How to Improve Almajiri Health

Almajiranci as an educational system and the almajirai that fill its ranks have been prominent in discourse throughout the Fourth Republic (1999-present). Hannah Hoechner, a University of East Anglia researcher, has argued that this reflects the usefulness of almajirai as scapegoats for other prominent anxieties around Nigerian life, such as the country’s crisis of out-of-school children, persistent extremist insurgency, worsening economic despair, overpopulation, social neglect, and ongoing sectarian conflict.

Some of these concerns have considered almajirai and health, though many still have painted almajirai as threat to health. That almajirai live on city streets and in other open spaces means they are seen as unclean, and so carry the stigma of suspected contagion. This was shown in dramatic fashion during the COVID-19 pandemic, where several states expelled many of their resident almajirai, returning them to their supposed states of origin for fear they might spread the new virus. Whether almajirai actually made it back to their home states, and any evidence of increased COVID-19 transmission among almajirai, were less emphasized in the logic around these expulsions than the assumption of contagion, and the wisdom of government action to eliminate this risk.

THE BEGINNINGS OF WISDOM

The academic literature around their health has given almajirai more sensitive treatment, paying attention to their experiences and the ways these shape their health risks and outcomes. Our group at Yale University reviewed this literature, looking through research articles about almajiri health from both Nigeria and Niger, to assess its breadth and depth, catalogue notable findings, and identify research gaps that might guide future work around almajiri health.

Our review revealed a sparse research landscape, with 17 articles concerning almajiri health from just six Nigerian states—a surprisingly small number for such a well-known and widely distributed population. For these limitations, these studies all reflected poorly on the state of almajiri health. Almajirai suffer high rates of mental illness, occupational injury, malaria, and other infectious diseases, and poorer levels of rabies awareness and oral hygiene than their peers in secular- and western-curriculum schools.

Other gaps pertained to research design. One of these was that the literature, in its current form, is entirely descriptive, asking the question, ‘what is the status of disease x among almajirai?’ Despite considerable state and non-governmental organization engagement around almajiri issues in the Fourth Republic, no study asks the question ‘what works to improve almajiri health?’. This leaves efforts to improve almajiri health without information to guide their work and to measure their progress.

Related to this was a lack of engagement of almajirai and their communities in the goals, direction and execution of research. In every study, researchers approached almajirai and their communities with their questions in hand, informed either by research on other groups or by researchers’ own ideas about which problems deserved investigation among almajirai. It is not hard to see, given the sparsity of research around almajiri health, and the social distance between research institutions and the tsangayu where almajirai live and learn, that this model might lead to suboptimal research.

THE PROMISE OF PARTICIPATION

A better model would involve researchers starting their projects by approaching almajirai with the question, ‘what health problems matter to you?’. This model reflects the ethos of community-based participatory research (CBPR), a research framework that ‘begins with the involvement of, and a research topic of importance to, the community’, centring the subjects of research in its design, aims, interpretation and outcomes. This framework turns the traditional research model on its head, and leverages community knowledge to develop research questions better suited for their intended contexts.

CBPR emerged out of earlier socially grounded research frameworks, such as Participatory Action Research (PAR), which ‘blend the experimental approach used by social scientists with programs of social action to address social problems’. Orlando Fals Borda, an early champion of PAR, charged fellow researchers to ‘not monopolize your knowledge nor impose arrogantly your technique, but respect and combine your skills with the knowledge of the researched or grassroots communities, taking them as full partners and co-researchers’.

CBPR centres these types of partnerships, and, for the cultural and intellectual humility it fosters, has been of particular value in guiding collaborations between researchers and neglected communities. It has been used to identify health needs among Canadian women under incarceration, to strengthen HIV awareness and screenings among American Black people, and to document mental health disparities among children in refugee communities.

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How to Improve Almajiri Health

THE BEGINNINGS OF WISDOM

THE PROMISE OF PARTICIPATION

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