Demographic Dividend: A Paradigm Shift for Proper Healthcare Provision


The age-long saying that health is wealth has not been taken seriously. Consequently, this has plunged Nigeria into what might be referred to as massive population growth without adequate planning, especially in the provision of healthcare services which in turn affects the economy. The continuity of this if not swiftly tackled, will only lead to demographic disaster. Kuni Tyessi writes

As Nigeria’s youth population grow, what is plan for their healthcare?

Okon, an experienced bricklayer is 34 years and is married to Maryam, a petty trader who is 10 years younger. Together they have eight children between the ages of nine and 10 months with another on the way as Maryam is already five months gone. They live in a one-room apartment in a compound of 16 rooms which gives shelter to other families of the same or slightly different sizes. They all share one kitchen, one bathroom and one toilet, and will most times have to queue in a bid to answer nature’s call.

Okon leaves home in the morning whenever he is lucky to get a ‎part-time job at building sites and returns by 7p.m. after he must have taken a bottle or two of beer alongside goat head pepper soup in order to calm his fatigued nerves. At midnight, when he suspects that all the children‎ are asleep, he engages their mother in what he refers to as marital rights, a form of his own kind of recreation and a way of relieving stress and temporarily keeping his challenges at bay. Sadly enough and unfortunately too, it is a situation he lacks the will to change.

The stress is a blend of anger, disillusionment with its root in unemployment and its attendant consequences of inadequate food for the family, lack of sound education for his growing children and inaccessible primary healthcare facility to attend to his wife’s needs due to conflict in the neighbouring wards by restive youths and which has claimed lives and property as a result of a political feud.

Even if she could access the facility, there were hardly midwives, nurses, nor doctors on standby to attend to the hundreds of women in need of attention. The reason isn’t far-fetched as most of the medical personnel posted to the nearby facility have refused to resume work, claiming that social amenities and working tools have not been provided and their entitlements from all the tiers of government which are part of the national budget come only in trickles, thus affecting their overall output.

Further adding to his pain is his immediate environment which lacks good water, sanitation, and drainage system as broken sewages and gutters have made it a duty to constantly romance the atmosphere. ‎Cases of child abuse and molestation ‎were also growing at an alarming rate and of recent, a father; 30 years old man and father of six was arrested in the compound for constantly abusing his 12 years old daughter, while another, a 26-year-old was caught having sex with a goat in the general bathroom. The issue of theft, especially of basic needs such as food was an everyday scenario as body and soul must be kept together with the hope that situations might change for the better.

A glance at Maryam reveals that she is always unhappy, absent minded and wasting despite her delicate state, while the children are all malnourished with visible signs of stunting in four of them. She has battled with the dreaded kwashiorkor to save the lives of three of them. They don’t go to school, not even the public schools, because Okon cannot afford even stipends being required from time to time and as such, they stay at home and constitute a nuisance to their always-tired mother while the three eldest, all girls, are mandated to help their mother in her trade.

Maryam, from the look of things is overwhelmed with what seems to have befallen her. She considers herself too young to have the number of children she has. She has heard about family planning from one of her neighbours, Mama Dimka, during one of their cooking sessions in the kitchen, but has continued to raise fears for its practice, claiming that her culture vehemently abhors women who use any form of birth control as children are gifts from God and should not be rejected. She claims that provision for the children’s upkeep, irrespective of their number is God-ordained and never manmade.

Okon’s family serves as an example of many families in Nigeria and unfortunately, most of them have accepted the existentialism way of life. In a country with a growing population of over 180 million and one-third are within the ages of 15-35, and is estimated to have 65 million more people come the year 2030 due to high fertility rate and less than 17 per cent family planning compliance, its growth and development in terms of health, education, government services, women’s empowerment, socio-political stability, environment and most importantly, economy, leaves so much to be desired.

Arguably, Nigeria in the next 13 years will be the 5th most populous nation in the world after China, India, America, and Indonesia. While there is strength in numbers, how it is used and where it is channelled is of utmost importance. However, physical and numerical strength will not achieve so much if the people’s creative and mental strengths to transform their cognitive abilities into useful and valuable resources are lacking, hence the need to tap, understand and appreciate demographic dividend.

At the national summit on Demographic Dividend and with the theme ‘Investing in Youth ‎to Harness Demographic Dividend in Nigeria’, it was clearly stated that Nigeria is at an opportune moment and if it invests in meeting the needs of young people which include education, jobs, healthcare and voluntary family planning, it can access Demographic Dividend which has improved the development of many countries. This transition will definitely include a higher percentage of working-age people and a lower percentage of children and senior citizens who are mostly dependants. Interestingly, the youthful population of Nigeria will remain for a very long time to come.

Similarly, Demographic Dividend can serve as a boost to GDP per capita in growth rate from demographic change and decline in fertility level as well as investments in youth, health, education, infrastructure and job creation as experts have revealed that investing in Nigeria’s growing youth population could double its GDP per capita and produce significant health, educational and social outcomes.

In parts of the country with poor health indicators, there is also the need to make massive enlightenment and create awareness in the face of culture and religion. With this, fertility levels may begin to decline more significantly and children will be more likely to achieve better basic levels of health and education and the likes of Okon and his family will gradually phase out. With additional investments in the key sectors, Nigeria should be able to experience rapid economic growth.‎

Little wonder, the Acting President, Prof. Yemi Osinbajo who was represented by the Minister of Budget and National Planning, Senator Udo Udoma at the summit, was quoted to have said youths were the most viable resources Nigeria needs and not oil. They are no longer the leaders of tomorrow as their tomorrow has come and it starts today.

He said, “According to a British report, from 2030‎, young people and not oil will be the country’s most valuable resource. Indeed, right now, young people and not oil are the country’s most viable resource.

“The implication of these demographic realities on our country’s development may have consequences too grave to be ignored. Launching Nigeria into a new era of economic growth and prosperity must proceed on the basis of harnessing employment opportunities that our population has to offer,” he said.

It is important to note that family planning is beyond health. It is at the centre of development and that’s what brings about demographic dividend. Imagine if Okon and Maryam had just four children, not minding their gender. It is possible to say that life would have been more easier and comfortable as what is used to feed 11 persons (the unborn baby inclusive) will be used to feed just six and the diet can be enriched with what is meant for the outstanding three. The diet of the remaining two can be converted to cash to take care of the children’s educational needs. With this, the children will not have to be malnourished and educationally stranded. On the other hand, their mother will be healthier and will be able to generate more in terms of income and services.

With the crusade of economic recovery and growth plan reaching its peak, as if it had never been discussed before, the onus lies with individuals, families and the government in the achievement and realisation of Demographic Dividend, a plus for every Nigerian.