This was presented at the guest lecture on the second day of the 6th Nigeria Family Planning Conference which happened in Abuja from December 7 - 11, 2020.
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Professor Lanre Olaniyan: Family Planning, COVID-19 Pandemic and Progress Towards Achieving the SDGs
1. Family Planning, COVID19
Pandemic and progress towards
achieving the Sustainable
Development Goals
OLANREWAJU OLANIYAN
HEALTH POLICY TRAINING AND RESEARCH PROGRAMME (HPTRP)
DEPARTMENT OF ECONOMICS
UNIVERSITY OF IBADAN
IBADAN, NIGERIA
2. Outline
Introduction
The demography of Nigeria
Family planning during emergencies
Preparedness for Emergencies (Any role for FP2020, policies and programmes of
government) Population structure, demographic dividend etc.
In the Midst of the COVID-19 emergencies (Access issues; Quality issues;
Post COVID-19 emergency activities (Implementation, Financing, New normal)
Family Planning and the SDGs
Policy Options
What can COVID19 response learn from Family Planning programming?
What can Family Planning programming learn from COVID19 response ?
2
3. Introduction
First case of COVID 19 in Nigeria was February 27, 2020 and it was
imported
The types of uncertainty, health and economic shocks associated with
the illness had been unprecedented
The pandemic has reminded us of
Global health security
Weaknesses in health systems, social protection and public services.
Weakness of the economic systems and dependence on social systems
the critical way in which the formal economy of developing countries including
Nigeria has been sustained on the back of an informal economy and invisible and
unpaid care labour.
3
5. Introduction
The health sector of the country is one of the most affected sector by the
COVID pandemic.
While prompt response was initiated for different areas of the health sector by
government, there re arguments on whether reproductive health and family
planning has received appropriate response during the pandemic
Incidentally, reproductive health is a fundamental human right; only
individual adults should have the power to decide whether, when, or how
often to conceive. Rights and responsibility…
Family planning is at the core as it assists individuals who do not wish to
become pregnant, dramatically reduces the number of unwanted
pregnancies and abortions.
5
6. Family planning ensures a balanced fertility and demographic transition in a society with attendant
benefits
empowering women to choose how many children they have,
better health and survival of mothers and children,
a reduction in poverty and
a better educated population.
With adequate and effective family planning, individuals take responsibility for the number of
children they desire leading to birth rates fall and increase in the share of the working-age
population relative to the dependent population.
This puts countries at a window of opportunity to harness “demographic dividends”.
Given that family planning directly shape the pace and patterns of demographic dividend, it will be
used as the discussion framework in this presentation
6
Introduction
7. Response to COVID 19 across countries had been
similar…
Setting up of Pandemic Task forces
Lockdown of cities and settlements
Closure of Schools, Markets and Businesses
Travel Bans and Social distancing
Personal hygiene and Community Hygiene
Testing, Isolation and Quarantines
Search for drugs and vaccine
All these come with attendant risks and uncertainty for family planning and
reproductive health
7
8. 26
31
38
39
41
60
57
63
63
64
53
49
52
50
37
40
34
34
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Europe
Northern America
Oceania
Asia
LAC
Africa
Ghana
West Africa
Nigeria
Age Structure of Population by Region in 2019
Under 25 years old 26-64 years old 65 years and above
Africa has the
largest
proportion of
children and
youths in the
world and its
share of the
population at
working ages
(25 to 64 years)
is increasing,
providing an
opportunity for
accelerated
economic
growth
Starting with the demography of Nigeria 8
9. The demography of Nigeria: Population
37,859,750
55,982,142
95,212,454
158,503,203
206,139,587
401,314,997
0 100000000 200000000 300000000 400000000 500000000
1950
1970
1990
2010
2020
2050
9
10. How prepared was Nigeria for the Pandemic?
Nigeria has a National Pandemic Influenza Preparedness and Response Plan that was prepared in
2013. The health system preparedness for a global health shock was available, at least in a printed
document. Although there was ebola but COVID is on a different scale
It should be noted that neither reproductive health nor family planning was mentioned in the document
Note that the Global Health Security Index, a comprehensive assessment of a country's health system
capabilities, shows that most African countries are rated as least prepared.
Nigeria with a score of 37.8 was ranked 96th out of the 195 countries that were assessed.
Only 21 of 54 African countries are classified as being more prepared from a clinical perspective to deal
with epidemic threats with international implications. The other 33 are ill-equipped and least-prepared
to respond to the outbreak.
Preparedness of Family planning system: Availability, distribution and supply chains
10
11. Preparedness: Where were we on
contraception and unmet needs?
Contraceptive use allows couples
to realize their full potentials,
the woman can better fulfil her roles as a wife, mother, wage earner and community
member.
The man can better expand his roles as husband, father and family caregiver
promotes small family size, improves child survival and reduces sibling competition for
scarce family and maternal resources
curtailing population explosion thereby reduce dependency ratio
better the health indices for the country and
improve socio-economic conditions.
assist Africa to make progress in achieving all the sustainable development goals
(SDGs)
11
12. 12
0
5
10
15
20
25
30
35
40
1990 2003 2008 2013 2018
Demand for family planning
0
5
10
15
20
25
30
North
Central
North East North
West
South East South
South
South
West
Unmet need for family planning
• Approximately 45per cent of women in Nigeria
are sexually active and do not want a child in
the next two years.
• In Nigeria, unmet need vary among geopolitical
zones
• Unmet need for modern contraception is also
higher among unmarried sexually active
adolescents
What do we know about
Preparedness: Contraception
13. Family Planning in the Midst of the COVID-19
emergencies
Restrictions on mobility make it even more difficult for
young people to access high-quality, respectful, and
confidential care.
Limited mobility due to lockdowns increases the risk of
unwanted pregnancies and unsafe abortions.
Negative effect on access to many healthcare services,
Negative effects on access to sexual and reproductive
health services which are actually essential and
lifesaving.
Possibility of increased unmet need for modern
contraceptives, unintended pregnancies, increased
unsafe abortions, maternal and neonatal deaths and
child marriages during the lockdown
13
-
5.0
10.0
15.0
20.0
25.0
30.0
0-14 15 - 34 35- 54 55 - 64 65 and
above
Proportion of individuals who are
unable to access medical
treatment
14. Family Planning in the Midst of the COVID-19
emergencies (Access issues; Quality issues)
Health System Issues
Financing Issues
Economic and General Planning Issue: Economic
Sustainability plan of Government
Global Goals that the government has signed into SDGs
14
20. Effects of COVID 19 on Reproductive Health and Planning:
Demographic Dividend Index (DDMI) for Nigeria (index = 36.4)
Components of the Nigerian Demographic
Dividend Index, 2018
Components of the Health and Wellbeing
Pillar of the Nigerian DDMI, 2018
33.2
42.5
33.448.4
23.4
Health and
Wellbeing
Education
and Skill
Development
Employment
and
Entrepreneurs
hip
Governance
and Youth
Participation
Practical
Evidence-
Building on
DD
16.9
39.5
18.1
32.6
48.1
34.7
54.2
Child
health
Reproducti
ve health
Adult
health
Health
Finance
Nutrition
Water and
Sanitation
Housing
Source: Olaniyan et al, 2020 Construction of Demographic Dividend Monitoring Index and Procedure for Setting up a Demographic Dividend Observatory for Nigeria
20
21. 16.9 39.5
18.1
16.0
48.1
34.7
54.2
Child health
Reproductive
health
Adult health
Health
Finance
Nutrition
Water and
Sanitation
Housing
HEALTH AND WELLBEING (BEFORE COVID)
16.9
27.9
18.1
16.0
48.1
34.7
54.2
Child health
Reproductive
health
Adult health
Health
Finance
Nutrition
Water and
Sanitation
Housing
HEALTH AND WELLBEING (AFTER 6 MONTHS OF
COVID)
21
22. 50.0
22.5
38.1
48.5
19.7
Total Fertility
Rate
Adolescent
Fertility Rate
Skilled birth
attendant
Proportion of
demand for
family planning
satisfied
Maternal
mortality
REPRODUCTIVE HEALTH (BEFORE
COVID)
44.0
18.1
19.124.3
10.5
Total Fertility
Rate
Adolescent
Fertility Rate
Skilled birth
attendant
Proportion of
demand for
family planning
satisfied
Maternal
mortality
REPRODUCTIVE HEALTH (AFTER 8
MONTHS OF COVID)
22
26. There can be no sustainability without
efficient and effective family planning
• The demand for family planning will never cease as long as life continues
to exist on earth
• Humans want to satisfy their physiological desires and need for
procreation (generational species sustainability).
• At any point in time, there will always be a cohort of young adult couples
who not only want to fulfil their sexual desires but also want to delay or
postpone pregnancy, and so the demand for contraception will
continue.
• The way these are handled will determine the desired future which is
sustainability and sustainable development…
26
27. Post COVID-19 emergency activities:
The future is sustainability and sustainable
development…
“Sustainable development meets the needs of the present without
compromising the ability of future generations to meet their own
needs”
Seen as the guiding principle for long-term global development,
sustainable development consists of three pillars: economic
development, social development and environmental protection”
(http://www.uncsd2012.org/).
27
28. How do all these fit into the Nigeria we desire:
Sustainable Development Goals…
• 17 Goals, 169 Targets, 230 Indicators
28
30. SDGs that address Reproductive
health directly
Target 3.7:
By 2030, ensure universal access to sexual and reproductive health-
care services, including for family planning, information and
education, and the integration of reproductive health into national
strategies and programmes
Target 5.6
By 2030, ensure universal access to sexual and reproductive
health and reproductive rights as agreed in accordance with
the Programme of Action of the International Conference on
Population and Development and the Beijing Platform for Action
and the outcome documents of their review conferences
30
33. What do Family Planning and SDGs have in common
The political declaration stipulates the vision of the agenda and its
underlying principles:
• Universality: The goals and targets are applicable to all countries:
Developing, emerging economies as well as developed countries
• Integrative character of the all dimensions of sustainable
development (economic, social, environmental and cultural)
• Multi-stakeholder-Approach: all actors in line with their capacities
have a shared responsibility to implement the agenda – shared
responsibility for the outcomes!
• Transformative: Sustainability shall be the new principle of all actions
33
34. • People
• End poverty and hunger, in all their
forms and dimensions, and to ensure
that all human beings can fulfil their
potential in dignity and equality and
in a healthy environment
• Planet
• Protect the planet from degradation,
including through sustainable
consumption and production,
sustainably managing its natural
resources and taking urgent action
on climate change, so that it can
support the needs of the present and
future generations.
What can Family Planning preparedness learn from the
SDG Elements 34
35. • Prosperity
• Ensure that all human beings can enjoy
prosperous and fulfilling lives and that
economic, social and technological
progress occurs in harmony with nature.
• Peace
• Foster peaceful, just and inclusive
societies which are free from fear and
violence. There can be no sustainable
development without peace and no
peace without sustainable
development.
• Partnership.
• mobilize the means required to
implement this Agenda through a
revitalised Global Partnership for
Sustainable Development, based on a
spirit of strengthened global solidarity
What can Family Planning preparedness learn from the
SDG Elements 35
36. Making Family Planning work for the SDGs
Digital
Revolution
Implementation
arrangement
Financing
strategies
Communications
and outreach
Partnerships
36
37. Digital Revolution for Sustainable
Development
Given the new normal of social distancing and lockdowns,
efficient and effective digital health solutions to reduce the
burden on family planning providers is required as it will also
increase access
Further development of other digital government services and e-
commerce
Further investments in STEMS, digital skills, equity, and lifelong
learning for reproductive health
Accelerate the adoption of measures that support a fair transition
for workers affected by the digital and technological revolution
37
38. Government must take the commanding
heights in the implementation…
Increased role of government in key sectors (economy, health, food,
social security)
Develop a detailed action plan.
Re-think global supply chains and dependence for strategic equipment
and materials
Strengthen development cooperation to support recovery plans
Strengthen statistical capacity, and the availability of timely data
Strengthen government capacities to anticipate and manage unforeseen
disruptive events
Strengthen international platforms, exchanges and transparency among
scientists/researchers (open science)
38
39. Making Family Planning work for the SDGs
Implementation Issues
Invest in health preparedness to update and upgrade healthcare systems. In the long
run, large investments in health preparedness are required to update and upgrade
Africa’s health care systems.
No single framework can apply equally to all countries, so these transformations will
need to be adapted and tailored to suit local needs and customs.
Issues of supply chain and distribution of vaccines when they are eventually available
for distribution.
With the number of targets and indicators within the SDGs, it creates opportunities
and challenges for research.
Political and financial support from individual African governments is vital to achieve
regulatory governance and health research capacity.
Quality of health system governance including those of reproductive health and
family planning
39
40. Financing Strategies
Strengthen financing mechanisms for developing countries.
Finance: The Elephant in the Room: The magnitude of the SDG financing challenge far exceeds the
capacity of any one organisation and demands a strong partnership among governments, the private
sector, and development organisations.
Redirect resources to the public health sector and develop sound health emergency plans. In the short
run, Countries should tap into existing resources to invest in health infrastructure for detecting,
testing, confining, and treating COVID– 19 infected people.
Various financing mechanisms are used for family planning. This is good also for COVID 19 response.
Note that the IMF was created for global crises like this one
Private creditors will need to refinance or capitalize debts falling due.
What is missing is the specific Reproductive health and family planning facilities
40
41. Communication and Outreach
There is the need to develop effective information sharing and
communication: strategies. Early dissemination of accurate information
on the coronavirus symptoms, prevention, and treatment can contain
its spread and reduce public panic and misinformation.
African governments need to engage and create an environment that
a) uses results from health research, b) adapts national health policies
to invest in new and better medicines, and c) makes these accessible
through public health systems.
The world needs urgently to learn from and to emulate the information
and dissemination strategies for fighting Covid-19. Family planning
programmes seems to have mastered the art of communication and
dissemination to the different stakeholders well.
41
42. Partnership is key
Governments, development partners and other stakeholders must respond in
a coordinated, targeted, and rapid manner to be effective in limiting its
impacts.
Across the country, the response must be well-sequenced and multipronged,
involving every stakeholder
This can bring all the stakeholders in ways that address family planning and
COVID 19 issues
There are compelling advantages to having institutional partnerships so that
individuals can collaborate to have a sustainable impact compared to
working individually within institution.
If built, maintained, and managed in an equitable fashion have the potential
to generate a lasting positive impact on global health
42
43. Making Family Planning work for the
SDGs
Ensure social protection.
As part of any comprehensive response to the pandemic, governments should
promote new instruments of social protection. This should include both child and
maternal health protection. Family planning must also be at the core of this social
protection
Continuous promotion of new drugs and vaccines.
Financing R&D for Covid-19 drugs and vaccines is an urgent global public good.
Without global cooperation, R&D will be inadequate and duplicative.
Family planning programmes can suggest optimal ways for distribution and mass
uptake. While Global Fund and GAVI, the Vaccine Alliance are two exemplary
institutions that serve as historical precedents, Nigerian family planning stakeholders
have a lot of experience to fall back on
43
44. Take home points
COVID 19 pandemic emergencies have affected family
planning negatively in the last ten months
The effects is escalated due to the structure of the pace and
pattern of the country’s population and preparedness of the
health system
The effects of the emergency on family planning have
important implications for the country’s progress in harnessing
the demographic dividend as well as attaining the sustainable
development goals
44
45. Olanrewaju Olaniyan
Health Policy Training and Research programme (HPTRP)
Department of Economics
University of Ibadan
Ibadan, Nigeria
Tel: +234-802-325-5741
• Alternate Mail: o.olaniyan@ui.edu.ng
• Skype: Olaniyan57
• Linkedin: lanreolaniyan
• Facebook: lanreolaniyan
• Twitter: @Lolaniyan
45
