Abstract
IntroductionAmong the most critical health systems components that requires strengthening to improve maternal, newborn and child health (MNCH) outcomes in Nigeria is the concept of equity. UNICEF has designed the equitable impact sensitive tool (EQUIST) to enable policymakers improve equity in MNCH and reduce disparities between the most marginalized mothers and young children and the better-off.MethodsUsing the latest available DHS data sets, we conducted EQUIST situation and scenario analysis of MNCH outcomes in Nigeria by sub-national categorization, wealth and by residence. We then identified the intervention package, the bottlenecks and strategies to address them and the number of deaths avertible.ResultsEQUIST profile analysis showed that the number of under-five deaths was considerably higher among the poorest and rural population in Nigeria, and was highest in North-West region. Neonatal causes, malaria, pneumonia and diarrhoea were responsible for most of the under-five deaths. Highest maternal mortality was recorded in the North-West Nigeria. Ante-partum, intrapartum and postpartum haemorrhages and hypertensive disorder, were responsible for highest maternal deaths. EQUIST scenario analysis showed that an intervention package of insecticide treated net can avert more than 20,000 under-five deaths and delivery by skilled professionals can avert nearly 17,000 under-five deaths. While as many as 3,370 maternal deaths can be averted by deployment of skilled professionals.ConclusionScaling up integrated packages of essential interventions across the continuum of care, addressing the human resource shortages in rural area and economic/social empowerment of women are policy recommendations that can improve MNCH outcomes in Nigeria.
Highlights
In Nigeria maternal and child health outcomes remain unacceptably poor, largely due to the weak health systems
There exists a wide variation in maternal mortality ratio (MMR) across the six Nigeria geo-political zones, with the northern zones generally having worst maternal, newborn and child health (MNCH) indicators than the southern zones [1]
The result of the Nigeria equitable impact sensitive tool (EQUIST) profile analysis showed that underfive mortality rate was highest in the North-West region (149/1000 live births) and the mortality figure was more than double the number obtained in the region with the lowest under-five mortality in Nigeria (South-West region) (72/1000 live births)
Summary
In Nigeria maternal and child health outcomes remain unacceptably poor, largely due to the weak health systems. There exists a wide variation in maternal mortality ratio (MMR) across the six Nigeria geo-political zones, with the northern zones generally having worst maternal, newborn and child health (MNCH) indicators than the southern zones [1]. Nigeria loses 2,300 under-five year olds and 145 women of childbearing age every day, making the country the second largest contributor to the under-five and maternal mortality in the world [1]. Many of these deaths which occur during pregnancy, labor and delivery are preventable, but the coverage and quality of health care services in Nigeria continue to fail women and children [1]
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