How to Improve Almajiri Health And Why Almajirai May Know Best

Despite their prominence in the Nigerian imagination, almajirai and their experiences in health have been overlooked in research. Socially-grounded research models may offer some ways to address this.

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 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. 


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. 

The type of collaboration that CBPR encourages may be of value among neglected communities in Northern Nigeria, where distrust of Western institutions is widespread and based on real historical trauma. This is particularly true for issues around health, where Western pharmaceutical companies and their research have inflicted real harm on Northern Nigerian communities, and where resultant scepticism towards Western models of health has sometimes erupted into violence. CBPR may offer a way around this distrust, by establishing equal partnerships between researchers and almajirai, and ensuring that almajirai, more than just research subjects, are given active roles in determining what questions guide research, and how research is performed.  

There are, still, significant barriers to using this approach. While CBPR offers a way around distrust, the fact of distrust itself can still complicate the partnerships on which this research model relies. In this writer’s conversations around this research, many have also suggested that almajirai are simply too young to be seriously engaged as partners in research, or to have meaningful insights into their health needs. These reflect portrayals of children as ‘vulnerable, incompetent and … powerless in society’ throughout much of the academic literature.  

We have good reason to doubt these portrayals. Attention has been increasingly paid to children’s agency and their roles as ‘social actors’ capable of effective engagement with their surroundings to protect their own interests and wellbeing. CBPR has been used to leverage this capacity through research with children around a broad range of health questions, and even in African contexts, to promote cervical cancer screening for South African girls, and guide research around orphaned and neglected children in Kenya. 

CBPR with almajirai would help to highlight their own social agency. Almajiranci is often seen as an illogical choice, or the outcome of some intersection between poverty and neglect. This view fails to consider that, for many almajirai and their families, engagement in almajiranci may often be a superior alternative to enrollment under-resourced government schools, and may be seen to hold moral and practical value overstaying at home. Engagement with almajirai through CBPR would require and allow acknowledging these complicated pressures and enrich research with the perspectives of all stakeholders involved in almajiranci, including parents, almajirai, and even the malamai that teach them, many of whom often enter the system as almajirai themselves.  


We should feel encouraged that almajirai have already been involved as participants in research. Hannah Hoechner, the researcher cited earlier in this article, in her work with almajirai in Kano, helped produce a film (available on YouTube) on the almajiri experience, whose theme and structure were largely determined by almajirai themselves, and gives insight into the forces that motivate their enrollment as students, the major features of their daily lives, the abuses they experience in society, as well as their aspirations and goals. 

For all its promise, this collaboration was not without complication, and some tension arose over almajirai’s limited experience with film production and their compensation for various aspects of the work. This shows that, while participatory approaches hold promise for almajiri research, they also require meticulous care to ensure that all partiesinterests are protected in work and its outcomes. 

In a 2016 study of oral health among almajirai in Kano, Enoch Idowu and colleagues end with a call to action around almajiri health, citing their extreme social disadvantage as need for urgent and focused intervention, and decrying a lack of action on the part of government and global health organizations to support almajiri health. We should echo this call today. Almajirai and the disadvantages they suffer are too widely known to accept the sparsity of research on their health. This research must also urgently move beyond just documenting this disadvantage, and towards studying means to address it. Our best hope in finding these means may be in asking almajirai themselves

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