By Abubakar Jimoh
The Partnership for Advocacy in Child and Family Health (PACFaH), Coalition of Civil Society working on Child and Family Health in Nigeria, has charged the Ministry of Health and relevant stakeholders on inclusiveness in the implmentation of the national Health Act recently signed by President Goodluck Jonathan.
The group made this call during a press conference organised in Abuja to draw attention of the electoral candidates to the poor Reproductive Maternal, New-born and Child Health (MNCH) indices in Nigeria and encourage them to share with Nigerians their proposed realistic plans to improve the lives of mothers and children.
The group said Nigeria’s poor Maternal New-born and Child Health status was underlined by an overarching poor governance and stewardship responsibility for health, especially at the Primary Health Care level.
“Some of the dimensions of the problem include absence, inadequacy and implementation challenges with regards to extant policies, commitments, legislation, budgets; and fragmentation and multiple management structures, unclear roles and responsibilities, inadequate funding, weak referral system and accountability mechanisms and weak collaboration and coordination among others.
“While availability of Family Planning services at health facilities may have improved in the last 2-3 years, this has not been matched by improved service quality and increased demand especially at the community level where women from poor households with low education abound. The low utilization of Family Planing services is worse in the states of North East and North West where the utilization in some states is less than 1% while unmet need is as high as 16.9%. Currently a major support for the FP program comes from donor agencies. There is an urgent need to demonstrate the political will to provide these services by government at national, states, local government areas by creating permanent budget line for FP commodities, logistics and consumables as well as allocate and release funds committed for FP activities as at when due. This is important, because evidence from research studies show that an effective FP would contribute to about 25-30% reduction of MMR,” the Coalition disclosed.
The Coalition called Government at all levels to adopt and implement operation plan to combat poor nutritional status of Nigerian children, noting that 37% of children under age five in Nigeria are classified as stunted—the highest in sub-Saharan Africa and second in the world.
It added: “In 2013, about 3 million children under age 5 years died globally, 51.8% of them from infectious causes with Nigeria being one of the countries with the highest number of deaths. In Nigeria most of the deaths are caused by malaria and pneumonia with pneumonia as the single infectious and preventable disease with the highest mortality.
“The NDHS 2013 have identified five as important risk factors for Childhood Pneumonia and they are malnutrition, low birth weight, non–exclusive breastfeeding, solid fuel use, crowding (7 or more persons sharing the same household) in a household, in addition to zinc deficiency, measles and poor hygiene especially lack of hand washing culture. The Coalition calls on the Government to revise the National Treatment Guidelines with Amoxicillin (dispersible tablet) adopted as first line of treatment for Childhood Pneumonia by 2016 as well as increase buy-in and support for Zinc and oral rehydration solution (ORS) as treatment for Childhood Diarrhea.
“The 2013 NDHS shows that about 25% of children (age 12-23 months) had received all the recommended vaccinations (DPT, BCG and Polio vaccines), while 21% of eligible children received no vaccination at all, with children in urban areas nearly three times more likely than children in rural areas to be fully immunized. Although immunization coverage has improved in the last decade, however, Nigeria still falls short the increase needed to achieve the MDGs target of 90% immunization coverage rate by 2015. The factors which have hampered routine immunization coverage include weak governance, inadequate funding, vaccine stock-outs, lack of vaccine bundling, distribution challenges, non-maintenance of Cold Chain Equipment, and poor staff performance at state and local government levels.”
The group therefore, called on: Clerk of the National Assembly, to ensure National Health Act is gazetted and put in the public domain; Hon. Minister of Health, to set up all inclusive committee for the implementation of NHA; media, to promote MNCH issues and hold government accountable on their commitments and ensuring improved budget allocation, release and utilization for the various MNCH components.
“State Governments should ensure that they do the needful to qualify for the basic health care fund by establishing and strengthening state primary healthcare development agency and commit to paying the counterpart funds of 25% as provided by the National Health Act,” PACFaH said.