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Reducing child and maternal mortality in Nigeria

Funmi Fasipe

Maternal mortality is a key indicator of international development, and its reduction has long been a challenge in low-income countries, despite the existence of effective interventions.

A recent World Health Organization, (WHO) report indicates that more than 600,000 women have died in recent time due to child-birth or pregnancy-related complications while Nigeria accounts for close to 10 percent of that figure. Similarly, a document released in April 2012 titled ‘Trends in Maternal Mortality; 1990 to 2010, WHO, UNICEF, UNFPA and World Bank estimates situated Nigeria with maternal mortality; 1990 ( 1100), 1995 ( 1000), 2000 ( 970) , 2005 (820) and 2010 (630). In 2013, another report indicated that two years to 2015, Nigeria is still not among some 25 countries with high child mortality that have “met or are making significant progress” toward a health-related Millennium Development Goals (MDGs) to reduce child mortality by two-thirds, according to a ranking by the charity, Save the Children.

The report tagged, “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 that 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.

A 2016 UNICEF report indicated that an estimated 2,600 children died within the first 24 hours every day of the year. For almost 2 million newborns, their first week was also their last. In all, 2.6 million children died before the end of their first month. Among those children, more than 80 per cent died from preventable and treatable causes such as premature birth, complications during delivery, and infections like sepsis and pneumonia.

 Beyond the achievement of sustainable development goals, there is no better time than now to save every new born. The United Nations Children’s Fund (UNICEF) is set to launch the “Every Child Alive” global campaign to demand and deliver solutions on behalf of the world’s newborns.

UNICEF said global deaths of newborn babies remain alarmingly high, particularly among the world’s poorest countries.  The organization’s new report on newborn mortality rates globally – Every Child Alive – has found that babies born in Japan, Iceland and Singapore have the best chance of survival while newborns in Pakistan, the Central African Republic and Afghanistan face the worst odds.

The report has placed Nigeria in the 11th position in global ranking where newborn babies die due to lack of assistance during delivery, poverty, conflict and weak institutions. Beyond achieving an increased progress rate to attain the sustainable development goals, every new born deserves the right to live. However, the progress rate should be increased if the country must attain the Sustainable Development Goals.

UNICEF released a report on February 20, 2017 on the urgent need to end new born death through her “Every Child Alive” – a global campaign to demand and deliver solutions on behalf of the world’s newborns.   Global deaths of newborn babies has been said to remain alarmingly high, particularly among the world’s poorest countries.

Through the campaign, UNICEF is issuing an urgent appeal to governments, health care providers, donors, the private sector, families and businesses to keep every child alive by recruiting, training, retaining and managing sufficient numbers of doctors, nurses and midwives with expertise in maternal and newborn care,  guaranteeing clean, functional health facilities equipped with water, soap and electricity, within the reach of every mother and baby, making it a priority to provide every mother and baby with the life-saving drugs and equipment needed for a healthy start in life; and empowering adolescent girls, mothers and families to demand and receive quality care.

Several studies from global bodies such as the  WHO  and UNICEF have shown that critical strategy for reducing maternal and child morbidity and mortality is ensuring that every baby is delivered with the assistance of a skilled birth attendant which generally includes a medical doctor, nurse or midwife. According to the WHO and UNICEF, every single day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world.

In a bid to reduce maternal and infant mortality in Nigeria, The Gamaliel and Susan Onosode Foundation (GAMSU) partnered with General Electric (GE) Healthcare in 2017 to train no fewer than 45 nurses at the Lagos University Teaching Hospital (LUTH) on maternal and infant care. This is small compared to the number of hospitals and health care centres across the country in urgent need of skilled nurses and healthcare professionals, especially in the rural areas where most women are victims.

In Lagos, the overall goal of the State Government is safe delivery of newborns regardless of means of delivery, be it through modern day doctors or through Traditional Birth Attendants, (TBAs) who have been certified and licenced to operate by the State Ministry of Health. While this is quite commendable, adequate monitoring mechanisms should be put in place in ensuring compliance with standard practise and professionalism.

Medical issues that require professional attention should not be attempted by (TBAs) but referrals be made appropriately to government hospitals anytime there is need for such. Also, TBAs should be periodically celebrated for their contribution to human existence. They should not be allowed to practise in fear and in secret or under unfriendly legislations as such may worsen access to care and result in worse outcomes if women deliver at home without support of TBAs.

This is the best time for all tiers of governments and other stakeholders to put up a common front in dealing with maternal health and infant and child survival-related issues in the country.  UNICEF advises that in order to save mother and child from avoidable death, there is a need for a strong cooperation of all stakeholders. Certainly, if we are to reduce cases of child and maternal deaths in the country, everyone that has something to do with the health sector must come together. This, indeed, is the major way forward.   

Fasipe writes from Green Meadows Childcare Centre, Ogba, Lagos.


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