Nigeria: Averting Under 5 Deaths Through Improved Sanitation, Hygiene

3 September 2019

In this report, ODIRI UCHENUNU-IBEH examines how poor access to Water, Sanitation and Hygiene (WASH) is fueling under five deaths in Nigeria and what needs to be done to avert the trend.

Clean water, basic toilets and good hygiene practices are essential for the survival and development of children. On the other hand, poor access to improved water and sanitation have been identified as major causes of high morbidity and mortality rates among children under five.

In Nigeria for instance, the use of contaminated drinking water and poor sanitary conditions result in increased vulnerability to water-borne diseases, including diarrhoea which leads to deaths of more than 70,000 children under five annually, according to a report by the United Nations Children's Fund (UNICEF).

The report stated that: "73 per cent of the diarrhoeal and enteric disease burden is associated with poor access to adequate WASH and is disproportionately borne by poorer children. Frequent episodes of WASH related ill-health in children, contribute to absenteeism in school and malnutrition. Only 26.5 per cent of the population use improved drinking water sources and sanitation facilities. Also, 23.5 per cent of the population defecate in the open.

A World Bank Report (2012), stated that around 122,000 Nigerians including 87,000 children under five die each year from diarrhoea; nearly 90 per cent is directly attributed to WASH.

One of the major reasons for iron deficiency anaemia (IDA) among adolescent girls and young mothers is found to be worm infestation that is attributed to open defecation. An anaemic mother, in all probability, will deliver a low-birth-weight baby not only endangering the life of the new born but also the mother, says UNICEF, adding that it is, not surprising that one in every 15 Nigerian children dies before reaching his/her first birth day and one in every eight does not survive to see his/her fifth birth day.

WASH specialists who spoke with LEADERSHIP at a media dialogue on Sanitation, Clean Nigeria: Use the Toilet Campaign sponsored by European Union and UK aid in collaboration with UNICEF, in Oyo state, said poor access to WASH is the major causes of under five deaths in Nigeria.

They said Nigeria is loses a whopping N455 billion, representing 1.3 per cent of its GDP annually, due to poor sanitation and a third of that cost is as a result of open defecation.

While referring to the 2018 WASH National Outcome Routine Mapping, World Health Organisation/United Nations Children's Fund (UNICEF) Joint Monitoring Programme for Water Supply and Sanitation Survey, the specialists said that Nigeria ranks second among countries practicing open defecation globally, after India.

"The survey further stated that more than 100,000 children under five years of age die each year due to diarrhoea, of which 90 per cent is directly attributed to unsafe water and sanitation.

"If Nigeria can add two million toilets per year between 2019 and 2025, the target of Universal Basic Sanitaion would be achieved, thereby saving the country N455 billion, representing 1.3 per cent of its GDP that is lost to poor sanitation," they added.

WASH specialist, UNICEF, Bioye Ogunjobi, said Nigeria's current delivery of improved toilet is approximately 160,000 per year. He said the implication of this, is that one out of four children under five years of age exhibit severe stunting, while one in 10 are wasted, due to frequent episodes of diarrhoea and other WASH related illnesses.

Ogunjobi said 1020 children die in Nigeria from diseases caused by poor sanitation, adding that 47 million Nigerians, representing 24.4 per cent of the population of Nigeria still do open defecation and 32 million people in Nigeria are still using unimproved toilet. "Almost 80 million people need support of an improved latrine/toilet," he added.

He said 10.3 per cent of people living in North West practice open defecation; 17.9 per cent of people living in South South practice open defecation; 21.8 per cent of people living in North East practice open defecation; 53.9 per cent living in North central practice open defecation; 22.4 per cent of people living in South East practice open defecation and 28.0 per cent of people living in South West practice open defecation.

While one out of four Nigerians practice open defecation, Ogunjobi said in the North Central, it is one out of two persons. He added that only 13 out of the 774 local government areas in Nigeria are certified open defecation free.

He, however, urged the government to increase sanitation budgetary allocation and the private sector to compliment government's efforts in curbing open defecation.

In his response, Head, Child Rights Information Bureau, Abuja, Mr Olumide Osanyipeju, urged the private sector and other stakeholders to come on board so as to improve sanitation and hygiene situation in Nigeria.

It is a fact that UNICEF has been in the forefront of ensuring that Nigeria has access to safe drinking water supply, adequate sanitation and proper hygiene in our environment and communities, says Osanyipeju.

He said recently, Nigerian government declared a state of emergency on WASH and launched an open free defecation campaign strategy to jump start the countries journey towards ending open defecation.

Osanyipeju said the Partnership for Expanded Water, Sanitation and Hygiene (PEWASH) programme was formulated and launched in 2016 in direct response to challenges affecting the rural WASH sector, with the aim of achieving 100 percent WASH coverage in rural areas.

He said, "Nigeria is currently leading open defecation free campaign to end open defecation in the country by 2025 and achieve universal access to safety manage sanitation by 2023. Clean Nigeria, Use the Toilets Campaign is one of the most ambitious behavior change and campaign in Nigeria with a strong citizen /public engagement component."

This campaign, according to Osanyipeju, will create a national movement with elements of policy advocacy, public advocacy and grassroots mobilisation, adding that private sector engagement sanitation is essential to the survival and development of children as it can reduce the severity and impact of malnutrition.

It can also help to reduce spread of worms as well as promoting dignity and boosting safety, particularly women and children, Osanyipeju, adding that open defecation perpetuates a vicious cycle of diseases and poverty.

He however called on stakeholders to join hands with the federal government to achieve its goal to achieve the Universal Basic Sanitation and end open defecation by 2030. He said, "We must double our current efforts in order to end open defecation by 2030."

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