Human capital or infrastructure? (II)

Before Bill Gates came to Nigeria last year, he asked some researchers at the University of Washington to model Nigeria’s future. The result of that assignment will help answer the question of what would happen if we don’t invest in our people i.e. what will happen if we don’t DELIBERATELY focus on human capital.

Bill Gates people gave him three scenarios based on health and education, the core components of human capital development.

As a guest, Mr. Gates presented his findings at the expanded Federal Executive Council meeting last year.

“If current education and health trends continue,” Mr. Gates said, “if you spend the same amount in these areas and get the same results-per capita GDP flatlines, with economic growth just barely keeping up with population growth.

“If things get worse, it will decline. Unfortunately, this scenario is a very real possibility unless you intervene at both the federal and state levels,” Bill Gates said.

What are the realities to which he referred and upon which we must improve?

Nigeria is one of the most dangerous places to be a child under five years. It is also one of the most dangerous places to give birth. We have one of the worst maternal mortality records in the world. This means that we kill our mothers every day. In this regard, Nigeria is fourth; we are better than only the most unfortunate countries  like Sierra Leone, Central African Republic, and Chad.

Also, one in three Nigerian children, over 30%, is chronically malnourished.

All the statistics above are indications of another reality: life is painfully short here.

Life expectancy in upper middle income countries is 75, in lower middle income countries it is 68 and low income countries it is 62. Nigeria, classified as a low income country doesn’t even have the life expectancy of a low income nation. Our life expectancy is 53 years.

How can we improve productivity if the workforce is either sick or dead?

I know what you’re thinking. All these statistics are from foreigners who don’t know anything about us.

Indeed, when I shared the statistics with a group of women at a seminar recently, one of them raised her hand to say she couldn’t believe the statistic that says one in three children is malnourished.

I told her that it was difficult for me to also believe such statistics and some times don’t put too much stock on them. So let’s put them aside and use our personal experiences, I said.

For example, during the campaigns, we went to the remotest villages and towns and we saw how desperately poor the people were and the children weren’t properly fed. They may be eating. But certainly not the right food.

Even regular people are hungry. As I write this, I’ve many messages on my phone from people who are begging for money for food. I’m sure you also have many people like those.

As for maternal mortality rate, I had a step sister who died of childbirth in Kaduna. I had an aunt who died of childbirth in Bida. I had neighbours who died of childbirth. Almost everyone had a lady -whether family or friend – who died due to child birth complications in this country. So we don’t need foreigners to tell us this.

But even if we decide to forsake data by our foreign partners, the ones generated by our own public agencies are also full of bad news.

Three years ago, I wrote a column with the title “Wife goes to the hospital” where I cited the Nigeria Demographic and Health Survey (NDHS) anchored by our National Population Commission.

“The focus on the PHCs would reduce maternal mortality.  In Nigeria, maternal deaths account for 32 percent of all deaths among women age 15-49, according to Nigeria Demographic and Health Survey (NDHS) 2013. What this means is that if 100 women in this age group died last month, 32 of them died due to child-bearing related illnesses. Many things kill women: accidents, cancer, AIDS, natural disasters, wars, etc.  But when only one cause of death takes up to 32% of their lives, every government must sit up and do something.”

In a column before that titled: “Why and how we kill our mothers,” again, using our own government’s statistics, I showed that we were not doing what is necessary to meet our healthcare targets:

“In 2004, Nigeria released a policy called National Policy for Sustainable Development with the objective of improving ‘the quality of life and standard of living of the Nigerian population.’ (NPC, 2004).

Specifically, it wanted to [reduce] the maternal mortality ratio to 125 per 100,000 live births by 2010 and to 75 by 2015.

Unfortunately, we must lower our heads in shame because if NDHS 2013 is an indication, we’re nowhere near achieving these targets; we wanted to reduce “the maternal mortality ratio to 125 per 100,000 live births by 2010” but it was 576 in 2013!”

This means that we don’t focus enough on healthcare, we don’t spend enough and we are not serious enough.

Accordingly, in October 2017, the World Bank through its president, Jim Yong Kim, observed that Nigeria spent less than one per cent of its GDP on health. To provide context, it’s 16.9% in the United States according to CMS.gov.

But even the little we allocate is usually stolen. This also should keep us awake at night. According to Lancet, Nigeria ranks 140th out of 195 countries surveyed between 1990 and 2015 in quality as well as access to health care.

If the human capital, as we discussed in the first part of this essay, lasts longer than infrastructure, and if human capital is two thirds of the wealth of nations, and if human capital is defined as education and health, then I agree with Bill Gates who said the future of Nigeria “depends on healthy, educated people and the surge of economic activity they will unleash.”

To emphasize the above thesis, the first part of this essay was focused on the educational component of human capital. This second part is on health. The last part will focus on what others are doing right and what the government is already doing right and should scale up.

We will also discuss why we should revisit Kwankwaso’s model, why FG should educate 20,000 master’s degree holders and 10,000 PhDs in the next four years, lessons from Asian Tigers, TETFUND and Paraguay; also, what FG is doing right in the agriculture sector and digital financial services and how addressing child nutrition will add $30 billion to our GDP.

(To be continued)