Despite the grim and glaring reality of human mortality, the latest figures on newborn deaths released by the United Nations Children’s Fund (UNICEF) are alarmingly revealing and signify a call for urgent action to arrest the death rate. Findings of a survey of 51 countries with the highest burden of newborn deaths showed that as many as nearly three million newborn babies die worldwide every year. India tops the list in South Asia and globally with 779,000 newborn deaths per year, while Nigeria leads in sub-Saharan Africa with 267,000, which is certainly a thought-provoking and unwelcome record for the country.
According to UNICEF, newborn deaths account for 44 percent of total mortality among children under five, and represent a larger percentage of under-five deaths than they did in 1990, which suggests a disturbing deterioration in the quality of care infants receive in various countries these days, particularly given the organisation’s detail that 2.9 million babies die within their first 28 days. Further information that an additional 2.6 million babies are stillborn and 1.2 million die because their hearts stop during labour is little comfort and does not redeem the sad situation of such a heavy loss of infant lives in today’s world, with all the advantages of highly developed health equipment, advanced scientific know-how and improved child health care knowledge.
The grave picture is especially striking against the background of clear identification of the problem, which the organisation expressed in informed terms, saying, “The first 24 hours after birth are the most dangerous for both child and mother – almost half of maternal and newborn deaths occur then.” Instructively, UNICEF’s head of global health programmes, Dr. Mickey Chopra, said, “We have seen tremendous progress in saving children under five, but where the world has stumbled is with the very youngest, most vulnerable children.” He added, “This group of children needs attention and resources. Focusing on the crucial period between labour and the first hours of life can exponentially increase the chances of survival for both mother and child.”
Perhaps it is pertinent to point out that, related to the UNICEF release, Nigeria is ranked 2nd among the top 10 countries with the most first-day of life deaths, according to a 2013 State of the World’s Mothers Report. At least 89,700 (nine per cent) babies die on their first day of life every year in Nigeria, said the report which compared first-day death rates for 186 countries. In addition, Nigeria was 169th on the Mothers’ Index out of the 186 countries assessed in critical areas such as mother’s health, education and economic status, as well as key child indicators of health and nutrition.
Of course, situation recognition will not suffice, and the UNICEF statement expectedly recommended solutions that hopefully will be practicalised in the interest of humanity in general. Notably, the identified most effective interventions in saving newborns include breastfeeding; newborn resuscitation; ‘kangaroo care’ for premature babies – that is, prolonged skin-to-skin contact with the mother; and preventing and treating infections.
However, perhaps more critically, the organisation called for more funding and adequate equipment, which cannot reasonably be divorced from politics and governance; consequently, the political will and performance is essential. It is significant to note that UNICEF argued that if the quality of care received by the richest were to become universal, this would result in a phenomenal reduction in newborn deaths, specifically, 600,000 fewer deaths per year.
It may be wishful thinking on the part of the organisation to imagine that the day would come when access to health care would be a function of egalitarianism. However, the underlying lesson of its argument should not be trivialised, which is that a more socially responsive health care system is a desideratum in many countries.
Such advocacy cannot be truer for Nigeria in particular, especially considering the fact its oil wealth should ordinarily ensure a health care system that is vastly superior to the dysfunctional one which many Nigerians have sadly got used to, even if regretfully. It is a fact that the country’s public health sector continues to attract widespread criticism for lamentably poor services due largely to funding issues. Indeed, it is noteworthy that the country’s proposed N262.74 billion budget for the health sector in 2014 represented a 6.7 percent decrease compared with the 2013 allocation which was N273 billion.
Not surprisingly, experts rubbished the proposal for this year mainly on account of the figure earmarked for recurrent expenditure, which was about 80 percent of the financial plan and meant that there would be little or no funds left for infrastructural development, expansion and upgrade of medical facilities, research and development, and human capital development, the very essentials needed to improve the infant survival rate.
Regrettably, a major implication of the UNICEF release is the high possibility that the Millennium Development Goal of reducing child mortality by two-thirds by 2015 may prove to be a pipe dream. Perhaps even more unfortunate is the likelihood that Nigeria will count among the failures.
