They underscored the necessity for immediate measures to tackle the underlying factors contributing to child mortality, advocating for the enhancement of primary healthcare systems, particularly in underserved and crisis-affected regions, as well as improving access to vital health services.
The summit, held in Lagos, gathered government representatives, healthcare experts, and international organizations to confront the issue of child mortality in Nigeria and to bolster and broaden the implementation of IMCI strategies aimed at decreasing preventable child deaths.
According to the 2023/2024 NDHS, Nigeria's infant mortality rate is recorded at 63 deaths per 1,000 live births, highlighting the critical need for effective interventions, while neonatal mortality is reported at 41 per 1,000 live births.
In a presentation titled “Justification and Guiding Principles for the Development of National Child Survival Action Plan” Dr. Omokore Oluseyi, Head of the Child Survival Branch at the Federal Ministry of Health, revealed that Nigeria is among 54 countries worldwide identified as needing immediate, evidence-based interventions to address the ongoing challenges in child survival. This is crucial for meeting the Sustainable Development Goal 3 target of reducing child mortality to a maximum of 25 deaths per 1,000 live births.
Dr. Oluseyi expressed concern that Nigeria is currently achieving only a 2.6 percent annual reduction in its under-five mortality rate, with malnutrition accounting for 50 percent of deaths among children under five.
To meet the 2030 objectives, Nigeria must significantly enhance its efforts to lower the under-five mortality rate (U5MR) by at least 80 percent compared to the figures from the 2018 Nigeria Demographic and Health Survey (NDHS).
“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 emphasized that a substantial proportion of pediatric fatalities from these illnesses are attributable to malnutrition, highlighting the imperative for a holistic strategy.
“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 emphasized the need to acknowledge pneumonia as a primary contributor to child mortality, advocating for proactive initiatives to inform parents about critical symptoms, including a persistent cough, breathing difficulties, and chest pain.
Dr. Osita Okonkwo, Country Director of Nutrition International, also urged immediate action to address childhood mortality in Nigeria, aiming to lower the rate to 25 or fewer by 2030, in alignment with the Sustainable Development Goals.
He pointed out the effectiveness of the Integrated Management of Childhood Illness (IMCI) strategy but noted that implementation faces challenges due to political and social issues. Okonkwo called for improved collaboration among stakeholders, a thorough evaluation of existing programs, and the exchange of best practices.
He remarked that straightforward interventions could lead to a significant decrease in mortality rates, yet many vulnerable children still lack access to these essential services.
“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 emphasized the significance of collaborations, notably with organizations such as Nutrition International, which aids millions of mothers and children. Advocating for the expansion of community-based healthcare initiatives and equitable access to healthcare services.
Furthermore, a public health expert from the Department of Community Health at OAUTHC, Ile Ife, Professor Adedeji Onayade, expressed deep concern regarding the distressing state of child mortality in Nigeria.
“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 and Head of Children with Special Needs at the Federal Ministry of Health, Mrs. Helene Akhigbe-Ikechukwu, highlighted the critical role of training healthcare professionals through programs such as IMCI to disseminate knowledge effectively, thereby enhancing health outcomes across all 36 states.
She underscored the necessity of addressing gaps in child survival to ensure that every child receives the care they need.
Supporting her perspective, Prof. Wammanda Robinson from the Department of Paediatrics at Ahmadu Bello University Teaching Hospital noted that, despite ongoing efforts and advancements in healthcare, child mortality remains a pressing public health concern in Nigeria.
He acknowledged some progress in lowering child mortality rates but pointed out that the newborn phase still experiences alarmingly high mortality rates.
He attributed the ongoing challenges to a lack of political will and commitment, despite Nigeria's implementation of various policies and strategies aimed at improving child health.
However, these initiatives often falter due to insufficient funding, inadequate infrastructure, and a shortage of qualified healthcare professionals.
“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.”
In his contribution, Mr. Ogeh Azure, representing the Department of Health Planning, Research, and Statistics within the Federal Ministry of Health, acknowledged certain advancements highlighted in the 2023/2024 Nigeria Demographic and Health Survey (NDHS) report. He proceeded to outline ongoing interventions designed to enhance 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.”
The progress In nutrition metrics has been impeded by several significant factors, including security concerns, the repercussions of the COVID-19 pandemic, and other systemic challenges.
“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 mitigate this issue, regular data quality evaluations are being conducted at the national level, accompanied by initiatives to train healthcare professionals in appropriate data collection and reporting methodologies.