By Lexi Elo
New data just released by the United Nations show that under-five mortality rates have dropped by 49 percent between 1990 and 2013. The average annual reduction has accelerated – in some countries it
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has even tripled – but overall progress is still short of meeting the global target of a two-thirds decrease in under-five mortality by 2015.
New estimates in “Levels and Trends in Child Mortality 2014″ show that in 2013, 6.3 million children [pro_ad_display_adzone id=”10″]under five died from mostly preventable causes, around 200 000 [pro_ad_display_adzone id=”10″]fewer than in 2012, but still equal to nearly 17 000 child deaths each day.
“There has been dramatic and accelerating progress in reducing mortality among children, and the data prove that success is possible even for poorly resourced countries. There is now a gathering momentum from countries in every part of the world to make sure proven, cost-effective interventions are applied where they will save the most lives,” Mickey Chopra, head UNICEF’s global health programmes, said.
In 2013, 2.8 million babies died within the first month of life, which represents about 44% of all [pro_ad_display_adzone id=”10”]under-five deaths. About two-thirds of these deaths occurred in just 10 countries. While the number of neo-natal deaths has declined, progress has been slower than for the overall under-five mortality rate.
In June 2014, WHO, UNICEF and partners issued the first-ever global plan to end preventable newborn deaths and stillbirths by 2035. The Every Newborn Action Plan calls for all countries to take steps to provide basic, cost-effective health services – in particular around the time of childbirth, as well as for small and sick babies – and to improve the quality of care.
A SURE-P MCH 2013 document shows that only 23 percent of children aged 12-23 months received all recommended vaccination in the country. While vaccination coverage varies widely by residence and zones, 40 percent of children in urban areas are fully vaccinated compared to only 16 percent in rural areas and about 29 percent of children estimated not to have received any vaccination against childhood killer diseases such as measles, tetanus, whooping cough, polio, hepatitis B, pneumonia, etc.
While the main causes of neonatal deaths include birth asphyxia, severe infection like tetanus and premature birth, on the other hand, malnutrition remains an underlying cause of morbidity and mortality of a large proportion of children under-five in Nigeria. It accounts for more than 50 percent of deaths of children in this age bracket.
Underneath the statistics lies the pain of human tragedy, for thousands of families who have lost their children. Although analyses of recent trends show that the country is making progress in cutting down infant and under-five mortality rates, experts believe that the pace to achieve the Millennium Development Goals (MDG) 4 and 5 targets of reducing under-five and maternal mortality rate by two-thirds and three-quarters respectively by 2015 is still slow as the date approaches.
While noting that the country adopted and implemented the Integrated Maternal, Newborn and Child Health Strategy (IMNCH), Prof. Onyebuchi Chukwu, former minister of health maintained that it decided to strengthen institutional capacity and infrastructure in a bid to meet MDG target for Nigeria.
According to Prof. Chukwu “Current strides to meet the MDG target include improving human resources at PHC level through the Midwives Service Scheme and capacity building of midwives in Life Saving Skills (LSS) and Integrated Management of Childhood Illness (IMCI) to enhance their performance in providing quality care, establishment of vesico-vaginal Fistula centres and the upgrade of Ebonyi VVF centre to a national one, management of childhood Illness, implementation research projects on Prevention of Mother-to-Child Transmission of HIV (PMTCT), Maternal, Newborn and Child Health (MNCH), etc.
Dr. Osahon Enabulele, vice president, Commonwealth Medical Association, noted that there is need for urgent resuscitation and strengthening of primary healthcare and referral system with an adequate mix of health manpower to improve health outcomes in the country.
In a bid to improve the situation analysis in Nigeria as revealed by the preceding account of the existing health indicators, as well as in her commitment to achieving the MDGs 4 and 5, Nigeria has put in place some programmes such as; National Health Insurance Scheme(NHIS); Health Sector Reforms (HSR); introduction of Midwifery Service Scheme (MSS).
As Nigeria marches towards 2015, experts believe that government must take the issue of maternal and child mortality seriously by matching words with actions for it to achieve the set target. There is also the need to allocate 15 percent of government annual budget to health in order to meet the Abuja commitment of 2001 by heads of governments in Africa, review implementation of the National Health Insurance Scheme to identify gaps and to scale-up services to offer community-level insurance, continue roll-out of IMNCH strategy in all states, including support for supervision, logistics and data tracking.
Besides this, there is need to develop a national KMC guideline to address service standards, admission and discharge criteria, and best practices that can be adapted for all levels of healthcare, enable communication and information sharing between national, state, LGA, facility and community levels as well as keep lower- and mid-level health facilities up to date on new and revised national policies and link national strategic planning and action in LGAs.
