Nigeria slows progress in child deaths

Two years to 2015, it is still not among some 25 countries with high child mortality that have “met or are making significant progress” toward a Millennium Development Goal to reduce child mortality by two-thirds, according to a ranking by the charity Save the Children.The report Lives on the Line-An Agenda for Ending Preventable Child […]

Two years to 2015, it is still not among some 25 countries with high child mortality that have “met or are making significant progress” toward a Millennium Development Goal to reduce child mortality by two-thirds, according to a ranking by the charity Save the Children.
The report Lives on the Line-An Agenda for Ending Preventable Child Deaths considered trends in child and infant mortality, as well as measures to sustain health programmes and ensure equity over periods exceeding 10 years, and concluded Nigeria made “very little progress.”
It ranks Nigeria 24 among 75 countries for reduction in under-five mortality, equity and sustainability, with a total score of 1.5 out of a possible three.
The score places Nigeria far behind countries that have met targets to reduce child deaths-Ethiopia, Liberia, Tanzania, Malawi, Bangladesh, Nepal.
Between 2000 and 2012, deaths among children under age five dropped from 188 per 1,000 to 124-a change of nearly 34%, but up to 32% of occurring deaths are still among newborns, the charity said in the report.
“Importantly, we have a big chunk of these deaths in newborns,” said Tinu Taylor, an assistant director for child survival at the federal health ministry.
“What is killing these newborns are also preventable causes-birth related injuries, complications in preterm birth. These gaps are still there because we have not been addressing these issues properly,” Taylor said at the report’s launch in Abuja, on behalf of the ministry’s director for family health.
The report pointed  out that percentage of children receiving treatment for diarrhoea and rate of exclusive breastfeeding have both fallen.
Taylor was among panelists at a forum to mark Global Day of Action, including renowned social media expert Blossom Nordin and Ademola Olajide, a health director at the African Union Commission, who spoke from Ethiopia via video conference.
Slow progress
The proportion of population with access to improved sanitation dropped from 35% to 30% over an 11-year period and measures of equity still show wide gaps in wealth, gender and geography, the report said.
The report notes that children born poor are two-and-a-half times more likely to die before the age of five than a child born in the wealthiest 20% of the population.
In addition, a child born in a rural area is 60% more likely to die before age five than a child born in an urban area, and girls have a higher likelihood than boys of dying before age five.
The report has “clearly shown us that the issue of equity has not been addressed at all in this part of the world,” said Dr David Olayemi, a programme advisor for Save the Children at the launch.
“The rural poor, even in urban areas, people who are not educated are still where they were. People who are vulnerable are being left behind and therefore our percentage has continued to relatively increase when we compare it to other parts of the world,” he said.
Specifically, Nigeria’s progress slowed because the “number of newborns dying has not changed significantly in this part of the world,” he explained.
In addition, Olayemi said, poor attention has been given to equitable distribution of health workforce and malnutrition, which is still is basic problem in some five in every 10 child deaths.
The report recommends four steps for governments to end preventable child deaths by 2015:
• Publish and implement comprehensive and costed national plans to address key causes of child mortality and ensure essential care for mothers and children
• Ensure access to safe water and sanitation, and launch national campaign to reduce stunting and ensure nutrition diet for children are targets in social and agriculture policies
• Commit the level of funding needed to guarantee equal access to health care for all children regardless of where they are born and ensure a transparent process that allows civil society track budgets and spending
• Commit to end preventable child deaths and health care for all a single framework beyond 2015.
“Don’t have enough”
Training, recruiting and retaining healthworkers still leave huge gaps in government employing the right hands.
The ratio of healthworker to population is still far less than recommendations set by the World Health Organisation.
“We don’t have enough available,” says Taylor.
“We used to say we have too many unemployed midwives. When the Midwives Service Scheme came up, we advertised for unemployed and retired midwives. We were looking for 5,000 for a start; it was a herculean task to get 2,000. Many of these were already working in some private facility. What it simply means is that we still do not have enough.”
Among campaigns are plans to create awareness and interest in issues of child mortality and health care using new media, says new media expert Nordin.
It also includes online petitions gathering thousands of signatures to push leaders into action.
“What we try to do is call attention to how it affects individuals from our own little space,” Nordin said.