Nigeria as global capital of under-five deaths

RECENTLY,  Nigeria overtook India as the global capital for the deaths of children under the age of five. According to the 2020 mortality estimates released by the United Nations Children’s Fund (UNICEF), Nigeria recorded 209,000 neonatal deaths in 1990, a 61,000 increase compared to 270,000 deaths in 2019. Quite disturbingly, the figure for the number of deaths among children aged five to 14 also increased from 104,000 in 1990 to 119,000 in 2019. While child deaths were uneven across regions, the situation was worse in sub-Saharan Africa and Central and Southern Asia. The report added that while the Covid-19 pandemic had limited direct impact on child mortality, countries worldwide are now experiencing disruptions in child and maternal health services due to resource constraints and a general uneasiness with using health services due to a fear of contracting COVID-19.

As noted by Henrietta Fore, UNICEF Director: “The global community has come too far towards eliminating preventable child deaths to allow the COVID-19 pandemic to stop us in our tracks. If the child survival targets are to be met on time, resources and policy must be geared toward not only sustaining current rates of decline but also accelerating progress, which would save millions of lives. If the trends from 2010 to 2019 continue, 53 countries will not meet the SDG target on under-five mortality on time—if all countries were to meet that target, 11 million under-five deaths would be averted from 2020 to 2030.” Fore added that achieving the child survival goals and heading off a reversal of progress in child survival this year would require universal access to effective, high-quality and affordable care and the continued, safe provision of life-saving interventions for women, children, and young people. Her verdict: if all countries reach the SDG child survival targets by 2030, 11 million under-five lives under will be saved, more than half of them in sub-Saharan Africa.

Quite tragically, Nigeria acquired the latest notoriety earlier than anticipated. As Nigerians would no doubt recall, the World Bank had in 2018 projected that the country would take over from India as the world capital for deaths of children under the age of five by 2021. The bank’s report was based on the fact that India, with a population of 1.3 billion, recorded 989,000 under-five deaths in 2017, while Nigeria, with 196 million citizens, recorded 714,000 deaths in the same year. In its bi-annual economic update on Nigeria, the World bank revealed that Nigeria recorded the highest number of child malaria deaths anywhere in the world, adding that it had the highest number of out-of-school children anywhere in the world, and that 90 per cent of these children were from Northern Nigeria. Said the bank: “Nigeria’s weak revenue mobilisation has major implications for its growth and development, including for improving its dire social service delivery outcomes. Poverty remains high in Nigeria and access to basic social services is not universal. In 2016, the World Bank estimated poverty at 38.8 per cent of the population using the national poverty line. By international poverty line of PPP-corrected $1.90 per capita per day, an estimated 49.2 per cent of the population lived below poverty in 2017.”

To say the least, it is unfortunate that Nigeria, the global poverty capital, has now added another notoriety to its name. For Nigerians still battling prejudice abroad and governance cruelty at home, this definitely hits hard below the belt. But sad and distressing as the latest report is, it is perhaps only natural given the less than stellar, poorly put together and criminally ostentatious cabinets that the country has had the misfortune of being saddled with at all levels, particularly since the return to civil rule in 1999. Tellingly, at the onset of coronavirus pandemic, the Minister of Health, Dr. Osagie Ehanire, declared that he didn’t know that the situation in the health sector was so bad, apparently having discovered highly disturbing things. Indeed, if the latest report shows anything, it is the fact that the much touted investments in the health sector are mostly a ruse. Over the years, governments at all levels claimed to have put in place mechanisms to achieve quality healthcare, but no sooner had the coronavirus pandemic hit the country than it quickly exposed the shenanigans of the garrulous but criminally ineffective tenants in the corridors of power.

The message, quite simply, is that the society needs total overhaul. Politicians at all levels of government must begin to make real investments in the health sector. In this regard, there is nothing wrong in replicating models like the Abiye initiative rolled out by the Olusegun Mimiko administration in Ondo State a few years ago, with significant improvements. The initiative was hailed by the World Bank and there is no crime in adopting and fine-tuning it for optimal national benefit. The investments in the health sector must be complemented with a vigorous campaign at all levels to combat poverty. A country that houses the world’s poorest cannot be realistically said to be enjoying democracy.

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