Sightsavers’ submission to the IDC inquiry on the UK’s development partnership with Nigeria

August 2025

Summary

Sightsavers is an international development organisation which works with partners to prevent avoidable blindness, eliminate neglected tropical diseases (NTDs) and realise rights for people with disabilities in more than 30 countries in Africa and Asia.  We also lead the Inclusive Futures consortium alongside the International Disability Alliance, including overseeing the FCDO’s flagship Disability Inclusive Development (DID) programme.

We welcome the opportunity to contribute to this inquiry with our submission focussing primarily on questions one and two in the call for evidence.

Key questions

1. What key lessons can the UK Government learn from its development engagement with Nigeria in recent years?
2. What are the key development challenges facing the country and how can the UK best provide distinct support for a) the Nigerian Government and b) civil society in seeking to tackle them?

FCDO-funded programming in Nigeria has a proven track record of success which builds capacity in country and has generated learnings for mainstreaming which can provide models for development within Nigeria and beyond. Sightsavers is currently involved in the delivery of such projects in the areas of disability inclusion and treatment and elimination of neglected tropical diseases. These projects provide concrete examples of partnership with both government and civil society that have built in systems strengthening and sustainability, challenging the premise that ODA-funded programming is necessarily indicative of a paternalistic approach. We would particularly highlight the following:

Inclusive Family Planning (IFPLAN) project in Northern Nigeria

Inclusive Family Planning (IFPLAN) is part of the UK’s Disability Inclusive Development (DID) programme[1] and the broader Inclusive Futures initiative to create equitable access to education, healthcare, and employment for people with disabilities, especially in low- and middle-income countries – bringing together development organisations, along with public and private sector partners, to foster inclusive environments where people with disabilities can fully participate in society.

This £2.9 million co-created IFPLAN project is led by Sightsavers and BBC Media Action, in partnership with the Joint National Association of Persons with Disabilities and the Network of Women with Disabilities, working with the Nigerian Primary Healthcare Development Agency to implement change in accordance with the principles of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). It was the first ever disability-inclusive family planning initiative implemented in Kaduna state through meaningful engagement of organisations of persons with disabilities, government agencies and other stakeholders at state and local level, supporting 24 health facilities.  Its four-year duration commenced implementation in January 2022 and lasts until December 2025.

IFPLAN aims to improve access to family planning services for people with disabilities by focusing on three key outcomes of increasing their knowledge, intention to use services, and perceived support, ensuring healthcare providers deliver inclusive and accessible services whilst strengthening organisations of persons with disabilities (OPDs) to engage meaningfully in policy and advocacy for disability inclusion.

Overall, the project aims to reach approximately four million people – including 72,000 people with disabilities directly, and 576,000 indirectly through targeted social and behaviour change (SBC) messages – and to strengthen health systems and services in Kaduna, mainstreaming disability inclusion throughout.

Media

In IFPLAN, the inclusive design approach included the formation of two interconnected SBC design groups – one focused on mass-media activities for radio and digital outputs and the other on community-level activities. For example, a three-week scriptwriting workshop for the mass-media design group led to the production episodes of the Hausa radio drama ‘Madubi’ by BBC Media Action, focusing on family planning and modern contraceptives for people with disabilities in northern Nigeria. Consultations with stakeholders, including government officials and disability experts, informed the scriptwriting process to enhance the inclusivity of healthcare services for people with disabilities in Kaduna. Additionally, a digital collaborative design team co-created social media messages for 55 micro and nano influencers (with and without disabilities) in Kaduna State, targeting social media platforms to help debunk myths about disability and family planning sparking conversations with their followers.

Training and Learnings

Accessible and inclusive community level SBC approaches and materials have been used to train and influence community members, traditional and religious leaders, people with disabilities and their families, as well as 1,500 health workers.  This is with a view to promoting more equitable access to family planning into the future, upholding the rights of women and girls with disabilities, promoting their bodily autonomy and ensuring they are able to make informed sexual and reproductive choices without coercion as well as tackling stereotypes and negative social norms at community level, mobilising men to become champions for gender equality.

A learning report[2] has also been produced with recommendations on mainstreaming disability inclusion in the Sexual and Reproductive Health and Rights (SRHR) sector. This report draws on the lessons from IFPLAN in collaboration with Lafiya programme, another UK/FCDO-funded health intervention which operates in Northern Nigeria with the aim of improving health outcomes and reduce maternal and child mortality by strengthening health systems and promoting healthier behaviours. IFPLAN has also explored strategies with other UK funded programmes by, for example adapting the La Famille Ideale (The Ideal Family) board game developed by MSI Reproductive Choices and used in WISH (Women’s Integrated Sexual Health Programme) by making it more disability inclusive. We are currently exploring how this adapted version can be used in the WISH 2 programme to add yet more value for money to other UK-Aid funded programmes.

Local, state and national policy influencing and change

After initial advocacy training for representatives of local organisations of persons with disabilities, the project coordinated several influencing activities at local, state and national level. These included activities to sensitise 233 state committee representatives on disability-inclusive family planning while eight persons with disabilities have been appointed to health committees at different levels.

At state level, following advocacy initiatives led by persons with disabilities involved in the project, and the collaboration with the Lafiya health programme, the Kaduna state domesticated the national SRHR policy for persons with disabilities. The government subsequently launched a three-year ₦33 billion (£15.8 million) costed implementation plan for disability inclusive SRHR, the first of its kind across the whole of Nigeria – paving the way for implementation at scale at state level. This represents more than a five-fold increase arising from IFPLAN’s initial investment demonstrating how UK Aid has led to much more systematic investment from Nigerian government authorities.

Persons with disabilities and their representative organisations also supported government partners to appoint a Disability Inclusive Desk Officer in each of the 23 Kaduna State Local Government Health Authorities, one at the State Ministry of Health and one at the State Primary Health Care Board. They will be responsible for leading the integration of disability inclusion in health interventions going forward, working closely with organisations of persons with disabilities, promoting local ownership and longer-term sustainability. 

At national level the project has engaged with organisations of persons with disabilities and other partners to support the implementation of the WHO Guide for action process, which includes a national health system assessment on health equity for persons with disabilities leading to an action plan.

Collaborating with the 14 Federal-level Health Regulatory Bodies in Nigeria, the project has also initiated a collaborative process to incorporate disability inclusion into the curricula of health training institutions – with a view to ensuring all future health professionals gain knowledge and experience on disability inclusion in SRHR and the broader health sector as part of their standard education.

Eliminating Lympatic Filariasis in Africa (ELFA) project and Reaching the Last Mile (RLM) Fund

Nigeria is among several countries in Africa in which Sightsavers is working to eliminate lymphatic filariasis (LF), a painful neglected tropical disease characterised by abnormal swelling of body parts, which can lead to disfigurement and stigma.

ELFA supports the broader Reaching the Last Mile Fund initiative established in 2017 by the President of the United Arab Emirates in partnership with the Gates Foundation to eliminate LF and river blindness from Africa by 2030.  The UK’s contribution was announced by the then UK Minister for Development and Equalities Rt Hon Anneliese Dodds MP marking the FCDO’s return to neglected tropical disease programming after UK Aid’s flagship Ascend programme ended in August 2021 following cuts under the previous Government. In her speech, Minister Dodds said: “Every pound that goes into addressing neglected tropical diseases pays for itself 25 times over, and we know that in Nigeria alone, reaching the 2030 targets for elimination could result in an additional 19 billion increase in productivity. The moral case is the strongest one, but my goodness, what a strong economic case as well.”[3]

Nigeria carries 25% of the burden of neglected tropical diseases in Africa including the highest burden of lymphatic filariasis[4].

The ELFA programme is being implemented in countries that are close to eliminating LF, supporting them reach this milestone. Programme activities include disease mapping, treatment, surgeries and supportive care to treat long-term symptoms. The programme has been designed to build capacity and strengthen national leadership, so that Nigeria and other African countries can continue to provide services after the programme has closed.

The ELFA Business Case[5] noted that “the re-entry for the UK in support for NTD programmes, has been conceived to complement this work and, importantly, to deliver on achieving the SDGs leaving no-one behind; striving to make the world a safer and more prosperous place, supporting economic transformation, unlocking opportunity for everyone (especially women and girls), and working in equal partnerships – all guiding principles of the UK’s strategic approach for international development.”

Conclusions

As the Committee’s call for evidence notes, Nigeria has by far the largest population in Africa and one of the highest population growth rates, however, continues to face development challenges. Whatever development model and financing arrangements are in place, no successful development policy and Africa Strategy particularly can be achieved without continuing engagement in and with Nigeria.  We would submit that this is particularly the case with regard to the Leave No One Behind and disease elimination agendas.  We would however reiterate that it would be inaccurate to characterise the UK’s current development approach to Nigeria, including its ODA-funded programming as paternalistic.

As the examples above illustrate, UK ODA funds innovative initiatives in the country, co-created and delivered in partnership not only with Nigerian governments and institutions at national, state and local levels, but crucially also with civil society. These initiatives have capacity-building, systems-strengthening and long-term sustainability for the future at their core. Taken together these make a major contribution to the UK Government’s stated global commitments and are demonstrative of an approach based on genuine respect and partnership with the global South.