Nigeria has been grappling with high maternal and newborn deaths. All that will soon change. OYEYEMI GBENGA-MUSTAPHA reports.
High maternal and infants deaths have become a common phenomenon in the health sector. This is, no doubt, a sad story. However, many initiatives have been launched to combat the problem.
Some of the initiatives, such as Saving One Million Lives, have been praised by Lancet, a leading general medical and specialty journal, which said if the initiatives are properly implemented the hydra-headed monster would be tamed.
Lancet Series to highlights clinically important topics and areas of health and medicine often overlooked by mainstream schemes.
The Saving One Million Lives Initiative sets a target of preventing 180,000 newborn deaths by 2015, by increasing the proportion of pregnant women who attend four or more antenatal care visits from 45 per cent to 80 per cent. It also intends to increase the proportion of births with skilled attendants from 40 to 85 per cent; and increase the number of upgraded primary health care facilities from 1,000 to 5,000.
The initiative was described as creating an opportunity to accelerate the attainment of maternal and newborn health goals.
The government plans to upgrade health facilities and train and equip their workers to resuscitate babies, and offer thermal care, clean cord care, and Kangaroo Mother Care and to manage newborn jaundice to attain the targets.
The Lancet Every Newborn Series findings present the clearest picture to date of a newborn’s chance of survival and highlight the steps that must be taken to end preventable newborn deaths.
New analyses indicate that three million maternal and newborn deaths and stillbirths can be prevented each year around the world with proven interventions-including the promotion of breastfeeding, neonatal resuscitation, kangaroo mother care for preterm babies, and the prevention and treatment of infections.
Nigeria ranks second in the world as having the greatest potential to save the lives of women and their babies and prevent stillbirths with high coverage of quality care.
A systematic assessment of challenges in high-burden countries-including Nigeria-as revealed by Lancet stated that the most common barriers to improving survival were related to the health workforce, financing, and service delivery.
By addressing these challenges, thousands of lives can be saved in the next decade alone.
According to the Series research lead and senior health adviser to ‘Save the Children’, Prof Joy Lawn: “There is tremendous opportunity and we know what needs to be done to ensure every baby has a healthy start. Countries that have made recent, rapid reductions in newborn and maternal deaths have done so by expanding their skilled workforce, especially midwives and nurses, rolling out innovative mechanisms to reach the poorest families, and focusing on improving care for small and sick newborns.”
In essence, The Lancet Every Newborn Series said by 2025, Nigeria could save as many as 375,000 lives of mothers and babies, each year, if the country develops and implements these effective strategies to improve maternal and newborn health.
The journal stated that these interventions can be implemented for an annual cost of US$1.15 per person. Providing quality care at birth yields a triple return on investment, saving mothers and newborns and preventing stillbirths. It also protects babies from disabilities.
About half of all stillbirths and deaths among mothers and their newborns occur on the day of birth and almost all are preventable. Birth is also the time when newborns face the greatest risk for disability.
Babies born too early or too small are most vulnerable and more than 80 percent of newborn deaths occur among small or sick babies.
With 170 million people, Nigeria—Africa’s most populous country—has the continent’s highest annual number of newborn deaths. Each year more than 250,000 babies die in their first month of life, accounting for more than a third of all under-five deaths. Complications during childbirth, preterm birth, and infections—all preventable and treatable conditions—are the major causes of newborn deaths.
Key interventions exist but coverage is low,much lower than most other African countries. For example, just half of all mothers are vaccinated against tetanus toxoid, 39 per cent of mothers deliver with a suitably qualified attendant and 30 per cent of women breastfeed their newborns within the first hour of life. Yet over two-thirds (70 per cent) of newborn deaths in Nigeria could be prevented if essential interventions in existing packages reached all Nigerian women and their babies.
The ‘Series’ stated that the policies are mostly in place; what is needed is action at state and local levels to increase coverage and quality of life-saving interventions while closing the equity gap for the poorest families.
Celebrating this commendation, the Minister of State for Health, Dr. Khaliru Alhassan launched The Lancet Every Newborn Series along with ‘Nigerian every Newborn Action Plan’ (NENAP), as the road map for ending preventable newborn deaths in Nigeria, at the two-day Nigeria Newborn Health Conference, held in Abuja. It was a high-level advocacy event. The theme was- Make every Nigerian newborn count: Renew the momentum for newborn survival.
According to Dr. Khaliru Alhassan: “Nigeria shall stop housing the greatest burden of newborn deaths in Africa. The time to act is now.”
Though expected to flag off the programme as the ‘Special guest of Honour’, together with the First Lady, as the ‘Mother of the day’, President, Goodluck Jonathan with his wife, Mrs Patience Jonathan were absent. They were said to have gone on a Pilgrimage to Jesrusalem.
The President was expected to launch the ‘Nigerian every Newborn Action Plan’ (NENAP), as the road map for ending preventable newborn deaths in Nigeria. Nigeria accounts for nearly one quarter of Africa’s maternal and newborn deaths. In 2013, 260,000 babies died in Nigeria in their first month of life and an additional 295,000 were stillborn.
In the country, newborns currently account for more than 33 percent of all deaths of children under age five. The majority of these newborn deaths result from prematurity, complications during child birth including asphyxia and severe infections.
The Nigeria Newborn Health Conference was convened to build synergy and commitment toward ending preventable newborn deaths and renewing the momentum for newborn survival.
State health profiles were also released, making it possible for health officials to easily compare the health status of mothers and newborns in each of Nigeria’s states.
The Deputy Mission Director, United States Agency for International Development in Nigeria, Ms. Julie Koenen said: “At a time when people wonder if we can still come together to accomplish big things, I say we can, and we are showing the world that this is possible. But we need to do more. With a strong and sustained commitment from all of us, we can end preventable maternal and child deaths within a generation.”
The new Every Newborn action plan (ENAP), rooted in the evidence presented in the Series, was launched 30 June 2014 at the 2014 Partners’ Forum in Johannesburg, South Africa after endorsement at the World Health Assembly. The ENAP, co-led by the World Health Organisation (WHO) and UNICEF, is based on epidemiology, evidence, and global and country learnings from the Series and sets a framework to end preventable deaths for newborns and stillbirths by 2035 as part of the A Promise Renewed effort.
The Bill and Melinda Gates Foundation’s Country Representative in Nigeria, Dr. Mairo Mandara said: “The foundation commends the Nigerian Ministry of Health and its partners for its commitment to identifying and taking forward specific opportunities to advance the Every Newborn Action Plan (ENAP) and improve newborn health and survival in Nigeria.”
According to Maternal Newborn and Child health (MNCH) advocates the National Newborn conference was geared towards providing an opportunity where child survival champions were able to establish and renew partnerships and strategies, that will help improve new born survival in Nigeria through a high-level advocacy platform that brings together national and international stakeholders from different sectors – public, private, and non-government.
“Giving every baby a healthy start at life could rapidly accelerate improvements in child survival, health, and development.
“Furthermore, a major focus of the Subsidy Reinvestment and Empowerment Programme (SURE-P) launched in February 2012 is to invest in maternal and child health at primary health care levels, including the introduction of a volunteer health worker cadre at community level.
“An adoption of the 15 lifesaving commodities for women and children by the President in 2012 and the recent launch of the ‘Universal Health Care’ initiative, show that the platform to reach every woman and child is already set; what is needed is commitment at state and LGA levels to ensure that all these interventions reach every woman and child anywhere they are across the country,” they
