Nigeria ranked among top countries with child mortality burden

Despite efforts, Nigeria still ranks top among the countries with a high burden of child mortality by contributing about 16 per cent to the total global under-five deaths.

Minister of State for Health and Social Welfare, Dr Adekunle Salako, who stated this at the event to mark the World Pneumonia and Prematurity Day in Abuja, said the country may not meet the Sustainable Development Goals (SDGs) for the reduction in child mortality by 2030 unless every proven intervention is adopted and implemented.

Salako said that while the global health community is swiftly mobilising and focusing attention against malaria, polio, tuberculosis, and HIV, childhood pneumonia, an important contributor to global childhood morbidity and mortality has not received priority attention.

He observed that one of every eight Nigerian children dies before their fifth birthday, adding that Nigeria and 14 other countries account for about three-quarters of the global childhood pneumonia mortalities.

He noted that over the years, Nigeria has been developing policies, evolving strategies and implementing interventions to reduce the under-five mortality rate in the country.
Salako said about 100 million childhood pneumonia episodes with associated 808,920 related deaths occur in low and middle-income countries (LMICs), particularly those in Sub-Saharan Africa being disproportionately affected.

The minister stated that these unfavourable indices and those of the other childhood killer diseases are the drivers of the unenviable high under-five mortality of 110/1,000 live births as reported by the 2023 Nigeria Demographic and Health Survey (NDHS).

He observed that the collaboration over the last five years has been impactful with the development of tools like the In-Patient Pneumonia Treatment Algorithm, which has not only strengthened the clinical skills of secondary and tertiary healthcare workers in managing severe and complicated pneumonia but contributed to the drop in under-five mortality rate from 132/1000 in 2018 to 110/1000 Live Births in 2023 as reported by the NDHS.

He said: “While we celebrate this reduction in the overall under-five mortality rate, Nigeria is still way behind in reaching the global target for 2030 of 25/1000 live births. To maintain and increase this trajectory of downward movement, a lot of work is still required of all of us.”
Salako assured that the Federal Government will continue to promote routine immunization, exclusive breastfeeding, hygiene practices, improved basic oxygen access in hospitals, and continuous training for health workers to address the challenge of undernutrition.

“We will also continue to collaborate outside the health sector to address other drivers of prematurity and child pneumonia not within the full glare of the health sector. The death of a child is a traumatic experience, which places a huge psychological and financial burden on the family. For us in the health care sector having about 700,000 children die yearly before their 5th birthday due largely to preventable causes is a moral burden on all of us.”

The minister stated that the 2024 theme for World Prematurity Day, “Access to Quality Care Everywhere,” and that of the Pneumonia Day celebration “Championing the Fight to Stop Pneumonia”, highlighted and underscored key inputs to reverse the trend.

According to him, offering quality care for newborns and under-fives as a fundamental aspect of the healthcare delivery system is imperative.

Salako observed that the Nigeria Every Newborn Action Plan (NiENAP) recognised that many neonatal deaths are preventable and called for high-quality neonatal care to meet the target of reducing neonatal deaths to 12 per 1,000 live births by 2030 with emphasis that every level II health facility should be equipped with Continuous Positive Airway Pressure (CPAP) for the care of neonates with respiratory distress syndrome.

He noted that as a step to reduce the Neonatal Mortality Rate in Nigeria, HATCH Technologies and the Christian Health Association of Nigeria (CHAN) have donated 400 CPAP machines for distribution to 139 health facilities across the country, which added value and strengthened the effort in reducing neonatal and under-five mortality.

The minister noted that bringing down the contribution of pneumonia to under-five mortality requires policies, activities and interventions outside the health sector, stressing that air pollution is a leading risk factor for pneumonia death in children across all ages.

In her remarks, the Permanent Secretary of the ministry, Dajun Kachollom, said that both pneumonia and preterm birth are major contributors to neonatal morbidity and mortality.

Kachollom said evidence has shown that under-five deaths from pneumonia and preterm birth-related complications are responsible for the observable high under-five mortality Rate of 110/1000 live births in the country.

She said, “Pneumonia takes the life of a child every 20 seconds; this is even more than the mortality from HIV/AIDS, malaria, and measles combined. While most deaths resulting from Pneumonia occur in developing countries, about three-quarters of the global mortalities take place in Nigeria and 14 other countries.”

Kachollom stated that the ministry has articulated various interventions necessary for the reduction of neonatal mortality rates, which were outlined in the national guidelines for basic and comprehensive newborn care launched in 2021.

Other policy documents are the 2022 revised National Child Health Policy and the Action Plan on ‘Nigeria Every Newborn’, which was launched in 2016, and further revised in 2023.

“We reaffirm our commitment to combating pneumonia and the challenges posed by prematurity. We must advocate for increased access to vaccines, improved sanitation, and better nutrition, as these are essential barriers to pneumonia.

“Through initiatives such as the pneumococcal vaccine and the measles vaccination, we can protect infants and young children from the diseases that threaten their lives.

“Our fight against pneumonia and prematurity will require concerted efforts from governments, healthcare providers, NGOs, and advocates. It will demand that we work together, share knowledge, and allocate resources effectively. Together, we can build a future where children can breathe freely, flourish, and grow to realise their potential,” she added.