Need to improve child, maternal health care

As we commemorate the Maternal Newborn and Child Health Week (MNCHW), we are in a spirit of celebration. Therefore, we call on government at all levels to take as a priority, appropriate awareness creation to improve health-seeking behaviour of Nigerian mothers and children to complement its and development partners’ ongoing efforts to deliver  basic health  […]

As we commemorate the Maternal Newborn and Child Health Week (MNCHW), we are in a spirit of celebration. Therefore, we call on government at all levels to take as a priority, appropriate awareness creation to improve health-seeking behaviour of Nigerian mothers and children to complement its and development partners’ ongoing efforts to deliver  basic health  services to  mothers, new born  babies and  children  under  five years to ensure universal coverage of high impact and low cost interventions.

It would be recalled that MNCHW was introduced in 2010 as a bi-annual programme following the recommendation of the National Council on Health. Consequently, one week every six months-May to November, the health system in Nigeria works for MNCHW.

While the main objective of MNCHW is to reduce morbidity and mortality in mothers and children less than five years of age in Nigeria, the specific objectives include to ensure access by mothers and children 0 to 59 months to routine immunisation as scheduled. And for missed opportunities, mobilise the community and create demand for routine services. Ensure that at least 80 per cent of children six to 59 months are given Vitamin A every six months. De-worm children 12 to 59 months every six months in the target local government areas (LGAs). Screen for acute malnutrition in children: six to 59months old and appropriate referral when malnourished. Provide focused ANC-Iron-Folate and SP for pregnant women and HIV Counselling and Testing (HCT). Distribute LLINs to pregnant, lactating women and under-five children. Provide health education on key household practices.

In Nigeria, pneumonia and diarrhoea remain major killers of children under five years, accounting for about 400, 000 preventable deaths annually. While an estimated 6.7 million cases of childhood pneumonia are reported annually, Nigeria reportedly has the second largest burden of the disease after India which has about 10 times Nigeria’s population. Pneumonia and diarrhoea are estimated to constitute 16 per cent and 19 per cent respectively of all causes of deaths in children below the age of five.

In 2010, in a report titled Integrated Management of Childhood Illness by World Health Organisation (WHO), diarrhoeal diseases were observed among the most frequent childhood illnesses and leading cause of preventable deaths, especially among children under five in developing countries, with Nigeria included. 

According to WHO, “Acute diarrhoeal diseases are one of the main problems affecting children in the world, reducing their well-being and creating considerable demand for health services.” 

With over 11 million stunted children, Nigeria is without doubt confronted with the daunting challenge of malnutrition and ranks second with highest number of stunted children globally. Malnutrition impacts negatively on the socio-economic development of a nation, and sustainable growth in Northern Nigeria cannot be achieved without prioritised attention to nutrition investment at all levels.

According to the United Nations Children’s Fund (UNICEF), under-nutrition remains high in Northern Nigeria with about 2.2 million out of the 2.5 million severely acute malnourished children being from Northern Nigeria. Majority of children do not receive minimum acceptable diet. While 50 per cent child mortality in the country has malnutrition as underlining cause, no fewer than 1200 out of 2600 estimated daily deaths are caused by malnutrition.

With the cases of severe acute malnutrition in Community Management of Acute Malnutrition (CMAM) across the country, we are deeply touched and worried that inadequate Ready-to-Use Therapeutic Foods (RUTF) across the states is a threat to saving lives of children with conditions of acute malnutrition, thus defeating the efforts in addressing childhood malnutrition and mortality.

Also, food insecurity, inappropriate feeding habits, poor awareness on acceptable adequate diet, insufficient health facilities and services are contributory factors to maternal and child malnutrition.

Polio is a crippling disease caused by a highly contagious virus that spreads from person to person. In an analysis of the Centre for Disease Control and Prevention (CDCP), the virus spreads from person to person and can invade an infected person’s brain and spinal cord, causing paralysis.

As reported by WHO in 2012, Nigeria accounted for more than half of all polio cases worldwide.

Child mortality remains a serious public health concern in Nigeria. The child mortality rate is among the highest in the world, with 109 deaths for every 1,000 live births, as estimated by the World Bank in 2015.

Chronic malnutrition and micronutrient deficiencies are also enduring challenges. Nationally, 36 per cent of children under five years are stunted and 30 per cent of pre-school aged children suffer from Vitamin A deficiency. Consumption of foods rich in Vitamin A is rare and access to fortified foods remains limited. Only one third of all children aged six to 23 months receive a minimum acceptable diet.

The large scale use of high dose Vitamin A Supplementation can reduce child mortality by up to 23 per cent. An assessment showed that if no effective action was taken, more than 80,000 Nigerian children will die annually due to Vitamin A deficiency. Given the high contribution of Vitamin A deficiency to morbidity and mortality in Nigeria, bi-annual Vitamin A Supplementation has been recognised as a key child survival intervention.

As the National Primary Healthcare Development Agency (NPCDA) advocates, we call on mothers and parents at all levels to ensure all children under five years are given Vitamin A Supplementation to prevent diseases, protects lives and is good for their eyes.  Ensure all acutely malnourished children 12 to 59 months are screened using the Mid Upper Arm Circumference (MUAC) tape. 

We encourage mothers to adopt exclusive breastfeed for their children; ensure adequate routine immunisation for their children to protect them from preventable childhood diseases and ensure birth registration of the children.

In order to prevent malaria, mothers must ensure that all children under five years and pregnant women sleep under Long Lasting Insecticide Treated Nets (LLINs) at all times. Pregnant women should visit the nearest health facility for Ante-Natal Care (ANC), Tetanus Toxoid (TT) vaccination, HIV Counselling and Testing (HCT) and malaria prevention and treatment.

At least four ANC visits during pregnancy save the lives of mother and child. Wash hands with clean water and soap or ash after using the latrine, before preparing food and before and after eating. Washing hands with water and soap kills germs. This will protect you and your family against diseases.

Furthermore, child spacing has proven to improve the lives of women and children.

Dr. Ukachi is the Director, Community Health Service (NPHCDA)