By: Smith Nwokocha
National Policy on the Health and Development of Adolescents and Young people in Nigeria: 2021-2025, in Rivers State.
Date: 19th – 22nd October, 2021.
Venue: Landmark Hotel
DAY 1: NATIONAL POLICY ON THE HEALTH AND DEVELOPMENT OF ADOLESCENTS AND YOUNG PEOPLE IN NIGERIA: WHAT IT MEANS TO ADOLESCENTS HEALTH IN RIVERS STATE.
Mrs. Wokoma Mbreba, delighted to a large audience at today’s meeting, inspite of the public holiday. Institute of Virology; partnering with Rivers State Government has a five (5) years plan to domesticate the National Policy and the Policy will help us to have a direction. Youth Organizations for Health and Development Initiatives (Emmanuel Worgu);It will give a proper guide and rule for the Adolescents and urge all to participate actively for an impactful document.
Clinton Health Access Initiative (CHAI)-Eddidiong said she is happy that the Government is intentional about the future of the Adolescents.
Gloria Ndujiechi was appointed as a Rapporteur for 20-10-2021.
First presentation on “Policy Presentation (Rationale for Policy, Context for Policy Development, The Process of Policy Development) “…By Joyce Iwatutu-Consultant-
In her words, Joyce, said: In the process of Policy Development, we cannot develop policies without consultation and people who design programmes for the Adolescents are key. In defining who an Adolescent is, she said; Adolescent is a critical stage- a transformational stage where a Child begins to take decisions. It is pertinent to have a document and invest in our Adolescent for them to have direction. Citizens of Nigeria, Adolescents occupy 1/3 (one-third) of the Nigerian population. The essence of the Policy Development gives us a priority needs/investment in Adolescents. The National Policy developed in 1995, 2007 – 2010 – 2019. Target Population: In 2007 National Policy. Age 10-24 years determines a young person according to the United Nations, while age 10 – 29 years determines a young person (local content-Nigerian perspectives).
The Constitution of the Federal Republic of Nigeria was considered in the definition of the Rights of this target population. The Constitution of Nigeria assures the Rights of every Citizens to health and development. This Policy considers the Rights of the Adolescents and young persons in the highest standard. It ensures that young women can have access to post-Abortion services, Family Planning. Nigeria is a signatory to the Regional Treaties. The National Adolescent Health and Development Technical Working Group (NAHDTW) proposed for a revised National Policy through the Federal Ministry of Health Revised National Policy 2018.
Major Stages of Policy Development:
National Stakeholders Policy Workshop.
Engagement of an experienced National Consultant and Production of an Initial Draft of the Policy Document.
Stakeholder’s review of the Initial Draft of the Policy and Revision of the Initial Draft.
Finalization and National Adoption of the Draft Policy Document.
Final Approval Processes.
The Policy process started in 2019 and because of the covid-19 in 2020, it was not adopted, but has been adopted in 2021 at a Conference in Abuja. Adolescents are a diverse group, based on differences by sex, age, wealth, education, ethnicity etc. Tomorrow’s Agenda will be to discuss about the ”’The Situation Analysis” and Attendees will be divided in groups for focused discussion.
Age of Consent has always been an issue for the Adolescents. Education is a major determinant of Adolescent’s health and HIV is a major health and development concern relating to young people in Nigeria.
Issues identified by Attendees/participants includes:
Teenage Pregnancy and Unsafe Abortion
Drug and Substance Abuse
Cultism and Violence among Adolescent and young people.
Establishment of Adolescent Friendly Centres and people that should manage the facilities are Psychological Clinical Person and Social Workers.
During the Consultative Global Health Conference, GBV, Inequality, Empowerment issues were addressed.
It’s a new term used to define programmes (like Education) designed for young people. Societal Enablers shouldn’t be left out when discussing issues affecting young people.
A participants added that 3-11 years is Character Moulding age/stage in Children.
POLICY DECLARATION AND GUILDING PRINCIPLES: STRATEGIC TARGETS; ROLES OF STAKEHOLDERS IN THE ADOPTION AND IMPLEMENTATION PROCESS
Young people as a vital resource for a sustainable future and national development.
Right Based Approach.
Diversity of Adolescents and young people’s needs and situation.
Gender equity and responsiveness
Participatory and Consultative Integration of Services.
Evidence-Based and Innovation Driven.
Quality-Focused and result oriented.
Policy Declaration: The Government (FGN);
Investment in the health and development of Adolescents and other young people shall be prioritized in the National Agenda.
This Policy shall be complementary to other National Policy Documents.
Young people, themselves have the right and duty to lead as well as to participate individually and collectively referred in the planning of implementation, and evaluation of health and development programmes for young people.
All Stakeholders and development partners, including Government and her Institutions, Civil Society Organizations and the Private Sector as well as international development and Organizations.
An enabling environment will be created and relevant implementation frameworks, including a Strategic framework, an action plan and a costed monitoring.
VISION, MISSION AND GOALS!
Vision: A Healthy Life and Optimal Development for all Adolescents and Young people in Nigeria and Successful transition towards a healthy, active, productive, successful, and fulfilled Adulthood.
Reduce morbidity, disability, and preventable mortality rates.
Strengthen capacity of the health systems and its linkage with the health sector.
Roles of Stakeholders in the Adoption and Implementation of the Policy:
For Media: Role of Stakeholders-involves informing, educating the Adolescents on the policy. Example; Sex Education, etc via Radio and other channels. Media can project budget financing- Media plays a key role in accountability.
Ministry of Budget and Economic Planning to ensure a budget line/allocation for the Adolescents programmes flies.
Ensure Teachers gives correct information for Adolescent care- (Education Sector).
Ensure we have a workable Policy that is implementable and ensure the Adolescents in Rural areas will also have access to these.
Religious Leaders should be engaged; a lot of Adolescents are influenced through Spiritual growth; The Churches/Mosques matters.
Faith Based Organizations helps Adolescents meets needs.
To design an informed programmes for the Adolescents.,
Start designing Employability Skills for Young People to take them out of Poverty.
In conclusion, the work of CSOs, Stakeholders present is very important and it counts no matter how small.
Dr. Emmanuel Adebayo (Consultant for Adolescents) added; Everything we do in our space comes together to make a whole lot of difference. What we are doing, is to lay a huge foundation for what is to come… let’s see this, as an investment of stating our opinions.
Prof. Nwadiuto Akani added, this period, Teachers are more in charge of the Children, Parents are not and it’s important to know what to do and what not to do. Research: Without research, we can’t achieve more, but for we to do research, we need an effective data and this will drive the process of Policy implementation. When we talk of Situation Analysis, we want to look at realities and tackle the situation on ground without sentiment. Career Counselling should be left open for young people. Young people need training on “Skills in Decision-Making”. Traditional Rulers should be carried along in issues of the Adolescents.
Mrs. Wokoma Mbreba, moderated the meeting and did the Closing remarks. Closing Prayer was taken by Igoni Agnes.
Organizers: Rivers State Ministry of Health and Partners.
Participants: RSMOH-Rivers State Ministry of Health
MYD-Ministry of Youth Development
MSWR-Ministry of Social Welfare and Rehabilitation
CSOs-Civic Society Organization
CBOs-Community Based Organization
RIVSACA-Rivers State Agency for the Control of HIV/AIDs
RIV-CISHAN-Civil Society on HIV/AID in Nigeria
IHVN-Institute of Human Virology, Nigeria
NOA- National Orientation Agency
FIDA- International Federation of Women Lawyers
NPF- Nigeria Police Force (Police Medicals)
UPTH- University of Port Harcourt Teaching Hospital
RSUTH-Rivers State University Teaching Hospital
Rivers media for health and family Planning
RIV-NYNETHA-Youth Network on HIV/AIDS in Nigeria, Rivers State Chapter
RSPHCMB-River State Primary Health Care Management Board.
Rivers state Ministry of Budget and Economic Planning.
Nigerian Police Force (Medicals) NPF.
MEETING REPORT ON DAY 2: REVIEW AND CONSULTATION WITH STAKEHOLDERS WHO WORK AROUND ADOLESCENT HEALTH @LANDMARK HOTEL, 20-10-2021.
Mrs. Wokoma Mbreba, started the meeting around 10:00am and welcomed all participants present and appealed for attendees to be conscious of time, and she called for an opening prayer, and Rev. Felix Ekiye, volunteered to take the opening prayer.
The Recap for Day 1 was well reported by Gloria Ndujiechi, observations were made by Mrs. Jenewari Utomi, she pointed the omission of Rivers Media for Health and Family Planning and other omissions which includes contribution by Prof. Akani, Rivers State University Teaching Hospital, Rivers State Primary Health Care Management Board among others were rectified and captured.
The Presentation Proper for Day 2:
Dr. Emmanuel Adebayo (Consultant of CHAI), did a sound and detailed presentation on the “Overview of Situation Analysis for Adolescents and Young People (AYPHD) Policy Domestication and Implementation Plan in Rivers State” and he was very thorough and engaging with participants.
One of the outlined Objectives of the Situation Analysis, is that, it’s focused on achieving and describe the current state of affairs on the health and development of Adolescents in selected states (Rivers State inclusive). Methodology used, involves; Desk Reviews and Primary Data Collection. Demographics: -Population-Young people (10-24 years) are about 2,616,384 accounting for about 50% of the State’s population. -Educational rate in Rivers increased access to education among females-over 8% enrollment for girls. Completion rate low. Health Status and Risk Factors: -Nutrition, Non-Communicable Diseases, Alcohol Consumption. Mental Health: -Mental disorders, Depression, Substance Use Disorder, Suicide (success) etc. Violence and Injury: Violence continue to be the highest reason for injury and mortality among Adolescent etc. Sexual and Reproductive Health: Relationship status, Sexual debut, Risky Sexual behaviour, Adolescent Maternal Health. Mortality: Accidents, Maternal deaths among Adolescents, Abortion related complications. HIV: HIV Test, FLHE Implementation.
Adolescents Health Programming and Systems Response: AYFHS, Government facilities-11, private-0, Systems: – AHD Desk officer –yes, Functional TWG-yes, FLHE Desk officer-yes etc.
Priority Measurement: – Priority Areas for Monitoring in AHD, Established Monitoring Systems, Established Monitoring Systems for AHD Health Care delivery, Access to AYFHS, Data: disaggregated by age, Data: disaggregated by sex.
In closing the session, Dr. Emmanuel asked some pertinent questions and they are as follows:
Q1. What should the State prioritize for implementation?
Q2. What Strategies should be employed?
Q3. What opportunities exists within the State, that can be harnessed?
He then reflected on yesterday’s (19-10-2021) document as follows:
Monitoring and Evaluation on Adolescents and Young People in Nigeria:
Programmatic Areas: – Sexual and reproductive etc.
Indicators: – 19 Core indicators, 15 Additional indicators and 156 Thematic indicators.
Monitoring Process: -Community systems to PHCs to L.G.A’s to States to FMOH to National Bureau of Statistics.
Monitoring Tools: -Supportive supervisory, National scorecard, Sub-National scorecard, The Implementation Plan, The priority Areas…
Contributions were made by Mrs. Lynda Nwankwoala , she said, there should be synergy among NGO’s working on Adolescent and youth friendly projects. Some valuable contributions were made by Dr. Okari Iyowuna, Mr. Otobo, Dr. Chidi, Wendy Wokoma, Emmanuel Worgu, Catherine and Rev. Felix Ekiye.
Dr. Emmanuel Adebayo, re-emphasized on proffering Solutions, before then, he said; “One of the major challenges of Health system and Implementing partners is working in siloes ” and the solution is simply working together. “If we can shift from sentiment-based services to right based services, that will accommodate Adolescents in the facilities without judgment and biases”. Integration of the services is what will work in our system. Adolescents are Adolescents everywhere in the world, just as Parents are Parents everywhere in the world. In conclusion, he said: Make sure Advocacy is not just information based, but with a proof of an edge to show the benefits of Advocacy. “Do Advocacy beyond information and it should be target based.”
Breakout session for Group Exercise: We had five (5) groups and a work plan was developed at the end of the day. National Implementation plan will be looked at tomorrow (21-10-2021).
Closing remark by Mrs. Wokoma Mbreba, thanked everyone for their contributions and active participation to make Rivers have a Working document and Mrs. Inyingi Blessing Morgan Ogolo volunteered for closing prayer. The meeting came to an end around 4:00pm
Rapporteur: Smith Nwokocha.
REPORT ON DAY 3: REVIEW AND CONSULTATION WITH ADOLESCENT AND YOUNG PERSONS, YOUTH LEADERS, AND YOUTH-LED ORGANIZATIONS/INITIATIVES WHO WORK AROUND ADOLESCENT HEALTH.
Opening prayer for the day was taken by Alhaji.
Recap for Day 2 was presented by Mrs. Wokoma Mbreba
And then the Group Exercise kicked off immediately, but before the Group Exercise proper, Dr. Emmanuel Adebayo gave an in-depth insight on ways and how to go about preparing the Work-plan for the day’s activities.
During the Group Exercise, the Deputy Mayor of Phalga L.G.A and Deputy Mayor of Obio-Akpor walked-in and joined the exercise. The Group Exercise, moderated by Mobolaji, who did an awesome job anchoring the session. In responding to Group feedback, Mobolaji, emphasized that, Rape and many other factors can trigger Drug and Substance abuse.
Some valuable recommendations, re-actions and contributions were made by some of the participants, unfortunately, they didn’t introduce themselves. Mobolaji, added in respond to group exercise, he said, “Plans as regards expansion should be made, not just advocacy on FLHE”. Mr. Ezekeil and Adolescent Champion, made a valuable contribution, when he said, “there is so much focus on educating the Girl Child, while the Boy Child is left behind”, the males should be educated as well to stay out sexual abuse of any sort, this will help reduce SGBV.
Mobolaji added, that, it is only in our clime that drugs are sold without prescriptions. On the long run, young people have the rights to access health facilities, including contraception. Wendy Wokoma, made a contribution, that we should look at preventive measures as well and we should do as much we can to educate the TBA’s to better handle issues related to Adolescents that seeks their services.
Dr. Emmanuel Adebayo, made a general comment, reflecting what he said, yesterday. Advocacy as Actors, as we do advocacy, we should put into consideration the Politicians, our Advocacy should be target base. When we think of strategies in preparing the work-plan, we should look at the implementers. Are there systematic things we can do, that do not rely on political will, even in our individual space, how do we orientate the system to ensure, it runs directly without Politics. There are some programmes that are dead in arrival, because the right people were not engaged. Community engagement is key. It’s important we put all these together as we work along.
Tomorrow (22-10-2021), we will look at the feedbacks and make sure the documents are re-assessed, and we will adopt the strategies in principles and then, we close the meeting, hopefully by 1:00pm, we are done. We hope to continue to work together as we work along, even after the meeting, until the final validation of the document and with the help of the participants, we will be able to actualize a document for the Adolescents in 5 years.
Rev. Ekiye Contribution; If the Permanent Secretaries and Commissioners of the Ministry’s present are here with us, we would have made more mile stones in this agenda, so the organizers should persuade these heads of the Ministry’s to show up at least in the final day of the meeting, so that they will be abreast with realities and also see that these policies are good for adoption. Dr. Emmanuel Adebayo, added that, at the stage we are with the documentation, we don’t need certain hierarchy or heads, but at the point of ratification, we will get these heads to be part of the process and they will oblige.
In closing, Mrs. Wokoma Mbreba appreciates everyone for their time and contributions. She emphasized, this documentation must come to light and she specially appreciates the Adolescents for being part of the documentation process. And the closing prayer was taken by Mrs. Mary Obisike. Meeting close around 4:50pm.
DAY 4: REVIEW MEETING FOR THE ADOLESCENT @ LANDMARK HOTEL, 22-10-2021, 10:00AM.
Opening prayer by Mrs. Lynda Nwankwoala.
Day 2 Recap Mrs. Wokoma Wendy.
The meeting was moderated by Mrs. Wokoma Mbreba.
According to Mrs. Wokoma Mbreba, Groups that have not completed their work-plan. Should endeavour to round-up by 12: 30pm.
Joyce Iwatutu, moderated a session of experience sharing by the participants.
Prof. Nwadiuto Akani contributed by emphasizing that; “each young person you see on the street, should remind us that we owe the Adolescents a duty of responsibility”. It is now everybody’s responsibility to transform the state. Adolescents’ health is not much of a physical challenge, but a psyche-social challenge. ”If you are called upon, make sure you represent”.
Joyce-she said, the Technical Working Group, can invite other CSOs not included in this training to support the team achieve the target. Whether, we like it or not, global influences will always have a way of making impact-Advocacy has to be done at global level and move to regional to national. It helps us to hold Government accountable.
Our work is important, no matter the challenges, whether we receive grants or not. No matter how little our work is, it’s important. Competition is good, if it is healthy. Lastly, once the document has gone through the initial draft and are out, let’s all endeavour to comment on the lopholes, if any, that’s the only way we would make progress.
Closing Remarks by Mrs. Wokoma Mbreba; Finally, it has come to an end. Thanked everyone and appreciate the efforts of all the attendees. We will keep sending updates for review, until it is finally ready and validated. Special thanks to Prof. And every Ministries and NGOs, including Faith-based Organizations and of course our amiable Consultants. Closing prayer was taken by Rev. Felix Ekiye. The meeting closed around 3:00pm.