Young people today are in constant flux. Unemployment is at an all-time high, educational systems are in constant crisis, and youth-friendly health care systems are not available, let alone a human right for all. For Nigerian youth, this ever-increasing pace of change can be especially demanding as uncertainty becomes a constant force in their lives. It would be difficult to imagine whether Nigerian youth can thrive in face of these adversities. Even in the face of these uncertainties, the problem lies not in what young people are expected to do: go to school, get a job, live healthy lives. Rather, the problem lies in what young people are not trained to do. Among policymakers, researchers and key stakeholders in the healthcare industry, fierce battles have been fought about the right way for example, to develop lifesaving health products or services and deliver it to young people who need them. In one corner stands, advocates for top-down research strategies and deliberation focused on deducing a set of choices or experiments that help young people confront the choices before them only as beneficiaries. In the opposite corer are those who support what’s termed as “youth-led”: young people working as partners or leaders as they come up with ideas, trying them out, learning from experience, adjusting and gradually crafting a strategy that makes sense to them and their peers. This special issue illustrates how Nigerian youth are practitioners of their own destiny, championing youth-led ideas in sexual and reproductive health or health care in general, expertly spotting opportunities, acting on them, and working diligently to sustain them overtime.
In thinking about how young people can be strategic about their destiny, competition is a natural point of departure. The general truth is that in these times of uncertainties and adversities, all young people should search for opportunities that foster their competitive spirit. Take for example, the annual World AIDS Day competition, Designathon and Innovation Bootcamp carried out by the 4 Youth by Youth program, young people compete for solutions to promote HIV self-testing not only with their direct rivals, but also whether potential customers may find these ideas appealing. All participants create value as they compete, paying attention to the entire chain of events that will ensure that their own strategies are successful with enabling their fellow peers to know their status. But not all opportunities are easy to spot and execute. In the Nigerian landscape and with a population of 200 million people of which close to a quarter are young people, an opportunity might be free of competitive pressure because no one else has conceived of it or taken the necessary steps to execute and keep it sustainable. This is the story of LifeBank. The overlooked opportunities in the delivery of life-saving blood, led to a mental leap for more sustainable options for blood donations with lead chief executive officer Temie Giwa-Tubosun spotting an opportunity that still remains invisible to her rivals. The opportunity discovered by lifebank as a -business that save lives- offering an array of lifesaving medical products to hospitals across the country-has not been exploited earlier because nobody has been able to conceive of it, even though many hospitals and health systems within Nigeria have been in the business of saving life since before we got our independence. In other words, Lifebank like many upcoming health innovations championed by young Nigerians, do not require sophisticated knowledge, but a commitment to search for opportunities, act on them, and work to keep them going over time. While Giwa-Tubosun provides access to a safe and ample blood supply, Jaiyeoba, founder of Brown Button Foundation, created a simple, low-cost Mother’s Delivery Kit targeted at low-income, rural communities to equip health workers and traditional birth attendants – who are often the sole health care provider in rural areas —with essential life-saving supplies for safe delivery. In addition, several companies such as mPharma, Drugstoc and RxAll are dedicated to creating safer, smarter and more trusted pharmaceutical supply chains in Nigeria. For Nigerian youth, the time to search for these opportunities, act on them and keep them going for nearly 50 million youth, is now. We still have miles to go, not only with providing access to lifesaving blood donations, but also with youth-friendly sexual reproductive health services, securing funding for these services, human rights and health policy reforms that regulate health products currently in the market.
Make no mistake, the fight for young people’s health in Nigeria will not be easy. Deep, top-down experiences in the health care industry might predispose top leaders, stakeholders, and policymakers to view young people only as beneficiaries of sexual reproductive health services, even if young people are spotting and acting on opportunities they come across. Simply raising this possibility of change will evoke criticisms that are powerful and may stymie young people’s potential. But this should not stop Nigerian youth to think outside the box. If we are going to work like LifeBank, 4 Youth by Youth, brown button foundation, mPharma and other health innovations in Nigeria to be in the business of saving lives, it is neither searching for opportunities, acting on them and sustaining them alone, but a marriage of all three, that holds the key to radically better results. I believe that with young people at the helm, not merely as beneficiaries, but as partners and leaders, the right to health, the right to sexual and reproductive health is within reach.
Juliet Iwelunmor, PhD is Associate Professor of Global Health at Saint Louis University. She is also a core faculty in the Department of Behavioral Science and Health Education. As a global health implementation scientist, Dr Iwelunmor’s work focuses on implementing and sustaining evidence-based health interventions in low, middle-income countries. She is the lead principal investigator (PI) on a multi-PI, National Institutes of Health (NIH) project titled Innovative Tools to Expand Youth-Friendly HIV Self-Testing in Nigeria. In addition, she co-leads NIH R-01 implementation science research study that integrates evidence-based task-shifting strategies for hypertension control within HIV clinics in Nigeria.