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| EDITORIAL COMMENT |
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| Year : 2014 | Volume
: 11
| Issue : 2 | Page : 33-34 |
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Autism in Nigeria: A call for action
Foluso E.A. Lesi1, Joseph D Adeyemi2, Olatunji F Aina2, Yewande O Oshodi2, Charles S Umeh2, Andrew T Olagunju2, Wellington Oyibo3
1 Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
2 Department of Psychiatry, College of Medicine, University of Lagos, Lagos, Nigeria
3 Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria
| Date of Web Publication | 8-Dec-2014 |
Correspondence Address:
Foluso E.A. Lesi
Department of Paediatrics, College of Medicine, University of Lagos, Lagos
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1595-9587.146494
How to cite this article:
Lesi FE, Adeyemi JD, Aina OF, Oshodi YO, Umeh CS, Olagunju AT, Oyibo W. Autism in Nigeria: A call for action. J Clin Sci 2014;11:33-4 |
Autism, a neurodevelopmental disorder, is a behavioral syndrome of neurological dysfunction characterized by impaired reciprocal social interaction, impaired verbal and nonverbal communication, impoverished imaginative social activity, and a markedly restricted repertoire of activities and interests. Evidence suggests that its prevalence is increasing globally. [1],[2] There is a lot of information available about the etiology, clinical features, and treatment of this condition and its related disorders. While research and education are increasing worldwide, not enough is known about the condition in Nigeria. Most of what is known locally is through the motivation of concerned persons (often parents), when faced with this challenge for which they have not found answers in the local environment. While some countries have addressed the challenges arising from this condition, others are lagging behind in the care and support of children and their families. In Nigeria, one out of every 125-150 children is living with this condition. This amounts to about 600,000 Nigerian children. The burden this places on the child, his/her family, the society, and the nation at large is unquantifiable, and not only on the nation's social services but also on its GDP. The greater cost is the loss in harnessing the potential in individuals with autism spectrum disorders (ASD) due to inaction and neglect. The depletion of family finances and its effect on the other members of the family; the loss of productivity through time spent on care, instead of engaging in gainful employment; and the loss of future potential of the child (there is ability within every disability). The greatness of a nation is often measured by the premium of care it places on its weakest members. Currently, Nigeria does not have a policy in place for neurodevelopmental disorders, probably because most are hidden, despite the fact that no social class or economic status is spared.
There are major gaps in the knowledge about autism and in the care of children affected, as well as demands on the families of persons living with autism in Nigeria. [3],[4] The availability and accessibility of screening as well as diagnostic tools, the cultural determinants of health-seeking behavior, and the availability and spread of facilities where children can receive care and the support available to children and families with autism-related conditions require urgent attention. A national policy and firm political commitment will go a long way in filling these gaps and addressing related issues. A well-conceived and well-articulated national policy should have as its primary objectives the protection of the rights and well-being of children living with autism, the empowerment of their families to make the best-informed decisions, and to provide the most appropriate framework for government at all levels to support the care of affected persons physically, medically, educationally, and psychologically in order to optimize whatever potential they possess. The abiding principle is that no child is left behind. The other benefits of such a policy are that it would assist in setting research priorities and channel funding appropriately.
Stakeholders in the policy and legislation for sustainable and inclusive care for individuals with autism and related conditions need to be identified and their roles specified. These include National and State Assembles that will enact enabling laws to protect the rights and to establish laws for the financial empowerment and support of families with appropriately diagnosed disorders; Ministries of Health that will implement policy and monitor it, and also determine training needs and distribution of personnel within their spheres of authority; and Ministries of Education that will develop, implement, and monitor training curricula. Other important stakeholders include professionals who will care for the persons with neurodevelopmental problems and conduct relevant research, Non-Governmental Organizations (NGOs) whose role will be to increase awareness and promote activities, especially in the community, particularly in underserved areas in Nigeria; and, most importantly, families/caregivers, whose role in the management of patients with chronic pathologies such as autism cannot be overemphasized. There is a need for public enlightenment/health education on early recognition and the presentation of cases of autism by caregivers.
Burden of care is a subject that has attracted research interest in the past few decades. The burden of care of persons with autism (PWA) for family members or caregivers usually involves emotional burden and resources required, such as time, finances, as well as the health care and rehabilitation facilities needed to manage such cases. Another important burden of autism is the stigma and culturally determined prejudices against PWA. Some of these include local terminologies and appellations used to describe developmental disorders such as autism and broader societal discrimination against not only PWA but also their family members and caregivers. Additionally, the culturally influenced belief among some Africans that autism can be caused by supernatural forces makes health-seeking behavior for PWA tortuous, with consequent delay of presentation for most cases.
There is overwhelming justification for policy and legislation that will drive change in the way the problem is addressed in Nigeria. There is a need for countrywide availability and accessibility of care, for empowerment to all families who have special needs children, and for scaling up the training of relevant personnel. Research and advocacy that underpin further policy development and action are required urgently. Clearly, the time for action is NOW.
| References | |  |
| 1. | Fombonne E. The prevalence of autism. JAMA 2003;289:87-9.  [ PUBMED] |
| 2. | Wing L, Potter D. The epidemiology of autistic spectrum disorders: Is the prevalence rising? Ment Retard Dev Disabil Res Rev 2002;8:151-61. |
| 3. | Bakare MO, Agomoh AO, Ebigbo PO, Eaton J, Okonkwo KO, Onwukwe JU, et al. Etiological explanation, treatability and preventability of childhood autism: A survey of Nigerian healthcare workers' opinion. Ann Gen Psychiatry 2009;8:6. |
| 4. | Bakare MO, Ebigbo PO, Agomoh AO, Eaton J, Onyeama GM, Okonkwo KO, et al. Knowledge about childhood autism and opinion among healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders in Nigeria. BMC Pediatr 2009;9:12. |
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