DFID’s programme in Nigeria Contents

4Delivering Basic Services

“The ultimate purpose of DFID’s programme in Nigeria is to ensure Nigeria is able to deploy its own resources effectively towards the delivery of services; and for the poorest (including women and girls) to have a say in and benefit from Nigeria’s development.”—DFID Nigeria

73.In a country such as Nigeria, the consequences of limited access to and low quality of basic social services are dire. A healthy, well-educated population is the cornerstone of economic and social development, yet Nigeria scores very badly on key development indicators, ranking 152nd of 185 countries in the 2015 Human Development Index.136 While Nigeria accounts for around 2.5% of the world’s population, it contributes to about 10% of global maternal, infant and child deaths.137 A Nigerian mother is 90 times more likely to die in childbirth than a mother in the UK, and one in ten children do not live to reach the age of five.138 Many of these deaths are largely the result of preventable diseases such as malaria, measles, respiratory infections and diarrhoea.

74.Along with these prominent health issues, DFID has suggested that Nigeria “urgently needs to take steps to rejuvenate [its] basic education.”139 The country has the highest number of children out of school in the world—of the 57 million worldwide who are not receiving a formal education, more than 10 million live in Nigeria.140 As figure 2 reveals, between 1999 and 2010, the number of children of primary age not in school decreased globally, yet increased in Nigeria, with girls making up the majority of those not in education. Only 59% of 6–12 year olds regularly attend primary school and there are wide geographical disparities, with regional differences contributing to lifelong inequalities in opportunities—typically between the North and the South. It is not only access to education that poses a development challenge, but equally the quality of education provision. More than two-thirds of children in the North remain illiterate by the end of primary school, leading DFID to suggest that the current system: is “failing to equip Nigeria’s children with the knowledge and skills they need to thrive in today’s rapidly changing society and economy.”141

Fig 6: Out of school primary age children, millions

Source: World Bank Databank (accessed 1 July 2016)

Political and financial commitment to basic services

75.Education, health and other basic social services including access to justice are key in translating Nigeria’s wealth into tangible social benefits for the poorest. As Health Partners International wrote: “DFID should continue to see health programmes as a key entry point in its cross-sectoral approach to poverty reduction”.142 Yet despite the country’s increased wealth, adequate quality and reach of these services has not materialised in recent decades. The 36 state governments and 774 local government areas (LGA) are assigned primary responsibility for the delivery of basic public services for Nigerians. However, in written evidence, Palladium stated: “the spending priorities of states often fail to sufficiently focus on basic services”143 and a recent report from the Africa Research Institute suggests that LGAs “have all but ceased to function”.144

76.The effective delivery of services by state governments and LGAs depends on improved governance processes and structures (see Chapter 1) but also on adequate funding. As Chris Horn, former Consultant, ICAI, stated in written evidence: “This financial environment is fundamental to education and other public service improvements.”145 In 2014, Nigeria’s public health expenditure stood at 0.9% of GDP compared with 7.6% in the UK,146 and prospects of a substantial increase under the new government of Muhammadu Buhari are uncertain. Edwin Ikhuoria of ONE Campaign has written:

“While there is a slight increase in the overall provision for funding health programmes in the federal budget proposal (not accounting for inflation), the funding gap is still very wide and grossly inadequate to achieve the health objectives of the SDGs especially at the primary health care level.”147

77.Nick Hurd MP, Parliamentary Under-Secretary of State, Department for International Development, also expressed uncertainty regarding the Federal Government’s commitment to education. He told us: “it is not entirely clear to me yet what priority the Government attaches to education at the federal level”.148 DFID noted in oral evidence that Sustainable Development Goal 4—ensuring inclusive and equitable quality education and promoting lifelong learning opportunities for all—is “unlikely to be achieved”.149 Given that the Goals were only agreed last year, it is of great concern to us that there is already talk of Nigeria’s failure on such a key Goal.

78.In written evidence, Chris Horn set out a number of the main challenges to making major progress towards SDG 4, highlighting that the core issue underpinning them all is “security and consistency of funding over the whole period to 2030”.150 There appears to be considerable variation in state funding for school improvements, ranging from 70% of the annual budget being released and utilised in Jigawa to less than 3% in Enugu.151 This variation in commitment to education between states is reflected in the resources available for schools. In Kwara state, the ratio of pupils to text books is 1:1 but in Kano it is 1:5.152 This has a knock-on effect on educational outcomes. There is also an acute shortage of teachers, and Chris Horn also told us that: “I am not sure the scale of the problem is fully recognised either by DFID or the state governments and the federal Government.”153 In light of fiscal pressures associated with the fall in the oil price, substantial and consistent financial commitment is all the more important. While it is of course up to the Nigerian Government how it should spend its own resources, Dr Oliver Owen wrote in written evidence: “DFID should provide research, modelling and scenario planning which may better enable key decision-makers to come to the best-informed decision possible while respecting their role as a sovereign government.”154

79.State governors are largely responsible for releasing funding for basic services, therefore connecting DFID’s programmes with key decision-makers and ensuring strong working relationships is highly important to the success of development interventions. However, concerns were raised in evidence about how effectively this is operating in practice. Dr Oliver Owen wrote:

“Many DFID programmes complain of the lack of strategic engagement with Nigerian governmental partners by DFID staff on their behalf, and so programmes are left to either ‘manage upwards’ and coordinate DFID itself, or to try and manage their own political relationships, or risk their work being held up by slow DFID efforts to engage politically on their behalf. Certain DFID staff have in the past seemed slow to forge direct working relationships with key FGN counterparts”.155

It is also unclear how effectively DFID’s education programmes are able to engage fully with State Education Commissioners and Governors, or whether the memoranda of understanding that govern these relationships are sufficiently robust. As Chris Horn told us: “I was quite surprised that some of the memoranda of understanding were very general […] I tend to think that some of the conversations that go on are simply too general and do not really get to the heart of the matter.”156

80.One of the fundamental barriers to poverty reduction in Nigeria lies in the commitment at all levels of Government to delivering basic services. While the allocation of resources is of course the prerogative of the Nigerian Government, DFID has a key role to play in informing Nigerian policymakers on the importance of basic services in supporting a healthy, well-educated and productive population. We are particularly concerned about the prospects for Nigeria’s achievement of SDG 4 on inclusive and quality education. An important part of making progress towards SDG 4 is understanding, and helping the Nigerian Government to understand, the scale of the task at hand.

81.DFID should support key Nigerian decision-makers to help them come to the best-informed decisions possible, with a specific emphasis on the value of basic public services. It should help the Nigerian Federal Government in developing a system to compare the performance of different states on delivering basic services. DFID should ensure that it has the resources to connect its programmes to key decision-makers at the state and federal levels, with a particular emphasis on health and education, and that memoranda of understanding reflect specific and firm commitments on the release of funds.

82.DFID should also assist the Nigerian Government in performing an exercise to scope its trajectory towards SDG 4. It should develop a working model on education logistics (covering pupil numbers and distribution, teachers, classrooms, learning materials, etc) which will deepen understanding of what needs to change to get closer to achieving that Goal.

83.We are concerned that inadequate hospital management systems act as a key structural barrier to improved health outcomes in Nigeria—a problem that DFID in-country staff appeared to be aware of on our visit. In Kano state, Committee members visited Dambatta General Hospital which served as a teaching base for midwidery students participating in the £29m DFID-funded Women for Health (W4H) programme. Students were being trained in hospital surroundings that were unacceptably unhygienic, notably the birthing units. DFID staff informed us that there are clinical directors but no operational directors in such hospitals. Further pressure is added to the system by ‘ghost’ workers and poor management of those workers who do attend.

84.We recommend that DFID address the following issues when funding such projects in the future:

a)Ensuring immediate and urgent improvement of hospital hygiene standards; and

b)Ensuring that structural problems in hospital management systems are resolved before funding agreements for any specific programmes are finalised.

DFID should work with the Nigerian Government to ensure that memoranda of understanding include commitments to improve hospital management, operational systems and hygiene.

Delivering quality, inclusive education

85.There are several components to DFID’s education programming in Nigeria, with the most substantial being the Girls’ Education Project (GEP, currently in a third £110m phase) and Education Sector Support Programme in Nigeria (ESSPIN, £139m). These programmes aim to increase enrolment rates, particularly amongst girls, and get millions of out of school Nigerian children into education. Another important part of DFID’s approach is improving the learning outcomes of those in school. As DFID stated in written evidence:

“Even when children are in school a large proportion are not learning. Nearly half of all children who have completed primary school cannot read a complete sentence and more than two-thirds of children in the north remain illiterate by the end of primary school.”157

86.There are a number of barriers to quality education in Nigeria—one core issue relates to the policy on the language of instruction. In Nigeria, the language of instruction from Grade 4 is English, but as the British Council told us: “various factors rooted in culture and geography negatively affect the quality of teaching in English and student learning outcomes, which impacts the student’s whole education career.”158 Securing qualified teachers is also a challenge, particularly in rural areas. Dr Joanna Härmä told us that this is due to the remoteness of communities, and that: “91% to 95% of all children who are out of school, either having dropped out or never having been, are from rural areas.”159 Due to poor work force planning, a mismatch exists between the supply of, and demand for, teachers. Urban schools are often more fully staffed than those in rural areas; there are more women in urban schools than in rural schools160 and higher numbers of qualified teachers in urban schools than in rural schools.161

87.DFID is trying to address the lack of trained teachers through its Teacher Development Programme, which aims to provide pre-service and in-service training to 66,000 teachers. However, unlike in other interventions there is no clear emphasis on recruiting to satisfy rural needs. One example where rural demand is a consideration is the Women for Health (W4H) programme that we visited in Kano state.

88.Due to the attraction of living and working in urban areas for teachers, we are concerned about worsening imbalances in the supply of qualified teachers between urban and rural areas. Unlike the Women for Health (W4H) programme which recruits health worker trainees from rural areas in an attempt to fill gaps in services in those areas, there appears to be no clear rural focus in the Teacher Development Programme to address this imbalance.

89.DFID aims to ensure quality education is delivered not only through public schools, but equally through private schools. Minister Hurd told us that in Lagos State, 70% of children attend private schools.162 This highlights the need for DFID to work with private sector education providers and state governments, which it does through the Developing Effective Private Education in Nigeria (DEEPEN) programme. While 90% of DFID’s education sector support focuses on the public sector, Ben Mellor, Head of Office and Country Representative, DFID Nigeria explained that DEEPEN aims to: “improve the ability of the Lagos state—of the state system—to regulate and improve the quality of the private schools.”163

90.Dr Joanna Härmä told us that private provision of education is a necessity in Nigeria. In reference to Lagos state, Dr Härmä said:

“I have seen primary 4 classrooms of 200 children in a Government school […] As far as I am concerned it is past the tipping point, and there is no way that the Lagos state government would ever come back to a situation of being a majority provider.”164

Like in public schools, the quality of education in the private sector is a major concern. DEEPEN is a good example of where DFID has recognised a need and responded to an opportunity—in the form of a change to a Lagos State Commissioner for Education who recognised the importance of the private sector—to meet this need. Dr Härmä said that DFID “is definitely right in the DEEPEN programme […] in supporting the Government to see the private sector as carrying a huge part of the burden of educating their children.”165

91.While we recognise and accept that the state government in Lagos does not have the capacity to deliver education to all children, we are deeply concerned about the affordability of private education for millions of families. In written evidence, Bridge International Acadamies, a for-profit education provider funded by DEEPEN, stated that: “At an average cost of $78–$110 per child per year, 90% of families in our communities can afford to send all of their children—both boys and girls—to our academies.”166 DFID is thus funding an organisation that provides a service that the poorest 10% cannot access. Dr Joanna Härmä said that it is “not right that the UK taxpayer is providing money to a for-profit corporation” in the form of Bridge International Academies.167 The costs provided can also be misleading, as Dr Härmä told us: “They claim that they educate children for about $6 a month. I presume they mean only their fee, because research has found that they charge around $15 a month in reality.”168

92.Even the minimum fees suggested by Bridge may be prohibitively expensive outside Lagos state. Assuming three children per family (a conservative estimate given a fertility rate of 5.7 in 2014), $234 in annual school fees is likely to be unaffordable for many in a country where more than half the population lives on less than $1.90 a day.169 In Lagos, the country’s richest state, access problems due to unaffordability have not emerged on a large scale as only 2% of school-age children are out of school.170 However, even there Dr Joanna Härmä told us in reference to Bridge International Academies:

“They do not serve the poorest. They told me that they would never set up in Makoko slum because there is no market for them there. They are not interested in serving the poorest; they are interested in serving a large market […] Giving money to Bridge will never reach the poorest people.”171

In its policy paper “Leaving no one behind: Our promise”, DFID promised that: “people who are furthest behind, who have least opportunity and who are the most excluded will be prioritised”.172 Yet we are concerned that the current approach to private sector provision of education is failing to do that, particularly if this model is replicated in poorer parts of the country outside Lagos. As UNESCO wrote:

“Where access depends on paying fees, many of the poorest are left behind. And private providers are highly unlikely to locate to sparsely populated and remote areas, so reliance on private provision can reduce educational and social equity for poor and remote populations.”173

93.The responsibility for the provision of education lies with the state government, and it is important that even with an increasing share of services being provided by the private sector, the state government is effective in ensuring equal access and, crucially, quality learning outcomes. As Chris Horn told us: “While it can be attractive for a state government to have some of the burden shared by the private sector, someone still has to have the responsibility to ensure that children learn […] [W]hen you end up with disappointing results of children going to school, the challenge to get them back into school—or their neighbour’s children or the children’s children—is even greater.”174

Box 3: DFID’s education programmes in Nigeria

Members of the Committee saw first-hand the pressure on the Nigerian public school system on our visit to a primary school in Kano with over 13,000 registered students. Kano is one of six states (three of which are in the North) where the Education Sector Support Programme in Nigeria (ESSPIN) is operational. ESSPIN is DFID Nigeria’s largest education programme in terms of funding, running from 2008 to 2017 with a budget of around £140m. The four main outputs of ESSPIN focus on the following areas:

  • Strengthened Federal Government systems supporting states’ implementation of school improvement;
  • Increased capability of State and Local Governments for governance and management of basic education;
  • Strengthened capability of primary schools to provide improved learning outcomes; and
  • Improved inclusion policies and practices in basic education.

ESSPIN aims to reach 11,308 schools in total by 2016 as well as supporting 55,000 students in non-formal (Islamic and Nomadic) education centres.

In 2012, the Independent Commission for Aid Impact (ICAI) conducted a review into DFID’s education programmes in Nigeria, with a focus on the two large-scale programmes: ESSPIN (implemented by Cambridge Education) and the Girls’ Education Project (implemented by UNICEF).175 It acknowledged that supporting an education system on the scale of Nigeria is a daunting task, and that a functioning education system requires key building blocks to be in place to create the opportunity to learn. This requires very effective programme management and logistics. ICAI concluded that, due to a combination of strong local presence and better planning and execution, Cambridge Education appears to be better at delivering on this than UNICEF and that the ESSPIN model seems more likely to succeed.

94.We recognise that in parts of Nigeria, state governments are not equipped to provide schooling for all children, therefore supporting quality private sector provision is a necessary feature of DFID’s approach. In Lagos we visited a Bridge International Academies school and were impressed by the quality of education provision. However, we are concerned about the affordability of private schooling for the poorest families, and that reliance on for-profit companies to deliver education is not easily reconciled with DFID’s commitment to “leaving no one behind”. One risk is that families who can only send some of their children to school may prioritise the education of boys over girls. Regardless of the public/private sector balance of provision, the responsibility of educating children lies with state governments. While DFID is supporting public sector education in Lagos and Kano through its Education Sector Support in Nigeria (ESSPIN) programme, the extent to which DFID is encouraging the expansion of the sector is unclear.

95.We urge DFID to ensure that its support to private sector provision of education aligns with its commitment to “leaving no one behind”, and that the very furthest behind are prioritised. The furthest behind are not going to be served by for-profit companies, therefore DFID should deliver a focused strategy on how it is going to help the Nigerian authorities significantly expand public sector provision and deliver quality education to those who cannot afford school fees. If the DEEPEN approach is to be expanded to other parts of Nigeria, the model must pay due attention to regional variations in both the prevalence and depth of poverty. We also urge DFID to concentrate attention on educational outcomes across both the public and private sectors. DFID should ensure that the state governments it works with are equipped to effectively regulate both public and private schools, guaranteeing both quality and access for all.

96.Education prospects are a challenge for all Nigerian children, but girls are particularly disadvantaged. Enrolment rates are lower among girls than boys across the country, with the disparities most obvious when looking at the regional picture: 85% of female children in the North East cannot read at all, compared with 20% in the South West,176 and 25% of all young people in the North between the ages 17–22 have fewer than two years of education with 97% of these being women.177 The implications of poorly educated girls are lifelong and can transfer across generations. Educated women are more likely to play productive social and economic roles within their families and communities. They become better mothers and they have fewer, healthier children who they want to have better educational opportunities so the benefits are trans-generational.178 DFID has worked on improving girls’ access to education, primarily through the Girls Education Project (GEP), now in a third £107m phase. GEP3 is expected to get one million extra girls into school by 2020.

97.While GEP3 has registered some successes in terms of enrolment numbers, the programme has consistently underperformed. While the most recent annual review indicated a slight improvement in terms of the programme performance (‘Outputs moderately did not meet expectation’ as opposed to ‘substantially’ not meeting them in 2014), the GEP3 is still not delivering effective results, despite the fact that the project’s first phase began over a decade ago in 2004. Serious concerns over the performance of GEP3 were raised in an Independent Commission for Aid Impact (ICAI) report in 2012.179 This underperformance continues despite DFID instituting a Performance Improvement Programme and initiating the complementary Education Data Research and Evaluation in Nigeria (EDOREN) programme to “address research and evaluation needs” in GEP3 and other DFID education interventions.180

98.When questioned about these concerns, Ben Mellor told us:

“We have spent a lot of time and a lot of effort in terms of turning that programme around. We had the option of stopping the programme, but because of the fact that we were absolutely committed to improving the number of particularly girls in education in the north and this was part of that response, we thought it better to try to invest the time turning the programme around rather than simply stopping it. […] We took it up at very senior levels within UNICEF to make sure they put the right people on to the programme in-country and that has definitely improved over the last couple of years.”181

99.In its 2012 report, ICAI recommended that DFID: “should work with its partners and each participating State to secure a clear agreement about the policy changes and financial contributions required to improve enrolment and learning and to introduce effective financial management and resource planning into education.”182 Written evidence regarding GEP’s most recent annual review stated:

“[…] the evaluator is continuing to recommend that this UNICEF managed programme must move from an advocacy approach […] The 2012 ICAI Report on Education Programmes in Nigeria had identified this change as fundamental. DFID instituted a Performance Improvement Programme and has given additional funding to manage the transition to an effective programme. The weakness still remains.”183

Other contributors to this inquiry also raised concerns about GEP3. The British Council suggested that the centralised management of GEP3 “can result in a detachment from the local context which can reduce impact”.184

100.While we commend DFID’s commitment to closing the gap in primary school enrolment rates between girls and boys, with a specific focus on regions where girls are particularly disadvantaged, we are concerned about the continued failure of the Girls Education Project (GEP3) to perform satisfactorily. Despite the various phases since 2004, this UNICEF-managed project, awarded without competition, has consistently failed to meet targets and in a number of DFID reviews has been given ratings to indicate that outputs “substantially did not meet expectation”. While there have been improvements, these are relative to an unacceptably low baseline. We are also disappointed to hear in the project’s latest annual review that the recommendations made by the Independent Commission for Aid Impact (ICAI) in 2012 have still not been successfully implemented. While we recognise the operational difficulties associated with this programme, we are concerned by DFID’s continued funding of a programme that has so consistently failed to meet expectations.

101.In its response to this Report, DFID should set out what steps it, and UNICEF, are taking to improve the effectiveness of the GEP project and address the specific concerns raised about enrolment, learning, effective financial management and resource planning. It should identify the criteria that improvements will be judged against and to what extent these fall short of the project’s original targets. DFID should also state over what timeframe it expects the project to be fully meeting expectations. This should include an indication of at what point continued underperformance will mean that DFID no longer deems the project viable, and will withdraw its support.

Learning from health successes

102.Despite the scale of the public health challenge in Nigeria, DFID has been commended for its contributions in fighting the causes of ill-health: particularly with regard to malaria and neglected tropical diseases (NTDs). In written evidence, Malaria Consortium stated:

“DFID have been the pacesetters in the control of malaria in Nigeria. Taking the lead in designing and roll-out of interventions, learning from these and handing it over for other partners and government to roll-out further. DFID is therefore well positioned to lead the elimination efforts in Nigeria in the next five years and also encourage other donors to continue to support efforts.”185

Since 2008, DFID’s £89 million Support to National Malaria Programme (SuNMaP) has been fighting malaria and strengthening health systems in Nigeria through its support for the National Malaria Elimination Programme (NMEP). SuNMaP assisted NMEP through capacity building, harmonisation, prevention, treatment, demand creation and operational research, resulting in an estimated 48,000 lives saved over the course of the project.186 With the successes of SuNMaP, there are a number of lessons that we would hope are learnt by DFID, applying to DFID’s health programming as well as more broadly. We visited the pharmacy at Dambatta General Hospital to check the availability of anti-malarial drugs and were impressed by the supply available, even in such a remote area. We were encouraged by the enthusiasm of pharmacy staff about encouraging the use of bed nets to prevent malaria.

The value of catalytic investments in health

103.The SuNMaP programme was established to help in malaria control, though it appears that the benefits stretched well beyond the tackling of a single disease. Regarding the programme, Dr Prudence Hamade told us:

“[…] it had a very novel approach in the sense that it was done entirely through the federal and state government programmes. […] That was a really important and innovative approach from DFID that was done through the SuNMaP programme.”187

This capacity building element of the SuNMaP programme was an important strength as it had reach into wider health systems. As the programme’s final report stated: “The programme was established to help in malaria control but ended up strengthening the health sector in intervention states such that the results are helping service provision across the entire health sector.”188

Long term certainty for partners

104.SuNMaP concluded in March 2016. In written evidence from Malaria Consortium, there appeared to be uncertainty over future funding. It wrote:

“If bilateral and strategic funding is not continued following the bilateral and multilateral aid reviews, then the capacity of NGOs to innovate and react to evolving development needs, will result in the effectiveness of UK Aid to suffer. Malaria Consortium therefore recommends that DFID fully lays out their intentions for strategic funding in the future and ensure that it allows this type innovative approach to work in the future.”189

While it was clearly indicated to us in oral evidence by DFID that SuNMaP would be followed by a second phase, the importance of longer term commitments to strategic funding—to ensure that the length of programmes match what research has found to be most effective—was stressed throughout this inquiry. This is relevant to interventions across DFID’s portfolio, including in economic development,190 protection of women and girls191 and governance.192

Connecting research communities with the Government

105.A strong evidence base is an important part of programming and effective policy. A strength of SuNMaP was that it effectively connected research communities with decision-makers in Government. As Dr Hamade said: “The other area that was very important was operational research, and bringing the research community into the Government, so that the research community and the Government now hold annual meetings to exchange information about the way forward and applying research into policy.”193 Lessons on how best to do this can be of great value across DFID’s portfolio.

106.DFID’s SuNMaP (Support to National Malaria Programme) has been widely regarded as a success, both in tackling malaria itself and in strengthening health systems more broadly. We believe that a number of lessons have been learned from this programme that may apply across DFID’s health programming and wider interventions in Nigeria and elsewhere.

107.We urge DFID to apply lessons from SuNMaP on how catalytic investments, such as in building the capacity of the Nigerian Government’s National Malaria Elimination Programme (NMEP), can have wider benefits for the provision of basic services. DFID should also ensure that the length of programmes matches what research has shown to be most effective: we have heard evidence that this is not always the case at present. Implementing partners and stakeholders should also be kept up-to-date on strategic funding priorities so that they can plan their activities accordingly. We would also like to see DFID invest in building networks between research communities and relevant state and federal authorities in order to deliver effective partnerships and policies that have a strong evidence base.

108.DFID has also made a substantial contribution towards the fight against neglected tropical diseases (NTDs) in Nigeria through the Integrated Programme Approach to Control a range of Neglected Tropical Diseases implemented by a Sightsavers-led consortium. NTDs including blinding trachoma, elephantiasis, river blindness and hookworm, can lead to irreversible blindness, chronic illness, physical deformities and death, and over 100 million people in Nigeria (two out of every three Nigerians) suffer, or are at risk from, one or more of these diseases.194 When left untreated, NTDs keep children out of school, parents out of work and cause stunting and impaired brain development, locking societies into endless cycles of poverty.195

109.The Leprosy Mission England and Wales pointed out in written evidence that DFID’s efforts have been particularly effective in: “disability prevention through enhanced case notification and treatment of NTDs in Zamfara and Kaduna States, thereby mitigating the poverty that could result from disabilities and other consequences of these diseases.”196 At its last annual review, the Sightsavers-led programme had reached over 23.7 million people. With a budget of £12.2 million, the cost per person treated at the end of the programme should be less than or equal to US$0.12 in some states.197 On our visit we heard that, in certain areas, the seven NTDs that form the focus of the programme had been eliminated amongst target populations.

110.With costs per beneficiary expected to be as low as US$0.12 per person treated by the end of the programme, DFID’s Tackling Neglected Tropical Diseases through an Integrated Approach has shown how cost effective life-saving health interventions can be. We urge DFID to actively use such examples as evidence to the public of how cost-effective UK aid can be in changing the lives of millions of Nigerians. We recommend that DFID scale up this programme as part of the effort to eliminate NTDs in Nigeria. Such a programme should also be replicated in other countries that DFID operates where NTDs are a problem.

Services for women and girls affected by violence

111.The disadvantages faced by women and girls in Nigeria are staggering, with the country standing 152nd out of 180 countries in the Gender Inequality Index.198 Due to cultural practices of seclusion and restrictions on mobility, the economic opportunities, visibility and voice of women is limited. These same barriers affect their access to basic services and the widespread violence that they face reinforces this disadvantage and exclusion.199 Data suggests that 30% of 25–29 year old Nigerian females have been subject to physical violence,200 yet the true proportion is likely to be much higher. Victims are unwilling to report certain types of violence, such as rape, because of shame and social stigma, so that very few cases are brought to court.201

112.DFID’s Voices4Change (V4C) programme works with women and girls as well as those around them, particularly boys and young men, to shift attitudes and behaviours. This has seen some success, particularly in supporting the movement to get the Violence Against Persons Bill approved.202 The V4C programme is about changing social norms, so it is difficult to assess progress at such an early stage. As Ojobo Ataluku, Country Director, ActionAid Nigeria, pointed out: “Most DFID programmes are three years or five years at the most, maybe with an extension of several years, and you do not change social norms within that kind of window.”203

113.Evidence to our inquiry suggested that one area where the approach of DFID and other donors is lacking is in the services provided to women and girls affected by violence. Georgia Taylor, Director, WISE Development told us: “It is not just about creating awareness or saying that men and boys should stop perpetrating violence; it is about the services that are available and about where women can go for support and relief.”204 Ojobo Ataluku expanded on this point:

“In terms of the services for women and girls who are facing violence, that is a very weak area not just for DFID but for almost every actor, including the Government and other donors and development actors within the country. This is an area that needs to be strengthened, because you cannot just say that people should go to the police, even though DFID has an access to justice programme, because the police are just not the solution to an issue of violence against women. Once you go to the police, it becomes a criminal issue and you find that many women and girls who are victims of violence do not want a criminal solution; they want the violence to stop.”205

114.DFID has played a role in supporting Sexual Assault Referral Centres (SARCS), where women and children who have been victims of sexual violence can benefit from counselling, emergency medical treatment, assistance through reporting to the police, forensic evidence, legal advice and support before the courts. In written evidence, Diana Good referred positively to the SARCS:

“The end result appeared to provide a joined up and sustainable programme which was making a real difference and which could be scaled up. It had set out to tackle a the problem not from the top down through the eyes of the institutions of justice but had set out to understand the problem from the citizens’ point of view bottom up based on an understanding of the obstacles for women and children.”206

Although the SARCS show signs of early promise, only two exist at present (with plans for five more underway).207 In a recent review of ‘DFID’s Efforts to Eliminate Violence Against Women and Girls’, the Independent Commission on Aid Impact (ICAI) recommended that: “DFID will need to deliver results on a much larger scale across the full range of VAWG [violence against women and girls] types if it is to achieve transformative impact.”208

115.DFID has shown strong commitment to reducing the disadvantages faced by women and girls in Nigeria across all of its programming, while also running targeted interventions aimed at transformative change. However, one of the concerns raised in evidence to this inquiry is the lack of support services to women and girls who have been victims of violence. While the Sexual Assault Referral Centres (SARCS) are a promising start, they are too few and need to be scaled up.

116.DFID should take immediate action to influence the Nigerian Government to scale up its support services to victims of sexual violence through SARCS, and extend this support to all women and girls subjected to violence. We urge DFID to act upon the recommendations in the recent Independent Commission on Aid Impact (ICAI) report on violence against women and girls, and build upon the ‘strong start’ it has made in tackling this issue by prioritising support services for affected women and girls in Nigeria.

136 UNDP, Human Development Report 2015 (December 2015), p 210

137 USAID, ‘Global Health - Nigeria,’ accessed 1 July 2016

138 World Bank, ‘World Development Indicators: Nigeria,’ accessed 1 July 2016

139 DFID (NIG0011) p 9

141 DFID (NIG0011) p 9

142 Health Partners International (NIG0018) para 9

143 Palladium (NIG0012) para 4.1.1

144 Africa Research Institute, State(s) of crisis: Sub-national government in Nigeria (March 2016), p 1

145 Chris Horn (NIG0037) p 2

146 World Bank, ‘World Development Indicators: Nigeria,’ accessed 2 July 2016

150 Chris Horn (NIG0037) p 2

151 ESSPIN, 29th Quarterly Report, October - December 2015 (February 2016), p 13

152 DFID, Teachers’ Development Programme: Business Case (June 2012), p 3 (ODT 924KB)

154 Dr Oliver Owen (NIG0033) p 2

155 Dr Oliver Owen (NIG0033) p 2

157 DFID (NIG0011) p 9

158 British Council (NIG0014) para 5.7.3

160 Paul Bennell and Kwame Akyeampong, Teacher Motivation And Incentives In Sub-Saharan Africa And Asia (2007) p 48

161 T.O. Adeyemi, “The Effective Distribution of Teachers into Secondary Schools in Ekiti State, Nigeria: A Critical Analysis”, Current Research Journal of Social Sciences, vol 1(3) (2009), pp 74–83

166 Bridge International Academies (NIG0031) para 2.4

169 World Bank, ‘World Development Indicators: Nigeria,’ accessed 2 July 2016

172 DFID, ‘Leaving no one behind: Our promise,’ (November 2015)

173 UNESCO, EFA Global Monitoring Report 2015 (April 2015), p 65

177 DFID, Girls’ Education Project Phase 3 (GEP3): Business Case (October 2012), p 10 (ODT 1.1MB)

178 DFID, Girls’ Education Project Phase 3 (GEP3) - Business Case (October 2012), p 14 (ODT 1.1MB)

179 Independent Commission for Aid Impact, DFID’s Education Programmes in Nigeria (November 2012)

182 Independent Commission for Aid Impact, DFID’s Education Programmes in Nigeria (November 2012), para 3.17

183 Chris Horn (NIG0037) p 2

184 British Council (NIG0014) para 5.5.5

185 Malaria consortium (NIG0010) para 5

186 Malaria consortium (NIG0010) para 6

189 Malaria consortium (NIG0010) p 3

190 Palladium (NIG0012) para 3.3.2

192 Dr Oliver Owen (NIG0033) p 1

194 Sightsavers (NIG0023) para 9

196 Leprosy Mission England and Wales (NIG0001) para 3.1

198 UNDP, Human Development Report 2015 (December 2015), p226

199 British Council, Gender in Nigeria Report 2012 (May 2012) p iii

200 National Population Commission, Nigeria Demographic and Health Survey 2008 (November 2009), p 263

201 British Council, Gender in Nigeria Report 2012 (May 2012), p 47

206 Ms Diana Good (NIG0030) para 30

207 Ms Diana Good (NIG0030) para 17

208 Independent Commission for Aid Impact, DFID’s efforts to eliminate violence against women and girls (May 2016), p ii

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25 July 2016