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Scaling up child survival through awareness creation


• Nigeria Loses About 2,300 Under-Five Children, 145 Women Of Childbearing Age Daily- UNICEF
• Low Attendance Of Antenatal Clinics Impede Success Of Maternal Newborn Child Health Week
• Many Pregnant Women Still Opt To Deliver Away From Hospitals- NDHS

Recently, the country marked the Maternal Newborn Child Health Week (MNCHW), a five-day national programme dedicated to health interventions surrounding maternal, newborn and child health. This vital programme was instituted by government in order to tackle the soaring maternal and child’s mortality rate.

During the week, intervention such as immunisation, antenatal care, nutrition, HIV counselling and testing, long lasting insecticide-treated nets distribution, among others were provided freely at the primary healthcare (PHC) level nationwide.Health promotions, including hand washing, early initiation and exclusive breastfeeding, hygiene and sanitation are some of the issues that are largely spoken about.

However, the poor health-seeking behaviour of women, especially in rural areas, and low attendance of antenatal clinics by pregnant women at health centres are some of the major factors that continue to impede the success of the MNCHW programme.According to reports by the National Demographic Health Survey, about one third of pregnant women in Nigeria do not attend antenatal care, while many more do not deliver at hospitals.

What this mean is that many women and children continue to miss out on the free maternal services provided during the MNCHW.It is based on this that the National Primary Healthcare Development Agency (NPCDA) advocates, are calling for more awareness creation on the MNCHW, so that the health-seeking behaviour of Nigerian mothers and children can be improved.
According to them, this will complement the ongoing efforts of government and development partners to deliver basic health services to mothers, newborn babies and children under five years, and 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, the MNCHW is held one week every six months in May and November.The objective of the week is to improve the healthcare seeking behavior of the whole family, especially pregnant women and caregivers of under-five children.

It is also to provide integrated high-impact and no-cost package of protective and preventive services to the whole family. The services rendered include routine immunisation; Vitamin A supplementation; growth monitoring and promotion; malnutrition screening for all under- five children; de-worming of all children from 12 months to 59 months, and donations to pregnant women who register during the week.

Other services are antenatal care; immunisation of pregnant women of childbearing age against tetanus infection; distribution of routine antenatal drugs such as blood tablets and malaria preventing drugs. The rest are family planning services such as counseling; distribution of condoms; implants of contraceptive pills etc to women of child-bearing age and men and distribution of Informative Educative and Communicative (IEC) materials on preventable and treatable infectious diseases.

A strategic intervention like the MNCH week is very vital not only in addressing Nigeria’s high maternal and child mortality rates, but also in achieving the SDG goals.Although Nigeria has made great progress in maternal and child health over the years, current statistics are still very unsettling.

According to UNICEF, Nigeria loses about 2,300 children under five and 145 women of childbearing age daily. This makes the country the second largest contributor to the maternal and under-five mortality rate globally. Nigeria also accounts for about 30 per cent of the burden in mother-to-child-transmission (MTCT) of HIV in the world, which is also very high compared to most African countries. It is very important to note that HIV/AIDS is also one of the largest contributors to infant mortality in the country.  

Further reports show that pneumonia and diarrhoea remain major killers of children under-five years in the country, accounting for about 400,000 preventable deaths annually. By practising exclusive breastfeeding, and attending all routine immunisation exercises, mothers can protect their children from preventable childhood diseases.

Another high contributor to Nigeria’s child mortality rate is malnutrition. According to UNICEF’s Chief of Nutrition, Mr. Arjan De Wagt, who spoke during a two-day summit for state policy makers on financing nutrition in northern Nigeria, about 50 per cent child mortality in the country has malnutrition as its underlining cause, and 11 million children are stunted in Nigeria. 

Wagt equally stated that about 2.2 million out of the 2.5 million severely acute malnourished children are from Northern Nigeria, hence the need to scale up the Community Management of Acute Malnutrition (CMAM) across the country, especially in those areas.

In view of all these frightening statistics, NPCDA advocates are also worried about the shortfall in Ready to Use Therapeutic Foods (RUTF) across the states, maintaining that this remains a threat to saving lives of acutely malnourished children, thus defeating efforts to address child malnutrition and mortality.Vitamin A supplementation given during the MNCHW strongly guards against its deficiency and by extension malnutrition. Nationally, 30 per cent of pre-school aged children suffer from Vitamin A deficiency.

Consuming food rich in Vitamin A and access to fortified foods remains limited as reports show that only one third of all children aged six-23 months receive a minimum acceptable diet rich in vitamin A.Based on this, the NPCDA advocates are calling for large-scale use of high-dose Vitamin A supplement, which can reduce child mortality by up to 23 per cent.

This is as health experts have also warned that if no effective action is taken, more than 80, 000 Nigerian children will die annually due to Vitamin A deficiency. Given that the biannual Vitamin A Supplementation has been recognised as a key child survival intervention, the advocates call on mothers and parents at all levels to ensure all children under five years old are given Vitamin A supplementation to prevent diseases, protect lives and ensure all acutely malnourished children 12 to 59 months are screened using the Mid Upper Arm Circumference (MUAC) tape.    They also calling for serious attention to be paid polio, which they say can be prevented through immunisation.

“In order to prevent malaria, mother must ensure that all children under five years old and pregnant women sleep under long-lasting insecticide treated nets (LLINs) at all times. Pregnant women should visit the nearest health facility for antenatal care (ANC), tetanus toxoid vaccination, HIV counseling and testing, and malaria prevention and treatment.

At least four antenatal visits during pregnancy, experts say would save the lives of mother and child, just as washing hands with clean water and soap, or ash after using the latrine, before preparing food and before and after eating is highly recommended. This is because washing hands with water and soap kills germs.

Since child-spacing has proven to improve the lives of women and children, as a lesson from MNCH Week, the advocates are encouraging governments at all levels to take as priority, improved service provision and delivery on maternal, newborn and child health to avert maternal and child morbidity and mortality at all levels.

In this article:
Franka Osakwe
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