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Nigeria Health Sector

The conflict stemming from the insurgency of non-state armed groups (NSAGs) in northeast Nigeria continues as intensely as ever. The attacks and insecurity have displaced millions of people, devastated agricultural production and other livelihoods, cut off essential services, and caused a crisis of protection. No early end to the conflict is foreseen. Some 8.4 million people in the north-east states of Borno, Adamawa and Yobe (BAY states) will need humanitarian aid in 2022, only slightly fewer than a year ago. Of these, 2.2 million are internally displaced; 1.5 million are returnees who lack essential services and livelihoods; and 3.9 million are members of communities affected by their hosting of internally displaced people. This figure also includes the majority (an estimated 733,000) of the 1 million people in areas currently inaccessible to international humanitarian actors.

The conflict and insecurity make humanitarian operations difficult and dangerous. Most main supply routes and secondary roads in Borno State are highly risky for humanitarian staff or materials to traverse. Helicopter transport is often the only option for staff movements. Where other options exist, they are usually costly.

Access to health services is hindered by the high cost of medical care/services – as reported by 75% of IDPs, 61% of returnees, and 80% of non-displaced households. Mental health challenges are also becoming more prevalent, especially in the context of attacks and GBV (female IDPs are frequently exposed to sexual violence, and forced into survival sex and early/forced marriages). Worldwide research indicates that around 20% of affected people in humanitarian emergencies develop mental health conditions. About 5 million people are still in dire need of humanitarian health assistance. Among the key risks are the ongoing COVID-19 pandemic, cholera, measles, cVDPV2 (a form of vaccine-derived poliovirus), and malnutrition. The BAY states have the highest maternal mortality rate in Nigeria, estimated at 1,549/100,000 live births. Approximately 18% of IDPs (396,000 people), 17% of people in host communities (663,000), and 23% of returnees (345,000) do not have sufficient access to safe water for drinking, cooking, and personal hygiene.