A new report was published recently in a collaboration between Nigeria’s health ministry and World Health Organisation Regional Office for Africa titled ‘Assessment of barriers to accessing health services for disadvantaged adolescents in Nigeria’ to know which adolescents are being left behind on the path
to universal health coverage, and why.
Universal health coverage is firmly on the global agenda and takes its bearings from the WHO Constitution of 1948, which declares health a fundamental human right. Universal health coverage is relevant to all the health-related targets of the Sustainable Development Goals (SDGs) and will ensure better health and protection for the world’s poorest.
Though in Nigeria, universal health coverage is also at the top of the health agenda, with nearly a quarter of the 191 million population falling between 10 and 19, universal health coverage is unlikely to be achieved without prioritising adolescent health policy and programming, the report noted in its executive summary, pointing out that in acknowledgement of this, Nigeria included adolescents as a specific area of focus in its draft five-year integrated reproductive, maternal, newborn, child and adolescent health strategic plan (2017–2021).
Furthermore, the national policy on the health and development of adolescents and young people in Nigeria (2007), the national strategic framework on the health and development of adolescents and young people in Nigeria (2007–2011), and the action plan for advancing young people’s health and development in Nigeria (2010–2012) are currently being reviewed and revised to ensure that the policies guiding and informing programming adequately reflects the current health needs of adolescents.
To assist the policy reviews, a national situation analysis was commissioned in April 2018 to determine
the knowledge, attitudes and perceptions of adolescents aged 10–19 concerning available health services. It also sought to determine the unique health needs of adolescents, as well as where they are currently accessing services.
The report mentioned that an inclusive policy is needed that guarantees every adolescent’s fundamental human rights. This requires going beyond meeting the needs as articulated by the average adolescent to also assessing and meeting the needs of those who live on the fringes of society: the marginalised, under-served and often invisible adolescents.
The report shared the findings from an assessment to identify under-served adolescent groups and to
highlight the barriers they experience in accessing health services in Nigeria, citing it as the “product of the first the pilot of WHO’s draft handbook for conducting an adolescent health services barriers assessment, with a focus on disadvantaged adolescents, a tool designed to assist health ministries in informing policy and programming to ensure no adolescent is left behind.”
It added, “Further piloting of the handbook for conducting an adolescent health services barriers assessment is underway in several countries and will strengthen the guidance given in the handbook with every use. This pilot was based on the handbook, which assessed health service barriers experienced by the most disadvantaged adolescents, developed by WHO in April 2018. It will inform broader assessments of barriers to health services and work done on integrating equity, gender and human rights into policies and programming in Nigeria and beyond.”
The report is from an assessment that constitutes part of the support the WHO provided to Nigeria’s health ministry per the country’s cooperation strategy for 2018–2022. The work is the first national pilot of the draft handbook for conducting an adolescent health services barriers assessment, developed by WHO in 2018. This guidance is in keeping with the WHO’s Thirteenth General Programme of Work 2019–2023 emphasis on reducing barriers to health services on the path to universal health coverage.
Andrew Lingililani Mbewe and Joy Ufere managed the assessment in the Federal Republic of Nigeria from the Family and Reproductive Health Cluster of the WHO Country Office in Nigeria, who worked in close coordination with the following representatives of the Nigerian government for their strategic oversight and to ensure alignment with national policy and planning processes on adolescent health.
