Checking Rising Child Mortality Profile in Nigeria

By Alex Abutu,

Last year's National Population and Housing Census put the country's population figure at 140 million.

The figure further confirms Nigeria as the most populous black nation in the world.

Development partners such as WHO and UNICEF say the country has one of the worst child mortality rates in Africa. According to the UN agencies, for every 1,000 live births in Nigeria, 194 die before they attain the age of five.

By this figure, the country ranks 14th globally with the highest child mortality rate. However, a 2005/2006 publication by the Federal Ministry of Health puts thechild mortality rate at 98 per 1,000 live births.

Comparatively, it says that Ghana and South Africa have 59 per cent and 53 per 1,000 live births respectively.

Nigeria is thus in the league of disaster-ridden countries, including Afghanistan, Sierra Leone, Liberia and Cote d'Ivoire.

The government publication also says that Nigeria's life expectancy at birth is 43.3 years, while it is 56.7 years in Ghana and 49 years in South Africa. India and China, with populations greater than Nigeria's, have their mortality rates put at 85 per 1,000 and 31 per 1,000 respectively.

Considering Nigeria's West African neighbours, Benin Republic has 150 per 1,000; Togo, 139 per 1,000; Ghana, 122 per 1,000; and Niger 259 per 1,000.

But more worrisome is the fact that Nigeria's per capita expenditure on health is almost double that of Niger Republic. The fourth Millennium Development Goal prescribes a two-third reduction in under-five mortality rate in 15 years between 2000 and 2015.

It, therefore, implies that Nigeria must reduce its child mortality rate to less than 70 per 1,000 live births by 2015.

With seven years into the target year, the country is faced with the urgent need to fast-track activities to meet the goal.

But what are the factors responsible for the country's rising infant mortality profile? Experts met recently at a forum organised by the Nigerian Academy of Science to x-ray the situation.

Prof. William Ogala, of the Department of Paediatrics, Ahmadu Bello University, Zaria, says that though child mortality is a global problem, Africa bears the greatest brunt.

Ogala says there are 10.8 million global child deaths annually, with most of them being preventable.

According to him, global statistics on child mortality show that sub-SaharanAfrica accounts for 41 per cent, while South Asia has 34 per cent. The rest of the world, he says, accounts for 25 per cent.

Ogala says it will take Africa the next 70 years to reduce its under-five mortality by two-thirds, going by current efforts to address the problem.

For Dr Ndi Onuekwusi, a Consultant Obstetrician and Gynaecologist, mismanagement of the nation's healthcare system is a major reason for the rising child mortality rate. ''The country's health care system is a monumental failure.

''The system has succeeded in creating unnecessary agencies which are drain-pipes, even as Nigerian children die from preventable and treatable diseases.''

Onuekwusi says the country's healthcare system lacks both input and output indicators. Besides, it lacks the database as well as a monitoring and evaluation mechanism to efficiently measure the impact of policies and programmes.

''An efficient health system is characterised by integrity which cannot be breached easily. ''It must have inter-connectivity, allowing for robust relationship with stakeholders, and give room for self-appraisal. ''But all this is lacking in Nigeria,'' he says.

Onuekwusi notes that the nation's health care system discountenances the contribution of experts and is devoid of community involvement.

He identifies other areas of inadequacy to include absence of aconducive environment and the lack of collaboration among agencies involved in various policies and programmes.

Prof. Theodore Okeahialam, of the Imo State University, Owerri, says that the rising child mortality profile is caused by the absence of social infrastructure and high level poverty.

He adds that it also lacks sustained environmental sanitation. ''We cannot reduce the number of children who die from malaria, diarrhoea and measles when they do not have access to potable water, clean environment and electricity,'' he argues.

A former Commissioner for Health in Lagos State, Dr Leke Pitan, agrees that the poor child mortality record is a cause for concern.

Pitan says that low birth weight and infections such as asphyxia, malaria, pneumonia, diarrhoea, HIV and HIV,measles and malnutrition are some factors responsible for the problem.

Mrs Yetunde Olumide, Professor of Medicine, University of Lagos, says that the infant mortality rate is unacceptable.

The time has come, she says, for the country to take a critical look at the funding pattern in order to reduce child mortality.

She calls for judicious use of funds. ''We cannot fold our hands and watch our children die from preventable infections.''

What, therefore, should be done to reduce child mortality rate in the country drastically?

Experts say that if every baby were exclusively breast-fed from birth, an estimated 1.5 million lives would be saved every year.

Pneumonia which kills some 500,000children can be prevented with vaccine, they note. Measles also can be prevented with vaccines at a cost of less than N50 per child.

The use of insecticide-treated bed nets, the experts say, is a vital strategy for controlling malaria.

Studies have shown that under-five mortality rate can be reduced by about 25 per cent to 30 per cent if all young children in malaria-prone areas are protected by treated bed nets.

Concerned citizens say that government's intervention programmes are not reaching enough children.

Experts, therefore, say that there is a compelling need to scale up such intervention programmes.

''All we hope to do at this conference is to find ways of scaling up the already known interventions for these conditions,'' says Okeahialam.

The experts suggest that governmentshould intensify its immunisation campaigns to cover at least 90 per cent of the country.

They also recommend that efforts be made to eradicate religious and traditional beliefs that discourage the use of vaccines.

The campaign on exclusive breast feeding and the use of insecticide-treated bed nets should equally bestepped up.

Government's intervention should have a specific budget for the control of all preventable diseases rather than wait on donor funding, the experts suggest.

They agree that the country's child mortality rate can be reduced if the right policies and programmes are put in place and religiously executed.

The diseases killing the children cannot only be treated but are also preventable, the experts reason.

Government should, therefore, articulate policies and programmes, and take informed decisions that can ensure that more children celebrate their fifth birthday. Such measures must be geared toward ensuring that Nigerian children grow up to adulthood.