If the collaboration among the trio of federal government, Delta state government and UNICEF is anything to go by, newborn and stillbirth would soon be a thing of the past. AMAECHI OKWARA writes from Asaba.
The increasing death of children, especially newborn, has called for serious concern at both local and international levels thereby neccessitating deliberate activities by the United Nations Children Fund (UNICEF) and World Health Organisation (WHO) to eliminate the scourge.
Globally, statistics has shown that newborn deaths account for 45 percent of deaths among children under the age of five, resulting in 2.7million lives lost each year.
In Nigeria, under-five mortality rate remains high with neonatal mortality rate contributing about 32 percent and its reduction is the lowest and has remained static for the past 15 years.
Investigation shows that 2.6million babies die in the last three months of pregnancy or during childbirth (still birth) while 303,000 maternal deaths occur each year.
The major causes of high mortality rate include prematurity, birth asphyxia and what is called sepsis in medical parlance. Other contributing factors are poor education status of women/ empowerment, low social class, ignorance, unavailability of skilled man power, poor infrastructure, lack of basic equipment, drugs and consumables as well as weak referral system.
The worrisome state of this newborn death was what led to the global Every Newborn Action Plan (ENAP), endorsed by 194 member states of the 67th World Health Assembly (Resolution WHA 67.10) and was launched by UNICEF in 2014.
Every newborn action plan provides a road map of strategic action for ending preventable newborn mortality and still birth and and contributing to reducing maternal mortality and morbidity rate.
The collaboration
The federal government in its deliberate effort to eliminate newborn deaths in Nigeria, launched the action plan in 2017 and charged states government to domesticate it.
Delta state government keyed into it and was the second to launch the plan after Rivers state with a well planned strategy to end the scourge.
Launching the plan in Asaba, the capital of Delta state, emphasis was on the need for state governments to key into every newborn action plan to reduce newborn death in the country.
‘Newborn’ deaths and ‘still birth’ call for concern and it should be taken very seriously to eliminnate the death to the bearest minimum.
The minister of health, Dr Osagie Ehanire, urged Delta state to fully implement the action plan to reduce neonatal mortality rate.
It was launched by Delta State Primary Healthcare Development Agency (DSPHDA) in collaboration with the United Nations Children Fund (UNICEF).
The minister, who was represented by Dr Bose Adeniran, a director in the ministry said the state must mobilise adequate resources to implement the action plan for newborn babies to survive and reach their full potentials.
Among other strategies to ensure the implementation, the minister called for capacity building for front line health workers at the primary, secondary and tertiary levels of healthcare services.
Dr. Ehanire commended the state for being the second to domesticate the action plan after Rivers which was first launched in 2017 by the federal government.
Secretary to the State Government, Mr Chiedu Ebie, while unveilling the action plan document lamented the worrisome rate of women and children mortality, noting that the launch was an indication of the state government’s commitment to ending the preventable newborn mortality.
According to him, “Each year, 289,000 women still die while giving birth, an estimated 18,000 children die every day from preventable diseases and circumstances and 2.9 million newborns die during their first 28 days of life.”
Mr. Ebie said that in 2014, the World Health Organisation (WHO) and UNICEF launched the ‘Every Newborn Action Plan’ to provide a roadmap of strategic actions for ending preventable newborn mortality, stillbirth and reduce maternal mortality.
Presenting the action plan document on behalf of the state government, a consultant, paediatrician at the Central Hospital, Asaba, Dr Peace Ighosewe, said the goal of the state is to reduce neonatal mortality rate from 32 death per 1,000 lives birth in 2019 to 15 deaths per 1,000 birth by 2030, while their vision has a zero tolerance to preventable death and still birth where all pregnancies are wanted; all birth celebrated and women, babies and children survive, thrive and reach their full potentials.
She said the implementation of the state action plan is the one that would bring about tremendous transformation in the current health indices, saying that the resultant effect would be a significant reduction in neonatal mortality in the state.
“This plan is aimed at working with all relevant stakeholders at the state and local government levels to ensure consistent availability of commodities and essential supplies for care around the time of delivery. “
She said emphasis would be on determining and implementing strategies that ensure all population groups are reached with high impact interventions, especially the marginalised, vulnerable and poorest population groups.
“It is for strengthning facility readiness by addressing the physical infrastructure and basic amenities such as safe water and electricity, ensuring adequate and competent staff/health workers are available, including midwives, nurses and physicians, providing quality, respectful care and ensuring that mediation and other necessary supplies are adequate. “
The consultant explained that the state would provide skilled and essential newborn training to all health professionals involved in the delivery and care of newborns especially midwives, health workers in the primary health facilities.
Dr Ighosewe recommended an increase in the number of consultant paediatricians in the state such that there would be at least one in each zone.
However she made mention of the availability of basic equipment for resuscitation of newborn such as ambu bag, suction machine and resuscitaire in all primary health care and hospitals where delivery takes place.
“To increase the number of funtional incubators and phototherapy units such that there are at least two incubators and four phototherapy units in one of the hospitals in each zone which would serve as referral centre to others in the zone,” Ighosewe said.
Global body’s assistance
Earlier at the, health specialist in UNICEF Rivers Field Office, Dr Eghe Abe, commended the Delta State Primary Health Care Development Agency for being able to develop document aimed at bringing about plans and activities that would reduce the unacceptable high levels of neonatal death in the state.
“It would interest all of us to note that while the under-five mortality rate has continued to reduce, the rate of decrease of newborn deaths has somewhat plumeted.” Therefore, for the state and country to achieve the SDGs, it needs to do things differently if the neonatal mortality rate is to reduce.
Dr Abe noted that, “It is in the light of this that UNICEF wholeheartedly supported the development of this plan. If the plan is fully implemented, it is believed that every newborn would not only survive but would thrive and develop to its full potentials.
“As we are all aware, there are emerging and strong evidence that progress towards achieving the SDGs by 2030 would only be made if we identify the greatest health disparities and reduce them.
The UNICEF field officer said further that, “UNICEF would continue to support the government of Delta state towards its effort at addressing disparities and inequities in health outcomes among the most marginalised people with poor health indicators.
“We would continue to support the state government with technical and financial assistance towards strengthened coordination of the health sector, data generation for evidence and development and use of framework for accelerating action for impact in order to achieve results for women and children especially the newborn.”
Dr Abe said it is only through those measures that one can ensure equity, social Justice, poverty alleviation and promotion of rapid human development.
Also speaking, the executive director, National Primary Health Care Development Agency, Dr Faisal Shuaib, said, “Regrettably, we have the knowledge and tools to prevent at least two-third of these deaths.
Shuaib, who was represented by a director in the agency, Dr Utibe Abasi Urua, said that every newborn action plan presents evidence-based solutions to prevent newborn death and still birth. It sets out a clear path to 2020 with specific global and national milestones.
“As the world transits to achieving sustainable development goals (SDGs), Nigeria must accelerate to improve outcomes for its newborn. This Delta State Every Newborn Action Plan (DSENAP) sets forth specific actions neccessary to achieve significant mortality reduction targets and coverage targets by 2030.
“It is also a vision of a country with no preventable death of newborn and still births, where every pregnancy is wanted, every birth celebrated, women, babies and children survive, thrive, and reach their full potentials”.
She said, “NIENAP presents a set of intervention packages aligned with the 10 key areas of the National Health Policy 2017-2021.
“The intervention packages follow a four gronged approach of promoting facility-based deliveries at scale addressing equity issue, stregthening of community – based intervention, stregthening of facility readiness for providing quality care for the newborn and provision of quality care for the newborn with focus on labour, birth and immediate care after birth during the first week of life.
“The document also defines a set of preliminary, national – level milestones and steps taken to identify core indicators that should be tracked to ascertain progress toward meeting targets.”
