Lu Wei Pearson is the associate director of the health, maternal, and newborn child health at UNICEF in New York. In this interview with Anthonia Obokoh, she spoke on adolescent health in Nigeria and what UNICEF is doing to drive the awareness of human papillomavirus (HPV) vaccination.
What is the connection between adolescent and sexual reproductive health?
Adolescent is when going through development from childhood to teenage years, early teens, and late teens. Their body goes through changes – hormonal changes, they become curious about their body, and they also become sexually active. This is when they can expose themselves to risks unless they are aware of the risks such as they can have sexual intercourse without protection either by condom or contraceptives by girls, or they can contact with people with sexually transmitted infections (STIs) or human immunodeficiency virus) (HIV)that they get themselves infected. This is especially true for adolescent girls and they have much higher infection risk than boys during the adolescent years.
While addressing issues in adolescent health, UNICEF is also scaling up access to human papillomavirus (HPV) vaccines to eliminate cervical cancer. How can Nigeria improve access to the vaccine?
The 2023 National Conference on Adolescent Health offers a chance to directly listen to the thoughts of young people, which would be highly useful in determining ways to properly guard their all-around health. So, we met with the permanent secretary Lagos State Ministry of Health, and he said the cervical cancer rate in Lagos state is very high and suggested that since HPV vaccination could prevent cervical cancer it should be scaled up.
HPV vaccines are often targeted at nine to 14-year-old girls, it’s the most critical age that has the effect of the vaccination. Nigeria is among the countries UNICEF is supplying with this life-saving vaccine to protect these girls from cervical cancer. The immediate priority when it comes to HPV is vaccination. Vaccines are one of the most cost-effective medical interventions.
HPV vaccination to take effect for cancer to reduce cervical cancer will take many decades because cervical cancer happens in adults and, if children are vaccinated today, it will take three or four decades to show the effects. This means HPV vaccination is important and at the same time, we still need to screen women and especially women over 40 years when it becomes a higher risk in cervical cancer, they should be screened and treated and following the national protocol, I am sure Nigeria has the national screening protocol which has to do with age and frequency of where you can receive the screening.
Recognising the potential of Nigeria’s large number of youth population and the importance of providing and supporting its health and well-being. How is UNICEF committed to strengthening its program and system for adolescents?
The adolescent programme is a priority for UNICEF and we handle adolescent physical and mental health from different angles. First of all, education, boys and girls should receive primary and secondary education. In Nigeria, education is not that free, however, there should be free education as a state obligation to its population.
Also, good nutrition is important. We know that adolescent girls if they are anemic and they get pregnant when they become mothers, the children are at higher risk of low birth weight and other conditions. So, nutrition is important as a lifestyle and I have seen in Lagos City, many children are quite overweight. You see both spectrums, you see malnourished children, you also see obese children. So, we need to make sure those children that are overweight do regular exercise and have a healthy lifestyle.
The third is about their mental health and when we have seen that in the sessions we have had with some children, these young people have concerns with their mental and physical health, they are stressed and they have a lot of anxiety when they do not have an answer to their concerns. So, UNICEF needs to work with the media, and government so there is a way for them to express and share their concerns and for us to answer their questions.
UNICEF is committed to supporting the government of Nigeria and the private sector including the media and using clubs and other organisations to support the youth programme.
In some states across Nigeria, health workers have a poor understanding of adolescent-responsive service. How can this be improved?
Adolescents should have access to high-quality and responsive sexual and reproductive health. Healthcare workers are expected to provide counseling to adolescents on safe sex practices to prevent STI/HIV infection, as well as screening and treatment for STI and HIV where needed.
Read also: NDDC: New director takes over at corporate affairs division as FG directive on tenure sweeps on
I understand there is a huge brain drain outbound migration of healthcare providers. This is a situation that needs to manage because if not, Nigeria produces a lot of doctors, midwives, and nurses, and they are very capable people. But unless they are paid very well, have adequate working conditions such as electricity, water and equipment, and medicines. They won’t be fully motivated and productive. So, to keep the doctors and human resources on the ground, especially in remote areas, we need to make sure they have the enabling environment and they have to feel motivated enough to commit themselves to providing services to people.
Realising the rights of adolescents, how more can Nigeria invest in SGDs to improve sexual and reproductive health?
There is no one answer to investing in SDGs, there has to be a multi-sector effort. I mentioned education, nutrition, and health services. In any country, the government is the biggest stakeholder in everything in education, health services, youth-friendly health services, health information system, among others. Government is the biggest investor and stakeholder.
We at UNICEF and other development partners are here to help. However, the government is the primary body to make sure that the rights of every child, and every human being in Nigeria is realised. It’s government accountability and there is something that the media can do to amplify them, the voice and messages of people from the grassroots level, especially for those who do not have a voice, so that the government can hear their voices and that can hold them accountable to people’s well being and concerns.
What lessons can Nigeria learn from other countries to improve Adolescent Health?
It is a shared learning, there are many good practices such as this youth-friendly health service is an example of how other countries can learn and there could also be learning within Nigeria, the experience in Lagos can be shared with Northern Nigeria perhaps where the social and cultural norms are different. The expression of concerns and opinions may be different, there could be different ways of dealing with stigma. I feel, first of all, we have to share the good experience through the third youth conference within Nigeria.
Other countries are there is a good experience that Nigeria can learn from countries that have wider social media coverage, such as a hotline, a free hotline for young people to call, wherever they have a concern, the hotline can refer them to free services, and in other countries, there is good health insurance coverage, including young people’s services to health care, and they don’t have to pay at service utilisation point. So, health insurance and universal health coverage, including young people, are important.
Many other countries have scaled up HPV for both boys and girls because boys can acquire HPV and they can transmit it to girls. So, when there are enough vaccines and resources, Nigeria should immunize both girls and boys with HPV.
Anything to add before we wrap up?
I have one request for social media influencers, the state media, and the government information channel, to continue to voice people’s concerns, collect stories from the grassroots level, come visit the field more often and look at what’s happening in people’s lives at household and grassroots level. UNICEF is ready to work with the government, media, partners, and with every individual to improve adolescent health in Nigeria.
