Nigeria, time for action against child mortality

In remote parts of Nigeria, the lack of essential healthcare services can be deadly. I saw this firsthand as a physician when a young mother lost her infant to a preventable infection because the nearest clinic, situated over 20 kilometers away, was poorly equipped and lacked both necessary medications and trained staff. This tragedy is not an isolated incident but a reflection of broader systemic deficiencies impacting countless families across Nigeria.

Indeed, Nigeria’s child mortality crisis starkly highlights the urgent need for systemic change. According to a recent report, despite significant global progress—where the under-five mortality rate declined by 51% between 2000 and 2022—Nigeria remains a troubling outlier. Nigeria has one of the highest death rates in the world among young children, with daily deaths of about 2300 from preventable illnesses. This statistic from the Nigeria Demographic and Health Survey is not just a number but a harsh reality that affects countless families every day.

Of course, the Nigerian government has made some notable strides in addressing child mortality, reflecting a significant commitment to improving health outcomes for its youngest citizens. Initiatives like the Community Health Influencer and Promoters Services program, launched in 2018, have advanced community-led vaccination efforts and case-finding strategies to close immunisation gaps and prevent disease outbreaks. Similarly, the Nigeria Midwives Service Scheme, established in 2009, has provided essential skilled birth attendants in underserved areas. Nigeria’s endorsement of the Global Strategy for Women’s, Children’s, and Adolescents’ Health and collaborating with the World Health Organization underscores Nigeria’s dedication to global health best practices.

Despite these commendable initiatives, significant challenges remain. The slow progress in Nigeria can be attributed to several critical issues, including weak healthcare infrastructure, widespread poverty, inadequate maternal health services, and high rates of infectious diseases. While cash transfer programmes and community health initiatives have proven effective elsewhere, Nigeria’s high mortality rates persist due to systemic issues that demand targeted action.
The reality on the ground, as I have seen in rural Nigeria, reveals a gap between available services and actual needs that continues to impact child survival. Investing in healthcare infrastructure is crucial; facilities must be well-equipped and staffed with trained personnel to provide essential services. Expanding maternal health services and implementing incentive-based programs, such as cash transfers for attending prenatal and postnatal care, can make a substantial difference. Additionally, improving vaccination coverage, addressing malnutrition through enhanced nutrition programmes, and raising public awareness about health and hygiene practices are essential components of a comprehensive strategy. Research into barriers to healthcare access and the effectiveness of different interventions should guide policy decisions and ensure solutions are evidence-based and tailored to Nigeria’s context.

The contrast between Nigeria and other low-resource countries that have made substantial progress in reducing child mortality is both illuminating and disheartening. Nations such as Cambodia, Malawi, Mongolia, and Rwanda have achieved over a 75% reduction in under-five mortality rates since 2000.
These countries often share several effective strategies. They typically focus on strengthening their healthcare systems by investing in primary healthcare and improving access to essential services, including vaccinations, prenatal care, and nutrition. They also emphasize community-based interventions, such as training local health workers and engaging in public health education campaigns to promote practices like exclusive breastfeeding and proper sanitation. Additionally, these countries frequently adopt data-driven approaches to target and address specific health challenges, ensuring that resources are allocated efficiently.
Rwanda in particular offers valuable lessons. The country has established a community-based health insurance scheme that reduces financial barriers to care, significantly increased the number of skilled birth attendants and improved access to emergency obstetric care, and implemented comprehensive health sector reforms to strengthen health systems and improve service delivery.

Also, Rwanda’s use of data-driven decision-making has allowed for targeted interventions, addressing specific health challenges effectively. The country’s success demonstrates that, even in resource-constrained settings, significant progress is possible with the right interventions. If these countries can achieve such outcomes, Nigeria—rich in resources and potential—should also be able to make substantial strides.

Critics may argue that Nigeria’s challenges are too complex and entrenched to overcome. While poverty and conflict present significant barriers, they should not deter us from pursuing targeted interventions. The success stories from countries like Rwanda prove that strategic, evidence-based approaches can yield remarkable results. Nigeria must learn from these examples and adapt successful strategies to its unique context. The combined efforts of the government, NGOs, and international partners will be crucial in this ongoing battle for a healthier future.

This is not just about improving statistics; it’s about transforming lives and building a healthier, more resilient nation. As we move forward, we must harness the lessons learned from successful interventions in other countries and work together to secure a brighter future for Nigeria’s children. The time to act is now, and with dedicated effort, we can make a meaningful difference in the lives of countless families across Nigeria.