When discussing Africa's economic and social future, we must reflect on the importance of demographic dividend in its progress.
Demographic dividend refers to an opportunity that occurs when there is a higher proportion of working population, which if properly implemented, results in a more productive population structure and the increase of labor supply and savings rate, which consequently stimulates positive economic growth. Harnessing the economic dividend without ensuring and investing in the healthcare of youths will be impossible.
The term 'demographic transition' is defined as the shift in fertility and mortality from high and unstable levels to low and stable ones, which will result in people having fewer children. Demographic transition usually involves an initial decline in mortality, followed by a decline in fertility decades later, which is very significant to harnessing the dividend, increase in life expectancy and increase in the manpower available to contribute to growth and development.1
This brings us to the notion of 'demographic dividend'. Demographic dividend refers to the economic benefits arising from a significant increase in the ratio of dependents to working adults, and it results in a more productive population, an increase in labor supply and savings rate, as well as being a source of stimulation for positive economic growth.2,3 Harnessing the demographic dividend requires concerted and strategic efforts on part of the relevant nation, which must make significant reforms and investments in health, education, governance and economic policies to benefit from it.4,5
Nigeria is the most populous country in Africa, the seventh most populous in the world, and it continues to grow at a rapid rate. Nigeria's population is presently estimated to be about 180 million, and is projected to hit above 300 million by the year 2050, making it the third most populous country in the world in an almost alarmingly rapid window. 6 This huge population is largely comprised of young people, with over 50% of the population currently below the age of 24, and about 20% of that demographic between the ages of 15 and 24 years. With an estimated growth rate of 2.6%, this youth population is bound to keep growing, and therefore must be given consideration in existing policies and practices.7,8
Nigeria's development, like other sub-Saharan African countries, has been hindered by high fertility rates. There has also been a decline in gross domestic product (GDP) per capita and an HIV/AIDs pandemic that has contributed to increased mortality rates against a depreciating economy. Accordingly, demographic transition has stalled and challenges are arising to the possibility of harnessing the demographic dividend.9
Harnessing the demographic dividend requires a series of successive steps, which includes creating a window of opportunity through which appropriate health policies to ensure the benefits.10 Young people are integral to the success of harnessing the demographic dividend, and so it is important to protect and improve the rights of youth to health services for sexual and reproductive well-being. This will ensure a productive and competitive labour force and life-long health of the population at large.11 To this end, policies and interventions should include improved access to contraceptives and other family planning services and information, accompanied by the promotion of late marriage and reductions in mortality rates relating to reproductive, maternal, newborn, child, and adolescent health.12
A study has shown that approximately half of the declines recorded in fertility rates in emerging countries between the 1960s and 1980s can be attributed to family planning program efforts.2 An increased pace of declining fertility is not just a positive thing – it actively ensures the opening of the window of opportunity. When harnessed appropriately, declining fertility can create the favourable youth bulge, in which more people are available to contribute to the workforce rather than having too many economic dependants. and reduce the number of economic dependants especially those aged 0 – 15.13 A study done in Nigeria in 2011 showed that a decrease in Nigeria's fertility rate by one child per woman would boost the GDP per head by 13% over 20 years, due largely to the dependency effect.14
In Nigeria's case, harnessing the economic dividend without ensuring and investing in the healthcare of youth is an impossibility. To be successful in this regard, it is imperative that all African nations make pragmatic approaches to ensuring the following:
- Increased budgetary allocation to healthcare, in order to improve the quality of healthcare delivery. All health system stakeholders and policy influencers must also work more actively towards creating Universal Health Coverage to ensure that young people can access healthcare when and where they need to, and at a reasonable cost. This will enable them to become healthy adults and will collectively go a long way in helping individual countries achieve Sustainable Development Goal 3 – Good Health and Wellbeing.
- Stepping up education campaigns on safe family planning, sexual practices, HIV/AIDS awareness and identification, and how to prevent, manage, and treat sexually transmitted infections among youths.
- Increased allocation to family planning and reproductive health services to help young people protect themselves from sexually transmitted infections and avoid unintended pregnancies and attendant complications.
- Investment in creating more youth-friendly health centers to destigmatize health-seeking behavior around reproductive health services and increase youth accessibility to healthcare as needed. Improving existing reproductive health clinics in government hospitals to make them comfortable and easy to use for youths would also make a substantive positive impact on health outcomes in the community.
Significant investments must be made in the health of young people to fast-track and maintain national decline in fertility, and to also ensure that governments are able to sustainable support their human capital for economic development.