An excerpt from the Save the Children report, Lives on the Line:
Child mortality in Nigeria has halved over the last decade, but newborn mortality has declined by only 20 percent.
The Government of Nigeria has recently taken important steps to reduce child mortality. Under the Every Woman, Every Child strategic framework, Nigeria committed to fully funding its health programme by 2015, pledging to increase spending at the federal, state and local levels from less than 5 percent of the national budget to 15 percent, a per capita investment of US$31.63.
In 2012, as a part of its commitment to end preventable child deaths, Nigeria launched the Saving One Million Lives initiative, which includes a costed plan for improving nutrition nationwide. The government has established a newborn health desk within the Federal Ministry of Health and has introduced a subsidy re-investment empowerment fund to administer maternal, newborn and child health funds. The government has also introduced new pentavalent and pneumococcal vaccines, while two states have introduced separate budget lines for nutrition and four states have established nutrition partners' forums.
NIGERIA AND THE EVERY ONE INDEX
Nigeria has moved backwards on important measures that impact child mortality, reflected in a much lower rate of decline than other countries. A smaller percentage of the population has access to proper sanitation facilities now than 10 years ago, and the percentage of children who receive treatment for diarrhoea and the rate of exclusive breastfeeding have both fallen.
Nigeria has made very little progress in improving equity. A child born in the poorest 20 percent of the population is two-and-a-half times more likely to die before the age of five than a child born in the wealthiest 20 percent. A child born in a rural area is 60 percent more likely to die before the age of 5 than a child born in an urban area and girls have a higher likelihood than boys of dying before the age of 5.
Sustaining Nigeria's Progress
Nigeria's investment in health recently increased from 4 percent to 7.5 percent of the national budget. But this is still only half of the 15 percent target set by the African Union Abuja Declaration in 2001. The Government of Nigeria has made numerous commitments to maternal, newborn and child health. But the government faces daunting challenges in efforts to improve and sustain reductions in child mortality including insecurity, weak governance, inequity, and a weak primary health-care system. The Open Budget Index measure for the Nigeria federal budget process declined from a score of 20 in 2006 to 16 in 2012.
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The constitutional review process currently underway provides an important opportunity to advocate for universal health coverage in Nigeria, as health is not a priority of any arm of the government in the current constitution.
Campaigning for the Presidential election, scheduled for early 2014, is also underway, providing opportunities to make child survival an election issue and help to spur further progress.
The passage of the National Health Bill which is now awaiting the 3rd and final senate reading will provide a breakthrough deal for mothers and children if signed into law.
If the bill is fully funded and implemented, it could potentially lead to scaling up the coverage of basic life-saving health care services to 90 percent coverage. Achieving a 90 percent coverage means a near universal coverage, which could improve healthcare for numerous Nigerians and help Nigeria achieve its MDG 4 and 5 goals.
