The dRPC-PAS Research and Writing Fellowship is a response to a thought-provoking remark by Mr Bill Gates, co-chair of the Bill and Melinda Gates Foundation (BMGF) on the 22nd of March 2018, in Abuja, while addressing the National Economic Council; challenging the Nigerian government to prioritize human capital development
A bubbly and cheerful slim-figured young man emerged from the midst of the cheering applause of the youthful and exuberant crowd that jam-packed the conference hall; he was wearing a black-with-white-stripes knee-level kaftan – and looking as visibly excited as he was bewildered. Thirty-year-old Ibrahim Banaru Abubakar had just been announced co-winner– along with Isaac Ejakhegbe of the Women’s Health and Action Research Centre – for the third prize of the Investing in Health for National Development Research and Writing Fellowship of the Development Research and Projects Centre (dRPC), organized under the Partnership for Advocacy in Child and Family Health at Scale (PACFaH@Scale) programme.
The cash prizes cum research findings-sharing ceremony was taking place on the auspices of the First National Conference on Adolescent Health and National Development at the University of Ibadan, Nigeria’s premier university. Themed: “Advancing Adolescent Health in Nigeria in the SDG Era,” the conference was organized by the nonprofit Society for Adolescent and Young People’s Health in Nigeria (SAYPHIN) in collaboration with the United Nations Population Fund (UNFPA), United Nations Children’s Fund (UNICEF) and the Partnership for Advocacy in Child and Family Health at Scale (PACFaH@Scale), among many other partners.
The Partnership for Advocacy in Child and Family Health @ Scale (PAS) is a health accountability network of Nigerian civil society organizations working to catalyze national and state governments to make adequate provision for child and family health in Nigeria. Funded by the Bill and Melinda Gates Foundation (BMGF), NGOs in PAS conduct evidence-based advocacy for adequate domestic financing and also collaborate with government to support champions for policy implementation.
“Winning the award was a great surprise for me; receiving the award was really a great thing,” recalls Abubakar, a resident doctor in family medicine at the Ahmadu Bello University Teaching Hospital, Zaria, shortly after the ceremony. A natural-born researcher, he holds dual master’s of health sciences degrees in Health Economics cum Reproductive Health and Rights from the Pan African University Institute of Life and Earth Sciences (PAULESI) and University of Ibadan, respectively. His major research interest is modeling health policies to achieve improved health systems and Universal Health Coverage (UHC) in low-resource settings.
Abubakar, author of the award-winning research paper: “Effects of Performance-based Financing on the Uptake of Family Planning: A Case Study of Kano and Adamawa states,” was one of 20 select dRPC-PAS graduate students, health reporters, independent researchers, as well as members of accountability NGOs who conducted field researches and authored research papers and essays on the topic: “Investing in Human Capital for National Development.” The researchers had spent the previous eleven months under the mentorship and tutelage of internationally-renowned researchers.
“It was an invaluable experience, you can’t get that in a [conventional] classroom; although I hold two master’s degrees, I will say the three-day intensive training we had at the beginning of the fellowship programme was so great. We were mentored by professors of multidisciplinary backgrounds whom you only read about on the pages of journals; we had one-on-one engagements and were exchanging ideas in a friendly manner, learning the knitty-gritty of research. Even after the capacity building [methodology] workshop and while we were already in the field, they kept supporting us,” Abubakar, a Zaria-trained medical doctor, recalls with nostalgia.
He and 19 other successful applicants for the year-long fellowship had in July 2018 participated in a week-long methodology training workshop led by scholars from Leiden University in the Netherlands, before they were awarded research grants and deployed to the field where they conducted researches which resulted in many translational research papers and essays. His research paper compared the prevalence of new up-takers of Family Planning (FP) services in Adamawa state – where a Performance-Based Financing (PBF) Mechanism had been introduced in 2011 – and Kano state, where no such scheme exists.
“My conclusion was there’s an improvement in uptake of FP services in the state with PBF [Adamawa] – compared with the state without [Kano] – using verified FP quality indicators. Moving forward, I would want to check if there is also improvement in quality of FP services available in the state with PBF – compared with the state without – again, using verified FP quality indicators. This is because it is one thing to have improved uptake of services and entirely another to have improved quality of services,” he said.
Bauchi-born Abubakar’s paper was accepted at the biennial 5th Nigeria Family Planning Conference held in December 2018; he had also submitted another abstract for review at the International Summer School on Research of the University of Göttingen in Germany, holding later in 2019. He believed the dRPC-PAS research fellowship had not only opened up doors of opportunities to him but had also broadened his horizon: exposed him to tools that enabled him produced researches that were “translational in nature, that could serve as policy briefs to policy actors and can bring about tangible benefits to communities for real societal change.”
The dRPC-PAS fellowship is a response to a thought-provoking remark by Mr Bill Gates, co-chair of the Bill and Melinda Gates Foundation (BMGF), on the 22nd of March 2018, at the State House, Abuja, while addressing the National Economic Council. Gates had challenged the federal government of Nigeria to prioritize human capital development, if the country was serious about laying a solid foundation for sustained prosperity – which instantly elicited a barrage of reactions and became a topic of national dialogue, in both mainstream and social media.
“If you invest in their health, education, and opportunities —the “human capital” we are talking about today—then they will lay the foundation for sustained prosperity. If you don’t, however, then it is very important to recognize that there will be a sharp limit on how much the country can grow,” Gates candidly told members of the special session of the National Economic Council chaired by Vice President Yemi Osinbajo, which also had in attendance Africa’s richest man, Aliko Dangote.
Gates’ statement which was not viewed favorably by the Nigerian government plainly underlined the connection existing between the quality of healthcare and education available to Nigerians –a direct result of the degree of investment in public health and education by the government – and the country’s sustainable human capital development. In other words, Gates was saying, the level of investment in public health and education by Nigeria was directly proportional to the country’s human capital development.
Idongesit Eshiet, a lecturer in sociology at the University of Lagos, is another fellow of the dRPC-PAS research fellowship who also received an award at the ceremony in Ibadan on Saturday, April 13. She, alongside two others – Isah Imam Paiko of the Federal University of Technology, Minna and Turnwait Michael of the University of Ibadan – were co-winners of the first prize.
Eshiet’s first prize award-winning paper: “Voice and Accountability: The Role of Rural Women Association as a Platform for Civic Engagement in the Primary Health Care Sector through Public Private Partnership,” explored the potentially active role rural women associations could play in ensuring accountability in the delivery of primary health care services at the grassroots, looking at two rural women associations in her native Akwa Ibom state, as case study.
“Women associations were very active during the colonial period in fighting and resisting the oppressive policies of the colonialists. The likes of Funmilayo Ransome-Kuti led the Egba women to dethrone the Alake of Egbaland and stopped him from making women pay tax. The same thing happened in the Aba women riot. So, they [women] are a force to reckon with,” she said.
Eshiet said it was during discussions at the week long methodology workshop that she got her research idea: “I was now wondering, maternal mortality is very high, and child mortality is very high, we have deplorable primary health care centers. Yet, there is what is called social accountability; if the citizens engage the government, the government will become more responsive. So, I did in-depth interviews with the excos of two women’s associations in Akwa Ibom state; I tried to find out the activities they were engaging in – and if they were engaging in civic activism, I realized they were not. They never knew they had the capacity to hold government accountable.”
She is now looking forward to the opportunity to further her research on the role of rural women in guaranteeing accountability in the management primary health care, to a higher level of a policy paper, “to inspire women to join health committees at their communities and be able to produce scorecards about the PHC services.”
Nura Faggo, a journalist and graduate student in Mass Communication at Bayero University, Kano also partook in the dRPC-PAS fellowship. His paper: “The Role of Information Management System in Tracking the Efficacy and Efficiency of Community Health Extension Workers (CHEWs) in the Treatment of Diarrhea and Pneumonia in Yobe and Taraba states, Northeastern Nigeria,” was co-authored with Mohammed Modu of Mai Idris Alooma Polytechnic, Geidam, Yobe state.
“I am a trained journalist who is currently a post-graduate student…The methodology workshop exposed us to the [best] approaches for writing research papers that could be published internationally. Our papers were sent to Leiden University where they were edited and peer- reviewed; it exposed the understaffing in our healthcare system. The numbers of CHEWs are not commensurate with the number of under-fives seeking healthcare services. We used scientific methods of research exposed to us by dRPC,” said Faggo, who alongside Modu jointly won the fourth (consolation) prize.
The duo of Peter Adeyeye, an independent researcher, and Jite Phido of Arda Development Communication jointly authored the paper: “Can Community Health Extension Workers Drive Effective Primary Health Care Utilization in North West Nigeria?” and also produced a video documentary looking at the challenges of high fertility rates, low contraceptive prevalence rates (CPR), high illiteracy and high maternal mortality rates (MMR) in Nigeria’s northwest region.
“We appraised the performance of Community Health Extension Workers (CHEWs) and discovered both supply and demand barriers to primary health care utilization, particularly among women. The supply was not available, distance was an issue and there were sociocultural barriers. So, we came up with a model which we recommended to governors in North West, based on how countries like Ethiopia have utilized CHEWs to drive PHC utilization,” said Adeyeye, who was joint winner of the second prize with Phido.
All twenty fellows received certificates of participation at the gathering focused on how investment in human capital especially, in the social (health and education) sectors could lay the foundation for sustained prosperity in Nigeria. More so, Nigeria is signatory to many regional and global frameworks calling for more investments in public health, as a panacea for achieving Universal Health Coverage (UHC). Such frameworks include the AU’s Africa Health Strategy (2016 -2030); the Maputo Plan of Action; and above all, Agenda 2063 and the UN’s Sustainable Development Goals (SDGs).
What the federal and respective state governments in Nigeria need to understand is the reality that beyond saving lives, proportionate social sector investments comes with incredible prospects for economic growth and sustainable development. Thus, Nigeria must begin deliberate and intensive investment in human capital development; no country attains wealth and prosperity at the expense of the health and education of its people.
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