Nigeria has become the world’s number one contributor to deaths of children under the age of five.

Nigeria overtook India last year to secure the unenviable position, according to a report released Tuesday by UNICEF, the UN children’s agency.

The development which comes two years earlier than estimated by the World Bank, paints a worrying picture for child mortality and survival in the country, further exposing a lack of plan and ambition in tackling diseases causing the deaths of children, which are usually curable.

In 2018, the World Bank had said Nigeria would take over from India as the world capital for deaths of children under the age of five by 2021.

According to World Bank figures, India recorded an estimated 989,000 under-five deaths in 2017 compared to 714,000 deaths by Nigeria in the same year.

Nigeria’s population is about 200 million, while India’s is over 1 billion.

In the latest report titled Levels and Trends in Child Mortality, UNICEF said Nigeria recorded an estimated average of 858,000 under-five deaths in 2019 against India’s 824,000 deaths out of 5.2 million under-five deaths globally.

The numbers from both countries are almost a third of all deaths before age five globally.

The data, which covered a period of three decades –1990 to 2019 – showed that 49 per cent of all under-five deaths in 2019 occurred in just five countries: Nigeria, India, Pakistan, the Democratic Republic of Congo and Ethiopia.
“Nigeria and India alone account for almost a third,” it said.

The UN agency also warned that the COVID-19 incursion is capable of derailing decades of progress toward eliminating preventable child deaths.

“While the extent and severity of the mortality impact of COVID-19 on children and youth is still unknown, the potential of a mortality crisis in 2020 threatens years of remarkable improvement in child and adolescent survival from 1990 to 2019, the period covered in this report,” the agency said.

“While current evidence indicates the direct impact of COVID-19 on child and youth mortality is limited, indirect effects stemming from strained and under-resourced health systems; limitations on care-seeking and preventative measures like vaccination and nutrition supplements; socioeconomic strain on parents and households resulting from job loss or economic downturns; and stress to children and parents associated with abrupt societal shifts maybe substantial and widespread,” it read.
“Moreover, many of these indirect effects may not be apparent for some time after the pandemic recedes and may reverberate for an extended period following the pandemic.”

Gloomy
The UNICEF data lends urgency to the calls by health advocates on Nigeria to show commitment and prioritise management of certain diseases causing deaths of children under five.
Health experts have continued to decry the neglect and poor funding of health interventions by successive governments that would have cut down the yearly losses of lives of children in the country.

One of such is the poor funding of nutrition.
Nutrition experts are lamenting the removal of about N800 million budgetary allocation for Ready-to-Use Therapeutic Food (RUTF) from the 2020 budget.

The ICIR reported how the government in 2019 cut funding for the nutritional programme designed to save thousands of lives among an estimated 2.5 million children suffering from severe acute malnutrition.

Even before the cut, Nigeria was spending far less than needed to address its nutrition crisis. The World Bank estimates that Nigeria would have to spend N301 billion ($837 million) annually to combat malnutrition effectively.

According to Beatrice Eluaka, the Executive Secretary of Civil Society Scaling-up Nutrition in Nigeria (CS-SUNN), Nigeria has the second-highest number of stunted children in the world with two million children battling with Severe Acute Malnutrition (SAM).

While most deaths resulting from Pneumonia occur in developing countries and about three-quarters takes place in just 15 countries, more than half of the world’s annual incident cases occur in Nigeria and four other countries.

According to Save the Children, Nigeria has the highest number of pneumonia deaths globally, as the disease claimed the lives of 162,000 Nigerian children under the age of five in 2018.

This means, in every three minutes, a Nigerian child dies from the infectious disease.

It also means the disease now snuffs lives out of under-five children in Nigeria more than other child killers like HIV/AIDS, Malaria, Measles, Tuberculosis put together.

There are eight health indicators used to track health performance of countries – infant and child health, infant mortality, nutrition, reproductive health, maternal mortality, life expectancy rate among others – and Nigeria has not fared well in any.

Worst still, Nigeria’s poor data collation culture makes it even more difficult to get a clear picture of the situation.

Nigeria still remains one of the worst places in the world to raise a child, infant, or mother.
Asides UNICEF data, a 2018 report by the World Health Organization (WHO) showed that one in eleven children who die in the world before their fifth birthday are Nigerians.

The report
The 54-page UNICEF report marshalled several key facts and figures involved in child survival across the world.

It said despite dramatic reductions in child and youth mortality over the last 30 years— under-five mortality has dropped by almost 60 per cent since 1990—the global burden of child and youth deaths remains immense.

The report found that in 2019 alone, about 7.4 million children, adolescents and youth died mostly of preventable or treatable causes.
Same year globally, 70 per cent of deaths among children and youth under 25 years of age occurred among children under 5 years of age, accounting for 5.2 million deaths.

Among under-five deaths, 2.4 million (47 per cent) occurred in the first month of life, 1.5 million (28 per cent) at age 1–11 months, and 1.3 million (25 per cent) at age 1−4 years.

An additional 2.2 million deaths occurred among children and young people aged 5−24 years in 2019, 43 per cent of which occurred during the adolescent period, ages 10−19.

If all countries reach the SDG (Sustainable Development Goals) child survival targets by 2030, 11 million lives under age 5 will be saved—more than half of them in sub-Saharan Africa, the report stated.