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.