Nigeria has been dealt an economic double hit by not just the prevailing COVID-19 pandemic, but also erratic oil prices, mainly downward-looking. The recent World Bank Nigeria Development Update released June 2020, projected economic downturns, shrinking 3.2% in 2020.
While economists may debate the fine points of the relevance and impact of these turn of events, what is palpable to everyday people are the inevitable consequences. Five million Nigerians are anticipated to additionally be pushed into poverty in 2020 alone, representing more than 2% of the population. But this will not be evenly dispersed amongst the Nigerian population. The poorest will be worse affected, as well as women, the elderly, and people living with disabilities or internally displaced by the crisis.
Further, within the context of COVID-19 responses and their inevitable effects on labor, unemployment is expected to rise. According to the United Nation’s June Monthly Briefing on the World Economic Situation and Prospects, unemployment may rise, affecting about 30% this year. Additionally, where the average age of Nigeria’s citizens as of 2019 is approximately 17 years, education or economic activities are engaged in not just for income but also for self-esteem and positive societal contributions. Without doubt even adolescents are also likely to feel the economic brunt of the current situation.
Poverty has strong links to ill health. From malnutrition to maternal mortality, and from non-communicable diseases like diabetes and hypertension to infectious diseases, poverty is an underlying determinant. Gender-based violence, and low education, which also influence health, are equally determined by income levels. These associations varying between countries with differing gross national incomes also influences different income groups in-country. Hence poor economic projections equally translate to poor health outcomes.
This also comes at a time that the Nigerian health system, mirroring the global COVID-19 crisis, is under stress. Ranking 187th out of 190 countries by the World Health Organization accessing health systems across the world in 2016, Nigeria pre-COVID-19 was troubled. While improvements in numbers of public hospitals and health centers have been made, other aspects of the health system including financing, information, even adequacy in numbers of health workers also need revival. Chief of these is financing for health.
Significantly, the Nigerian government budgetary expenditure on health as a percentage of government expenditure has hovered around 5%, despite African Union heads of state agreeing on a target of 15%, in 2001. Nigeria has since been off track, even with this historic event taking place in Abuja. Meanwhile, several studies, including the Global Burden of Disease Health Financing Collaborator Network study in 2019, relate low governments spending on health to worse national health outcomes. These outcomes are particularly worse for women, and children.
Bearing this in mind, a special focus on the vulnerable at national, state, and even local government levels is in order. With the laudable Nigerian government announcing today, proposed creation of 1000 jobs for citizens in each local government across the federation, efforts must also be made to target the vulnerable. If for no other reason – pre-COVID-19 – Nigeria grappled with high maternal and under-five mortality.
But what can the average Nigerian do to secure health while the government proffers and implements their economic and other sectorial interventions? One key might be to invest more in the prevention of disease, rather than waiting for the windfall of illness. Indeed prevention is better than cure. With over 75% of Nigerians paying for health services out of their own pockets at the time of needed health care services, prevention should be the focus as incomes shrink.
First, the case for health insurance must be made, to prevent families and individuals from slipping into, or experiencing worsening poverty while seeking health interventions. Effective community-based health financing models in some low middle-income countries have utilized cooperative strategies to secure health for women and children. This approach can contribute to reducing maternal and under-five mortality at the community level. At this point, existing community cooperatives can synergize pooled funds, while looking ahead to such inevitable eventualities.
Secondly, a healthy lifestyle must be encouraged and engaged. To the best of one’s ability, diets must be balanced and rich in fruit and vegetables. It is true that food prices have also unfortunately increased in this economic environment, but a personal strategy to eat seasonal fruit and vegetable can still help. For instance, the ‘African pear’ or ‘Ube’ which is in season, provides a rich source of vitamins C, healthy fats amongst others. A complementary strategy might be to encourage and engage in micro or small-scale gardening. In short, growing as much as one can within the limits of space and time. Either or both approaches can help secure some respite in achieving healthier nutrition.
Living healthy and even economically friendly also means cutting back on alcohol and cigarette use, along with increased consumption of water or natural/ non-artificially sweetened juices for some. For many others, this might mean increasing exercise to promote heart health. Finally, often forgotten is the need for improved mental health. Sleep as well as simple stress relievers including exercise, cutting back on screen times, as well as indulging in games and family bonding activities might help.
Overall, instead of giving in to habitually ignoring health symptoms, Nigerians should seek early diagnosis and treatment in preventing deteriorating medical conditions and eventual financial burdens. Prevention is key to health, and economic rebound because only healthy individuals can work, generate productive livelihoods, and collectively push the economy into the green, eventually.
With the continuing pandemic, prevention is even more vital. As a nation, we must not relax but gear up to secure our lives, families, and country by adhering to guidelines in the fight against COVID-19. COVID-19 may have hit hard but the resilience of our individual and national spirit guarantees a better outcome.