Is Nigeria on track in achieving MDG 4?

The recent document ‘Saving New born Lives in Nigeria; NEWBORN HEALTH in the context of the Integrated Maternal, Newborn and Child Health Strategy; Revised 2nd edition, 2011’ has come at a significant time, as the world over, every country is taking stock of how far it has gone in accelerating effort to achieving the health related Millennium Development Goals (MDGs)

The forward signed by the Professor C.O. Onyebuchi Chukwu, Nigeria’s Minister of Health Federal Ministry of Health, has emphasized that “the first 28 days of life – the neonatal period – is a critical time for the survival of the child. Every day in Nigeria, about 700 babies die (around 30 every hour). This is the highest number of newborn deaths in Africa, and the second highest in the world.”

The report owned up to the fact that care of the newborn is an aspect of child survival that has received limited attention. The situation is tragic, especially as most of these babies are dying due to preventable causes such as intrapartum-related injury, infections, and prematurity.

In 2007, the Federal Ministry of Health (FMOH) put together the Integrated Maternal, Newborn, and Child Health (IMNCH) strategy to help revitalize maternal, newborn, and child health in Nigeria. This strategy is being implemented within the framework of the National Strategic Health Development Plan (NSDHP). In line with that, Nigeria has began the ‘Countdown to 2015 for Maternal, Newborn and Child Health (MNCH)’ which is a global movement of governments, academics, agencies, non-governmental associations and healthcare professionals, with The Lancet as a key partner. Countdown was established in 2005 to improve the use of country-specific data to stimulate and support action and accountability by tracking coverage for priority MNCH interventions to accelerate progress towards most especially MDGs 4 and 5 that aim towards reduction of Child and Maternal Mortality.

The report reiterate that “Nigeria, as the largest country in Africa holds the key to Africa’s progress towards the MDGs. Recent progress for MDGs 4 and 5 is more encouraging but much remains to be done with 33,000 maternal deaths and almost 1 million under-five deaths. Time is short and focused action is critical. Priority actions based on the Nigerian data are clear:

Focus on coverage gaps for high-impact interventions, particularly family planning services, and antenatal, childbirth, and postnatal care, and case management of childhood illnesses is essential.

Prioritize within the continuum of care, especially around the time of birth, and from pre-pregnancy through 24 months. This will save mothers, babies and also the many stillbirths in Nigeria each year, and improve child health and survival.

Implement equitable healthcare. Programmatic implementation is critical to address inequities by geographic region, by urban/rural and by socioeconomic status, supported by monitoring data.

Emphasize maternal and child nutrition. Nutrition is central to both national and sub-national development strategies and requires a multi-sectoral approach.

Ensure predictable, long-term funding for MNCH in all states, and invest in the highest impact care for the poorest families.

Monitor progress and evaluate outcomes. Conduct locally driven implementation research and act on the results.

The report has informed the readers some home truth that 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

“While some progress has been made to reduce deaths after the first month of life (the post-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 under five deaths are newborns – 241,000 babies each year. Many deaths occur at home and are therefore unseen and uncounted in official statistics….. 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.”

The report pushed some specific recommendations that could ensure progress, such as;

Up to 70% of these newborn deaths could be prevented if essential interventions in existing health packages reached all Nigerian women and newborns.

The leading causes of death are intrapartum-related, or ‘birth asphyxia’ (28%), complications of preterm birth (30%), and severe infections (22%). Healthy home practices and community-based care – which are possible to improve even in hard to- reach areas – could save over 90,000 babies a year.

Greater priority on tackling malnutrition is vital to attain Millennium Development Goals on eradicating poverty, reducing child mortality and improving maternal health.

I will conclude this article by asking to what extend is the Federal Government and its international partners genuinely involving the states and LGAs in designing, planning, implementing evidenced based interventions and monitoring and evaluating initiatives that will improve our not too good health indices. The national figures are aggregates of what happens at the state and LGAs and selecting few of them to intervene may not lead to the changes we desire by 2015.

All comments to Dr Aminu Magashi at healthweekly@yahoo.com
http://dailytrust.dailytrust.com/index.php?option=com_content&view=article&id=12509:is-nigeria-on-track-in-achieving-mdg-4&catid=12:health-reports&Itemid=13