Stakeholders and experts are worried that some key
indicators to improved child health and survival, being part of Sustainable
Development Goals (SDGs) set to be achieved by 2030 have shown marginal
increase in nearly three decades following the release of 2018 Nigeria
Demographic and Health Survey (NDHS) writes CHIOMA UMEHA.
Research
indicates that reducing childhood mortality and improved nutrition, survival
and health of the Nigerian child is crucial to any country’s socioeconomic
development and quality of life.
Yet, important indicators in the 2018 NDHS like, breastfeeding,
immunisation and provision of Insecticide-treated Nets (ITNs), maternal
healthcare, health insurance coverage, among others, shows slow progress against
the actualisation of the SDGs.
Breastfeeding
According to the 2018 NDHS, the percentage of
Nigerian children who started breastfeeding within one hour of their birth only
increased by nine percentage points since 2013, from 33 percent to 42 percent.
Experts say that initiation of breastfeeding within
the first hour of life is important for both the mother and the child.
The first breast milk contains colostrum, which is
highly nutritious and has antibodies that protect the newborn from diseases.
Early initiation of breastfeeding also encourages
bonding between the mother and her newborn, facilitating the production of
regular breast milk, according to researchers.
Similarly, they say that breast milk contains all of
the nutrients needed by children during their first six months of life.
They, therefore, recommend that children be exclusively
breastfed during the first six months of their life; that is, they should be
given nothing, but breast milk.
According to them, exclusive breastfeeding for six
months prevents infections such as diarrhoea and respiratory illnesses and
provides all of the nutrients an infant requires for optimal growth and
development.
Exclusive breastfeeding for the first six months of
life is known to improve the health, growth, and survival status of newborns
(WHO 2003).
Reviewing the 2018 NDHS figures on infant feeding,
Maureen Zubie-Okolo, United Nations Children’s Fund, (UNICEF) Monitoring and
Evaluation Specialist corroborated that exclusive breastfeeding among children
aged zero to six months increased from 17 per cent to 29 per cent in 2013, but
fell short of the 50 per cent global target.
The World Health Assembly (WHA) has set a target to
increase the global rate of exclusive breastfeeding to at least 50 per cent by
2025. To coincide with the timeline of the Sustainable Development Goals, the
World Health Organisation (WHO) has extended the targets for maternal, infant
and child nutrition to 2030.
Among its benefits, Zubie-Okolo said, exclusive
breastfeeding is associated with a lower risk for many early-life illnesses,
including diarrhoea and respiratory infections.
She spoke during a two-day workshop on Media
Dialogue for Editors and Reporters on Data-Driven Reporting and Dissemination
of NDHS 2018 Result and SDGs in Port Harcourt, River State, organised by the
Child Rights Information Bureau and the Federal Ministry of Information
weekend.
Nigeria, in tandem with international best
practices recommends exclusive breastfeeding for the first six months of life
(Federal Ministry of Health 2005, 2014).
Despite its benefits, Nigeria attained 29 per cent on
exclusive breastfeeding below the global target of 50 per cent, Monitoring and
Evaluation Specialist stressed.
She said; “Though the percentage of children who had
ever been breastfed was high at 97 in both 2008 and 2018, exclusive breastfeeding
among children aged from zero to five months only witnessed a marginal increase
from 17 per cent to 29 per cent in five years, from 2013.”
Similarly, the number of those who started
breastfeeding within one hour of birth remained slow. For instance, the
percentage of children who started breastfeeding within one hour of birth also
increased slightly by nine percentage points since 2013, from 33 percent to 42 per cent, while those who started breastfeeding within one day rose from 65 per cent to 82 percent since 2008.
Stunting, Wasting And Underweight
The per cent of children under-five who were stunted
based on 2006 WHO Child Growth Standards, Nigeria was 37 per cent.
The prevalence of stunting increases from 19 per cent among children, less than six months to a peak of 47 per cent among children aged
from 24 to 35 months, the 2018 NDHS showed. Zubie-Okolo said; “This represents
the impact of undernutrition in the first 1,000 days of life of the Nigerian
child.
“Stunting, or low height-for-age, is a sign of
chronic undernutrition that reflects a failure to receive adequate nutrition over
a long period of time. The most direct causes of stunting are inadequate
nutrition (not eating enough or eating foods that lack growth-promoting
nutrients) and recurrent infections or chronic diseases that cause poor
nutrient intake and absorption.”
She observed; “Wasting, on the other hand, is more
prevalent (15 per cent) among children age from nine to eleven months. Wasting,
or low weight-for-height, is a measure of acute undernutrition and represents
the failure to receive adequate nutrition in the period immediately before the
survey. Wasting may result from inadequate food intake or from a recent episode
of illness or infection causing weight loss.
She explained, underweight, or low weight-for-age,
is a composite index of weight-for-height and height-for-age reflecting both
acute (wasting) and chronic (stunting) undernutrition.
The 2018 NDHS showed that the children are breastfed
for a median of 18.5 months and exclusively breastfed for 3.0 months. 29 per cent of children under six months are exclusively breastfed, the survey
said, adding that 37 per cent of children under five are stunted.
Child Mortality
With under-five mortality at 132 deaths per 1,000
live births, this implies that more than one in eight children in Nigeria die
before their fifth birthday, the NDHS 2018 also showed.
Similarly, despite the reduction of infant mortality
from 75 per cent deaths per 1000 live births to 67 deaths per 1000 live births,
the number of neonatal deaths remained unchanged, the survey showed.
At 67 deaths per 1000 live births, she further
alerted that the number of neonatal deaths remained unchanged, showing only
marginal increase.
The UNICEF Monitoring and Evaluation Specialist
stressed that though the survey showed that under-five mortality rate decreased
since 2008, from 157 deaths per 1,000 live births to 132 deaths per 1,000 live
births, it is still high.
She said; “There has been a slight reduction in
infant mortality, from 75 to 67 deaths per 1,000 live births from 2008 to 2018.
However, there has been no noticeable change in the neonatal mortality rate
over the same period.”
The report also notes that childhood mortality in
Nigeria remains high and that every year, an estimated one million Nigerian
children die before their fifth birthday.
Based on the trend, Nigeria is one of five countries
in the world with the highest number of under-five deaths.
Immunisation
Similarly, the percentage of children that have
received all-round immunisation in Nigeria remains very low at 31 per cent between
2008 and 2018, the National Demographic Health Survey (NDHS) stated.
The report also revealed that “the percentage of
children who received none of the basic vaccinations declined from 29 per cent to 19 per cent during the same period in review.
“But, the percentage of children age between 12 and
23 months who received all basic vaccinations increased from 23 per cent in 2008
to 31 per cent in 2018.”
Commenting, Zubie-Okolo said that immunisation
coverage was one of the indicators used to monitor progress towards reduction
in child morbidity and mortality as it was one of the most cost-effective
public health intervention.
She said that the objective of the NDHS was to
provide estimates on fertility levels, marriage, sexual activity, family
planning, breastfeeding practices and nutrition.
Others she said were childhood and maternal
mortality, maternal and child health, malaria, domestic violence, disability,
and female genital mutilation.
”This information is essential for programme
managers and policymakers to evaluate and design programmes and strategies for
improving the health of Nigerians,” she said.
Elaborating, she noted that the latest NDHS (2018)
was the sixth one in Nigeria since 1990 as part of the Demographic Health
Survey programme.
According to her, the sample design for 2018
NDHS is to provide estimates at the national level, for six zones, for 36
states, the Federal Capital Territory (FCT), and for urban and rural dwellers.
She, however, stressed that while the 2018 NDHS trends
showed an improvement, they still fell short of SDGs Three which the target is for
more than 90 per cent coverage of all basic vaccination among children age 12
to 23 months.
Earlier in his opening remarks, Olumide Osanyinpeju,
Deputy Director/Head, Child Rights Information Bureau who represented the
Minister of Information and Culture, Alhaji Lai Mohammed said; “Both Multiple
Indicators Cluster Survey (MICS) and Demographic and Health Survey (DHS) are
survey initiatives designed to assist countries, Nigeria inclusive, in filling
data gaps for monitoring human development in general and the situation of
children and women in particular.
“These surveys have been instrumental in
strengthening national statistics capacities, highlighting and filling gaps in
quality data, monitoring and tracking progress toward national and
international development goals like the SDGs and, in identifying emerging
issues and disparities among groups in societies.”
Nigeria Requires N126 trillion For SDGs
On his part, Dr Davis Omotola, Independent
Development Consultant, commenting on the gaps revealed by the 2018 NDHS on the
state of children, women and general human development, said that Nigeria
requires N126 trillion ($350 billion) to meet the SDGs set for 2030.
Omotola noted that the NDHS further stated that the
current public sector gap was estimated at $100 billion after all other
possible incomes including oil revenue and the Abacha loot have been pooled
together.
While lamenting that poverty was on the increase due
to population explosion and insecurity, he said 70 per cent of the poor people
in Nigeria were found in 10 states which all happen to be in the North.
Omotola who expressed fears that lack of effective
policies and budget constraints could serve as barriers for achieving the SDGs
in the next 10 years, maintained that Nigeria needs a large chunk of money to
achieve the 17 SDGs goals.
“We have 10 years, but Nigeria does not plan. We are
in a country were people just wake up and whatever happens is what we do. We
have been talking about insecurity, what is the plan to solve it?
We should have a robust plan
“There are so many plans and policies; we have even
the national population policy which proposes four children per family.
We are talking about quality education for all, but
we have different definitions of education in different parts of Nigeria.
“We just developed the Economic Recovery and Growth
Plan (ERGP) by 2017, the SDGs has been on since 2016, the discussion started
from 2012 yet when we were doing ERGP, we didn’t factor in the SDGs except we
now begin to realign the ERGP into the SDGs.
“The Sustainable Development Goals is about leaving
no one behind and to achieve that we need $350 billion and our total income in
2018 was $398 billion, so it means that we should just spend all that money to
achieve the SDGs.
“The President said he wants to lift 100 million
people out of poverty, we already have 98 million poor people as of 2018 and 70
per cent of them we know where they are, so what programme are we putting in a place for them?
“Most of our children do not have an education that is
skill-based that will make them get the right employment.
“It’s not all these small intervention programmes,
we must have policies that are effective, policies that are implemented and of
wide coverage. It’s not to do a small thing in one corner of Nigeria.”
Contributing, Dr Guy Modeste, UNICEF Chief of Field
Office, covering Bayelsa, Rivers, Delta and Akwa Ibom States, who raised concerns
over Nigeria’s failure in using data to tackle its demographical growth, said:
“We are facing the critical stage as regards demographical growth, many children
are left behind, we need to ensure that no child is left behind.”
