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Re-Assessing The Socioeconomic Effects Of The Boko Haram Conflict In A Qualitative Systematic Review

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This paper summarizes the arguments and counterarguments within the scientific discussion on the issue of the Boko Haram conflict in Nigeria. The main purpose of the research is to assess the socioeconomic impacts of the Boko Haram uprising. Systematization literary sources and approaches for solving the problem of the social and economic effects of the conflict indicates that there are two main approaches that are important to the Nigerian government to utilize in bringing the conflict to an end. The relevance of the decision of this scientific problem is that the conflict has taken its toll on the Nigerian economy and also affects the social lives of people living within and close to the conflict zone. Investigation of the topic of armed conflict and its socioeconomic impact in the paper is carried out in the following logical sequence: the opening introduction of the negative effects of conflict, followed by a paragraph on conflicts in Africa. Methodological tools of the research methods were a few years of research on the negative impacts of the conflict. The object of research is Nigeria that has experienced armed conflict because the country has been engulfed in the Boko Haram uprising since 2009. The paper presents the results of an empirical analysis of the enormous damage the Boko Haram conflict has done to the social and economic aspects of the Nigerian society which showed that the Nigerian government needs a proactive approach to end the conflict. The research empirically confirms and theoretically proves that armed conflict affects a country's economy as well as the lives of people living close to a conflict zone. The results of the research can be useful for finding a lasting solution to the Boko Haram conflict in Nigeria.
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SocioEconomic Challenges, Volume 3, Issue 1, 2019
ISSN (print) 2520-6621, ISSN (online) 2520-6214
42
Re-Assessing The Socioeconomic Effects Of The Boko Haram
Conflict In A Qualitative Systematic Review
https://doi.org/10.21272/sec.3(1).42-51.2019
Oladayo Nathaniel Awojobi
MA Student, Department of Social Security, Bonn-Rhein-Sieg University of Applied Sciences, Sankt Augus-
tin, Germany
Abstract
This paper summarizes the arguments and counterarguments within the scientific discussion on the issue of
the Boko Haram conflict in Nigeria. The main purpose of the research is to assess the socioeconomic impacts
of the Boko Haram uprising. Systematization literary sources and approaches for solving the problem of the
social and economic effects of the conflict indicates that there are two main approaches that are important to
the Nigerian government to utilize in bringing the conflict to an end. The relevance of the decision of this
scientific problem is that the conflict has taken its toll on the Nigerian economy and also affects the social
lives of people living within and close to the conflict zone. Investigation of the topic of armed conflict and its
socioeconomic impact in the paper is carried out in the following logical sequence: the opening introduction
of the negative effects of conflict, followed by a paragraph on conflicts in Africa. Methodological tools of the
research methods were a few years of research on the negative impacts of the conflict. The object of research
is Nigeria that has experienced armed conflict because the country has been engulfed in the Boko Haram
uprising since 2009. The paper presents the results of an empirical analysis of the enormous damage the Boko
Haram conflict has done to the social and economic aspects of the Nigerian society which showed that the
Nigerian government needs a proactive approach to end the conflict. The research empirically confirms and
theoretically proves that armed conflict affects a country’s economy as well as the lives of people living close
to a conflict zone. The results of the research can be useful for finding a lasting solution to the Boko Haram
conflict in Nigeria.
Keywords: Boko Haram, conflict, insurgency, socioeconomic, systematic review.
JEL Classification: E62, G21, I10, I12, I31, J12, J64.
Cite as: Awojobi, O. N. (2019). Re-Assessing The Socioeconomic Effects Of The Boko Haram Conflict In
A Qualitative Systematic Review. SocioEconomic Challenges, 1(3), 42-51.
https://doi.org/10.21272/sec.3(1).42-51.2019.
© The Author, 2019. This article is published with open access at Sumy State University.
Introduction
Armed conflict is a development issue (Gates et al., 2015). Armed conflict kills, and its effects spread much beyond
deaths (Gates et al., 2015). War generally contributes to forced migration, protracted refugee complications, and
the ruin of social amenities (Gates et al., 2015). Social, political, and economic establishments can be forever ruined
(Gates et al., 2015). Armed conflict remains significant in many developing countries and has developed into an
essential part of the research of economic development (Serneels and Verpoorten, 2012).
Africa has been known to be a conflict zone due to the reoccurrence of armed conflicts (Aremu, 2010; Ezeoha,
2015). This has contributed to the severe consequences for the development and growth of Africa (Aremu,
2010). Nigeria is one of the countries in Africa that has been engulfed in armed conflicts since the coming of
democratic governance in 1999. Notable armed conflicts that Nigeria has experienced in the current demo-
cratic dispensation included the Niger-Delta armed struggle, the ethno-religious conflict in Jos, Plateau State,
the Fulani Herdsmen armed conflict and the deadly Boko Haram insurgency.
This study is concerned about the socioeconomic effects of the Boko Haram insurgency in the North-east of
Nigeria. Since 2009 when Boko Haram originally established its uprising and the outcome of the murder of
Mohammed Yusuf the head of the sect, the violent actions of the sect have remained continuous despite the
intention of the authority to reduce the atrocity of the armed group (Awojobi, 2014). Boko Haram uses
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kidnapping and molesting of girls as a weapon of war (Awojobi, 2014). The underprivileged are the most
casualties of the sect brutalities and the effects of the armed group insurgency fall on the ordinary Nigerians
(Awojobi, 2014).
This study employs a qualitative systematic review to assess the socioeconomic effects of Boko Haram insur-
gency in the northeast of Nigeria. A qualitative systematic review draws together research on a problem,
systematically searching for research evidence from primary qualitative studies and bringing the outcome
together (Seers, 2015). This study is not aware of any systematic review methodology that had assessed the
socioeconomic effects of Boko Haram insurgency and this is the reason for using a qualitative systematic
review to assess the correlation between Boko Harm violent crime and its socioeconomic effects. This is the
main objective of this review and the research question that is formulated for this review is: what are the
socioeconomic effects of Boko Haram insurgency in the northeast of Nigeria?
The remainder of this review is structured as follows. Section 2 discusses the methods used to gather relevant
literature. Section 3 presents the results of the systematic review methodology while Section 4 discusses the
findings. Section 5 concludes.
Materials and Methods
This review employs qualitative systematic review methodology to assess the socioeconomic effects of Boko
Haram insurgency in the Northeast of Nigeria. This is the first time a systematic review is used to asses Boko
Haram atrocities in Nigeria. A systematic review is an analysis of research literature that applies accurate
methods to find relevant studies and it uses objective approaches to merge these studies (Rothstein and Boren-
stein, 2006). According to Rothstein and Borenstein (2006, p. 5), systematic review methodology encapsulates
the following:
Explicit (e.g. in its statement of objectives, materials and methods)
Systematic (e.g. in its identification of literature)
Transparent (e.g. in its criteria and decisions)
Reproducible (e.g. in its methodology and conclusions)
Unbiased
Systematic reviews are commonly used in the health sciences and later social sciences. However, other disci-
plines such as the Arts and Humanities are now embracing systematic reviews in their research work. See
Fehrmann and Hawkins (2015) for systematic literature review methods for topics in the Humanities.
Systematic search strategy
A systematic search of research articles was conducted on the web for relevant literature. Specific search items
were used to identify literature. These search items include Boko Haram insurgency, Boko Haram in Nigeria,
socioeconomic effects of Boko Haram violent crime and the assessment of Boko Haram armed conflict in
Nigeria. Google search engine was used for searching the items mentioned above.
Inclusion and exclusion criteria
Quantitative and qualitative research articles were considered for this review and only those article that inves-
tigated Boko Haram insurgency and socioeconomic effects were included. This review also considered studies
methods of data collection and theoretical framework. All relevant studies that incorporated data collection
methods and theoretical framework were included, and those that did not include these indicators were ex-
cluded. Further to this, only research articles that met the study inclusion criteria were included, grey literature,
dissertation, newspaper articles, online web articles and report and policy documents were excluded from this
review.
Critical appraisal and data extraction
This review did not use any quality assessment tool rather it employs its own quality assessment mechanism
to assess the quality of the included studies. Studies focus, abstracts, data collection methods and data analysis
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were the indicators used to assess the quality of included studies. In terms of data extraction, a form was
created where relevant data were stored after rigorous reading of the selected studies.
Data synthesis
Both quantitative and qualitative studies formed part of this review and it was not possible to use meta-analysis
for analysing this review findings. In this case, a narrative synthesis was employed after coding was used to
detect salient information. An initial coding was done after reading of the relevant studies that brought out
themes. A second coding was undertaken that made it possible for some data that were missed in the initial
coding to be included in the themes. A third coding was carried out that allowed all themes to be categorised
into categories after detecting similarities and differences of studies. At this stage, a narrative synthesis was
used to interpret the primary findings.
Results
Study selection
An electronic search for relevant studies produced 100 articles based on titles. The initial screening of these
articles led to the 82 articles being excluded and the retaining of 12 full-text articles. An additional screening
of abstracts and full-text of the remaining 12 articles resulted in the final retaining of 8 articles. Figure 1 shows
the flow diagram of studies identification, screening and included articles.
Study characteristics
Table 1 encapsulates the characteristics of the 8 studies included. All the studies were done in Nigeria with
the concentration of their research in the Northeast of Nigeria where the activities of Boko Haram are pre-
dominant. All studies were done within the period of 2014 to 2018. In terms of methodology, 6 studies em-
ployed a qualitative analysis while one studied used a quantitative approach.
The included studies used various sources of data collection techniques that range from a questionnaire, in-
terview, online information, historical record to DID. Socioeconomic effects observed by the included studies
included economic disruption, displacement, forced migration, unemployment, child malnutrition, education
disruption and the destruction of worship centres. Most of the conclusions of the studies focused on Boko
Haram insurgency effects on the socioeconomic development of Nigeria.
Socioeconomic effects of Boko Haram insurgency
Various themes emanated from the analysis which can be subsumed under two wider themes, the social con-
sequences and the economic legacy of conflict. Each broader theme and its sub-themes will now be discussed.
Social consequences
There are social consequences of armed conflicts wherever they happened. Social consequences of conflicts
may include deaths, childhood malnutrition, displacement and business disruption. The section of the review
discusses the social consequences of the Boko Haram conflict as reported by the included studies in this
review.
Mortality
War causes deaths. Of the 8 included studies in this review, 4 reported the killing of Nigerians by Boko Haram
(Afolabi, 2015; Awojobi, 2014; Mbaya et al., 2017; Othman et al., 2015). Within the period of 2009 to 2014,
the killings by Boko Haram fluctuated, the highest number of killings were recorded in 2009, 2011 and 2014
(Afolabi, 2015). Within this period, it was estimated that over 10, 000 people were killed when Boko Haram
attacked their targets (Awojobi, 2014; Mbaya et al., 2017). The frequent attacks by Boko Haram and security
agencies have killed many civilians in crossfire (Othman et al., 2015).
Destruction of worship centres
Initially, it was believed that Boko Haram was only interested in attacking only Christians and their worship
centres (Afolabi, 2015; Awojobi, 2014). This assumption has been erased going by the reporting of some of
the studies reviewed (Afolabi, 2015; Awojobi, 2014; Mbaya et al., 2017; Njoku and Nwachukwu, 2015). The
violent attacks of Boko Haram on Christian and Muslim worshipers made people believe that the sect is not
only after Christians in its attacks (Afolabi, 2015). The sect continues to attack churches and mosques and
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even killing Moslem clerics who are opposed to their ideology (Awojobi, 2014). From a qualitative study by
Mbaya et al., (2017), it was discovered that Boko Haram has killed innocent Muslim clerics, Christians and
forcefully converted kidnapped Christians to Muslim faithful. The study also reported that Christian and Mus-
lim worshipers have been bombed and killed in their sanctuaries. Njoku and Nwachukwu (2015) only reported
the attack of churches by Boko Haram and the study did not mention an attack on a Muslim worship centre.
Displacement/forced migration
One main consequence of armed conflict is displacement/forced migration of people. Of the 8 studies reviewed, 4
reported the displacement/forced migration of people due to Boko Haram attacks (Awojobi, 2014; Fehrmann and
Hawkins, 2015; Mbaya et al., 2017; Othman et al., 2015). As Boko Haram continues to attack churches, mosques,
markets, motor parks, a lot of Nigerians have been displaced or forced to flee their homes (Awojobi, 2014). The
National Youth Service Corp (NYSC) that was introduced by the Nigerian government to foster unity among Ni-
gerians has been ridiculed by Boko Haram insurgency (Awojobi, 2014; Fehrmann and Hawkins, 2015). This is
because many of the southern Corp members who are serving in the northeast of Nigeria where Boko Haram
activities are predominant are forced to be redeployed to states in the southern part (Fehrmann and Hawkins, 2015).
Just are southern NYSC members are relocating from the northern part to the southern part, most southerners that
have been residing in the northern part for many years have been moving to the south due to Boko Haram (Fehr-
mann and Hawkins, 2015; Mbaya et al., 2017; Othman et al., 2015).
Education disruptions
Aside from the killing of people by Boko Haram, one major effect of the Boko Haram conflict is the disrup-
tions of educational activities in the northeast. Around 5 studies reported how Boko Haram attacks have crip-
pled educational activities in the combat zone (Afolabi, 2015; Awojobi, 2014; Familusi and Oshomoh, 2018;
Mbaya et al., 2017; Othman et al., 2015). In Maiduguri, Boko Haram has burnt many schools and many other
schools are forced to suspend academic activities including the University of Maiduguri (Afolabi, 2015). In
Chibok Local Government Area, Boko Haram carried an unprecedented attack in a Federal Government Girls
College where over 250 schoolgirls were abducted (Awojobi, 2014). According to Familusi and Oshomoh
(2018), education is worst attack by Boko Haram, many school teachers and students have been killed and
many school pupils and students have been forced to stay away from school. This has made school enrolment
dropped drastically in the Northeast (Mbaya et al., 2017). It is also reported that aside from the attacks on
military formations, police stations and prisons, one of the main targets of Boko Haram is school buildings
(Othman et al., 2015). This is because Boko Haram is against Western education and it considered it to not
Islamic (Familusi and Oshomoh, 2018).
Children, girls and women
In violent conflicts, children, girls and women are the most affected because of their vulnerability. Five studies
have found children, girls and women being victims of Boko Haram violent conflict (Afolabi, 2015; Awojobi,
2014; Dunn, 2018; Familusi and Oshomoh, 2018; Mbaya et al., 2017). Due to the continuous attacks on edu-
cational facilities and the disruption of academic activities by Boko Haram, parents have withdrawn their
children from schools (Afolabi, 2015). Boko Haram has been kidnapping girls, women and children and using
them as a human shield against military onslaught (Awojobi, 2014). Further to this, women are the most
victims of Boko Haram rampage kidnapping and some of these women are sexually abused and, in some
cases, these women are forcefully married to Boko Haram commanders and their foot soldiers (Awojobi,
2014). Empirical evidence from another study also reports that Boko Haram conflict affects child health. The
analysis of the study also projects with a high degree of significance that the likelihood of childhood wasting
would have reduced by 13 percentage points if the conflict had not occurred (Dunn, 2018). For Familusi and
Oshomoh (2018), the future of many children in areas that are predominant to Boko Haram conflict is in
jeopardy because many of the children cannot go to school. Furthermore, the conflict has affected family
setting that made the men not to able to trace their wives and the women cannot trace their children (Mbaya
et al., 2017).
The economic legacy of Boko Haram conflict
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Protracted civil strife is ‘development in reverse’ (Collier et al., 2003, p. 13). During armed conflicts, the
economy suffered a lot. The following are some economic consequences of the Boko Haram insurgency in
the Northeast of Nigeria.
Economic decline
The decline of economic activities is reported by seven but one of the included studies (Afolabi, 2015;
Awojobi, 2014; Bello et al., 2018; Familusi and Oshomoh, 2018; Mbaya et al., 2017; Njoku and Nwachukwu,
2015; Othman et al., 2015). From a qualitative interview, many of the respondents significantly agreed that
Boko Haram activities have reduced economic activities in the Northeast (Afolabi, 2015). In Maiduguri, the
Borno State capital, the biggest Monday Market was badly affected by the insurgency as shop owners had to
close their businesses and left the belligerent city (Awojobi, 2014). A survey research design adopted by Bello
et al. (2018), reveals that over 84% of the respondents of the study subscribed to the notion that there is a
significant relationship between Boko Haram insurgency and the decline of business activities in the northeast.
The findings of the study suggest that Boko Haram insurgency could alter business investment, the entire
business establishment or some situation of its operations include production marketing, finance and human
resource (H/R). Most of the businessmen and women who have been affected by the conflict in the northeast
have left the affected areas have reinvested their capital in other major cities in Nigeria (Familusi and
Oshomoh, 2018). Using analysis of variance (ANOVA) method of analysis by Njoku and Nwachukwu (2015),
the findings of the study suggest that Boko Haram insurgency poses a real threat to the Nigerian economy.
The results of the study corroborated the work of Othman et al. (2015), whose findings reveal that over 10,000
shops have been closed due to the activities of Boko Haram.
Banks play a vital role in a country’s economy and during violent conflicts banking operations are disrupted.
Three studies mentioned the disruption of banking operations in the conflict zone (Awojobi, 2014; Familusi
and Oshomoh, 2018; Mbaya et al., 2017; Othman et al., 2015). In the affect areas of the conflict, banks no
longer operate on the normal banking hours. Instead the banks open for business for just four hours, 9 am to
12 noon, this is to safeguard their operations (Familusi and Oshomoh, 2018). The cost of doing business in
the conflict zone has also risen as reported by (Bello et al., 2018; Othman et al., 2015). Another economic
activity that has been affected by the conflict is agriculture as reported by 2 studies (Familusi and Oshomoh,
2018; Mbaya et al., 2017). The rumour that spread like a wildfire that Boko Haram planned to poison agricul-
tural products affected the consumption of some agricultural products from the northeast to southern cities
(Familusi and Oshomoh, 2018). In Konduga Local Government Area of Borno State, the Alua dam that is
economical to the inhabitants of the local government in terms of fishing and farming has been abandoned for
more than 6 years affecting the livelihoods of the inhabitants (Mbaya et al., 2017).
Infrastructure
The most vivid effect of armed conflict is the destruction of public amenities. Of the 8 included studies, 4
reported the destruction of amenities/property/infrastructure (Awojobi, 2014; Familusi and Oshomoh, 2018;
Mbaya et al., 2017; Othman et al., 2015). Boko Haram has destroyed markets, police stations, educational
institutions, telecommunication masts and other valuable properties. This has resulted in the over-stretching
of available facilities and social services in the conflict areas (Mbaya et al., 2017).
Government spending
In civil wars, government spending increases astronomically because the government uses all resources at its
disposal to end the rebellion. Three studies reported the increase in financial spending by the Nigerian govern-
ment to curtail Boko Haram insurgency (Afolabi, 2015; Familusi and Oshomoh, 2018; Othman et al., 2015). A
qualitative interview of respondents by (Afolabi, 2015) reveals that an overwhelming majority of the respondents
agreed that the Nigerian government has spent a huge sum of money to finance the war. A historical analysis of
the Boko Haram conflict indicates that as at 2016, the conflict has cost the Nigerian economy ₦1.3 trillion and
part of the fund has been used to replace infrastructure that has been destroyed by Boko Haram (Familusi and
Oshomoh, 2018). Similarly, a qualitative study by Othman et al. (2015) reveals that funds that would have used
to develop critical sectors are now being used to finance the Boko Haram war.
Miscellaneous effects
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Table 2 presents some socioeconomic effects of Boko Haram insurgency as suggested by the findings of the
sample studies in this review.
Discussion
This study is a qualitative systematic review, and it is the first systematic review that assesses the socioeco-
nomic effects of Boko Haram insurgency in Nigeria. This is because the review is not aware of any systematic
review that has assessed the socioeconomic effects of the Boko Haram conflict. The research question that
emanated from the review is “what are the socioeconomic effects of Boko Haram insurgency in the northeast
of Nigeria?” Eight studies were included in this review because they met the inclusion criteria and all, but one
employed qualitative methods. Only one study used a quantitive approach, and it measured child malnutrition
in the conflict zone.
The social effects of civil war are enormous. Most of the included studies reported various social effects that
have emanated from the conflict. The findings from this review reveal that the conflict has led to the death of
both civilians and military personnel. In armed conflict, both civilians and combatants are prone to be causal-
ities. Adults mortality are likely to have occurred because of adult’s greater vulnerability to the risk of combat
deaths, “few of these adult deaths are directly combat related” (Collier et al., 2003, p. 24). A juxtaposition of
these surges in mortality with the projections of deaths as a leading result of combat affirms that the death
of combatants is merely a secondary factor of the overall increases in mortality (Collier et al., 2003). These
increases indicate that wars kill much more civilians than they kill combatants during the conflict (Collier et
al., 2003). The findings of this review reveal that none of the included studies actual gives the figures of
civilians or combatants that have died in the conflict. This will make it difficult to support the hypothetical
statement of Collier et al. (2003) that stated that more civilians are killed in civil wars than the combatants.
While adults are likely to die in civil wars, children, girls and women are not exempted from death because
of their vulnerable nature. This review findings reveal that children, girls and women are major victims of
Boko Haram insurgency. Studies have supported these findings, in the south and west Darfur, a report in 2005
by the charity Médecins Sans Frontières mentioned approximately 500 cases of rape against women and chil-
dren (The Economist, 2009). The UN also reported that in eastern Congo, between June 2007 and June 2008,
in Ituri province, 6,766 cases of rape were reported, with 43% involving children (The Economist, 2009). The
Boko Haram conflict has affected children, girls and women because they have been kidnapped, raped and
killed. Health is a major issue in conflict zones, only one study mentioned child health among the studies and
there was no mentioning of attacks on health facilities by any of the included studies.
Displacement or forced migration and the disruption of educational activities were mentioned by some in-
cluded studies as parts of the social effects of the insurgency. According to the UN Refugee Agency, war and
violence globally are causing more people than ever to be forcibly displaced (UNHCR, 2017). Findings from
some included studies show that many Nigerians have been displaced by the conflict. While those Nigerians
from the southern part have relocated to the major cities in the southern part, the indigenes in the conflict zone
have been housed in camps. Most often these camps have become major targets by Boko Haram fighters.
The effect of civil war on education is visible. “Education is the most powerful weapon which you can use to
change the world Nelson Mandela (Signé, 2018). Boko Haram, the Islamist radical group is terrified by this
edifying power of education (Signé, 2018). That is why the findings of this review show that Boko Haram has
destroyed school buildings, kidnapped students, killed lecturers and students. The attacks on schools have put
fear on parents and students. Many schools have been shut and students have stopped going to school. This
has drastically reduced enrolment and attendance rates in the northeast. The consequences of the conflict have
reduced government educational expenditures. Funds would have been used for educational development are
being used to execute the war and rebuild amenities that have been destroyed.
The findings of this review show that aside from the social effects of the Boko Haram conflict, the economy
of the northeast has been crippled by the insurgency, Notably, economic decline, the destruction of infrastruc-
ture and government financing of the conflict are the major economic consequences of the conflict. Setting
away from the very substantial human cost, armed conflict has severe economic costs loss of houses, amen-
ities, a decrease in the working population, anxiety, a rise in deficit and disruption to regular economic activity
(Pettinger, 2017). Though from some aspects, armed conflict can also be profitable in terms of generating
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demand, employment, innovation and profits for business (Pettinger, 2017). None of the included studies in
this review shows that the Boko Haran conflict has been beneficial in any way. Instead, findings from this
review show the enormous consequences of the conflict.
This review assesses the socioeconomic effects of Boko Haram conflict, eight studies were included in the
review. The review encountered some limitations. Firstly, the included studies were not of high qualities
which made their findings to be clumsy. Secondly, most of the study use limited data collection methods
which affect the quality of their findings’ interpretation. Finally, most studies rely on secondary data and this
obstructs the evidence of their findings.
Conclusion
This review evaluates the socioeconomic effects of Boko Haram insurgency in Nigeria with the research
question, “what are the socioeconomic effects of Boko Haram insurgency in the northeast of Nigeria?” The
findings of the first systematic review revealed that Boko Haram insurgency affects the social and economic
life of people in the conflict zone. However, none of the included studies where able to establish if the effects
of the insurgency were with high degrees.
The insurgency affects all categories of people through income loss, displacement, kidnapping, rape educa-
tional disruption and the loss of lives. In terms of economic consequences, the insurgency has brought about
economic decline in the northeast, destruction of infrastructure and it has led to government spending more to
execute the war at the expense of other social development.
While this evaluation study is a systematic review that included low and middle-quality studies, a compre-
hensive evaluation study is needed to ascertain the true state of the socioeconomic effects of Boko Haram
conflict. For instance, studies need to be done on the mortality level for both civilians and combatants, the
health status of people in the conflict zone, numbers of educational facilities that have been destroyed and
what is the actual cost of financing the war.
In sum, this review intends to add to the debate on the socioeconomic consequences of conflict. While the
conflict in the northeast continues to take its toll on the Nigerian economy and the people living in the conflict
zone, the Nigerian government is left with two options to bring the conflict to an end. Firstly, the government
should initiate a serious dialogue with relevant stakeholders to end the conflict. Secondly, if dialogue fails to
bring the conflict to an end, the government should embark on a full-scale war to stop the conflict. If Nigerian
soldiers can effectively contribute in bringing the civil wars in Liberia and Sierra Leone to an end, they can
also end the 9-year-old conflict in the northeast if all saboteurs hindering the execution of the war are dealt
with. The Nigeria government has the manpower and resources to end the war, it just needed the political and
military will to do so.
References
1. Bauernschuster. S., Driva, A., Hornung, E. (2017). Bismarck’s health insurance and its impact on mortal-
ity | VOX, CEPR Policy Portal [Internet]. [cited 2018 Nov 4]. Available from: https://voxeu.org/arti-
cle/bismarck-s-health-insurance-and-its-impact-mortality.
2. Chubike, N.E. (2013). Evaluation of National Health Insurance Scheme (NHIS) awareness by civil serv-
ants in Enugu and Abakaliki. Int J Med Med Sci, 5(7), 356358.
3. Spaan, E., Mathijssen, J., Tromp, N., McBain, F., ten Have, A., Baltussen, R. (2012). The impact of health
insurance in Africa and Asia: a systematic review. Bull World Health Organ, 90(9), 685692.
4. Adewole D, Bolarinwa O, Dairo M. (2016). National Health Insurance Scheme and Universal Health
Coverage among Formal Sector Employees in Ilorin, Nigeria: Has Any Progress Been Made? Int J Trop
Dis Health, 18(4), 110.
5. Onyedibe, K.I., Goyit, M.G., Nnadi, N.E. (2012). An evaluation of the national health insurance scheme
(NHIS) in Jos, a north-central Nigerian city. Glob Adv Res J Microbiol, 1(1), 512.
6. Osuchukwu, N.C., Osonwa, K.C., Eko, J.C., Uwanede, C.C., Abeshi, S.E., Offiong, D.A. (2013). Evalu-
ating the Impact of National Health Insurance Scheme on Health Care Consumers in Calabar Metropolis,
Southern Nigeria. Int J Learn Dev, 3(4), 30.
7. Porter, J.J., Dessai, S., Tompkins, E.L. (2014). What do we know about UK household adaptation to
climate change? A systematic review. Clim Change, 127(2), 371379.
SocioEconomic Challenges, Volume 3, Issue 1, 2019
ISSN (print) 2520-6621, ISSN (online) 2520-6214
49
8. Ham-Baloyi, W., Jordan, P. (2016). Systematic review as a research method in post-graduate nursing
education. Health SA Gesondheid, 21, 120128.
9. Eyong, A.K., Agada, P.O., Asukwo, E.O., Irene, C. (2016). Awareness of National Health Insurance
Scheme (NHIS) and Quality of Health Care Services among Civil Servants in Cross River State, Nigeria.
Res Humanit Soc Sci, 6(13), 110.
10. Apeloko, O.D. (2017). Health Insurance Scheme (NHIS) in Nigeria: An Empirical Survey. Int J Polit
Good Gov, 8(8), 125.
11. Adewole, D., Osungbade, K. (2016). Nigeria National Health Insurance Scheme: A Highly Subsidized
Health Care Program for a Privileged Few. Int J Trop Dis Health, 19(3), 111.
12. Ele, G.N., Ochu, U., Odili, V., Okechukwu, R., Ogbonna, B. (2016). Evaluation of the Benefits, Quality
of Services and Challenges to the Nigerian National Health Insurance Scheme among Enrollees in a Ter-
tiary Teaching Hospital in Southeast Nigeria. J Adv Med Pharm Sci, 9(3), 111.
13. Owumi, B.E., Omorogbe, C.E., Raphael, S.C. (2013). An Evaluation of the Impacts of the National Health
Insurance Scheme on the Employees’ Health Status at the University of Ibadan. Afr J Soc Sci, 3(3), 40-52.
14. Ele, G.N., Brian, O., Uche, M., Valentine, U. (2017). Assessment of National Health Insurance Scheme’s
(NHIS) Effectiveness in a Tertiary Teaching Hospital in Southeast Nigeria. J Adv Med Pharm Sci, 13(3),
19.
15. Mgbe, C.G., Kevin, E.M. (2014). Evaluation of National Health Insurance Scheme: Benefits and Chal-
lenges in Eastern Nigeria: A Case Study. South Am J Public Health, 2(4), 491506.
16. Owumi, B.E., Adeoti, A.B., Taiwo, P.A. (2013). National Health Insurance Scheme Dispensing Outreach
and Maintenance of Health Status in Oyo State. Int J Humanit Soc Sci Invent, 2(5), 3746.
17. Akande, T., Salaudeen, A., Babatunde, O. (2011). The effects of national health insurance scheme on
utilization of health services at Unilorin Teaching Hospital staff clinic, Ilorin, Nigeria. Health Sci J., 5(2), 9.
18. Adewole, D.A., Dairo, M.D., Bolarinwa, O.A. (2016). Awareness and Coverage of the National Health
Insurance Scheme among Formal Sector Workers in Ilorin, Nigeria. Afr J Biomed Res, 9, 110.
19. Saksena, P., Antunes, A.F., Xu, K., Musango, L., Carrin, G. (2010). Impact of mutual health insurance on
access to health care and financial risk protection in Rwanda. Geneva, Switzerland: World Health Organ-
ization; p. 110.
20. Jembere, M.Y. (2018). The Role of Community Based Health Insurance Scheme on Financial Protection
and Healthcare Seeking Behavior of Households in Tehuledere District, Northeast Ethiopia. Int J Health
Econ Policy, 3(2), 13.
21. Abuosi, A.A., Domfeh, K.A., Abor, J.Y., Nketiah-Amponsah, E. (2016). Health insurance and quality of
care: Comparing perceptions of quality between insured and uninsured patients in Ghana’s hospitals. Int
J Equity Health, 15(76), 211.
22. Wang, Z., Li, X., Chen, M., Si, L. (2018). Social health insurance, healthcare utilization, and costs in
middle-aged and elderly community-dwelling adults in China. Int J Equity Health, 17(17), 213.
23. Ataguba, J.E.-O., Goudge, J. (2012). The Impact of Health Insurance on Health-care Utilisation and Out-
of-Pocket Payments in South Africa. Geneva Pap Risk Insur - Issues Pract, 37(4), 633564.
24. Michael, G.C., Suleiman, H.H., Grema, B.A., Aliyu, I. (2017). Assessment of level of satisfaction of
national health insurance scheme enrolees with services of an accredited health facility in Northern Nige-
rian. Ann Trop Med Public Health, 10(5), 1271.
25. Quynh, N.T.N., Dhar, N. (2014). A study of satisfaction among poor patients holding health insurance
card with health care services at two district public hospitals in vietnam. Health Popul - Perspect Issues,
37(1 and 2), 5056.
26. Mohammed, S., Sambo, M.N., Dong, H. (2011). Understanding client satisfaction with a health insurance
scheme in Nigeria: factors and enrollees experiences. Health Res Policy Syst, 9(20), 28.
27. Long, S.K, Dimmock, T.H. (2015). Consumer Satisfaction with Health Insurance Coverage in Massachu-
setts. AMA J Ethic, 17(7), 656664.
28. Orok, D.A., Usang, A.I., Ikpan, O.O., Duke, E.E., Eyo, E.E., Ekup, E.U., et al. (2016). Prevalence of
Malaria and Typhoid Fever Co-infection among Febrile Patients Attending College of Health Technology
Medical Centre in Calabar, Cross River State, Nigeria. Int J Curr Microbiol Appl Sci, 5(4), 825835.
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29. Andefiki, U., Ibrahim, A., Ushie, E.F. (2014). Prevalence of Malaria and Typhoid Fever Co-infection and
the Haematological Profile of Patients Attending Hospitals in Wukari Taraba State, Nigeria. AASCIT J
Biosci, 3(6), 7986.
30. Akande, T., Adekunle, S., Babatunde, O. (2011). The effects of national health insurance scheme on uti-
lization of health services at unilorin teaching hospital staff clinic, ilorin, nigeria. Health Sci J, 5(2), 98106.
Figure 1. Flow diagram of the systematic review
SocioEconomic Challenges, Volume 3, Issue 1, 2019
ISSN (print) 2520-6621, ISSN (online) 2520-6214
51
Table 1. Key characteristics of studies included in systematic review of studies on the socioeconomic effects
of Boko Haram insurgency
Study
Study objective(s)
Data collection
technique(s)
Socioeconomic effect(s)
considered
Comments/conclusion
Afolabi, 2015
Reviewing the effect of
Boko Haram insurgence
and its implications on
socio-political economic
in Nigeria
Questionnaire
Business, economic decline,
military spending, education
The findings suggest that
both religious and political lead-
ers promote the activities of
Boko Haram due to bad govern-
ance
Awojobi, 2014
This paper examines the
implications of the oper-
ations of the Boko Ha-
ram insurgency in the
northeast of Nigeria
Secondary source
Mortality, infrastructure,
commercial business, dis-
placement, forced migra-
tion, girls and women, edu-
cation, worship house
The findings reveal that the ac-
tivities of Boko Haram consti-
tute a threat to the development
of Nigeria
Bello et al. 2018
The paper is focused to
investigate the Boko-Ha-
ram revolt since it creates
economic challenges and
severely reduces the
business activities from
the concerned north-east-
ern states of Nigeria
Structured
interview
Commercial business, cost
of doing business
The findings disclosed that there
was substantial link between the
variables and hence a direct ef-
fect involved between Boko-Ha-
ram insurgency and the dwin-
dling business activities in the
north-eastern states of Nigeria
Dunn, 2018
This study explores the
relation between fierce
conflict and childhood
wasting in Northeast
Nigeria
Difference-in-
Difference (DID)
Children health
Descriptive evidence indicates
that poor child health outcomes
in the conflict zones of North-
east Nigeria may be owing to in-
terruptions to social services and
increased food insecurity
Familusi and
Oshomon, 2018
This paper investigated
Boko Haram insurgence
and the obstacles it poses
to the socioeconomic de-
velopment of Nigeria
Historical record,
oral interview, sec-
ondary source
Force migration, commer-
cial business, capital flight,
displacement, education,
government spending
The findings reveal that Boko
Haram has activities have done
more damage on socioeconomic
activities, slowing growth and
development in Nigeria
Mbaya et al.
2017
To determine the effect
of the insurgency on
Physical, social and eco-
nomic activities of the
residents of Maiduguri,
Interview
Education, mortality, infra-
structure, displacement,
children and women, forced
migration, commercial busi-
ness, unemployment, low
income, poor living condi-
tion, cost of doing business
From our findings, it was ob-
served that the situation and ter-
rorism are not unrelated to pov-
erty, unemployment and mis-
conception of the teaching of the
Holy Quran by some Islamic
“Ulames”
Njoku and
Nwachukwu,
2015
This study examined the
effects of Boko Haram’s
insecurity on the econ-
omy of Nigeria
Online
questionnaire
Economy
The findings established that
ideology and funding are the
compelling key elements that
propelled the Boko Haram sect
in Nigeria, the Boko Haram haz-
ard presents a substantial risk to
Nigeria’s economy
Othman et al.
2015
This study explores the
impact of boko haram on
business entrepreneur-
ship climate in Nigeria
Secondary source
Forced migration, mortality,
commercial business, cost
of doing business, military
spending, unemployment,
education
The findings affirmed that busi-
nesses no longer take place in
the distressed territories such as
the northeast part of Nigeria be-
cause markets were closed,
banking services not provided,
or hours of services reduced
Table 2. Other socioeconomic effects of Boko Haram insurgency
Sr. no.
Other socioeconomic effects of Boko Haram insurgency
Study
1
Fear/anxiety affects some people in the conflict areas
Afolabi (2015); Awojobi, 2014; Familusi
and Oshomoh, (2018); Mbaya et al., 2017;
Othman et al. (2015)
2
Unemployment increased
Mbaya et al. (2017); Othman et al. (2015)
3
People abducted still missing
Awojobi (2014); Mbaya et al., (2017)
4
The phenomenon of Internally Displaced Persons (IDPs) has become a social issue and
unhealthy for economic development
(Familusi and Oshomoh (2018)
5
Youth unemployment, bad governance, political corruption and poverty caused Boko
Haram insurgency
Afolabi (2015); Awojobi (2014)
Article
Full-text available
The paper intends to explore the transition of Boko Haram from a religio-social sect that championed social welfare in a community to becoming a sect that is commonly identified with sponsored violence and terror in Nigeria, particularly the Yobe state subjecting it to the reality of dire humanitarian crisis and utmost sorrow. The arguments will be centered on population displacement, health related emergencies, threats to livelihood, to emergent factors of growth influenced by the Boko Haram experience of the Yobe state. The study aims to assess the impact of the European Humanitarian interventions on the internally displaced population (IDP) caused by the activities of the insurgent group. A mixed-method research design was employed by utilizing both qualitative and quantitative method of data collection. The study was conducted on a sample size of 358 respondents. The results of the study indicate that European Humanitarian interventions have had some impact in improving both the socioeconomic and livelihood conditions of the displaced population in Yobe state, especially with regard to access to clean water, healthcare services, shelter, and food interventions. However, after a thorough data analysis the study findings indicate that further interventions should primarily focus towards providing additional assistance in the domain of shelter through more tents, food safety, and psychosocial support to the victims of insurgency.
Article
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A prepayment scheme for health through the National Health Insurance Scheme (NHIS) was commenced in Nigeria about ten years ago. Nigeria operates a federal system of government. Sub-national levels possess a high degree of autonomy in a number of sectors including health. It is important to assess the level of coverage of the scheme among the formal sector workers in Nigeria as a proxy to gauge the extent of coverage of the scheme and derive suitable lessons that could be used in its expansion. This is a cross-sectional, descriptive survey carried out among formal sector workers in Ilorin Kwara State, Nigeria. A stratified sampling technique was used to select study participants. A self-administered questionnaire was used to collect data from respondents. Data was analysed with the SPSS. Ethical approval to conduct the study was obtained from the Bowen University Teaching Hospital Research Ethics Committee. A total of 370 people participated in the study. Majority, (78.9%) of the respondents were aware of the NHIS, however only 13.5 % paid for health care services through the NHIS. Logistic regression analysis shows that respondents with post-secondary education (OR = 9.032, CI = 2.562 – 31.847, p = 0.001) and in federal civil service (OR = 2.679, CI = 1.036 – 6.929, p = 0.042) were over nine and three times more likely to be aware of the scheme than others. Coverage of the scheme among the respondents was unimpressive. A lot still need to be done to fast-track the expansion of the scheme among this sector of the population. © 2016, Ibadan Biomedical Communications Group. All rights reserved.
Article
Full-text available
Background: Although many studies have analyzed health insurance worldwide, most focus on whole populations rather than specific vulnerable groups. There is a lack of studies that compare different schemes. This paper evaluates the impact of different types of social health insurance and other associated factors on healthcare utilization and costs among middle-aged and elderly Chinese adults. Methods: Data were obtained from a nationally representative middle-aged and elderly household survey, the China Health and Retirement Longitudinal Study, which was conducted in 2015. Middle-aged and elderly are defined as people who are ≥45 years. Descriptive statistics were used to show the prevalence of each variable. Both logistic and multiple linear regression models were used to evaluate the association between healthcare utilization/healthcare costs and health insurance in addition to other related factors. Results: Although the rapid expansion of social health insurance coverage has significantly improved the healthcare utilization among middle-aged and elderly adults, the difference between three schemes is large. Urban Employee Medical Insurance (UEMI) has had a greater effect in improving healthcare utilization than New Cooperative Medical Insurance (NCMI) or Urban Resident Medical Insurance (URMI). Unification of health insurance programs and optimization of health resource allocations should be a practical way to alleviate healthcare utilization inequality across schemes. People having social health insurance spend more on total and out-of-pocket (OOP) healthcare costs than people not covered by social health insurance, suggesting that enrollment in social health insurance induces significant increases in both total and OOP healthcare expenses. UEMI for the urban employed has relatively higher funding criteria and reimbursement rate, which makes the greatest extent to induce increase in healthcare costs. Some demographic or socioeconomic factors significantly affect healthcare utilization and costs among middle-aged and elderly adults. Conclusion: Our study demonstrates the differences in healthcare utilization and costs between those with and without social health insurance and between those with different health insurance schemes. Policy efforts should further focus on adjusting social health insurance and optimizing healthcare resource allocation in order to enhance effective utilization of healthcare services and control cost increases among middle-aged and elderly adults.
Article
Full-text available
Introduction: Consumer satisfaction is one of the driving goals of goods and service production. Patient satisfaction surveys, as a means of periodic evaluation of the quality of services offered by the National Health Insurance Scheme (NHIS) accredited facilities, is necessary to ensure that the goals of the scheme are achieved and sustained. Materials and Methods: This was a cross‑sectional study of 202 respondents randomly selected from NHIS enrolees attending the Staff Clinic of Aminu Kano Teaching Hospital. It assessed respondents’ perceived waiting time, level of satisfaction at the clinic’s service units, and overall clinic satisfaction using a modified general practice assessment questionnaire. Results: The mean age of respondents was 36.4 ± 8.1 with a near equal sex ratio. They were predominantly civil servants (79.2%) with tertiary education (75.7%). Most respondents (70.3%) felt waiting time was too long; with 79.7% of those, feeling they spend at least 30 min after arrival at the registration unit to see their doctor. A majority of respondents: 90.1%, 86.8%, 79%, 76.8%, 75.9%, 77.5%, and 80.6% were satisfied with the consultation time, doctors’ consultation, medical records, pharmacy, laboratory, accounts, and nursing services, respectively. However, 65.8% were satisfied with the overall clinic services. The perceived sufficiency of the consultation time was associated with overall satisfaction (χ2 = 6.199, P = 0.013). Conclusion: Although 65.8% of respondents were satisfied with the clinic services, the perceived clinic waiting time was dissatisfactory; therefore, further studies on the determinants of overall satisfaction may be required if improvement in the proportion of satisfied service consumers is desired by the clinic managers.
Article
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Background: The fundamental concept of health insurance is risk sharing and burden bearing. The scheme is undermined by limitations ranging from very frequent use of the services more than necessary by enrollees, to cost escalation, poor management, and skimming. Assessment of services is a quality control measure in patients’ care and service delivery. It helps to identify gaps for improvement of care and services. Objective: This study assessed the effectiveness of NHIS from the perspective of healthcare providers and managers involved in its implementation to understand the nature of services, and gaps with the view to exploring ways of improving its service delivery. Methods: The study was a descriptive cross-sectional survey using focused group discussionguide to extract information from managers and healthcare providers. Structured interview guides were used to conduct key informant interview (KII). Data were summarized using descriptive statistics. Results: The greatest challenge was limited availability of essential drugs (60.0%), followed by inadequate space (40.0%), inadequate number of staff (40.0%) to meet up with the demand of NHIS patients and delay on reimbursement (40.0%). Most of the key informants 6.0 (60%) attested to poor availability of essential drugs. Conclusion: There is the need for an improvement in accessibility and availability of essential drugs in the scheme. Improvement on the quality of services can promote increased enrolment. Findings suggests the need for improved funding, staff training and development, and more investigative studies into the activities and operations of the scheme to positively impact health insurance operations and improve enrolment by clients. Improved funding, provision of adequate space, infrastructure, good monitoring and evaluation system will boost service delivery and promote sustainability. Keywords: Healthcare financing; healthcare coverage; access to healthcare; population health; health insurance; Nigeria.
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This study was aimed at evaluating the impact of National Health Insurance Scheme (NHIS) on health care consumers in Calabar metropolis, southern Nigeria. A pre-tested, 43 itemed questionnaires were designed and administered to 200 respondents using the household survey and patient exit survey methods. The result of this study showed that respondents were predominantly males (58.0%), Christians (94.5%), married (56.0%), civil servants (39.5%), had tertiary level of education (60.5%) and aged 30-34 years (27.5%). A reasonable proportion of the respondents 89.0% were aware of the scheme but enrolment into the scheme was only 37%. Inadequate information on the scheme, deficient delivery of health care services and lack of trust on scheme management were significant barriers to enrolment into the scheme. The scheme has a positive impact on health seeking behavior, utilization of maternal health services and reducing out-of-pocket expenditure for health services. About 72% of the respondents expressed their satisfaction with the performance of the scheme, whereas those who were dissatisfied with the scheme’s performance suggested it should be reformed. Wider coverage and increase awareness about the scheme will enhance equitable access to health care.
Article
Full-text available
Objective: Access to quality healthcare has been a prerogative of the middle and high socioeconomic class leading to the introduction of health insurance in developing countries to share the burden, reduce cost, and step up health care financing and coverage. This study assessed the benefits, quality of services and challenges of the National Health Insurance Scheme (NHIS). Methods: The study was a cross-sectional descriptive survey of all eligible NHIS enrollees. The study was conducted between January 2014 and April 2016. Data was collected using self-Original Research Article Ele et al.; JAMPS, 9(3): 1-11, 2016; Article no.JAMPS.28320 2 administered structured questionnaire and analyzed for demographics, enrollees perceived benefits of NHIS, quality of services, challenges, and problems using descriptive statistics. Results: Study showed that 91.1% of enrollees believed that the scheme is beneficial while 92.5% had confidence in the services and believed that it has reduced payment of their hospital bills. A total of 74.5% of the enrollees indicated positive response to quality and effective service under the scheme. The challenges borders on poor funding which does not allow for full coverage of all the essential medicines and entire family members for people with large families. Delay in collection of enrollees' card was another major setback. Conclusion: The National Health Insurance Scheme is beneficial to the enrollees and offers quality and effective services. However, poor funding limits its impact on the health benefits of the enrollees. The government needs to develop strategies to facilitate the operations of the scheme more efficient through improved funding and awareness campaign to improve coverage at all levels, boost the asset base, and improve services and efficiency.