MILLENNIUM DEVELOPMENT GOAL 4 IN NIGERIA: THE CASE SO

FAR,AND THE LIKELIHOOD OF REACHING THE TARGET.

OUTLINE

• BACKGROUND

• CURRENT TRENDS AND PATTERNS

• POLICY ISSUES

• CHALLENGES

• LIKELIHOOD OF REACHING THE GOAL.

BACKGROUND• MDG 4 is to reduce child mortality.

• Target is to reduce child mortality by two thirds in 2005.

• Focus in this case is under-5 mortality indicator in Nigeria; a country in Sub-Saharan Africa region.

• Reduce under-5 mortality from a value of 191 per 1,000 live births in 1990 to 64 per live births in 2005.

• Other indicators are immunization rate in one year olds, and infant mortality.

BACKGROUND

• Nigeria is a large country with a population of 148.1 million people

• West Africa, Sub-Saharan Africa• Has one of the highest rates of child mortality• One of the poor nations• Somewhat decentralised healthcare system

via the 3 tier system• Private and Public sector involved in

healthcare delivery

CURRENT TRENDS AND PATTERNS

1990 2001

Under-5 mortality values in recent years

20152006

50

100

150

200

Target

Current trend

MAJOR CAUSES OF UNDER-5 MORTALITY IN NIGERIA

• Malnutrition accounts for about 56% generally

• Malaria

• Pneumonia

• Neonatal causes

• Diarrhoeal illnesses

56%25%

10%

5% 5%

Causes of Under-5 mortality

Malnutrition

Malaria

Pneumonia

Diarrhoeal illnesses

CURRENT POLICIES AND SYSTEMS IN PLACE

• Policies on child health mainly built on recommendations by WHO AND UNICEF priorities.

• Strategies in place are;

1. Integrated Maternal and Child health; 2003

2. Partnership for Maternal and child health; 2007

3. National co-ordination and roll out to states

4. Integrated management of childhood illnesses.

MAIN INTERVENTIONS BASED ON STRATEGY

• ANC in mother

• Putting to breast 30 minutes after birth

• Exclusive Breastfeeding 0-5 months

• Expanded programme on immunization

• Use of Insecticide treated Mosquito bed nets

• Use of ORT for Diarrhoea

• Use of oral Zinc in diarrhoea

• Use of antibiotics in pneumonia

CHALLENGES• Political: 3 tier system in place, corruption, poor

governance and commitment

• Structural: Weak infrastructure, lack of adequate staff, equipment, poor programme implementation.

• Cultural: Beliefs and taboos such as Abiku/ Ogbanje

• Financial: Inadequate resources

• Poor data collection, analysis and registration systems.

LIKELIHOOD OF MEETING THE TARGET

• Nigeria MDG progress report 2004 says its unlikely.

• UN report indicates 0 percent probability.

• 2005 report says its probable in the face of improved governance and commitment, more financial resources.

• But have the recent figures and happenings proved it?

LIKELIHOOD CONT’D AND CONCLUSION

• UN requires 4.5% decline to achieve the goal, but current rate is less than 2.5%.

• Current political and economic situation in the country, worsening the healthcare system.

• Other MDGs also lagging behind hence affecting the overall picture.

• The goal not attainable in 2015, maybe in later years.

REFERENCES• UNICEF-At a glance: Nigeria.

ttp://www.unicef.org/infobycountry/nigeria.html.

• MDG Monitor: Tracking the millennium development goal in Nigeria. http://www.mdgmonitor.org/factsheets

• Christopher J.L. Murray et al. Can we achieve Millennium Development Goal 4? New analysis of country trends and forecasts of under-5 mortality to 2015. Lancelot 2007; 370: 1040-1054.

• United Nations Development programme Nigeria: MDGs at a glance. http://www.ng.undp.org/mdgsngprogress.shtml.

• Andy Haines, Andrew Cassels; Can the millennium development goals be attained? BMJ 2004; 329; 394-397.