MNCH Week: It’s time to improve maternal, child health service delivery in NigeriaCISLAC Admin
As the government at all levels mark Maternal New-born and Child Health Week, CHIOMA KANU examines various contributory factors to maternal, new-born and child morbidity and mortality in the country, calling on governments to prioritise awareness creation and effective service delivery to improve health seeking behaviour of Nigerian mothers and children to promote universal coverage of high impact and low cost interventions.
It would be recalled MNCHW was introduced in 2010, as a bi -annual programme following the recommendation of the National Council on Health. Consequently, one week every six months – May and November, the health system in Nigeria works for MNCHW.
While the main objective of MNCHW is to reduce morbidity and mortality in mothers and children less than 5 years of age in Nigeria, the specific objectives include to ensure access by mothers and children 0-59 months to: routine immunization as scheduled, and for missed opportunities; mobilize the community and create demand for routine services; ensure that at least 80% of children 6-59 months are given Vitamin A every 6 months; deworm children 12-59 months every 6 months in the target LGAs; screen for acute malnutrition in children; 6-59months and appropriate referral when malnourished; provide focused ANC – Iron-Folate, SP for pregnant women, HIV Counseling and Testing (HCT); distribute LLINs to pregnant, lactating women and under-five children; provide health education on key household practices.
With over 11 million stunted children, Nigeria is, without doubt, confronted with the daunting challenge of malnutrition and ranks second with highest number of stunted children globally. Malnutrition impacts negatively on the socio-economic development of a nation, and sustainable growth in Northern Nigeria cannot be achieved without prioritised attention to nutrition investment at all levels.
According to the United Nations Children’s Fund (UNICEF), under-nutrition remains high in Northern Nigeria with about 2.2 million out of the 2.5 million severely acute malnourished children being from Northern Nigeria. Majority of children do not receive minimum acceptable diet. While 50% child mortality in the country has malnutrition as underlining cause, no fewer than 1200, out of 2600 estimated daily deaths are caused by malnutrition.
With the cases of severe acute malnutrition in Community Management of Acute Malnutrition (CMAM) across the country, we are deeply touched and worried that inadequate Ready to Use Therapeutic Foods (RUTF) across the States is a threat to saving lives of children with conditions of severe acute malnutrition, thus defeating the efforts in addressing childhood malnutrition and mortality.
Also, food insecurity, inappropriate feeding habits, poor awareness on acceptable adequate diet, insufficient health facilities and services are contributory factors to maternal and child malnutrition.
Polio is a crippling disease caused by a highly contagious virus that spreads from person to person. In the analysis of Centers for Disease Control and Prevention (CDCP), the virus spreads from person to person and can invade an infected person’s brain and spinal cord, causing paralysis (can’t move parts of the body). As reported by WHO, in 2012, Nigeria accounted for more than half of all polio cases worldwide.
Child mortality remains a serious public health concern in Nigeria. The child mortality rate is among the highest in the world, with 109 deaths for every 1,000 live births, as estimated by the World Bank in 2015.
Chronic malnutrition and micronutrient deficiencies are also enduring challenges. Nationally, 36% of children under-5 years are stunted and 30% of pre-school aged children suffer from Vitamin A Deficiency. Consumption of foods rich in Vitamin A is rare and access to fortified foods remains limited. Only one third of all children aged 6-23 months receive a minimum acceptable diet.
The large-scale use of high-dose Vitamin A Supplementation can reduce child mortality by up to 23%. An assessment showed that if no effective action is taken, more than 80,000 Nigerian children will die annually due to Vitamin A Deficiency. Given the high contribution of Vitamin A Deficiency to morbidity and mortality in Nigeria, biannual Vitamin A Supplementation has been recognized as a key child survival intervention.
As the National Primary Healthcare Development Agency (NPCDA) advocates, we call on mothers and parents at all levels to: ensure all children under-five years old are given Vitamin A supplementation to prevents diseases, protects lives and is good for your child’s eyes; and ensure all acutely malnourished children 12 to 59 months are screened using the Mid Upper Arm Circumference (MUAC) tape.
In Nigeria, pneumonia and diarrhoea remain major killers of children under 5 years, accounting for about 400,000 preventable deaths, annually. While an estimated 6.7 million cases of childhood pneumonia are reported annually, Nigeria reportedly has the second largest burden of the disease after India which has about ten times Nigeria population. Pneumonia and diarrhoea are estimated to constitute 16% and 19% respectively of all causes of death in children below the age of five.
On this note, mothers are encouraged to adopt exclusively breastfeed their children; ensure adequate routine immunization for their children to protect them from preventable childhood diseases; ensure birth registration of the children.
In order to prevent malaria, mothers must ensure that all children under five years old and pregnant women sleep under long lasting insecticide treated nets (LLINs) at all times. Pregnant women should visit the nearest health facility for Ante – Natal Care (ANC), Tetanus Toxoid (TT) vaccination, HIV Counseling and Testing (HCT) and malaria prevention and treatment.
At least four ANC visits during pregnancy save the lives of mother and child. Wash hands with clean water and soap or ash after using the latrine, before preparing food and before and after eating. Washing hands with water and soap kill germs. This will protect you and your family against diseases.
More importantly, child spacing has proven to improve the lives of women and children.
As a lesson from MNCH Week, we therefore, encourage governments at all level to take as priority, improved service provision and delivery on maternal, new-born and child health to avert maternal, new-born and child morbidity and mortality at all levels.