Nigeria-c19 - Data-Pop Alliance

NIGERIA

Information last updated: May 08, 2020

Sources: TheWorld Bank and WHO (Population over 65 years old, Informal employment , GDP-PPP , Hospital beds).

Status

Nationwide curfew remains in a place as the government continues to ease measures.
Most of the current cases are concentrated in the state of Lagos and Kano.
At the moment, schools and shops are temporarily closed in Lagos, Abuja and Ogun. Borders are closed and gatherings forbidden.
Percentage of cases treated in hospitals: 74%

Response set up and capacity

The government is officially in charge of coordinating the response through the Nigeria Centre for Disease Control (NCDC). Nigeria’s health system is limited with a low hospital bed to population ratio, but the government has already increased capacity by increasing bed and testing capacities.

The Nigerian Ministry of Health also adopted the Polio Emergency Operations model to tackle the virus through Emergency Operations Centers (EOCs) in all affected states which are organized in 6 units: management and coordination, epidemiology and surveillance, case management, laboratory services, risk communication, and point of entry. The government organized a surveillance system where a total of 774 Disease Notification and Surveillance Officers are spread across Nigeria working on COVID-19 contact tracing along with community informants for sensibilisation.

Stakeholder Mapping

Entities / Organizations

• The Ministry of Health has developed an Incident Action Plan with restrictive measures in states where the virus spread.

• President's Emergency Plan for AIDS Relief (PEPFAR) provides technology assistance to scale up laboratories’ capacity.

Additional actors

• The European Union financed EUR 1.2 million for the provision of lifesaving preparedness and response activities for COVID-19 in Nigeria.

• UNICEF, with support from the European Civil Protection and Humanitarian Aid Operation (ECHO) and in collaboration with the State Primary Health Care Development Agencies of Sokoto and Zamfara, has set up Severe Acute Malnutrition treatment sites in 20 wards - 7 in Sokoto and 13 in Zamfara.

• The UN system in Nigeria launched a One UN Response Plan to COVID-19. It has provided 10,000 test kits, 15 oxygen concentrators, and various personal protective equipment (PPE), vaccines, IEHK/PEP kits, and other vital health supplies. The supplies are co-financed by the European Union (EU) and IHS Nigeria, the Nigerian subsidiary of IHS Towers.

• WHO has provided numerous testing kits along with technical assistance and virtual staff training assistance.

Mitigating factors - What is being done?

A total lockdown was established in 3 of the 36 States of Nigeria where virus outbreaks are reported: Abuja, Lagos and Ogun State. However, the response to the situation was different amongst the remaining 33 States with some applying restrictive orders such as school closures and imposing gathering bans sooner than others. A nationwide communication strategy has been launched with flyers, official announcements, official websites etc.

March 23: The Federal Government of Nigeria issued a ban on all international flights (except for emergency and essential flights).
March 30: Imposition of a lockdown of non-essential activities in the FCT, Lagos and Ogun States. Including. This includes restrictions on movement, suspension of passenger aircrafts, home confinement mandatory and work from home policy if applicable, physical distancing of 2 meters as well as the closure of schools, universities, bars and places of worship.
April 27: Announcement of gradual ease of lockdown but following measures still in place:
- - Mandatory use of face-masks in public spaces
  - Latex hand gloves are prohibited
  - Mandatory provision of hand-washing facilities/sanitizers and extensive temperature checks in all public spaces
  - Restrictions on interstates travels and services
  - Prohibition of gatherings of more than 20 persons outside of a workplace
  - Prohibition of gatherings of more than 20 persons at a funeral and social distancing must be practiced
  - Controlled access to markets and locations of economic activities
  - Physical distancing of 2 meters between people in workplaces and other public spaces
May 4: The easing of a federal lockdown on Lagos, capital Abuja and Ogun states. The reopening of the economy, says the government, will span over a six-week period. The President Buhari has waives import duty on all medical supplies.
May 6: Ban on flights is extended one month. People on isolation in Gombe protested against poor health care by blocking a road.
May 8: It is announced that “All Nigerians returning from abroad will undergo mandatory supervised quarantine in selected hotels for 14 days, before they will be allowed to go home”. Nigeria consolidates its spot as one of the countries most hardly impacted by the pandemic in the region.

In the most populated country of Africa, the restrictive orders are visibly impossible to maintain, and crowds are easily formed in the local markets in urban areas.

Risks, vulnerabilities, obstacles

Weak Health System: The Nigerian health system scores 5 on a 1 to 5 scale, with 1 representing less risk and 5 most risk. There are only 5 beds available for every 10 000 people, and Nigeria is currently testing only 4000 samples per week due to lack of laboratories (the capacity scaled up from 5 to 17 laboratories, however it is still not enough to reach the target of 50 000 tests per state). Further exacerbating these conditions are the lack of qualified personnel to detect cases (only 20 physicians, nurses, and midwives available for every 10 000 people). In addition, Nigeria’s healthcare system is plagued with chronic underfunding and limited infrastructure. Before the emergency of COVID-19, 35 percent of health facilities in the affected states of Borno, Adamawa and Yobe were damaged as a result of conflict.
Conflict area: The North East region is particularly impacted by the Boko Haram insurgency while the North West suffers from cattle rustling and rural banditry.
Economic vulnerability: A black market emerged for testing kits due to a lack of trust in the virus management by the government and the scarcity of the products. Overall Nigeria witnessed an increase of banditry and robbery due to the confinement. Nigeria is also impacted by the oil price war and had to decrease its oil production.
Food insecurity and poverty: Unemployment has risen following the spread of the pandemic, which has left millions of Nigerians dependent on humanitarian food supplies. In the BAY State, the number of food insecure individuals will rocket from 3.71 million to 7.07 million according to the World Food Programme Nigeria projections.An Increase children malnourishment is also feared by UNDP as thee virus spread has a severe impact on the Community Management of Acute Malnutrition (CMAM) program. The lockdown has put numerous families in extreme poverty making it harder for them to provide decent nutrition to their children.
Population health vulnerabilities: 1.8 million Internally displaced persons (IDPs) in the North East region live in crowded camps making social distancing impossible (The Jere, Gwoza and Kala Balge IDP camps have a 1m² static crowd per capita space).

Potential actions and demands

According to the WHO, Nigeria must increase its testing capacity to contain the spread. It is already supporting the countries with funds and technical assistance through the support of multiple partners.
UNDP recommendations include garnering financial support from the private sector, philanthropic organizations and foundations who are already willing to support fragile countries and limiting the congestion of Internally displaced persons (IDP) Camps (increase per capita space standard to meet the UNHCR standards by extended camps land capacity). Additionally, UNDP recommends to set up humanitarian distribution of a 2-months emergency food and nutrition assistance package to tackle the food insecurity in urban areas.

Key resources

Contributor(s): Imaine Kachi.