Pre­vent­ing Child Deaths Through Ac­cel­er­ated Ac­tion Im­pact

Yinka Ko­la­wole writes that the United Na­tions Chil­dren’s Fund re­cently or­gan­ised a me­dia work­shop in Ibadan, Oyo State on Ac­cel­er­ated Ac­tion Im­pact for re­duc­tion of preventabl­e child deaths and im­prov­ing over­all child health and de­vel­op­ment out­come in Nig


Do­ing what it knows best; cham­pi­oning the rights of chil­dren, the United Na­tions Chil­dren’s Fund (UNICEF), re­cently or­gan­ised a me­dia work­shop in Ibadan, the Oyo State cap­i­tal, on Ac­cel­er­ated Ac­tion Im­pact (AAI) for re­duc­tion of preventabl­e child deaths and im­prov­ing over­all child health and de­vel­op­ment out­comes in Nige­ria, but par­tic­u­larly in the state.

In lay­man terms, AAI could be re­garded as an ini­tia­tives that work to as­sist health de­vel­op­ment. Speak­ing on the ob­jec­tive of the pro­gramme, the UNICEF Com­mu­ni­ca­tion Of­fi­cer, Bless­ing Ejio­for, noted that the aim was to pro­vide me­dia part­ners with the knowl­edge, ma­te­ri­als to sup­port and in­form me­dia ad­vo­cacy on preventabl­e child deaths and the AAI as a game changer to fast track re­duc­tion of preventabl­e child-deaths in Nige­ria.

How­ever, Ejio­for also noted that the ex­pected out­come should be that me­dia prac­ti­tion­ers should be able to pro­duce, pub­lish and air ac­cu­rate and in­formed sto­ries and re­ports on preventabl­e child deaths, high im­pact in­ter­ven­tions avail­able and the need to scale up in or­der to re­verse the ugly trend of the preventabl­e deaths, as well as re­port on im­prove­ment made by stake­hold­ers.

Speak­ing on the score­card on ‘Health, the sit­u­a­tion in Nige­ria and par­tic­u­larly in Oyo State’, the Head, Qual­ity As­sur­ance Oyo State Pri­mary Health, Mr. Ola­bode Ke­hinde, noted that UNICEF has im­pacted pos­i­tively on health de­vel­op­ments in the state. He also com­mended UNICEF for the de­vel­op­ment and sup­port ex­tended to the state for the re­duc­tion of child-deaths.

Also Dr. Ade­bola Has­san, UNICEF health spe­cial­ist, stressed the need for AAI and the need to sup­port the pro­vi­sions of live-sav­ing in­for­ma­tion and ser­vices to ad­dress new­born deaths us­ing in­no­va­tive Tech­nol­ogy.

While not­ing that the AAI un­der­stands the data at a gran­u­lar level and also use avail­able re­sources, Has­san stressed that it also tracks ac­tion and re­sults.

On the part of Na­tional Ori­en­ta­tion Agency (NOA), the Deputy Direc­tor Pro­grammes, Mr Mon­s­hood Olal­eye, said some of the strate­gies adopted to re­duce death rates in­cludes com­mu­nity dia­logues on im­mu­ni­sa­tion and neona­tal deaths, dis­tri­bu­tion of UNICEF­sup­port check list as tool for track­ing of com­pli­ance and com­mu­nity de­vel­op­ment.

He said NOA en­hanced aware­ness of the grass­roots own­er­ship, while the agency tries to sus­tain and fur­ther en­cour­age the com­mit­ment of com­mu­nity de­vel­op­ment. He also listed some of the ob­sta­cles faced in the course of do­ing this, which in­cludes lack of health work­ers, han­dling of vac­cines, dis­tances within the lo­cal gov­ern­ment ar­eas, and at­ti­tude of health work­ers.

Also, Mrs Kadi­jat Omo­lara from Ibadan North, East, Ibarapa North, can­vassed for sen­si­ti­sa­tion of CDA vol­un­teers to­wards pro­mot­ing im­mu­ni­sa­tion and pa­tron­age adopted as­sisted in the im­prove­ment of health de­vel­op­ment. She also made men­tion of ex­clu­sive breastfeed­ing, which she said has as­sisted tremen­dously.

Mean­while, both Dr. David Olar­i­noye from Ibarapa North and Dr. Jola Moses from Saki West, com­mended UNICEF for pro­vid­ing the needed sup­port for the lo­cal gov­ern­ment ar­eas in the state. They noted that the outreach was dif­fi­cult, but with re­fur­bished dam­aged buses by the UNICEF in the ar­eas, they are able to per­form their job well.

Com­mend­ing UNICEF for the de­vel­op­ment in the ar­eas of health de­vel­op­ments, they also made it clear that most of the prob­lems they are con­fronted with in­cludes poor in­fra­struc­ture, lo­gis­tics, poor sur­veil­lance, re­port­ing sys­tem, poor ac­count­abil­ity, in­ef­fi­cient process.

But in his own sub­mis­sion at the me­dia work­shop, Mr. Onche Ode, a me­dia con­sul­tant, noted that Nige­ria rep­re­sents less than one per cent of the world’s pop­u­la­tion, yet ac­counts for 10 per cent of the global bur­den of in­fant, child and ma­ter­nal mor­tal­ity.

He said Nige­ria has a pop­u­la­tion of about 200 mil­lion peo­ple, which in­cludes about 40mil­lion chil­dren and a birth co­hort of 7.5 mil­lion. He stressed that deaths of new­borns and chil­dren in Nige­ria are un­ac­cept­ably high, with about one mil­lion child deaths re­ported an­nu­ally, a third of which is among new­borns.

Though some progress was recorded in un­der-five death re­duc­tion in the last decade, new­born deaths stag­nated over the same pe­riod. There­fore to achieve SDG tar­get of 25 deaths per thou­sand live births by 2030, Nige­ria needs to fur­ther ac­cel­er­ate on cur­rent rate of un­der five mor­tal­ity re­duc­tion from 9.6 per cent an­nu­ally to 3.7per cent.

Ode stressed that child deaths in Nige­ria mostly oc­cur in ru­ral lo­cal­i­ties of highly pop­u­lated states in North­ern Nige­ria. Ten states – Kano, Ji­gawa, Bauchi, Katsina, Zam­fara, Sokoto, Kebbi, Niger, in the North, and Oyo, and La­gos in the South, con­trib­ute about half of the ab­so­lute num­ber of chil­dren dy­ing be­fore their fifth birthdays.

Three of th­ese states – Zam­fara, Kano, and Ji­gawa – all in the North-west geopo­lit­i­cal zone, he said have the high­est rates of un­der-five mor­tal­ity. Sixty two per cent of un­der-five deaths oc­cur within house­holds and com­mu­ni­ties, while 38 per cent of deaths oc­cur in health fa­cil­i­ties (NDHS 2008).

Causes of child deaths in Nige­ria are well known. Malaria, pneu­mo­nia, and di­ar­rhea ac­count for close to 45 per cent of un­der-five deaths. Whereas 37 per cent of all deaths are preventabl­e through the use of avail­able vac­cines, mal­nu­tri­tion un­der­lies about 50 per cent of th­ese deaths.

That be­ing said, Nige­ria also faces im­mense chal­lenges in scal­ing up high im­pact in­ter­ven­tions for re­duc­ing preventabl­e child deaths and im­prov­ing over­all child health out­comes.

In re­cent years, the cov­er­age of DPT3/Penta 3, a key in­di­ca­tor of a coun­try’s per­for­mance of routine im­mu­ni­sa­tion has fallen from 52 per cent in 2014 to 33 per cent in 2016. Ev­i­dence from the re­cent 2016 MICS/NICS sur­vey in­di­cates that wide vari­a­tions ex­ist in routine im­mu­ni­sa­tion per­for­mance across the coun­try’s zones with the north­ern states record­ing some of the low­est fig­ures in cov­er­age with Sokoto at three per cent.

Whereas gov­ern­ment and part­ners in­vest on life-sav­ing in­ter­ven­tions, ac­cess to es­sen­tial pro­tec­tive, pre­ven­tive, and cu­ra­tive ser­vices against the child-killer dis­eases is very sub­op­ti­mal across the high bur­den states. Ser­vice in­equity is man­i­fest with large pop­u­la­tions of chil­dren in ru­ral, in­ac­ces­si­ble ar­eas re­main­ing un­der­served.

Im­ple­men­ta­tion of in­ter­ven­tions has not been in­formed or guided by ad­e­quate and on­go­ing analy­ses and re­views, es­pe­cially at the lower lev­els. The lack or in­ad­e­quacy of re­li­able pro­gram data, and lim­ited ca­pac­ity for crit­i­cal analy­ses of pro­gram per­for­mance negate abil­i­ties of pro­grams to meet set tar­gets.

Ode noted that the AAI ini­tia­tive was pro­posed as a game changer to fast track re­duc­tion of preventabl­e child deaths in Nige­ria through an in­no­va­tive data driven and im­ple­men­ta­tion science ap­proach along the life cy­cle fo­cus­ing on con­tin­uum of care, tar­get­ing high bur­den states, LGAs, wards and com­mu­ni­ties with com­ple­men­tary pack­ages of life-sav­ing in­ter­ven­tions of health, nu­tri­tion, wa­ter san­i­ta­tion and hy­giene, and HIV/AIDS.

Some par­tic­i­pants at the me­dia par­ley

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