Since its creation, the Office of the Senior Special Assistant to the President on the Millennium Development Goals has concentrated its efforts on the provision of additional funding to critical sectors to improve Nigeria’s chances of meeting the MDGs. In this interview, Dr Precious Kalamba Gbeneol, SSAP-MDGs, asserted that the federal government has currently achieved over 70 per cent of the requirements stipulated by the United Nations for countries to meet the Millennium Development Goals in 2015. Excerpts:
Could you take us through the MDGs framework in relation to Nigeria’s efforts towards attaining them by 2015?
At the United Nations Millennium Summit in September 2000, world leaders adopted a set of eight time-bound goals with related targets. These are referred to simply as MDGs (Millennium Development Goals). The MDGs are at the forefront of the global development agenda and represent the international community’s commitment to eradicate poverty by 2015.
The Eight Goals are: To eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and empower women, reduce child mortality rate, improve maternal health, combat HIV-AIDS, malaria and other diseases, ensure environmental sustainability and develop a global partnership for development
My office domesticates the international framework for the achievement of these goals. So far, for every MDG, there is a positive story to be told. With reference to the health goals for instance, although there are large variations from state to state, more children are surviving to their fifth birthday. More of them are starting school, and more are sufficiently nourished to be able to pay attention and learn. Their mothers have far less to fear about giving birth, and can be almost certain their children will not succumb to polio and other preventable children’s diseases.
Parents can be increasingly ambitious for their children. They have ever-increasing access to the technologies and opportunities that they need to earn income to support those they love. And as a nation, Nigeria has turned the tide on HIV/AIDS, malaria and international debt. In working towards the attainment of MDGs, we insist that services are delivered and equally encourage the institutionalisation of good governance. This is being actualized through a certain form of investment which is part of the grant to each participating state in the Conditional Grant Scheme (CGS), and our plan is to systematically strengthen government at the local level to deliver on MDGs.
What practical steps have you taken to ensure poverty eradication and attainment of goal 1?
The MDG1, which is the eradication of Extreme Poverty and Hunger, has the following measurable targets: Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day; achieve full and productive employment and decent work for all, including women and young people; halve, between 1990 and 2015, the proportion of people who suffer from hunger.
So far, I can tell you that the efforts towards poverty eradication have been yielding positive results. For example: We have deployed agriculture as a very important tool to gainfully engage a greater percentage of the populace as well as also help achieve goal 1. We have officially launched a value added initiative tagged: ‘MDGs GRANTS TO AGRIC-BASED COOPERATIVE SOCIETIES’, which involves a grant award to three agriculture-based co-operative societies in each of the participating 148 LGAs group for agricultural activities mainly for investment in enterprises along the agricultural value chain operated through a micro-credit finance processes.
The scaling up of the CCT and its implementation has helped Nigeria attain Goal 1 of MDGs by preventing over 100,000 basic school aged children from dropping out of school. About 103, 000 households are currently benefiting from the scheme across the country.
We are also distributing free fertilizers to farmers across the country in our quest to eradicate poverty. Already, we have attained the hunger target of goal 1 as recently recognized by the Food and Agriculture Organisation, FAO of the United Nations. Since 2011, OSSAP MDGs through the Conditional Grants Scheme have constructed over 77 skill acquisition centers.
Government, in her commitment to the MDGs has ensured the acceleration of the growth of the economy through a stable macroeconomic environment, while also addressing infrastructural gaps and an enabling environment for a market-based, private sector-driven economy with policies that ensure pro-poor economic activities.
Has this growth met the expectations of government, and the aspirations of the people?
Over the years, there has been reasonable growth in generation of jobs and provision of environments for poverty eradication efforts. However the pace is not as fast as we projected and we have, in these last few years been addressing the issues. Growth needs to be more equitably broad-based. Developing agriculture and jobs will require the public sector to create an enabling environment for business, including building critical infrastructure, making regulatory services transparent and providing sustainability to enterprise finance. Social protection and poverty eradication programmes need to be scaled up and better coordinated in all the three tiers of government, especially at the state and local government levels, which are the custodians of the grass root operations in the country.
With the crises in the North forcing many children out of school, could you tell us more about how you are surmounting the challenges in a bid to achieving Universal Primary Education by 2015?
The goal 2, centered on Universal Primary Education has one key target, which is to: “Ensure that, by 2015, children everywhere in the country, boys and girls alike, will be able to complete a full course of basic schooling. In other words, every child should be able to complete six years of primary school education. The programme and projects in this sector are targeted at quality learning outcomes, which include improving teaching skills, increasing school enrolment, providing teaching/learning materials and providing enhanced learning environment. It is globally acknowledged that education is of critical importance to sustainable development and basic education in particular is a necessity and a fundamental human right. My office has consequently, made engagement of adequate teachers and continuous teachers’ training a priority. More classrooms are also being provided to address the shortfall in school infrastructure.
From available records, net attendance levels for basic schooling have risen markedly when compared with baseline data. However, with ongoing security challenges in the North, we have continued to partner with stakeholders to deploy mechanisms to ensure out-of-school children return to the classrooms. The Federal Government is working on improving teaching standards in addition to addressing the low completion rates and poor learning environments. The government is also deploying the Universal Basic Education Scheme to tackle the challenges in meeting MDG 2. The Federal Teachers’ Scheme and in-service training by the National Teachers’ Institute, supported by my Office, have begun to address the urgent need to improve the quality of teaching. To accelerate progress and reduce regional disparities, these initiatives are also being rapidly expanded and improved.
We recently launched the three million free exercise books to indigent pupils as part of our belief that education is the bedrock of national development as it facilitates both individual and national development. We also believe that education is a major vehicle for lifting people out of poverty. Therefore, no child should be denied education regardless of his or her social or economic circumstances.
A key programme very worth mentioning is the Federal Teachers’ Scheme (FTS), implemented by the Universal Basic Education (UBE) Commission. The FTS was introduced in 2006 with the primary aim of addressing the shortage of quality teachers in the basic education sub-sector across the country. It has the dual aim of catering for unemployed National Certificate in Education holders while bolstering the number of teachers in the workforce.
In the first set alone, over 38,000 participated, out of which over 25,000 were absorbed. Another key intervention also aimed at teachers is a set of initiatives by the National Teachers’ Institute with the specific goal of improving the quality of learning at primary school level. In 2009, 120,000 primary school teachers were involved in a capacity building programme in pursuant of this objective. Since 2011, OSSAP MDGs through the Conditional Grants Scheme have trained over 1130 Education Extension workers respectively. So you can see that government is certainly determined to touch lives in every way possible through the MDGs.
The health component of the MDGs has a priority treatment with three goals dedicated to it. How well would you say Nigeria is faring?
The health goals are spread across goals 4, 5 &6. The Millennium Development Goals 4: Reduce Child Mortality Rate, has the main target of: “Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate in the country.”
Significant progress has been made in the drive to attain the health MDGs. For instance, there has been a reduction from the 2008 NDHS figure for the under five mortality rate of 157 deaths per 1,000 live births, to 94 deaths. This trend is similar for infant mortality rate. The infant mortality rate of 61 per 1,000 live births needs to reduce by 50% in order to meet the 2015 target. With increasing investment and ongoing interventions across the health MDGs, this Goal can be achieved. The proportion of children immunised against measles by 12 months of age increased from 31.4 per cent in 2003 to 55.5 per cent in 2012 and is still rising.
As part of the steps to deliver on this MDG, government is implementing a wide range of initiatives, including the Integrated Maternal, Newborn and Child Health Care Strategy, using the Ward Minimum Health Package. Access to primary health care is also being improved by more investment in infrastructure, human resources, equipment and consumables. Implementation arrangements are targeting local needs, which vary hugely from community to community and from state to state. There is also improvement in routine immunisation as a way of building on the successes of the near-eradication of polio. OSSAP-MDGs is the major sponsor of the Polio Eradication Initiative (PEI) in the country and has invested over N8 billion for this activity in the 2012 budget. In 2012, eight rounds of polio campaigns were conducted and over 248,007,078 OPV immunisations were done. Similarly, four rounds of maternal and neonatal tetanus campaigns were conducted and about 15,313,604 women of child bearing age (WCBA) were vaccinated.
In 2012, about 8,252,000 doses of BCG, 6, 566, 4000 doses of DPT, 14,000,010 doses of TT and 10,500,000 doses of HBV were procured. There is improved access to routine immunization through OSSAP-MDGs’ support for the procurement and distribution of routine vaccines and cold chain materials.
In addition, to facilitate the attainment of the MDGs, OSSAP-MDGs, in collaboration with the National Health Insurance Scheme (NHIS) is implementing the NHIS-MDG/MCH Maternal and Child Health Project. The project which is DRG funded, is aimed at facilitating the achievement of MDGs 4 & 5, by addressing the critical problem of financial barrier that hinder access to healthcare services for pregnant women and under five children. So, the government is doing everything possible, using the MDGs to touch lives and ensure safer child birth and longevity for all Nigerians.
What about the MDG 5?
MDG 5, which is “Improve Maternal Health,” has the following targets:
Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio, and achieve, by 2015, universal access to reproductive health.
Nigeria has continued to reduce the Maternal Mortality Ratio, which is a commendable achievement. In 1990, it was estimated that 1,000 mothers died per 100,000 live births; in 2008 this dropped to 545; and in 2012, the figure dropped further to 350. However, the statistics that will soon be released by the NBS indicates that the prevalent rate of maternal mortality has now further reduced to about 234 per 100, 000 live births as against the 350 per 100, 000 live births.
This indicates that Nigeria has attained that goal which is requires that the prevalent rate should be reduced to 250 per 100, 000 live births between 1990 and 2015. I can tell you that this is due largely to the implementation of some high impact initiatives like the Village Health workers Scheme, Community Health Extension Workers Scheme, MAF 5 and the Save one million lives programme put in place by the Federal Government. Progress has been driven in a major part by the introduction of the Midwife Services Scheme, which has seen the reversal of the previously negative trend in the percentage of skilled health personnel attending births. In 2008, deliveries that had skilled birth attendance was 38.9% while it rose to 53.6% in 2012.
To ensure that the proportion of births attended by a skilled health worker remained on the upward spiral to avoid the threats of holding back further progress, Government is strengthening the primary health care system at local level by implementing the Safe Motherhood Programme. The innovative Midwives Service Scheme and the Community Health Extension Workers’ Programme have contributed to the modest successes recorded by bridging the human resource gap that exists, further accelerating progress.
The Midwives Service Scheme (MSS) is indeed one of the most successful projects in solving the problem of human resource shortage in the country and this has contributed greatly to skilled birth attendance in Nigeria’s health facilities. So far, the MSS consists of 250 clusters with 1,000 PHCs (1 general hospital as a referral centre surrounded by 4 PHCs). Forty general hospitals and 160 PHCs are connected with ICT. There are 4,000 midwives and 1,020 CHEWs on ground serving the communities in these clusters. More mothers will be covered by antenatal care as access to quality primary healthcare improves and incentives attract health workers to rural areas, indicating that Nigeria will turn progress to date on this goal into an MDG success story.
We have also partnered with the Vesico-vagina fistula (VVF) office of the Federal Ministry of Health (FMOH) and the national VVF centres in Katsina and Abakaliki in repairing about 500 fistulae. The Office supported the training of 41 VVF surgeons and 44 VVF Nurses. The training was conducted in collaboration with UNFPA and the USAID VVF programme.
We are also in collaboration with the FMOH to deploy the “Saving One Million Lives Initiative” which has the potential to fast-track attainment of the health MDGs. The program scales up evidence-based interventions that have made impact nationally. The initiative mobilizes additional resources from the global community and private businesses in with the needed political backing.
The formulation of the MDGs Acceleration Framework Action Plan for Goal 5, popularly known as MAF 5 has also been completed, with bottlenecks identified, solutions proffered, and a five year plan costed. Efforts are currently being made to ensure the accountability matrix drawn is strictly adhered to during the implementation process.
We recently launched the Village Health Workers Scheme, which has been carefully planned in collaboration with stakeholders, particularly the State and Local Governments and the National and State Primary Health Care Development Agencies. The scheme is expected to make the required impact of contributing to improved community health outcomes by:
Increasing the uptake and utilization of Health Care facilities provided by OSSAP-MDGs and other stakeholders;
Increasing mobilization drives that stimulate the demand side of health services delivery for enhanced ownership, responsiveness, sustainability and accountability;
Contributing to the functionality and sustainability of health care facilities through close collaboration with other stakeholder groups.
The Village Health Workers Scheme will also generate employment for many Nigerians. At the moment, more than One thousand, four hundred (1,400) Village Health Workers have been trained across the six geo-political zones of the federation. Since 2011, we have also through the Conditional Grants Scheme trained over 69,000 health workers.
The MDG 6 is another strategic health goal. What have you achieved in this area?
Nigeria is certainly on the march to achieving the goal. On this goal, the targets stipulate that:
HIV/AIDS is to be halted by 2015 and begun to reverse the spread.
Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it. Data held by the National Agency for the Control of AIDs (NACA) demonstrate that there is a continuation in the fall of the HIV prevalence, from figures as high as 5.8 to 4.1 in 2012 and has further dipped to 3.4 as recorded by the NBS. This falling trend satisfies the criteria for the attainment of Target 6.A. In addition to this, the largest change that the 2012 MDGs Survey reports in MDG 6 is the increase in the proportion of under-5 children sleeping under Insecticide Treated Nets. In 2003, the figure was 2.2%, in 2008, it was 5.5% and in 2012, it is 34.6%.
There has been a sharp decrease in malaria prevalence rates. Nigeria has recorded a nationwide distribution of over 72 million long-lasting insecticide-treated bed nets. A cumulative total of 2,691,437 LLITNs and 44,679,846 doses of anti-malarial (ACTs/SPs) were distributed for use across the states. It is worthy to note that the DRGs-MDGs investment in malaria control is contributory to the reported decline in incidences of maternal and child mortality in Nigeria as related to MDGs 4 and 5. Similar progress has been made with tuberculosis. With sustained attention, tuberculosis is expected to be a limited public health burden by 2015.
To consolidate and extend progress on Goal 6, challenges that need to be addressed include improving knowledge and awareness of HIV/AIDS, improving access to antiretroviral therapies and effective implementation of the national strategic frameworks for HIV/AIDS, malaria and tuberculosis control. To this end, government has adopted the effective implementation of the new National HIV/AIDS Strategic Framework for Action 2010-2015 and has reinforced the implementation of an integrated approach to malaria control, tuberculosis and neglected tropical diseases (NTDs).