Gendered Impact of COVID-19 on the Decision-Making Power of Adolescents in Northern Nigeria

Authored by: Dr. Modupe Taiwo, Rahinatu Adamu Hussaini, Miftahu Yahaya, Nasiru Muhammad, Akeem Adesina, Save the Children Nigeria

August 12, 2020

The COVID-19 pandemic has severely disrupted normal life around the world and has widened gaps in gender relations and gender equality. Indeed, disasters like this pandemic often exacerbate pre-existing gender inequities and power hierarchies, and violence in the home may worsen as prolonged quarantine and economic stressors increases tension in the household. Women and girls are isolated from people and resources that can help them, and they have few opportunities to distance themselves from their abusers.

More importantly, women and girls may lose the rights and opportunities for decision making in homes and social interaction and may have a more limited control over their reproductive rights. Our research shows this has occurred for many girls in Northern Nigeria.

Nigeria reported its first case of coronavirus in February 2020 and following the global trend to do so, restrictive measures including a lockdown were introduced by the government for more than four months. This significantly negatively impacted the economy, education and health services and social relations. It also resulted in a substantial rise in cases of gender-based violence in Nigeria. Prior to the virus and lockdown, 30% of women and girls reported experiencing physical violence by age 15 either through early or forced marriages, physical, mental or sexual assault.[1] UN women found that under lockdown, there was a monthly increase of gender-based violence by 149% in 23 out of 36 states of Nigeria where data are available.[2]

Methodology

In June 2020, Reaching and Empowering Adolescent to make Informed Choices for their Health (REACH), a three year (2018-2021) sexual and reproductive health project funded by Global Affairs Canada (GAC) in Northern Nigeria conducted a rapid assessment to understand the effect of COVID-19 pandemic on girls and women’s agency in the project communities in Gombe, Katsina and Zamfara. The study aimed to examine the gendered effect of COVID-19 pandemic, especially in access and utilisation of adolescent sexual and reproductive health (ASRH) services, household chores and decision-making power on project beneficiaries.

The telephone interviews with 566 respondents (305 female and 261 male) were conducted with adolescents aged 10-19 years, of whom 26% were married and 74% were unmarried. Most were in school (67%), while 19% were out of school having completed school, 13% discontinued schooling and 1% refused to give their educational status.

Summary of Five Key Findings on the Decision-Making Power of Adolescents

The ability of adolescents, especially girls, to make their own decisions was assessed with carefully selected relevant items.

How much control do you have over your decision on leaving the house to go into the community when you have to?
General acceptable practice in Northern Nigeria is to restrict women’s and girls’ ability to leave their home. The COVID situation exacerbated this restriction and further disempowered girls and women in making their own decisions. Forty-one per cent of the female respondents reported that they have very little control over their decision to leave the house and 40% have no control at all.  As for married adolescents’ girls, 62% reported that their husbands have full control over the decision to leave the house. In addition, 51% of married girls reported they would be stopped and 15% would be punished if their husbands disagree with their decision. However, during COVID-19 pandemic and restriction of movement, 79% of the adolescent girls experienced further loss of control over their own decisions.

How much control do you have over your decision on who you will associate with outside of your household?
During lockdown, 40% of girls reported having very little control over their decision on who to associate with outside their households while 18% have full control. In the same vein, 48% noted that either their husbands or another household member has full control over their decision on social association in the community. Fifty-three per cent would be stopped and 15% would be punished if there is disapproval of their social association.

Access and utilisation of health services including SRH
Decision on where to seek healthcare during lockdown is dependent on the willingness of the husbands to grant permission to the wife, especially in a non-emergency situation, as confirmed by 60% of married girls. Husbands or household members have full control over their decision on where and when to seek healthcare and if the husband or family member do not agree with her decision, she will be punished. In addition, 67% of married girls reported that their husbands would stop them and punish them if they failed to seek prior permission.

Are you or your partner currently using any method to delay or avoid getting pregnant?
The majority (66%) of the married boys and girls are not using any contraceptive method during the lockdown while 34% reported currently using their preferred modern contraceptive methods. A few married adolescents have been denied access to SRH services and faced pressure to become pregnant. Husbands sometimes keep away the contraceptives or sometimes resort to physical abuse such as beating to get the cooperation of the wives.

With reference to quality of health service received, 20% of the respondents have had to see a health provider due to an injury or illness since the start of the pandemic. The majority (76%) visited government health centers while 24% patronized Private Patent Medicine Vendor (PPMV). The majority, 66%, could not associate the COVID-19 pandemic with lower quality of health care but indicated that the pandemic limited their access due to: fear of being infected, compliance to government movement restriction, inability to secure permission to go out and longer waiting time to see the available health workers.

Experiences of domestic violence and marital conflicts
Domestic violence was one of the greatest human rights violations documented with higher scale of occurrence in the COVID-19 pandemic. Some married girls have experienced different levels of domestic violence during the lock down ranging from being pressured by husbands or partners to get pregnant (39%), prevented from visiting the clinic or pharmacy to get family planning commodities (23%) and/or being physically abused for not getting pregnant (20%). Examples of marital conflict experienced include being slapped, hit, kicked, having things thrown at them, being forced to have sex without consent and getting bruised in the process.

Conclusion

Our research supports UN data showing that the COVID pandemic and the safety options adopted by the government have contributed to increasing gender equality gaps. This is not only tragic for the persons facing violence and restrictions, but it is reversing the gains of SDG 5 (achieve gender equality) with only one decade left to accomplish it. This must be addressed.

For our part, the REACH project is taking forward our findings to adapt current intervention approach for well-targeted gender responsive strategies to close the gender equality gaps in project states.

[1] Nigeria Demographic Health Survey report (NDHS) 2018

[2] UNWOMEN SGBV during COVID pandemic in Nigeria, 2020.

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About the authors:

Lead author: Dr. Modupe Taiwo is a public health professional with 20 years’ experience in design and management of development and humanitarian projects across Health, Nutrition, Gender and protection and Education themes in different international development agencies. She is currently the project director at Save the Children International, for an adolescent sexual and reproductive health project in Northern Nigeria. She is passionate about adolescent health and wellbeing. She is leads on gender and social norms research for the organization.

Co-author: Rahinatu Adamu Hussaini is a Gender Equality and inclusion expert.  In the last 15 years she has worked with different international development agencies and NGOs including ActionAid, British council, Voluntary services Overseas, Medicines Sans Frontières, IntraHealth International and currently with Save the children International Nigeria as a Gender Equality Adviser. She is passionate about girls and women’s rights and believes in gender and social justice. She is an advocate of working with empathy and development from “within”.

Co-author: Miftahu Yahaya, Monitoring, Evaluation, Accountability and Learning Officer at Save the Children International is a graduate of Mechanical Engineering. He has over 4 years’ experience in supporting monitoring and evaluation of development projects. His expertise includes database management, researches, accountability systems for community feedback and project monitoring.

Co-author: Nasiru Muhammad is currently the Monitoring, Evaluation, Accountability and Learning (MEAL) Officer for Save the Children’s REACH Project based in Katsina. He is experienced in M&E with a focus on Malaria, MNCH, Nutrition, ASRH and Food Security and Livelihood for development and humanitarian projects.

Co-author: Akeem Adesina is a Monitoring, Evaluation, Accountability and Learning (MEAL) Advisor with Save the Children International in Nigeria. His expertise includes M&E Systems Development, Information Systems Management, Research Design, Implementation and Quality Monitoring. He currently provides technical leadership on adolescent sexual and reproductive health project in Northern Nigeria.

Anita Raj

Anita Raj, PhD is a Tata Chancellor Professor of Society and Health and the Director of the Center on Gender Equity and Health (GEH) at the University of California San Diego. Her research, including both epidemiologic and intervention studies, focuses on sexual and reproductive health, maternal and child health, and gender data and measurement. She is also Principal Investigator on the EMERGE study referenced in this blog. She has served as an advisor to UNICEF, WHO, and the Bill and Melinda Gates Foundation. She recently contributed to the Lancet series on Gender Equality and Health as an author and steering committee member; she co-led analyses of gender inequalities in health systems and the role of gender norms on health.

Anita Raj

Anita Raj, PhD is a Tata Chancellor Professor of Society and Health and the Director of the Center on Gender Equity and Health (GEH) at the University of California San Diego. Her research, including both epidemiologic and intervention studies, focuses on sexual and reproductive health, maternal and child health, and gender data and measurement. She is also Principal Investigator on the EMERGE study referenced in this blog. She has served as an advisor to UNICEF, WHO, and the Bill and Melinda Gates Foundation. She recently contributed to the Lancet series on Gender Equality and Health as an author and steering committee member; she co-led analyses of gender inequalities in health systems and the role of gender norms on health.

Jay Silverman

Jay Silverman, PhD is a Professor of Medicine and Global Public Health, and Director of Research for the Center on Gender Equity and Health at the University of California, San Diego. Over the past 20 years, he has led multiple research programs on the nature and effects of gender-based violence and other gender inequities on health, including development and testing of community and health service-based interventions to reduce GBV and improve reproductive health and autonomy. He has published over 200 peer-reviewed studies on these topics, and co-authored the award-winning practitioner guidebook, The Batterer as Parent (Sage, 2002; 2009).

Rebecka Lundgren

Rebecka Lundgren, MPH, PhD is a professor at the Center on Gender Equity and Health (GEH) at the University of California San Diego, leads the global secretariat of the Social Norms Learning Collaborative and supports its regional communities in Nigeria and East Africa. Her work seeks to advance social norms theory, measurement and practice, with a focus on developing practical guidance for implementing and scaling norms-shifting interventions to promote gender equity and prevent gender-based violence.

Nandita Bhan

Nandita Bhan, MSc, MA, PhD is a Research Scientist–India at the Center on Gender Equity and Health at UC San Diego, based in Delhi. She is a social epidemiologist with degrees from Harvard University, University College London, and Delhi University. She works on developing rigorous measurement science on gender equality and empowerment for research, capacity building, and field-based program monitoring and evaluation. Her research also includes the role of gender, social context, and urbanization as determinants of agency and equity among adolescents, and in understanding the enablers and barriers to adolescent programming in India.

Meredith Pierce

Meredith Pierce, MPH is a Research Project Manager supporting the research portfolios of Dr. Anita Raj and Dr. Rebecka Lundgren at University of California San Diego’s Center of Gender Equity and Health (GEH). Meredith’s most recent areas of work include focus on family planning, youth, research utilization, and HIV/AIDS. Prior to GEH, Meredith worked at Population Reference Bureau in International Programs and at USAID in the Office of HIV/AIDS and the Office of Population and Reproductive Health. Meredith holds a Master of Public Health from George Washington University.