Saving Newborn Lives in Nigeria: Newborn Health in the context of the Integrated Maternal, Newborn and Child Health Strategy

Summary
Recent progress has been made towards reducing child mortality but Nigeria is currently off track for Millennium Development Goal (MDG) 4 – a two-thirds reduction in child mortality (on 1990 levels) by 2015. According to UN mortality estimates, Nigeria has achieved only an average of 1.2% reduction in under-five mortality per year since 1990; it needs to achieve an annual reduction rate of 10% from now until 2015 to meet MDG 4 (Figure 1).
While some progress has been made to reduce deaths after the first month of life (the neonatal period), there has been no measurable progress in reducing neonatal deaths over the past decade. About 5.9 million babies are born in Nigeria every year, and nearly one million children die before the age of five years. One quarter of all underfive deaths are newborns – 241,000 babies each year. Many deaths occur at home and are therefore unseen and uncounted in official statistics. Given that the country’s population is the largest in Africa, Nigeria’s failure to make inroads regarding the MDGs significantly influences Sub-Saharan Africa’s achievement of these goals as a whole and contributes disproportionately to global childhood mortality.
In 2009, the first edition of Saving Newborn Lives in Nigeria: Situation Analysis and Action Plan for Newborn Health was produced in order to provide a more comprehensive understanding of newborn survival and health in Nigeria, to analyse the relevant data by state and to present concrete steps to accelerate action to save newborn lives in Nigeria in the context of the Integrated Maternal, Newborn and Child Health (IMNCH) strategy. This second edition of the report includes updated national and state-level data profiles in line with the global Countdown to 2015 for Maternal, Newborn and Child Health process; a new chapter on maternal, newborn and child nutrition; updated recommendations; and a renewed call to action, including letters of commitment from key stakeholders in maternal, newborn and child health in Nigeria.
Report’s 2nd edition unveils critical findings:
• The 2nd edition of this report draws on NDHS 2008 data, whereas the 2009 edition used data from the 2003 NDHS and the 2007 Multiple Indicator Cluster Survey (MICS).
• Under-five mortality fell by 22% from 201 deaths per 1000 live births in 2003 to 157 deaths per thousand live births in 2008. Neonatal deaths improved marginally from 48 per 1000 live births to 40 per 1000 live births during this period.
• While mortality decreased, the gains for many indicators of coverage of care for women and children were less signifi cant. In 2008, 58% of pregnant women attended one or more antenatal visits, slightly lower than 61% in 2007. Around 39% of deliveries were with a skilled birth attendant in 2008, down from 44% in the 2007 MICS. Exclusive breastfeeding among children less than 6 months fell from 17% in 2003 to 13% in 2008. Treatment for childhood diarrhoeal disease, malaria and pneumonia have dropped or remained stagnant. Coverage of care remains on average much worse in the North East and North West of the country.

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