Saving newborn lives key to achieving child survival goal, says new report
12 JANUARY 2011 | ABUJA, NIGERIA – New data shows that as the death toll in Nigeria is falling, the percentage of deaths that happen in the first month of life is increasing. Newborn deaths now make up 28% of all deaths under five years compared to 24% two years ago. Six out of 10 mothers give birth at home without access to skilled care during childbirth and it is in the first few days of life when both women and newborns are most at risk.
Every year 241,000 babies die in the first month of life in Nigeria making it the African country with the highest newborn death toll, a new Ministry of Health report, Saving Newborn Lives in Nigeria, revealed today.
The report calls for an increased focus on reducing newborn deaths, the vast majority of which are avoidable. It says thousands of newborn lives can be saved via simple methods, such as teaching mothers about danger signs, encouraging them to seek help early and making sure there is enough medicine and enough healthcare workers at community health centres. The policies are mostly in place and the cost is affordable so now priority must be given to implementing these policies and making sure all families receive essential care.
“The loss of a baby at birth or soon after is a very traumatic experience, especially when the majority of these deaths can be prevented with well known interventions. Such loss affects the family, and also carries social and economic ramifications for the nation, creating a vicious cycle that keeps families in poverty,” said Save the Children in Nigeria’s Country Director, Susan Grant. “The health and survival of Nigeria’s newborns has gone unnoticed for too long.”
The report reveals that there is wide variation in mortality across Nigeria. Nearly 3,000 mothers, newborns and children die every day but there is a big difference between states, between urban and rural areas and between the poorest and the richest. This is partly due to the fact that, although the Nigerian health system is rich in human resources compared to many other African countries, there is inequitable distribution of maternal, newborn and child health staff across the country. For example, while over 90% of women in two states – Anambra and Imo – give birth with a skilled attendant present, in 6 states - Katsina, Jigawa, Sokoto, Kebbi, Zamfara, and Yobe, fewer than one in ten women have access to skilled care at birth.
The report, which was unveiled on 13 January at the 42nd annual Paediatric Association of Nigeria Conference, includes up-to-date child and maternal health profiles for each of the 36 states in Nigeria, as well as national data in order to make local decision making more effective. Mickey Chopra, UNICEF Chief of Health and the global Countdown to 2015 for Maternal, Newborn and Child Health co-chair says from New York, “We applaud Nigeria for this report focusing on state level data and critical coverage, equity and quality gaps. We call on the technical and political leaders in Nigeria to use this data to set evidence-based priorities, invest in implementation and be accountable for change, especially for the poorest families.”
Every state is different and so the key to success is the use the local data contained in the report so State and Federal Ministries of Health can develop and implement an effective, comprehensive health system that reaches all mothers and their newborns.
Nigeria is one of the first African countries with an integrated plan to look after mothers, newborns and children right through from conception to the child’s fifth birthday. The Federal Ministry of Health’s Integrated Maternal, Newborn and Child Health Strategy, is to be commended but implementation has been slow and coverage remains low and inequitable. “We need more funding for maternal, newborn and child health, and specifically a budget line for newborn health in national and state budgets,” says Dr Nkeiru Oneukwusi, Head of the Child Health Division at the Federal Ministry of Health. “We must re-double our efforts to make progress and save children’s lives in line with the United Nations Secretary General’s Global Strategy for Women’s and Children’s Health.”
Recommendations for the report
The Saving Newborn Lives in Nigeria report calls on healthcare decision makers to:
• Ensure leadership, appropriate funding and accountability by meeting the target set in the Abuja Declaration of 2001 to allocate 15% of the national government’s annual budget to health. The 2007 allocation for health of 6.5% of national government spending is still far below this target.
• Prioritize tackling malnutrition. More than a third of children’s deaths are attributed to maternal and child under nutrition, so it must be addressed to attain the Millennium Development Goals on eradicating poverty, reducing child mortality and improving maternal health.
• Orient policies, guidelines and services to include newborn care including advocacy for the passage of the National Health Bill into federal law and ensure its prompt implementation, while continuing roll-out of the IMNCH strategy in all state and support the development, review, dissemination and implementation of newborn care standards, to be adapted and used at state level. In addition, to review, adapt and disseminate newborn care standards and ensure accelerated implementation at state and LGA levels. Saving more newborn lives requires free and equitable access to a comprehensive package of health services for all mothers, newborns, and children under five years of age.
• Effectively plan for and implement policies related to human resources, equipment and supplies and accelerate implementation of the highest-impact and most feasible interventions using a clear, data-based process. Priorities and phasing of implementation will differ by state and can be linked to the IMNCH strategy planning process in each state in the context of the State Strategic Health Development Plan.
________________________________________
For more information on the Saving Newborn Lives in Nigeria report or to speak with newborn health experts, contact Hadiza Aminu at +234 803 388 1288 or h.aminu@scuknigeria.org.
Notes to Editors
The report is led by the Federal Ministry of Health in partnership with multiple agencies and professional associations. It features letters of commitment from key stakeholders in maternal, newborn and child health in Nigeria including the global Countdown to 2015 for MNCH; UNICEF, WHO, UNFPA; USAID’s Maternal and Child Health Integrated Program (MCHIP) led by Jhpiego, the Partnership for Revising Routine Immunisation in Northern Nigeria / MNCH project; Save the Children, Nigeria’s health professional associations (Pediatric Association of Nigeria, Society of Gynecologists and Obstetricians of Nigeria, Nigerian Society of Neonatal Medicine and the National Association of Nigerian Nurses and Midwives), celebrity ambassadors for children, and the Minister of Health.
http://www.who.int/pmnch/media/membernews/2011/20110112_savingnewbornlives_nigeria/en/index.html
In a similar vein we have the speech of her Excellency: First Lady of Kwara State, posted on the partnership for Maternal, and Newborn Child Health (PMNCH) website (She is known to run an advocacy called wellbeing foundation) where she expressed her views about infant mortality in Nigeria.
First Lady of Kwara State speaks out on infant mortality
All Africa.com
8 January 2008
Posted to the web 9 January 2008
Toyin Saraki
Ilorin
Over the past few years, I have continually ruminated over the incidence of infant mortality in Nigeria and how to put a stop to it.
As a private citizen without any executive power to effect any change, the only way one could make any impact remains in the areas of advocacy and public enlightenment.
The former is geared towards getting the powers that be to improve the health system, and the latter to alert communities towards the situation and various ways in which the ordinary citizens can also facilitate a drastic change in the situation.
I also embarked on research on what other countries of the world have done to change the trend and what Nigeria needs to do right to attain the Millennium Development Goals (MDGs). One of my discoveries is the lack of integration of the well-being of the mother, her newborn and her child up till the age of five.
We often talk about the issues of infant and maternal mortality as if they are totally exclusive of each other. The fate of these group of people are so intertwined that the lack of care for one invariably translates into trouble for the others.
Few families are aware that the quality of a child's nutrition from the age of three could be instrumental to the reproductive capacity of this child when he or she grows up as man or woman. Also, education of women and girls is central to the reduction of deaths from childbirth as it is to so many other things including national development. Nigeria terribly lags behind in this.
According to UNICEF, of the 3.2 million children who are out of school, 2.6 million of them are girls. The point is that to achieve Millennium Development Goal (MDG) 4 which is about saving the millions of children who die before the age of five annually, we must integrate Goal number 5 which aims at reducing maternal mortality by 75% before the target date of 2015! None of these two goals can be achieved with the exclusion of the other.
Only a very healthy woman, who is well informed on the options available to her and with adequate medical attention, would deliver a child with any chance of survival. So till date we suffer from lack of adequate data to even plan for proper and well articulated health delivery.
Hospitals at the primary, secondary and tertiary levels are usually not adequately equipped and managed while we are almost without a well co-coordinated referral system.
Nigeria, which produces one in every five Africans anywhere in the world ranks second
in global under-five mortality. This means that we lose not less that 1,000,000 under-five
children every year. It is estimated that between 100 and 201 infants and under-fives die
out of every 10,000, a frightening ten percent of global deaths. Neonatal mortality rate in
Nigeria is estimated at 48 per 1000 lives.
Maternal mortality rates are as frightening. A woman's chance of dying from pregnancy related complications in Nigeria is 1 in 13. So between 52,900 and 59,000 women are believed to die from pregnancy and child birth related causes in Nigeria annually. And for every woman who dies, between 20 and 30 more are believed to develop short and long term disabilities.
We have a weak health system and low coverage of previous interventions on Maternal,
Newborn and Child Health (MNCH) interventions; while there is a huge problem of lack of education for our women on the need for them to seek medical attention on
reproductive issues and even antenatal care.
There is the problem of the economic capacity of women to even attend these hospitals.
There are several instances of women who would not go to hospitals simply because
they do not have money for transportation, not to talk of money to consult doctors or pay
for drugs.
Nigeria is currently off track as far as MDGs 4 and 5 are concerned. True we have seen
a marginal decrease in the death of under-fives in the last few years; we are no where near achieving the MDGs. It is however not late to move in the right direction so that the giant of Africa is not left behind.
The current administration has put an Integrated Maternal Newborn and Child Health
Strategy (IMNCH) in place as policy guide toward achieving MDGs 4 and 5, which is expected to target focused antenatal care for pregnant women.
This ensures that every pregnant woman sees a doctor at least four times during her pregnancy. IMNCH also plans to strengthen interpartum care, emergency obstetric and
Newborn Care, routine postnatal care, newborn care, Infant Young Child Feeding and prevention of malaria through the use of Insecticide treated nets and IPT.
It will focus on immunisation; prevention of mother to child transmission of H1V/AIDS,
management of common childhood illnesses and care of HIV exposed or infected children as well as water, sanitation and hygiene; all in all, a huge plan to help Nigeria avoid unnecessary maternal and infant death.
With the drive being lead by the Minister of Health, Professor Adenike Grange, I am
confident there will be no problem with the implementation of this plan. The several
partnership initiatives currently and more of such collaborative efforts are needed to
ensure the IMNCH works.
We need to eradicate the inequality of access for women and children to hospitals. So
apart from providing more hospitals, states and local government administrations need
to consider the user fee abolition for pregnant women and children under five announced
by the federal government last year.
If we make the education of our girls' a priority we make the girls knowledgeable family
planners, more competent mothers, more productive and better paid workers, informed
citizens, confident individuals and skillful decision makers.
We must go some steps further towards dealing with all the encumbrances to the
emancipation of women. We must make effort to reduce poverty and income inequalities
among women.
We must also empower families and communities to take necessary MNCH actions at
home and to seek health care at the right time.
Every family must understand how to take the Temperature, Pulse, and Respiratory
Rate (TPR) of children when they present for illness. The issue of the nutrition of our
children is very important as their growth as children and their capability in future
depends on that. Everyone should know where the nearest hospital is and what services
are available there.
We really need to upgrade hospitals at the primary level with medical personnel who are
adequately remunerated and happy to do the job. Laboratory support with a framework
for prompt and accurate diagnostics must be a priority for us at this stage even as we
must ensure that we have a strong policy on the availability and standard of drugs.
I see no way we can have a healthy newborn or child without having a very healthy
mother. It is what we invest in our women that they give society back in the children they
deliver to us. And we can not blame them if they deliver still births or when their children
die even before they start life. A society serious about its future must take the physical,
mental and social well-being of its women seriously.
We all have a role to play in our various homes and places of work to change this sad
tide. We need to think well about how to work together to achieve this and give our
country a future we all can be proud of even when we are no longer here.
Saraki, First Lady of Kwara State, wrote in from Ilorin
http://www.who.int/pmnch/topics/newborn/sarakiletter/en/index.html
http://www.who.int/pmnch/topics/Sarakiletter.pdf
No comments:
Post a Comment