THE CONTINUING URGENCY OF BUSINESS UNUSUAL Spotlight 2: Investing in Adolescent Girls to Defuse Nigeria’s Demographic Timebomb Summary: As Nigeria enters a phase of rapid expansion Introduction and Context of the working-age population, there is a window of opportunity to benefit from the “demographic dividend”—a Nigeria’s demographic transition has stalled, period in which the share of those who are working starts to prolonging its placement as a “pre-dividend” outnumber the share of young and old dependents, and the country with a decline in fertility rates that lags other increase in labor supply boosts economic growth. However, countries and regions.39 The country’s population Nigeria’s transition into this window of demographic structure remains heavily skewed towards young opportunity has been sluggish. Nigeria’s persistently high dependents because of high fertility rates. fertility rates, especially in the northern regions and among adolescent girls, the poor, and those with low educational F  igure 3.12 (Panel A) plots the rate of decline in Total attainment, threaten to derail the demographic transition. Fertility Rate (TFR)40 over the last two decades among Poverty, low prevalence of and demand for modern countries in the African continent and provides three contraception, and lack of quality secondary schools and job categorical breakdowns: (a) countries where TFR decline market opportunities, all contribute to high rates of teenage has been less than 0.05 per year are categorized as having pregnancy, early marriage, and low educational attainment a “stalled” transition; (b) countries where TFR decline among Nigeria’s adolescent girls. To reap the demographic has been between 0.05 and 0.1 per year are categorized dividend, Nigeria must kickstart the stalled demographic as “early transition”; and (c) countries where TFR transition and ensure that the children of today have the decline has been more than 0.1 per year are categorized means to grow into healthy and productive adults. On as in “transition”.41 Nigeria is one of only four countries these fronts, Nigeria’s performance thus far has fared poorly in Africa with TFR above 5 and a pace of decline of TFR compared to its structural and aspirational peers. Policy of less than 0.05 a year, along with Niger, the Republic recommendations focus on ensuring adolescent girls remain of Congo, and the Gambia. Most other countries with in school longer, and are provided opportunities and services a stalled demographic transition have TFR below 3 and to enable their school-to-work transition. mostly lie in Northern Africa (Egypt, Morocco, Libya, Algeria, and Tunisia) and Southern Africa (South Africa, Botswana, and Eswatini). Nigeria’s prospects of reaping the demographic dividend are grim, owing to persistently high fertility rates. Between 2020 and 2050, Nigeria’s working age population is projected to increase by 132 million. This represents 20 percent of the expected increase in the 39 A country is classified in a pre-dividend typology when the working-age population is projected to grow within the next 15 years, and the total fertility rate is above four. Early dividend countries follow a similar definition, except they have a total fertility rate below four. The demographic dividend, which is in essence an economic surplus, is triggered when, owing to the fast decline of fertility, the working-age population becomes relatively larger and the dependency ratio for young people becomes more favorable. 40 The World Health Organization (WHO) defines the TFR as the average number of children a hypothetical cohort of women would have at the end of their reproductive period, if they were subject during their whole lives to the fertility rates of a given period and if they were not subject to mortality. It is expressed as children per woman. 41 A decline in TFR of 0.05 a year roughly corresponds to a decline by 1 child every 20 years. Part 3: Spotlights on Nigeria's Development Agenda 61 NIGERIA DEVELOPMENT UPDATE JUNE 2022 working age population across all of Sub-Saharan Africa, areas, but it has only declined by 0.5 percentage points and places Nigeria second only to India among countries in the latter compared to 0.4 percentage points in the expected to see the largest growth in their working-age former over the last 30 years. Comparing Nigeria’s trends population by 2050. Advancements in medical sciences in TFR with other regions and countries, Figure 3.12 and public health have ensured a rapid decline in child (Panel D) shows that the decline in TFR in Nigeria lags mortality rates in Nigeria and Sub-Saharan Africa. those in sub-Saharan Africa and other regions across the However, the decline in fertility rates have not kept pace globe. For example, South Africa’s TFR declined from 6 with the decline in child mortality, as Nigeria’s TFR has in 1960 to 2.4 in 2019. failed to diminish substantially over the last five decades. Fertility rates in Nigeria are highest in the North,  igure 3.12 (Panel C) shows that the TFR in Nigeria F among women in the poorest quintile, and among has declined by only 0.7 percentage points over the last women with no secondary education. Figure 3.12 30 years, from 6 in 1990 to 5.3 in 2018. As expected, shows the TFR disaggregated by urban/rural zones, the TFR is higher in rural areas compared to urban education level of the mother giving birth, and wealth Figure 3.12. Nigeria's Stalled Demographic Transition. Panel A.  Rate of TFR decline over the last two decades  atio of working age population (15–64) to young Panel B. R dependents (0–14), Nigeria and peer countries, 2020–2050 Ratio Morocco 4.5 Algeria Libya Egypt 4.0 Mauritania Niger Mali Sudan Eritrea Chad Senegal Burkina Faso 3.5 Guinea Somalia Nigeria Central Ghana South Ethiopia Sierra Cote African Leone Cameroon Republic Sudan d'Ivoire 3.0 Uganda Gabon Kenya Democratic Republic of Republic the Congo of Congo Tanzania 2.5 Angola Zambia Mozambique 2.0 Zimbabwe Madagascar Namibia Botswana Less than 0.05 - Stalled 1.5 0.05–0.1 - Early Transition South Africa More than 0.1 - Transition 1.0 2020 2025 2030 2035 2040 2045 2050 … VNM … BGD ▬ IDN ▬ EGY ▬ PAK ▬ GHA ▬ TGO ▬ SSA ▬ NGA Panel C. Nigeria's TFR, rural and urban areas, 1990–2020 Panel D. Rate of TFR decline, Nigeria and comparator regions and countries, 1990–2020 Ratio Ratio 6.5 8 6.3 6.3 6.2 6.1 6.0 7 6.8 6.0 5.9 6.4 5.7 6.5 6.1 5.7 5.8 6 6.5 5.5 5.5 6.0 5.3 5.5 5.3 5.0 5 5.0 4.0 5.0 4.9 4 4.7 4.7 4.5 3 2.7 4.5 2.6 2.4 2 4.0 1 90 92 94 96 98 00 02 04 06 08 10 12 14 16 18 20 19 19 19 19 19 20 20 20 20 20 20 20 20 20 20 20 1960 1970 1980 1990 2000 2010 2020 ▬ Rural ▬ Urban ▬ Total ▬ EAP excl. high income ▬ LAC excl. high income ▬ MENA excl. high income ▬ Nigeria ▬ South Asia ▬ SSA excl. high income ▬ South Africa Source: World Bank estimates based off WDI (Panel A; Panel C; and Panel D) and UN World Population Prospects (2019) (Panel B). 62 Part 3: Spotlights on Nigeria's Development Agenda THE CONTINUING URGENCY OF BUSINESS UNUSUAL quintile. The North West region in Nigeria has a TFR population in 2020, and will continue to represent more of 6.6, which would be the second-highest fertility rate than 20 percent of the population by 2050.44 Second, of any country in the world, behind only Niger. On and similar to TFR, Nigeria’s adolescent fertility rate of average, the state with the lowest TFR is Lagos with 3.4, 104 births per 1,000 women aged 15–19 is very high and the state with the highest fertility rate is Katsina compared to its income level, and substantially higher with 7.3. Similarly, the TFR among women with no than average in the northern regions of the country.45 education (6.7) is almost twice that among women Nigeria’s adolescent fertility ratehas failed to decline who have completed secondary education (3.4), and below 100 over the last 50 years, and its pace of decline the TFR among women in the poorest quintile (6.7) is lags that of Sub-Saharan Africa and peer countries. It is 3 percentage points higher than among women in the also worth noting that Nigeria recorded increases in birth richest quintile (3.8). rates by girls aged 10 to 14 between 2007 and 2017.46 Third, and most importantly, interventions that help This stall in the demographic transition dims adolescent girls reach their full potential, by increasing Nigeria’s prospect for a demographic dividend in the their education and skills and delaying childbearing near future. The demographic transition is the phase and early marriage, can create a virtuous cycle that in which the conditions to capture a demographic improves adolescent and child health and paves the way dividend are created, because of declines in child for women empowerment—ultimately leading to higher mortality and fertility, and the increase in the share of economic growth.47 working-age population relative to dependents. Figure  he TFR in Nigeria is highest in Figure 3.13. T 3.12 (Panel B) plots the ratio of the projected working- the North, among females with no age population (15–64) to the projected population of education, and among the lower wealth quintiles. young dependents (0–14) in Nigeria and peer countries between 2020 and 2050.42,43 It shows that in 2050, TFR in Nigeria, 2018, national and disaggregates Ratio for every young dependent, Nigeria will only have 7 1.5 people in the working-age population, compared to 6 2.1 in Ghana, 2.6 in Pakistan, 3.4 in Indonesia and 4.2 5 in Bangladesh. In other words, comparator countries will 4 3 have a greater share of economically active people who 2 contribute to the economy. 1 0 Se est M nd Fo le H rth st rb l or R n N en l N th E l th st So uth st So S st N uth uth uc st Pr tion an co ary co ary Lo ry Adolescent girls are a crucial demographic group l C ra a ra a ed e d he or tr or a e ut Ea a th u co u So W W ve w id o m se nd nd a ig U i O h to fast-track Nigeria’s demographic transition. th e S o N There are several reasons why addressing the needs of e or M adolescent girls and empowering them presents Nigeria J NGA J Urban/rural J Zone J Education level J Wealth quintile with the best opportunity to harness a demographic Source: World Bank calculations based off Nigeria Demographic and Health Survey (NDHS), 2018. dividend. First, adolescents between the ages of 10 Note: Total fertility rate for the three years preceding the survey among women between the ages of 15–49. and 19 constitute an estimated 23 percent of Nigeria’s 42 Structural and aspirational peers are identified in the World Bank Systematic Country Diagnostics for Nigeria (2019). Available at: https://openknowledge.worldbank.org/ handle/10986/33347 43 Population projections are estimated using the “medium” variant scenario in the World Population Prospects data. Available at: https://population.un.org/wpp/ 44 Population projections are estimated using the “medium” variant scenario in the World Population Prospects data. Available at: https://population.un.org/wpp/ 45 The WHO defines the AFR as the annual number of births to women aged 15–19 per 1,000 women in that age group. It is also referred to as the age-specific fertility rate for women aged 15–19. 46 United Nations. 2020. Fertility among young adolescents aged 10 to 14 years. Available at: https://www.un.org/en/development/desa/population/publications/pdf/fertility/Fertility- young-adolescents-2020.pdf 47 Canning, D., Raja, S. and Yazbeck, A.S. eds., 2015. Africa's demographic transition: dividend or disaster? World Bank Publications. Part 3: Spotlights on Nigeria's Development Agenda 63 NIGERIA DEVELOPMENT UPDATE JUNE 2022 Constraints to Demographic Transition being and early marriage, teenage pregnancy, and low Through the Lens of Nigeria’s Adolescent educational attainment are established using recent data, Girls where available.49 Adolescent girls are a key demographic group to break the intergenerational transmission of poverty in Demand-Side Constraints developing countries.48 Previous analysis from Nigeria supports this view. With adolescents likely to be the A high poverty rate is one of the strongest second-largest demographic group, after young children, determinants of early marriage and high fertility rates for the foreseeable future, policies that help adolescent among adolescent girls. Prevalence of early marriage girls realize their potential will help Nigeria kickstart its and teenage pregnancy in Nigeria is much higher in the stalled demographic transition. On the demand side, lower wealth quintiles. Figure 3.15 (Panel A) shows that three constraints are assessed: (i) economic deprivation compared to 68 percent of women aged 20–49 who were and poverty; (ii) constraining social norms that curtail married before the age of 18 in the poorest quintile, only demand for family planning; and (iii) low child health 17 percent of women in the richest quintile were married outcomes which raise the need for more children. On before the age of 18 in 2016/17. Similarly, compared to the supply side, four constraints are assessed: (i) lack of almost 200 births per 1,000 women aged 15–19 in the access to quality secondary schools; (ii) inequity in access poorest quintile, Nigeria reported 35 births per 1,000 to quality health and reproductive services; (ii) lack of women aged 15–19 in the richest quintile. opportunities in the labor market; and (iv) insufficient national laws and regulations. The linkages of demand- Poverty also restricts demand for adolescent girls’ and supply-side constraints with adolescent well- education. Female educational attainment—one of the Adolescent well-being, demographic transition, and consequences for potential Figure 3.14.  demographic dividend in Nigeria. 1 Adolescent girls in Nigeria are 2 Poor outcomes for adolescent girls 3 Stalled demographic transition delays constrained by demand and supply stalls the demographic transition prospects for demographic dividend side factors that hinder their well-being process as the vicious cycle of early as dependency ratios remain high and and prevent them from realizing their marriage, teenage pregnancy and low human capital outcomes continue to potential educational outcome reinforce each suffer other Less than 10 percent Demand side constraints: 43 percent of of Nigeria’s secondary Ÿ Poverty prevents low-income households from Nigeria’s girls school age females HIGH enrolling girls in schools get married were attending secondary school Ÿ Constraining social norms and beliefs prevent before the age of 18 or higher in 2016/17 Ÿ Dependency ratio demand for modern contraceptives Ÿ Poverty Ÿ High child mortality and low child health outcomes raise the number of desired children Ÿ Gender inequality Early Low marriage education Supply side constraints: attainment Ÿ Lack of quality schools for adolescent girls pushes them out of school and raises their chances of early fertility Ÿ Lack of quality health and reproductive services Teenage Ÿ Human capital outcomes increases child mortality and illness and intensifies pregnancy desire/need for additional children Ÿ Economic growth LOW Ÿ Lack of job market opportunities for school to work Ÿ Women empowerment transition accelerates early marriage and childbearing Four of Nigeria’s Northern States Ÿ National laws and regulations are unable to deter (Bauchi, Jigawa, Zamfara, and Katsina) have early marriage and childbearing adolescent fertility rates higher than that of the country with the highest AFR (Niger) Source: Adopted from: Bergstrom, K. and Ozler, B., 2021. Improving the Well-Being of Adolescent Girls in Developing Countries. 48 Levine, R., Lloyd, C., Greene, M. and Grown, C., 2008. Girls Count: A global investment & action agenda. 49 While this section provides several correlational analyses linking demand- and supply-side constraints with indicators of adolescent well-being, these should not be interpreted as causal. More careful analysis is needed to establish causality and isolate the impact of individual constraints on outcomes of interest. 64 Part 3: Spotlights on Nigeria's Development Agenda THE CONTINUING URGENCY OF BUSINESS UNUSUAL Figure 3.15. Early marriage and teenage pregnancy rates in Nigeria in 2016/17, by wealth quintile. Panel A.  Marriage Before Age of 18, by Wealth Quintile  dolescent Fertility Rate, by Wealth Quintile Panel B. A 70 200 180 60 160 50 140 120 40 100 30 80 20 60 40 10 20 0 0 Poorest Second Third Fourth Fifth Nigeria Poorest Second Third Fourth Fifth Nigeria Source: World Bank calculations based off data from UNICEF, Multi-Indicator Cluster Survey (MICS) 2016/17.  ercentage of Nigerian children of secondary school age attending secondary school or Figure 3.16. P higher, by location and wealth quintile, 2016/17. Panel A.  Percentage of female children of secondary  ercentage of female and male children of Panel B. P school age attending secondary school or higher secondary school age attending secondary school (adjusted net attendance ratio), Nigeria, 2016–17 or higher (adjusted net attendance ratio), Nigeria, 2016–17, by wealth quintile 80 Sokoto Katsina Jigawa 70 Kebbi Zamfara Yobe Kano Borno 60 Kaduna Bauchi 50 Gombe Niger Adamawa Plateau 40 FCT Kwara Nasarawa Oyo Taraba 30 Ekiti Kogi Osun Adolescent Birth Rate Benue per 1,000 Ogun Ondo 20 Edo 18 Lagos Ebonyi Enugu Cross River 10 Anambra Delta Imo 118 Abia Bayelsa Akwa Ibom 0 Rivers 218 Poorest Second Third Fourth Richest Overall J Female J Male Source: World Bank calculations based off UNICEF, Multi-Indicator Cluster Survey (MICS) 2016/17. strongest predictors of fertility rates—is much lower senior secondary education are not free. In 2015, around in the north than in the south of the country (Figure 18 percent of Nigerian girls aged 6 to 16 who were out 3.16, Panel A). In 2016/17, the percentage of Nigerian of school reported the monetary cost of schooling among girls of secondary school age attending school was just the main reasons for their predicament.50 Another 9.3 percent in the poorest wealth quintile compared to constraint identified by families for not sending their 80.6 percent in the richest quintile, a staggering gap of daughters to school was losing a key income earner who 70 percentage points (Figure 3.16, Panel B). For poor is critical to meeting their basic family needs, as girls are households and their families, it is difficult to cover often more involved in generating family income in rural the direct and indirect cost of schooling. Although areas. Nigeria’s universal basic education (UBE) Program aims to provide nine years of free, compulsory, and universal Compared to the regional average, or to structural and primary education to all children, the three years of aspirational peers, the use of modern contraceptive 50 2015 Nigeria National Education Data Survey (NEDS). Available at: https://shared.rti.org/content/2015-nigeria-national-education-data-survey-neds Part 3: Spotlights on Nigeria's Development Agenda 65 NIGERIA DEVELOPMENT UPDATE JUNE 2022 methods for family planning in Nigeria is low. Figure increasing by two percentage points between 2008 and 3.17 (Panel A) shows that only 12 percent of Nigerian 2018. Compared to the national average, and similarly women aged 15–49, who were married in 2018, used to trends in TFR, there is substantial variation across modern contraceptive methods for family planning, geopolitical zones and states in the use of modern lagging the Sub-Saharan African average (27.5 percent) contraceptive methods. For example, 24 percent of and considerably behind some aspirational peers married Nigerian women aged 15–49 in the South such as South Africa (54 percent).51 The percentage of West use modern contraceptive methods, compared Nigerian women using modern contraceptive methods to 6 percent in the North-West (Figure 3.17, Panel has remained largely the same in the last decade, only B). However, even in the south, modern contraceptive  igeria has very low prevalence of modern contraceptives nationally, and especially in the Figure 3.17. N North East and North West. Panel A.  Countries in Africa by contraceptive prevalence,  ontraceptive prevalence, any modern method Panel B. C any modern method (percent of married women (percentage of married women aged 15–49), by ages 15–49), last available year zones, 2018 Percent of married women ages 15–49 25 Morocco Algeria Libya Egypt Mauritania 20 Mali Niger Sudan Eritrea Senegal Burkina Chad Faso Guinea Ethiopia Somalia Sierra Leone Cote Ghana Nigeria Central African South 15 d'Ivoire Cameroon Republic Sudan Uganda Gabon Kenya Democratic Republic of Republic the Congo of Congo Tanzania 10 Prevalence of modern Angola contraceptives Zambia 0.9 Mozambique 5 Zimbabwe Madagascar Namibia Botswana 33.35 South Africa 0 65.8 North North North South South South Nigeria Central East West East South West Overall Source: World Bank Calculations based on World Development Indicators (Panel A) and Nigeria Demographic and Health Surveys (NDHS), 2018 (Panel B).  ost fertility in Nigeria is wanted fertility with low demand for family planning, especially Figure 3.18. M among adolescents. Panel A.  Trends in total wanted fertility and unwanted  otal demand for family planning (met and unmet) Panel B. T fertility, 1990–2018, Nigeria of women aged 15–49, by education level and wealth quintile 6 0.2 60 0.4 0.4 0.3 5 0.5 50 40 4 30 3 5.8 5.3 5.3 5.2 20 4.8 2 10 1 0 y y ar n t nd ird th st ll 9 n es ra ar ar –1 io nd tha he y ur co Th or ve at im nd 15 Fo ic Se uc co re Po O 0 Pr co R es seMo ed 1990 2003 2008 2013 2018 Se Ag o NDHS NDHS NDHS NDHS NDHS N J Total wanted fertility J Unwanted fertility J Married women J All women Source: World Bank calculations based off Nigeria Demographic and Health Surveys (NDHS), 2018. 51 DHS, most recent available year is 2018 for Nigeria, 2017 for sub-Saharan Africa, and 2016 for South Africa. Available at: https://data.worldbank.org/indicator/SP.DYN.CONM. ZS?most_recent_value_desc=false 66 Part 3: Spotlights on Nigeria's Development Agenda THE CONTINUING URGENCY OF BUSINESS UNUSUAL prevalence among married women ranges between 13 of them survive beyond childhood. Nigeria’s U5MR and 24 percent, lower than the national averages in has declined from 183 per 1,000 live births in 2000 to Burkina Faso, Ghana, and Senegal, and lower than the 117 per 1,000 live births in 2019. Yet, Nigeria has the average for low-income countries (29 percent) worst U5MR of any country in the world. In the North West, U5MR is 187 per 1,000 live births, higher than Demand for family planning is especially low for the national average in the year 2000. adolescents between the ages of 15 and 19. Figure 3.18 (Panel A) shows the trends in wanted and unwanted The risk of neonatal, post-neonatal, infant, child, fertility in Nigeria between 1990 and 2018. It reveals and under-five mortality is substantially higher for that the gap between actual and wanted fertility is very adolescent mothers. U5MR in 2018 was 160 per 1,000 small, reflecting both a desire for large families and the live births among adolescent mothers, compared to 120 relative realization of desired family size. As with the among women aged 20–29 and 124 among women use of modern contraceptive methods, there is national aged 30–39. Similarly, the infant mortality rate— variation in demand for family planning. 50 percent defined as the number of deaths of children under one of married women who have more than secondary year of age, and expressed per 1,000 live births—was education demand family planning services, compared to 85 among births by adolescents, substantially higher 20 percent of married women with no education (Figure than 59 among the 20–29 age group, and 64 among 3.18, Panel B). Total demand for family planning is the 30–39 age group. In developing countries such as 15 percent among married adolescents between the ages Nigeria, wanted fertility often depends on infant and of 15 and 19. child mortality rates, as families consider the need for additional children to replace potential losses. Therefore, Although there has been progress in reducing when a country decreases its infant and child mortality the Infant Mortality Rate (IMR) and Under-Five rates, it can trigger a fertility decline as more children Mortality Rate (U5MR), Nigeria is still among the survive into adulthood.52 Not only do women who begin countries with the highest U5MR and IMR, causing childbearing early are more likely to have more children women to have more children in the hope that more throughout their lives, but there is also a greater risk  igeria has the highest under-5 mortality rate in the world despite a rapid decline in the last Figure 3.19. N 50 years, largely due to the high prevalence of childbearing among adolescents. Panel A.  Neonatal, Infant, Child, and Under-5 mortality rates  nder 5 Mortality Rate (per 1,000 live births), Panel B. U by type and mother’s age at birth, Nigeria, 2018 Nigeria and comparator countries/region 160 300 281.4 140 250 211.8 120 209.5 200 183.1 100 150 136.0 80 117.2 60 100 40 50 20 0 0 <20 20–29 30–39 40–49 1970 1980 1990 2000 2010 2019 J Neonatal mortality J Postneonatal mortality J Infant mortality ▬ Nigeria ▬ Sub-Saharan Africa ▬ Pakistan ▬ Ghana J Child mortality J Under 5 mortality ▬ Rwanda ▬ Bangladesh ▬ Indonesia Source: World Bank calculations based on Nigeria Demographic and Health Surveys (NDHS), 2018 (Panel A) and World Development Indicators (Panel B). 52 Conley, D., McCord, G.C. and Sachs, J.D., 2007. Africa's lagging demographic transition: Evidence from exogenous impacts of malaria ecology and agricultural technology. Part 3: Spotlights on Nigeria's Development Agenda 67 NIGERIA DEVELOPMENT UPDATE JUNE 2022 of death, disease, and illness for the mother and their shortage of secondary schools, with only 31,000 junior children, constraining their ability to contribute to secondary schools and 23,000 senior secondary schools society. compared to 112,000 primary schools, implying a ratio of approximately 3.6 primary schools for every junior More than one-third of Nigeria’s children under five secondary school and 4.9 primary schools for every are stunted, severely denting their hopes of realizing senior secondary school. The lack of secondary schools their full potential. In 2018, close to 37 percent of is significantly greater in the north, with an average of children between the ages of 6 and 59 months in Nigeria 4.1 primary schools for every junior secondary school. were stunted, or too short for their age.53 The prevalence COVID-19 has further affected access to schooling of stunting widely varies across geopolitical zones. among Nigeria’s adolescents, with girls in the north most In the North West it is 57 percent, or 20 percentage likely not to return when schools reopened. points more than the national average. In contrast, the prevalence of stunting is 18 percent in the South Adolescent mothers are less likely to give birth in the East, less than half the national average. With 2 out of presence of skilled providers, and often cite distance every 5 children under the age of five stunted, Nigeria’s from health facilities and lack of providers as barriers prospects for reaping the demographic dividend in the to accessing health services. Between 2008 and 2018, near-term look even more distant, as studies consistently the percentage of Nigerian women giving birth in show that stunting in early life is associated with lower presence of a skilled birth attendant increased from educational attainment, productivity, and wages during 39 percent to 43 percent. Despite this improvement, adulthood.54 fewer than 40 percent of newborns delivered in Nigeria in 2018 were born in a health facility.56 In the five years preceding the survey in 2018, only 31 percent of Supply-Side Constraints adolescent mothers delivered in the presence of skilled birth attendants compared to 46 percent in the 20–34 More than one in five primary schools in Nigeria do age group and 43 percent in the 35–49 age group,57 not have a junior or senior secondary school within significantly increasing the risk of death and illness for 3 km radius and one in ten primary schools do not both child and mother. In a study of utilization of skilled have a junior or senior secondary school within birth attendance considering 400 women in northern 5 kilometer radius. Lack of access to a secondary school Nigeria, lack of healthcare providers and lack of supplies is much worse in northern states than in southern and equipment were found to be major barriers to states. 32 percent primary schools in northern states do accessing skilled birth attendance, along with poverty.58 not have a junior secondary school within 3 kilometer radius as compared to just 8 percent primary schools Adolescents and young girls in Nigeria face limited in southern states55. The expansion of secondary school labor market opportunities in their school-to-work infrastructure has not kept pace with the rapid growth transition. According to NBS, Nigeria’s youth aged in primary enrollment or the rising transition rates 15–24 faced unemployment rates of 53 percent at the to secondary schools. Nationally, there is an acute end of 2020 (Figure 3.20).59 Both unemployment and 53 Nigeria Demographic and Health Surveys (NDHS), 2018. 54 McGovern, M.E., Krishna, A., Aguayo, V.M. and Subramanian, S.V., 2017. A review of the evidence linking child stunting to economic outcomes. International journal of epidemiology, 46(4), pp.1171-1191. 55 National Personnel Audit 2008. 56 Nigeria Demographic and Health Surveys (NDHS), 2018. 57 Ibid. 58 Adewemimo AW, Msuya SE, Olaniyan CT, Adegoke AA. 2014. Utilization of skilled birth attendance in Northern Nigeria: a cross-sectional survey. Midwifery. PMID: 24139686. Available at: https://pubmed.ncbi.nlm.nih.gov/24139686/#:~:text=Barriers%20to%20SBA%20utilisation%20identified,husband's%20approval%20and%20affordable%20 service. 59 NBS defines unemployment rates as the percentage of the labor force population who could not find at least 20 hours of work in the reference period. 68 Part 3: Spotlights on Nigeria's Development Agenda THE CONTINUING URGENCY OF BUSINESS UNUSUAL  igeria's youth faced an Figure 3.20. N unemployment rate of 53 percent at Despite the existence of national laws and the the end of 2020. ratification of relevant international treaties, child Percent marriage continues to plague Nigerian society. Nigeria 60 passed the Child Right Act in 2003 that guarantees the 53.4 50 rights of all children in Nigeria. Part III of the Child Rights Act includes protection from child marriage, 37.2 35.2 40 33.3 as well as punishments for the act on the adult parties 31.8 27.2 25.9 25.7 25.4 involved. However, only 26 out of Nigeria’s 36 states 24.4 24.2 30 23.6 22.8 21.8 21.6 19.8 20 have so far adopted the Act, while 10 northern states where child marriage rates remain high have yet to 10 adopt it.64 Even in some northern states that have 0 adopted the Act, provisions against child marriage Female Nigeria 15–24 25–34 35–44 45–54 55–64 Male Overall is yet to be incorporated in state laws, making it J Unemployment J Underemployment Source: National Bureau of Statistics (NBS). inadequate to protect children from forced marriages.65 As a consequence, Nigeria has one of the highest rates underemployment rates were higher for women. When of child marriage in the world, much higher than peer women do work, they consistently earn less than men.60 countries, with around 44 percent of Nigerian women Recent research shows that unemployment can accelerate currently aged between 20 and 49 married before the age the transition to motherhood for women.61 In Nigeria, of 18.66 It is estimated that child marriage costs Nigeria about 65 percent of working women in households about US$7.6 billion in lost earnings and productivity with children under five worked less than 40 hours per every year.67 week, compared with 57 percent of working women in households without children under five.62 Poor female The inability of Nigeria’s laws and regulations to labor market outcomes and high fertility rates reinforce prevent child marriage also stems from incongruities each other. Higher participation of women in the in the relevant laws. Although the Child Rights Act of labor force, especially when combined with secondary 2003 stipulates the minimum age of marriage to be 18, education completion, is associated with lower fertility the Constitution states that “any woman who is married rates, while higher fertility rates tend to decrease shall be deemed to be of full age.”68 Efforts to remove women’s work rates.63 Not only do poor labor market this inconsistency have so far met with stiff opposition in outcomes discourage young women from participating the Nigerian senate, as lawmakers and religious leaders in the market and increase their likelihood of having in the northern states often cite Islam’s lack of an age more children, but they also take away from young requirement for betrothal as a justification for early women’s contribution to the economy, thereby reducing marriage.69 the prospects of a demographic dividend. 60 World Bank. 2022. Closing Gaps, Increasing Opportunities: A Diagnostic on Women’s Economic Empowerment in Nigeria. Washington, DC: World Bank. 61 Andersen, S.H. and Özcan, B., 2021. The effects of unemployment on fertility. Advances in Life Course Research, p.100401. 62 World Bank.2021. Good Jobs for a New Generation: Delivering Quality Jobs for Young Nigerians After COVID-19. Available at: 63 Bloom, D.E., Canning, D., Fink, G. and Finlay, J.E., 2009. Fertility, female labor force participation, and the demographic dividend. Journal of Economic growth, 14(2), pp.79- 101. 64 Human Rights Watch. 2021. Nigerian States Should Protect Girls by Ending Child Marriage. Available at: https://www.hrw.org/news/2021/09/24/nigerian-states-should-protect- girls-ending-child-marriage# 65 Ibid. 66 UNICEF, Multi-Indicator Cluster Survey (MICS) 2016/17. Data based on 67 World Bank. 2018. The Cost of Not Educating Girls: Educating Girls and Ending Child Marriage: A Priority for Africa. Available at: https://documents1.worldbank.org/curated/ en/268251542653259451/pdf/132200-WP-P168381-PUBLIC-11-20-18-Africa-GE-CM-Conference-Edition2.pdf 68 Constitution of the Federal Republic of Nigeria. 1999. Available at: http://www.nigeria-law.org/ConstitutionOfTheFederalRepublicOfNigeria 69 Human Rights Watch. 2021. Nigerian States Should Protect Girls by Ending Child Marriage. Available at: https://www.hrw.org/news/2021/09/24/nigerian-states-should-protect- girls-ending-child-marriage# Part 3: Spotlights on Nigeria's Development Agenda 69 NIGERIA DEVELOPMENT UPDATE JUNE 2022 Policy Measures to Accelerate the Policy Message 1: Support measures Demographic Transition to Harness the that help keep girls in school, to delay Demographic Dividend marriage/pregnancy and improve learning outcomes. To accelerate Nigeria’s sluggish demographic transition and realize the demographic dividend, There is an urgent need to expand access to secondary this note proposes policy recommendations around schools, and make it free for poor households who four complementary pillars. Together, the four pillars find it hard to cover the direct and indirect cost of aim to achieve two key objectives to take advantage secondary schooling. Although Nigeria’s universal basic of the demographic window of opportunity in the education (UBE) Program aims to provide nine years of near term. First, the policy measures will help Nigeria free, compulsory, and universal primary education for all accelerate the demographic transition by reducing high children, the three years of senior secondary education fertility and child mortality rates, causing a shift in the are not free. For poor families, sending their daughters to age structure. Second, the measures will allow Nigerian school means losing a key income earner who is critical youth, particularly girls, to effectively contribute to the to meeting their basic family needs, as girls are often economy as they become equipped with the necessary more involved in generating income for the family in skills and capabilities. The four pillars are presented rural areas. Keeping girls in school will require removing below (in summary). the direct cost of schooling and compensating parents for the forgone income. In terms of school access, the F  igure 3.21 illustrates the mutually reinforcing nature lack of secondary schools is significantly greater in the of these policy actions, and how targeting support to north, with an average of eight primary schools for every adolescent girls can accelerate progress across all pillars. secondary school. For girls to transit to or complete Table 3.1 highlights the need for the policies proposed, secondary school, the government should provide the the short- and medium-term actions to support the necessary infrastructure to create safe learning spaces in policies, and the likely impact the policy measures will their communities. have.  argeting adolescent girls with holistic support is critical to reducing fertility and Figure 3.21. T accelerating the demographic transition in Nigeria. Accelerating Demographic Transition… 1 Support measures that keep girls in 2 Expand access to and demand for family 3 Increase investments in maternal and school planning child health Keeping girls in school until they complete Expanding access to and demand for family Increasing investments in maternal and secondary education (or higher) delays planning addresses informational and child health, and in turn reducing child early marriage and childbearing, reducing financial constraints to contraceptive use, mortality, reduces the desired number of family size, expands demand for family addressing unwanted fertility children and improves health outcomes for planning, and increases investments per adolescent girls and their future children child on health Examples of short-term Examples of medium-term measures measures Ÿ Provide cash transfers Ÿ Engage community elders and supplementary and leaders to address services discriminatory norms Ÿ Expand immunization 4 Boost women’s labor force participation Ÿ Expand supply of quality Ÿ Provide information on and earnings secondary schools benefits of family Expanding women’s economic opportunities Ÿ Improve access to quality planning reduces fertility by increasing the opportunity technical, vocational, and cost of women’s time socioemotional skills training for women ...to harness the Demographic Dividend in Nigeria Note: World Bank Illustration. Additional measures are highlighted in Table 3.1. 70 Part 3: Spotlights on Nigeria's Development Agenda THE CONTINUING URGENCY OF BUSINESS UNUSUAL Policy Message 2: Expand access to and Policy Message 4: Support programs and demand for family planning. interventions that address constraints to women’s participation in the labor force Nigeria needs to implement strategies that improve and increase their earnings. access to and increase demand for family planning services. There is a need to prioritize improvement in Nigeria needs to prioritize interventions that address demand for family planning—as current unmet needs constraints to women’s economic empowerment, for family planning are low across the country—by including helping the school-to-work transition focusing on both inter-personal and societal behaviors for adolescent girls. There is growing global evidence and norms, and engaging with women’s groups and that ensuring economic opportunities for women is community, religious and traditional leaders. Other an important entry point for reducing high fertility policies should focus on providing information on the and early childbearing, and ensuring better education, pros and cons of different family planning methods, and health, and nutrition outcomes for children. Measures targeting family planning vouchers to adolescent girls. that provide adolescent girls with a comprehensive set of vocational, socio-emotional, and technical tools to navigate the labor market seem to hold the most Policy Message 3: Increase investments in promise. multi-sectoral interventions that improve maternal and child health outcomes. Increasing fiscal resources available for health and social protection programs—focusing on those that come with evidence of reducing child mortality and stunting and improving maternal mortality rates— will diminish the need for more children. In 2019, Nigeria’s low public expenditure on education and health reflected its standing as the country with the sixth lowest Human Capital Index (HCI) in the world.70 There is a need to reduce the high child- and under-five mortality rates and to increase the utilization of maternal health services, especially among adolescent girls. Concurrently, interventions should be expanded to reduce childhood stunting, as this is strongly associated with lower productivity and earnings during adulthood. Despite the government launching several safety net programs in recent years, social protection coverage remains low, even if well targeted. Social protection measures that improve the demand for human capital services, and health measures that provide cost-effective preventative interventions to reduce under-five mortality, must be prioritized.71 70 World Bank, 2020. The Human Capital Index 2020 Update: Human Capital in the Time of COVID-19 71 These include including maternal tetanus toxoid vaccination, exclusive breastfeeding, clean-cord care, kangaroo mother care, immunizations, vitamin A supplementation, prevention of mother-to-child transmission of HIV, and expansion of the use of insecticide-treated mosquito nets. Part 3: Spotlights on Nigeria's Development Agenda 71 NIGERIA DEVELOPMENT UPDATE JUNE 2022  igeria needs to ensure adolescent girls remain in school longer and are provided services Table 3.1. N and opportunities as they come of working age. What measures are being proposed? Why are the measures What is the likely impact the needed? Short-Medium Term Medium-Long Term measures will have? (6–18 months) (18–36 months) Policy Message 1: Support measures that keep girls in school. • Less than 10 • Provide safe learning • Advocate for reforms, • Decrease in fertility percent of secondary spaces to adolescent including enacting and increased use of school-age girls in girls, in which they a law mandating 12 contraception. A multi- the lowest wealth meet inside or outside years of free and faceted program for girls in quintile attend of school to socialize compulsory education Uganda (Empowerment and secondary school, and receive vocational for girls. Livelihoods for Adolescent compared with 80 and life skills training Girls - ELA) combining clubs percent in the richest (including on sexual • Implement social with vocational and life-skills quintile. and reproductive and behavior change training led to decrease in health), such as in the communication, fertility and increased use of • 23 percent of World Bank-supported including community- contraception.72 primary schools in Adolescent Girls level dialogue, and Nigeria’s north do Initiative for Learning campaigns at the • Increase in school enrollment. not have a junior or and Empowerment federal, state, and Bergstrom and Ozler found senior secondary (AGILE) project. community levels to that school construction can school within 5 km change discriminatory lead to very large gains in of their communities, • Expand construction of social norms, increase educational attainment in compared to 5 community secondary demand for girls’ areas where schools are percent of primary schools and / or education, and reduce far away. They also found a schools in southern expansion of primary the prevalence of child promising impact on reduced/ Nigeria. schools to include marriage. delayed fertility.73 JSS and SSS, and renovation of existing • Encourage 10 states secondary schools that are yet to adopt to provide conducive the Child Rights Act of learning environment in 2003 to increase and the north of the country. enforce the minimum age of marriage of 18 for girls. Policy Message 2: Expand access to and demand for family planning. • Total demand for • Provide vouchers to • Engage community • Increased demand for family family planning is adolescent girls to leaders in the north planning services. A family 15 percent among access family planning and women’s groups to planning (FP) program in India married adolescents services. address societal norms that offered women vouchers between the ages of and behaviors leading to seek care and services with 15 and 19. • Provide information to low uptake of family their peers increased visits on the benefits of planning services. to an FP clinic for FP and • Prevalence delaying, spacing, reproductive health services.74 of modern and limiting births, contraceptive and on the pros and • Increased use of family method among cons of different family planning measures. In Kenya, women aged 15–49 planning methods, a 45-minute information is just 12 percent. especially in the north. session delivered by an outside facilitator with a focused message on the heightened risk of HIV faced by girls having sex with older partners was effective at reducing unprotected sex and consequently pregnancy among adolescent girls.75 72 Bandiera, O., Buehren, N., Burgess, R., Goldstein, M., Gulesci, S., Rasul, I. and Sulaiman, M., 2013. Empowering adolescent girls in Uganda. 73 Bergstrom, K. and Ozler, B., 2021. Improving the Well-Being of Adolescent Girls in Developing Countries. 74 Anukriti, S., C. Herrera-Almanza, and M. Karra. 2021. Women’s access to family planning: experimental evidence on the role of peers and vouchers. Forthcoming. 75 Dupas, P., 2011. Do teenagers respond to HIV risk information? Evidence from a field experiment in Kenya. American Economic Journal: Applied Economics, 3(1), pp.1-34. 72 Part 3: Spotlights on Nigeria's Development Agenda THE CONTINUING URGENCY OF BUSINESS UNUSUAL  igeria needs to ensure adolescent girls remain in school longer and are provided services Table 3.1. N and opportunities as they come of working age (continued) What measures are being proposed? Why are the measures What is the likely impact the needed? Short-Medium Term Medium-Long Term measures will have? (6–18 months) (18–36 months) ncrease investments in multi-sectoral interventions that improve maternal and child health Policy Message 3: I outcomes. • Nigeria has the • Expand immunization • Supplement the • Reduction in childhood third-highest infant and vitamin-A delivery of cash stunting. The Child mortality rate and supplementation in transfers with advice Development Grant Program the highest U5MR lagging areas. and counselling on (CDGP), a multi-faceted mortality rate in the • Expand and provide nutrition and health. program that provided cash world. unconditional cash transfers and information to • Close to 37 percent transfers to women extremely poor households, of Nigerian children during pregnancy and led to large and sustained between 6 and 59 until the child reaches improvements in children’s months are stunted. two years of age. anthropometric and health outcomes, including an 8 percent reduction in stunting four years post-intervention.76  upport programs that address constraints to young women’s participation in the labor force Policy Message 4: S and increase their earnings. • Adolescents and • Provide labor market • Encourage women • Increase in productivity young girls in interventions targeting to become involved among women farmers. A Nigeria face limited women and youth with in male-dominated psychology-based training opportunities in comprehensive job occupations/sectors, by called Personal Initiative their school-to- facilitation support, broadening the range led to increased profits for work transition. In including vocational of programs offered women entrepreneurs in 2020, the youth and socio-emotional in technical colleges Togo, and to increases in unemployment rate skills training. aimed at digital jobs surface cultivated, input use, was 20 percent. • Support adolescent and trades with good and adoption of cash crops • A significant portion girls by providing employment prospect among women farmers in of young Nigerian mentorship programs for women, integrating Mozambique.77 women are unable to and mitigating specific socio-emotional • Increased participation of make the school-to- constraints to their skills training in the women in male-dominated work transition: boys participation in the curriculum, supporting sectors. The Nigeria Business and girls are equally labor market, such the recruitment of Process Outsourcing likely to either attend as transportation or female teachers Youth Employment project school or work until childcare costs. and instructors, and provided information and the age of 14, after improving facilities communications technology • Deliver comprehensive in technical colleges which women’s packages to ultra-poor training which significantly participation drops. to make them more increased the likelihood women that combine attractive to females. grants, training, and of women working in ICT- linkages to markets • Sustained policy enabled service sectors and services. engagement to (traditionally male-dominated). promote reforms This was especially true • Establish vocational boosting women’s labor among women who initially and STEM programs force participation, held self-defeating bias to help girls build skills including enacting a against associating women and easily access the law against gender- with professional attributes in labor market. based discrimination in male-dominated sectors.78 work and laws around parenthood, as well as lifting restrictions on mobility and sectors of work. 76 Carneiro, P.M., Kraftman, L., Mason, G., Moore, L., Rasul, I. and Scott, M., 2020. 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