With less than 500 days left until the end of the Millennium Development Goals (MDG), Nigeria, a signatory to the Millennium Declaration adopted by world leaders in September 2000 is racing towards achievement of MDG 4 and 5 which seeks to reduce by two-thirds under-five mortality rate (U5MR) and reduce by three-quarters the proportion of women dying in childbirth by 2015.
Although Nigeria has made some progress in reducing child mortality, the country is behind the 2015 target of 30.3 deaths per 1000 live births as against 61 deaths per 1,000 live births Nigeria recorded in 2012. In the area of under-five mortality, Nigeria is still short of the 2015 target of 63.7 deaths per 1,000 live births as against the present 94 deaths per 1000 live births in 2012.
Nigeria’s MDG 2013 report reveals that the country’s current status, estimated at 350 maternal deaths per 100,000 live births is still 40 percent short of 2015 target of 250 maternal deaths per 100,000 live births with the major causes of maternal deaths to include haemorrhage, malaria, obstructed labour, anaemia and unsafe abortion.
Commenting on this development, Otive Igbuzor, executive director, African Centre for Leadership, Strategy & Development (Centre LSD), said that despite huge challenges to the achievement of MDGs in Nigeria, there is the need to formulate and implement policies that will overcome institutional constraints and practice inclusive urban development if the country is to meet the goals in 2015.
Igbuzor noted that it is to look beyond the MDGs to formulate an alternative development strategy to accelerate the development of the country.
According to Igbuzor, “There is the need for increased budgetary allocation to investment clusters that will accelerate development especially health. No nation serious about development can spend 72 percent of its budget on recurrent expenditure. There is the need to improve capacity for execution and mainstream citizen participation and ownership in the development process.
Nigeria’s development agenda must go beyond focus on the economy to include political, economic and environmental development.”
For Pat Utomi, a professor of political economy and founder/chief executive officer, CVL, “Nigeria is not yet there when it comes to the achievement of the MDG as it relates to health. The lessons learnt from Ebola containment in the country shows that Nigeria can be able to achieve this target if there is the commitment to do so.”
Only recently, in a move aimed at improving Nigeria’s health indices and reducing maternal mortality ratio by three quarters by 2015, in line with the MDG, the Private Sector Health Alliance of Nigeria (PHN) announced a $24.2 million commitment to drive a private sector emergency response to Saving One Million Lives initiative and invest in critical segments of healthcare value chain that benefits the underserved.
This initiative, billed to span within a two year period, is targeted at advancing Nigeria’s progress in meeting the health MDGs in the short term and advance the health sector from being an economic drag to a net contributor to economic growth and job creation in the mid-term.
Muntaqa Umar-Sadiq, managing director/chief executive officer, PHN, said “The Private Sector Emergency Response focuses on three areas: provision of essential commodities and routine immunisation logistics support to address the leading causes of mortality; leverage private sector capabilities and innovation to strengthen primary care systems and build the foundation for a more sustainable healthcare workforce at the frontlines.”
A peep into Nigeria’s health indices reveal that some states, including Ekiti, Ondo, Ogun, Lagos, Edo, Anambra and Taraba, have reached the national infant mortality rate (IMR) targets for 2015. However, a lower national outlook is a consequence of the relatively high IMR in Yobe, Kaduna, Jigawa, Bauchi and Katsina states.
In urban areas, the IMR is estimated at 42 deaths per 1000 live births, a much higher IMR incidence when compared with the 67 deaths per 1000 live births in rural areas.
By current estimates, the IMR in rural areas would need to be halved from its present level to achieve the target for 2015. Hence, a much more focused intervention remains a priority response for rural areas. The level of the IMR is much worse in the North West zone (82 deaths per 1000 live births) and North East zone (70.5 deaths per 1000 live births).
With regards to the under-five mortality rate (U5MR), twelve states have already achieved the national target of 60.8 deaths per 1000 live births for 2015, while the lagging states include Yobe, Kaduna, Jigawa, Bauchi and Katsina, among others.
Although target for U5MR may have been achieved in urban areas, U5MR in rural areas is significantly higher at 104.8 deaths per 1000 live births.
Factors militating against speedy progress range from the very large proportion (65 percent) of births that take place at home often without any contact with a health facility, insufficient numbers of skilled birth attendants, harmful traditional myths, considerable incidence of acute respiratory infections, fevers, and dehydration from diarrhoea, with low medical attention at the presentation of symptoms.
Given the short length of time to 2015, governments and other stakeholders have been tasked to achieve accelerated scale-up of tested high-impact interventions for maternal, newborn and child health including antenatal care, skilled birth attendants, emergency obstetrics and newborn care, and the prevention of mother-to-child transmission.
Alexander Chiejina
