. She is a fashion designer and community health promoter. Her culture, religion or tradition, she says, will not impede her desire to lead a healthy and productive life.

Adolescent Sexual & Reproductive Health in Nigeria

With young women below the age of 24 making up almost 25% of Nigeria’s approximately 202 million people, young women have been recognized as a special needs group, especially in the area of reproductive health. The sexuality and reproductive health of adolescent girls are important contemporary issues that are further compounded because of challenges such as early marriage, unintended/unwanted pregnancy, maternal mortality and sexually transmitted diseases, including AIDS.

AIDS and maternal mortality are two very significant health problems for adolescents in Nigeria. A large proportion of new HIV infections each year occur in adolescents, with a higher level of incidence in young women than young men; and pregnancy-related problems are a leading cause of death for adolescents, due mainly to complications from unsafe abortion and childbirth. 

There are many unmet reproductive health needs for adolescents in Sub-Saharan Africa despite the many reproductive health programs which have been initiated in the last decade. In Nigeria, there are social barriers for young girls to negotiate safer sex. This situation is even worse for the girls who live in communities where gender inequity is still a socially accepted way of life.

Despite the increasing focus and commitment to issues facing young women and girls by the global community, challenges to their health at the national and local levels have become more glaring in the face of recent progress. Far too many girls within the ages of 15 – 24 years of age remain marginalized and vulnerable; lacking basic life skills, career information and health knowledge to lead a healthy and productive life.

When girls lack basic skills and health information, and cannot make informed career decisions, they are more at risk of experiencing challenges to living to their full potential. Access to good health and economic empowerment information/opportunities give women and girls the ability to take control of their lives, pursue their goals and live according to their own values.

HACEY Health Initiative

The 2019 edition of the Gates Foundation’s Goalkeepers report stated, “No matter where you are born, your life will be harder if you are born a girl.” We agree, and this is the reality of millions of girls like Adeola in Sub-Saharan Africa. The publication implores everyone to take action and show what progress looks like, and we are determined to continue until we achieve a society where all women and girls are able to live to their full potential.

Over the last 12 years, our work at HACEY Health Initiative has been dedicated to empowering women and girls by supporting them to unlock productivity and innovation, cut poverty, create opportunities, and improve their health outcomes. Our programs are designed to engage and mobilize resources and competencies of key decision-makers, private sector leaders and institutions to accelerate the impact of development interventions focused on improving the life outcomes of women and girls in Nigeria.

Imagine the scenario of a young girl like Adeola with a child, who dropped out of school because of her pregnancy, and is currently without a means of livelihood. Every day of the week she begs for food from one house to another. Every sunset on Friday represents her biggest joy and sadness; it is the weekend. Adeola described her experience working as a part-time sex worker: “Bike men and bus drivers invite us to the brothel and have sex with us till Monday. My only reward was free food, alcohol, and a thousand Naira (less than 3 US dollars). This was my biggest source of sadness for almost four years before [HACEY’s] Back on Track program.” 

Adeola’s example is representative of 20% of pregnancies in Nigeria, where one in four pregnancies is not wanted. According to UNFPA, 29% of Nigerian mothers give birth before age 18, and only one out of 10 of these girls will have received a secondary education. Education is an important factor to increase the chances for delayed pregnancy and access to economic opportunity.

Fulfilling the Promise of the Demographic Dividend

In order to achieve the Sustainable Development Goals in Nigeria, it is important to harness the demographic dividend resulting from the booming youth population. A Brookings article shows that “as the youth population grows, so does the unemployment rate.” According to the article, young women accounted for more than 50% of the unemployed youth in Nigeria between 2008 and 2012. Among those who do have jobs, the majority are self-employed, working in the small informal wage sector. This emphasizes the need to invest in young people, providing them relevant skills and knowledge, and creating opportunities for them to live to their full potential.

Through experiential learning programs like our Back on Track or Code 4 Impact programs, young girls can define their career path by becoming business owners or working in small and medium scale enterprises. Knowledge that empowers and access to healthcare products and services are critical for them to maintain good sexual and reproductive health, leading to improved work opportunities and better quality of life. Conversely the lack of knowledge, access and supportive environment threatens their ability to save capital, complete vocational training and stay healthy and productive.

Hannah is a 19-year-old beneficiary of our Code 4 Impact training at HACEY Health Initiative. “My dad will allow me to go anywhere I can make money,” she says. As one of the members of the team who worked on our Tombey.org platform, she is determined to teach more girls about web development and make money designing web and mobile applications for big companies. The Tombey.org platform maps youth-friendly sexual and reproductive health facilities in Nigeria and gives young people information and referrals on sexual and reproductive health.

Overcoming Cultural Barriers

A leader from our beneficiary communities expressed an attitude that is common in some of the communities, stating “If you bring empowerment to our people, we will embrace you; if you want to teach them about sex, we will not allow you.” Some of the girls that have benefitted from our Back on Track and Code 4 Impact programs in those communities have become huge sexual and reproductive health advocates; community members and leaders listen to them because these girls have become role models to many other girls.

So what is the solution to deliver high impact maternal and sexual and reproductive health for women and girls across Nigeria? Like our Back on Track program, which integrates economic empowerment and sexual and reproductive health information and services, all our projects are designed based on the needs of the community and reality on the ground. Data from our HIV, Maternal Health, Sexual Violence, Female Genital Mutilation, education and economic empowerment interventions show that working with partners and integrating approaches across different sectors and generations can accelerate the impact of women’s and girl’s health and productivity programs.

Like Adeola and Hannah, we have seen many of our program beneficiaries transform their own lives through access to finance, mentoring and health services. Examples include the following;

• In Ibafo, many girls enrolled in the Back on Track program so they no longer needed to wait till sunset on Friday for the source of their income; this resulted in a small brothel shutting down.
• In Ibadan, integrating entrepreneurial-based approach into our maternal health program improved the health-seeking behavior of women during pregnancy.
• In the Northern part of Nigeria, empowered young people have become champions for girl’s education and access to sexual and reproductive health and rights.
• Our End Malaria program and market access program is changing the behavior of more fishermen; they are dropping the use of mosquito nets for traps or fishing and using them to protect their families.

We need to do more to make the world work for women and girls; it is not just a gender issue, it is a development challenge. When we make the world work for women and girls, we make it work for everyone. The best economics and science are the ones that improve the livelihood of people without jeopardizing the ability of future generations to do the same. Often, to deliver a sustainable high impact intervention, we need to be brave and listen to people.

A personal perspective

My 12 years of work as the Project Director at HACEY, including my period as an Atlas Corps Fellow at GBCHealth, has shown me that we can scale and sustain impact of simple solutions to create changes at the systemic level, thereby creating a healthy, just and productive society for all the millions of girls like Adeola and Hannah in Sub-Saharan Africa. To achieve this, we must be deliberate about documenting lessons, building capacity, and creating platforms conducive for mobilizing the resources and competencies of private and public sector institutions to transparently deliver social good.

Isaiah Owolabi is Project Director & Co-founder, HACEY Health Initiative (www.hacey.org). He is currently an Obama Foundation Scholar at Columbia University in New York. He is a One Young World Ambassador, a regional winner for the Commonwealth Youth Award and was presented with a Queen’s Young Leaders Award in 2015. Isaiah is also an alumni of the prestigious Mandela Washington Fellowship for Young African Leaders program (Young African Leaders Initiative – YALI).

HACEY Health Initiative is a development organization focused on improving the health and productivity of vulnerable and underserved populations in Africa with its focus on women & girls. HACEY’s “Back on Track” program has placed more than 150 girls in vocational training and paired over 200 girls with mentors. Their “Code4impact” program has provided media and digital skills training to over 1,000 women and girls. Find out more at https://www.hacey.org/.

Names in this article were changed to protect privacy.