Professor-Isaac-Folorunso-Adewole1Dear Honorable Minister for Health,
Be BOLD, BE UNUSUAL for the Health of Women and Girls in Nigeria.
We commemorated International Women’s Day last week. A day when we all should have been reflecting on what it means to be a woman or girl in our world today. This is a day where we all should have been thinking about what we can do to better improve this world to ensure that the rights of women and girls are upheld and advanced.
I want to acknowledge you for recognizing that day, as many of your colleagues who are serving as Ministers did not even acknowledge the day on their social media pages. Even the Honorable Minister of Women Affairs, who this day falls directly under her portfolio, only put out one post on twitter. But let’s hope she was busy with some events aimed at advancing women’s issues.
Sorry for the digression, let me go back to your post. So, I came across your post on my timeline and was really interested in seeing what you had shared. I read the blog and viewed the video. Honestly, Honorable Minister, I was really keen on reading about what new policy, program or innovation you were going to institute on this day, but what I read was nothing new. The blog just repeats what we already know with some links to how this will benefit some women. Actually, only women who want to be pregnant, but that was not my shocker! It was the video of you giving the Permanent Secretary (a woman) and some other women in your ministry a CAKE. A CAKE, Honorable Minister of Health! Of all things that you could have done or initiated on that day to advance the rights of women and girls, as the Minister of Health of the Federal Republic of Nigeria, giving out a cake should NOT have been the priority. As a young woman working on health issues in Nigeria, please permit me to share at least four things you could have done instead.
#1: Launch an initiative to expand access to sexual and gender based violence services in health sector. In a country, where three out of every 10 women has experienced sexual violence, it is critical for women and girls to be able to access comprehensive GBV services from public health facilities. There is a Health Sector Technical Committee set up to coordinate the health sector component for the implementation of the Violence Against Person Prohibition Act (VAPP Act), but the committee has not received adequate attention and support from the leadership within your ministry and thereby has to rely on international and local NGOs to facilitate its work. Many women and girls do not get the psychosocial support needed and still face judgment and shaming when they go to health facilities after surviving such a heinous crime. Post-Exposure Prophylactic (PEP) and Emergency Contraceptives are not available in most health facilities. The Federal Government has refused to procure Emergency Contraception as one of the many contraceptive methods under its reproductive health program, even though the UN Commission on Life Saving Commodities for Women and Children, identifies Emergency Contraceptive as one of the 13 overlooked commodities that if widely available could save the lives of more than 6 million women and children globally.
#2: Issue a directive to health facilities under your mandate to expand access to contraceptive services for girls and young women. With an adolescent birth rate of over 120 per 1000 live births, Nigeria has one of the highest birth rates in the world. This is fueled by a lack of access to contraceptive services, even though public health facilities are providing these services at no cost. Many adolescents and young women are consistently shamed and turned away, due to providers’ attitudes and unwritten policies, for trying to gain access to contraceptive services. Lifesaving services, as evidence has shown over and over again, will prevent unplanned pregnancy, reduce maternal complications and contribute to keeping girls in school (we all know this is a major reason for high rate of school drop out by girls).
#3: Create a program that will provide post-abortion care services for women and girls. Unsafe abortion accounts for 13% of all maternal deaths globally, or 70,000 deaths per year. In Nigeria, complications from unsafe abortion account for almost three quarters of all deaths for women under 19 years old and 50% of deaths for all female adolescents. As a professor of Obstetrics and Gynecology with a personal interest in reproductive health issues generally, I am sure you are very familiar with these statistics. Sadly, nowhere in the women’s initiatives you blogged about on this day, is there any mention of strategies to decrease death from unsafe abortion. Could it be that the topic of unsafe abortion is too controversial to address in your tenure as Minster of Health? I would hope not! I also hope that as a physician, the lives of ALL women and girls MATTERS to you, regardless of the factors that places these lives at risk of morbidity or mortality.
#4: Integrate the needs of women and girls living with disability into your health agenda and reforms. A perfect example would be the “Revitalizing Primary Health Care Initiative.” How does it cater to the needs of women with special needs? Does the renovation component take into consideration wheel chair accessibility? Are there any plans to include audio or Braille materials for the visually or hearing impaired? It would have been wonderful to see you make a statement on how your team will be exploring options for making these services disability friendly.
The tagline for this year’s celebration was “Be Bold for Change”! You made several references to it in your blog. With all due respect Honorable Minister, nothing in that blog demonstrates BOLDNESS. Being BOLD for change to me means doing something DIFFERENT and UNUSUAL! Honorable Minister, on that day, International Women’s Day, you could have been different and unusual for Nigerian women and girls by doing more than giving out CAKE.
But it is never too late! As a matter of fact, you still have 297 days left in this year to be BOLD for Change, BOLD for Women and Girls, like me…

iwd fmoh P.S, I have to agree with the Permanent Secretary that you should not have prayed for them to be good women in their work and homes, as they already are. So many people pray for women and girls to be good in their homes, so am not sure your prayer would have much of an effect. However, it would have been more effective if you had called all the MEN in your ministries and pray for them to be GOOD to their WIVES, DAUGHTERS and any other woman in their lives or place of work. I am sure that would be a prayer that GOD would have loved to hear on this International Women’s Day!

Yours faithfully,

Fadekemi Akinfaderin-Agarau.

(Founder, EVA Nigeria)