The Millennium Development Goals (MDGs) are eight international development goals that were established after the Millennium Summit of the United Nations in 2000, following the adoption of the United Nations Millennium Declaration. All 189 United Nations member states at the time and at least 23 international organizations committed to help achieve the Millennium Development Goals by 2015. The goals are – eradicating extreme poverty and hunger; achieving universal primary education; promoting gender equality and women empowerment; reducing child mortality by two thirds; improving maternal health; combating, HIV/AIDS, malaria, and other diseases; ensuring environmental sustainability; and developing a global partnership for development.
Less than a year to the target date, Nigeria is still racing to meet the health-related MDGs 4 and 5 targets which seek to reduce under-five and maternal mortality rate by two-thirds and three-quarters respectively by 2015.
Nigeria did develop a well articulated strategic plan for achievement of its health targets including MDGs 4 & 5; it is bedevilled with low coverage of high Impact Interventions such as exclusive breastfeeding, problem accessing healthcare, poor functioning health system with weak referral linkages especially for obstetrics and neonatal emergencies and inadequate financial support.
Furthermore, the country adopted the Integrated Maternal, Newborn and Child Health Strategy (IMNCH) and put in place programmes such as National Health Insurance Scheme (NHIS), Health Sector Reforms (HSR),and Midwifery Service Scheme (MSS), as well as improve human resources at PHC level through MSS, integrating the management of childhood Illness, implementing research projects on Prevention of Mother-to-Child Transmission of HIV (PMTCT), Maternal, Newborn and Child Health (MNCH), etc all in a bid to meet the MDG target.
However, recent statistics by United Nations Education Fund (UNICEF) reveal that in Nigeria, a woman’s chance of dying from pregnancy and childbirth is 1 in 13, compared to 1 in 5000 in developed countries. Although many of these deaths are preventable, the coverage and quality of health care services remains a major concern with about 40 percent of deliveries attended to by skilled birth attendants.
The deaths of newborn babies in the country represent a quarter of the total number of deaths of children under-five, according to United Nations Education Fund (UNICEF). Sadly, majority of these occur within the first week of life, mainly due to complications during pregnancy and delivery reflecting the intimate link between newborn survival and the quality of maternal care.
A SURE-P MCH 2013 document shows that only 23 percent of children aged 12-23 months received all recommended vaccination in the country. While vaccination coverage varies widely by residence and zones, 40 percent of children in urban areas are fully vaccinated compared to only 16 percent in rural areas and about 29 percent of children estimated not to have received any vaccination from childhood killer diseases such as measles, tetanus, whooping cough, polio, hepatitis B, pneumonia, etc.
On the other hand, malnutrition remains an underlying cause of morbidity and mortality of a large proportion of children under-5 in Nigeria, accounting for more than 50 percent of deaths of children in this age bracket.
Although health indices in Nigeria show that infant mortality has declined from 12.4 million in 1990 to 6.9 million in 2011; underneath the statistics lies the pain of human tragedy, for thousands of families who have lost their children.
As Nigeria marches towards 2015, experts believe that government must take the issue of maternal and child mortality seriously by matching words with actions for it to achieve the set target. There is also the need to allocate 15 percent of government annual budget to health in order to meet the Abuja commitment of 2001 by Heads of Governments in Africa. In addition, it has become imperative to review implementation of the National Health Insurance Scheme to identify gaps and to scale-up services to offer community-level insurance, as well as to aggressively continue roll-out of IMNCH strategy in all states, including support for supervision, logistics and data tracking.
The post-2015 agenda is already on many people’s lips. The global public health community is thinking about the next big target. As with most targets, Nigeria though an enthusiastic signatory cannot afford not to ensure it meets the 2015 MDG targets with respect to infant and maternal mortality by at least 80 percent.