·Link 50% of deaths to malnutrition, as IMCI seeks to check child deaths
Health experts at the Integrated Management of Childhood Illness, IMCI, Summit have raised the alarm over the high burden of child mortality, lamenting that the 2023/2024 Nigeria Demographic Health Survey showed that the country still faces a significant burden of child mortality with 110 per 1000 live births.
They emphasised the need for urgent action to address the root causes of child mortality, calling for the strengthening of primary healthcare systems, especially in marginalised and crisis-affected areas, and expanding access to essential health services.
The summit convened in Lagos brought together, government officials, healthcare professionals, and international organisations to address child mortality in Nigeria as well as strengthen and expand the reach of IMCI strategies to reduce preventable child deaths.
From the 2023/2024 NDHS, Nigeria's infant mortality rate stands at 63 deaths per 1,000 live births, a figure that underscores the urgent need for effective interventions. While neonatal mortality is put at 41 per 1000 live births.
In his presentation entitled: "Justification and Guiding Principles for the Development of National Child Survival Action Plan", the Head, of the Child Survival Branch, Federal Ministry of Health, Dr. Omokore Oluseyi disclosed that Nigeria was listed among the 54 target countries in the world that need to take urgent evidence-based actions to tackle the unfinished agenda of child survival if the SDG 3 target of reducing child mortality to at least as low as 25 deaths per 1000 live births are to be realised.
Lamenting that currently, Nigeria is reducing its under-five mortality rate by only 2.6 percent annually, he said malnutrition contributes to 50 percent of the deaths of under-five children.
To achieve the 2030 target, Nigeria should accelerate progress in reducing its under-5 mortality rate (U5MR) by at least 80 percent of the 2018 NDHS figure.
"The Integrated Management of Childhood Illness (IMCI) strategy focuses on three major child killer diseases: malaria, pneumonia, and diarrhoea, while also addressing the underlying issue of malnutrition. Under IMCI, healthcare workers are trained to manage multiple conditions simultaneously, recognising that many children present with overlapping symptoms.
He said a significant percentage of children who die from these diseases are malnourished, underscoring the need for a comprehensive approach.
"Despite ongoing efforts, progress in reducing child mortality remains slow, particularly in rural areas. The Nigerian Ministry of Health has implemented various strategies to tackle these challenges, including community-based programs to identify and treat malnourished and unimmunised children. The National Child Survival Action Plan aims to strengthen healthcare at the grassroots level, ensuring access to vaccinations and treatment."
He called for recognition of pneumonia as a leading cause of child mortality, urging proactive measures to educate parents about symptoms such as persistent cough, difficulty breathing, and chest pain.
Also speaking, Country Director, Nutrition International, Dr. Osita Okonkwo who called for urgent action to combat childhood mortality in Nigeria, emphasised the need to reduce this to 25 or fewer by 2030, in line with the Sustainable Development Goals.
Highlighting the effectiveness of the IMCI strategy, Okonkwo said implementation challenges persist due to political and social factors. He called for enhanced collaboration among stakeholders, evaluation of current initiatives, and the sharing of best practices.
Okonkwo noted that simple interventions could significantly reduce mortality rates but stressed that many vulnerable children lack access.
"For instance, simple interventions such as oral rehydration therapy (ORS) and zinc supplements could prevent nearly 50 percent of childhood deaths from diarrhoea. Similarly, timely antibiotics can save children with pneumonia, which is responsible for one-fifth of under-five deaths. Yet, many children in vulnerable communities do not receive these life-saving treatments.
"Through programmes that reach over 1.6 million pregnant women and eight million children under five, Nutrition International helps improve nutrition and health outcomes for the most vulnerable population. Our contributions to Vitamin A supplementation and diarrhoea management through zinc and ORS programmes are saving lives."
He underscored the importance of partnerships, particularly with organisations like Nutrition International, which supports millions of mothers and children. Urging for expanded community-based health programmes and equitable access to healthcare.
Also, a public health expert, Dept of Community Health, OAUTHC, Ile Ife, Prof Adedeji Onayade described child deaths in Nigeria as pathetic. "We have remained static, I would say, between 2015 to date, almost 10 years because at the end of the MDGs, our child mortality was such that one in nine babies born in Nigeria died before the age of five years. I'm looking at the 2024 NDHS, the figures are still the same. It was a little better because it is now one in eight."
The Assistant Director/ Head, Children with Special Needs, at the Federal Ministry of Health, Mrs. Helene Akhigbe-Ikechukwu, emphasised the importance of training health workers through initiatives like IMCI in order to cascade their knowledge to others, ultimately improving health outcomes across the 36 states.
She stressed the need to close the gaps in child survival to ensure no child is left behind.
Corroborating their views, Prof. Wammanda Robinson of the Ahmadu Bello University Teaching Hospital, Dept of Paediatrics, said despite concerted efforts and improvements in healthcare, child mortality in Nigeria remains a significant public health issue. He said while there has been some progress in reducing child mortality rates, the newborn period continues to be a critical period with high mortality rates.
He identified a lack of political will and commitment as a key factor contributing to the persistent challenge. Nigeria has implemented various policies and strategies to address child health issues, but implementation often falls short due to inadequate funding, poor infrastructure, and a shortage of skilled healthcare workers.
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"Moreover, the economic climate in Nigeria exacerbates the problem. Many families struggle to afford necessities, let alone healthcare expenses. Out-of-pocket payments for healthcare services remain a significant burden, particularly for vulnerable populations. The underperformance of health insurance schemes further compounds the issue, leaving many individuals without adequate financial protection."
On his part, Mr Ogeh Azure from the Department of Health Planning, Research, and Statistics, Federal Ministry of Health, noted that the 2023/2024 Nigeria Demographic and Health Survey (NDHS) report indicates some progress, he highlighted ongoing interventions aimed at improving nutritional outcomes across various sectors.
"While the final report is still pending, he said initial findings suggest that despite the challenges posed by poverty and a rapidly growing population, there are efforts in place to enhance nutrition nationwide."
He identified security issues, the impact of the COVID-19 pandemic, and other systemic problems as major factors that hindered the progress in nutrition metrics.
"As security improves and more resources are allocated, we will begin to see tangible advancements. Significant gaps remain, particularly in data quality. Many healthcare facilities lack the necessary tools for accurate reporting, leading to inconsistencies that undermine the effectiveness of nutritional strategies."
To combat this, periodic data quality assessments are being conducted at the national level, alongside efforts to train healthcare workers on proper data collection and reporting practices.
