PREAMBLE:
The Partnership
for Advocacy in Child and Family Health (PACFaH) Project is an innovative
intervention implemented by eight leading Nigerian Civil Society Organizations
(CSOs) who have adopted advocacy as a key strategy in tackling the challenges
of gaps in policy, budgeting and administrative frameworks, with a view to
advance Child and Family Health in Nigeria. The PACFaH Project focuses on four
issue areas: Family Planning, Routine
Immunization, Nutrition and Management of Child Killer Diseases-Pneumonia and
Diarrhoea.
The PACFaH Project
is implemented by Association for the
Advancement of Family Planning (AAFP), Community
Health Research Initiative (CHR), Civil
Society Legislative Advocacy Centre (CISLAC), Civil Society Scaling up Nutrition in Nigeria (CS-SUNN), development Research and Projects Centre
(dRPC), Federation of Muslim Women Associations in Nigeria (FOMWAN),
Health Reform Foundation of Nigeria
(HERFON) and Pharmaceutical Society
of Nigeria (PSN) in the following locations—Bauchi, FCT, Kaduna, Kano,
Lagos, Nasarawa, Niger and Oyo.
The Heads of State
and Government of the then Organization of African Unity (OAU) instituted in
1991 the Day of the African Child (DAC) celebration. June 16th of
every year was set aside to highlight the challenges faced daily by the African
Child. The 2016 theme is “Conflict and Crisis in Africa: Protecting all Children’s Rights”.
Access to quality healthcare is a fundamental Right of the African Child. This
Press Statement focuses on the sub-theme “Protecting
the Children’s Rights: Fund Child and Family Health”.
FAMILY
PLANNING:
Family Planning (FP) or Child spacing has been proven to be a very useful intervention in
addressing Child and Maternal Mortality rate. According to the 2013 Nigeria Demographic Health Survey (NDHS 2013), Nigeria has a Maternal Mortality
Rate (MMR) of 576/100,000 Live-Births, with one woman out of every
29 Nigerians facing a lifetime risk of death during Childbirth. Family Planning has been universally recognized as one of the key
pillars and approach towards achieving safe Motherhood and survival of the
Child directly and indirectly (it’s only a Healthy Mother that can PROVIDE
& PROTECT THE CHILD).
Due to its direct
positive impacts on the Health of the Family and consequently the Economy of a
Nation as a whole, meeting the unmet need for Family Planning can help
Nigeria significantly reduce Maternal and Child Mortality.
Demographic dividend which is the accelerated economic
growth that may result from a decline in the Country’s Mortality and Fertility
and the subsequent change in the age structure of the population can be
achieved through an effective Family
Planning Program. Providing
Family Planning or Child Spacing will avert at least Thirty-One Thousand (31,000) Maternal deaths, with over Seven Hundred Thousand (700,000) Mothers
prevented from injuries or long-term complications due to Childbirth.
Hence, we urge Governments at all
levels on:
·
Provision of appreciable access to Family Planning services
through adequate budget provision, fulfilled Government’s commitment (London
Summit) to Family Planning related issues;
·
Massive awareness creation on the appropriate compliance to
the required Medical procedures in administering Family Planning services
to secure individuals’ confidence and acceptance;
·
Prompt adoption and implementation of the National Blue Print on Family Planning
(Scale-up Plan 2014–2018) and the Costed Implementation Plans to reflect
the local context to promote effective implementation across the Country;
·
Sustained Free Family
Planning Commodity Policy in all
Public Health Facilities; and ensure uninterrupted supply of Consumables to
make the Free Family Planning services really free,
particularly to the poor Women in the Communities;
·
Adequate funds allocation for procurement of Family Planning Commodities and Consumables are released and used for that
purpose;
·
Increase accountability and
budgetary transparency for Family Planning Programs.
ROUTINE IMMUNIZATION:
Immunization
is the best buy in Public Health! Every Child has a right to access Life-Saving
vaccines that would protect them against vaccine preventable diseases such as; Tuberculosis, Tetanus, Diphtheria, Meningitis, Pneumonia, Measles, Polio, etc. These Childhood Killer Diseases
constitute a huge burden to our Society and is a major cause of deaths in Children
below the age of five. The Routine
Immunization system in Nigeria is
confronted with several challenges such as imminent shortage of funding for vaccines,
inadequate budget for Routine Immunization, delay and piecemeal
release of funds for Routine Immunization.
The
recent announcement by the World Health
Organisation (WHO) declaring Nigeria’s interruption of the long-time
dreadful Polio endemic may soon resurge in the absence of provision of adequate
finances by the Government to sustain intervention on Routine Immunization in
the Country. We appreciate the Federal Government for the allocation of N12.6 Billion for immunization covering
Polio campaign and immunization in the 2016 appropriated act. However, the Routine Immunization funds in the N12.6
billion are very minimal to cater for the 2016 vaccine procurement
requirement.
We hereby call on
the Government:
·
For timely release of the Routine Immunization appropriated funds for 2016 and full implementation of
the budget;
·
President Buhari to submit a
supplementary budget to cater for the 2016 funding gap for Routine Immunization;
·
To encourage the active participation
of CSOs and Media in the budget process;
·
To ensure adequate preparation for Leadership,
commitment and capacity to identify and plan for sustainable sources of funding
for Routine Immunization beyond 2021, as Nigeria begins transition from the
Global Alliance Vaccines Initiative (GAVI) support.
NUTRITION:
Adequate and proper Nutrition
is another fundamental Right of the African Child. Unfortunately, African
Children die daily due to preventable Malnutrition related illnesses.
Malnutrition among Women and Children is a major challenge to Health and Human
development of any Country. Malnutrition
is a condition that occurs when people consistently do not consume or absorb
the right amounts and types of Food and Essential Nutrients. Malnourished Children have an increased risk
of disability and premature Death and are highly predisposed to infectious
diseases. Nigeria has one of the highest burdens of Malnutrition Globally and
ranks second globally with about Eleven
Million stunted Children.
The main indicator
for malnutrition is stunting-when
Children are too short for
their age. Stunted Children have poor physical growth
which is irreversible and associated with poor brain development and reduced School
and work performance. Nationally the Nigeria
Demographic and Health Survey (NDHS) Results of 2013, reported at the National
level shows; prevalence of Stunting Thirty-Seven
percent (37%), Underweight Twenty-Nine
(29%), and Wasting Eighteen (18%)
in Children under five years old. In Kaduna State, Stunting is at Fifty-Six point Six percent (56.6%), Underweight
Fifty-Seven point Six percent (57.6%),
and Wasting Forty-Two (42%) in Children
under five years old. This means Kaduna State with Fifty-Six point Six percent (56.6%) Stunting has the third highest
number of Stunted Children under-5 years of age in Nigeria after Kebbi with Sixty-One percent (61%) and Katsina and
Jigawa with Fifty-Nine (59%)
respectively.
The renewed international focus and donor commitment
to address malnutrition has prompted the Nigerian Government to implement new
policies and initiatives, culminating in the development of National Strategic Plan of Action for
Nutrition (NSPAN) 2014 -2019 which sets out Nutrition-specific.
The Nigerian Government, through the Federal Ministry
of Health (FMoH), has developed the Health Sector Component on National Food and Nutrition Policy:
National Strategic Plan of Action for Nutrition (NSPAN) 2014 -2019. The
document, if adopted and fully implemented, at the State and Local Government
Area levels, will by 2019 reduce Stunting
by Twenty percent (20%), reduce Childhood Wasting by Fifteen percent
(15%) and increase Exclusive Breast Feeding in the first six months by Fifty percent (50%).
We
urge Governments at the National and State levels to:
·
Adopt the National Strategic Plan of Action (NSPAN);
·
Implement the NSPAN with specific focus on Maternal
and Child Nutrition component of the plan;
·
Create of
specific budget line on Nutrition across relevant institutions, encourage Exclusive Breast Feeding, adoption and
effective implementation of the costed NSPAN
at all levels to combat endemic Malnutrition in the Country;
·
Increase funding
for Maternal and Child Nutrition at the Ministries of Health and Agriculture;
·
Ensure prompt
release and effective management of budgeted funds to promote accountability
and transparency in Government spending on Nutrition.
MANAGEMENT
OF CHILDHOOD KILLER DISEASES-PENUMONIA & DIARRHOEA:
The African Child
is plagued with many Health challenges-most of which are preventable and
treatable. The most recent Nigeria
Demographic Health Survey (NDHS 2013) puts the National Annual Live-Birth
figure as Seven Million, Twenty-Eight
Thousand (7,028,000), of which Eight Hundred
and Fifty-Four Thousand (854,000) die before their fifth (5th)
birthday. The NDHS 2013 further indicates that for every One Thousand (1,000)
live-birth, One Hundred and Twenty-Eight (128) of them will die before
they mark their fifth (5th) Birthday (Under-5 Mortality Rate:
128 per thousand Live-Births). This translates to one in every eight
Children in Nigeria dying before they reach five years of age.
Pneumonia and Diarrhoea
account for 14% and 9% (respectively) of the U-5 Mortality rate amongst
Nigerian children. Thus, in Nigeria no fewer than Four Hundred Thousand (400,000) children die annually from Pneumonia
and Diarrhoea.
The major reason for these
preventable deaths is POOR ACCESS TO HEALTHCARE, PARTICULARLY IN RURAL AREAS
(which is a fundamental Right of the African Child). This
problem can be effectively addressed by ensuring the following:
·
Availability (up to the Community level) of recommended Essential Drugs
(Amoxicillin Dispersible Tablet-Amoxicillin DT-and Zinc Low Osmolarity Oral
Rehydration Salt-Zn-LO-ORS) for treating these Childhood Killer Diseases
(Pneumonia and Diarrhoea);
·
Improved Healthcare seeking behaviour amongst Parents/Caregivers and
appropriate referral to Healthcare Facilities;
As we mark the Day of the African Child today we
urge the Government of Nigeria and relevant Stakeholders to place high premium
on the adequate management of the aforementioned preventable and treatable
Childhood Killers.
Our specific advocacy requests are:
·
The adoption and listing of Amoxicillin DT as the First Line Drug for the
Management of Childhood Pneumonia in the National Standard Treatment Guidelines
and the National Essential Medicines List;
·
States’
Ministry of Health to invest in and scale up the implementation of the National
Guideline on Integrated Community Case Management (iCCM) of Childhood illness
for the reduction of under-5 mortality, as directed by the 58th
National Council of Health Meeting held in Sokoto in March 2016;
·
The implementation of the approved National Task
Shifting/Task Sharing Policy at all levels as directed by the 58th National Council of Health Meeting held
in Sokoto in March 2016;
·
Increase Public awareness and acceptance of the use of Zinc-LO-ORS
Co-pack as the First Line Drug in the Management of Childhood Diarrhoea;
·
The creation of a SPECIFIC BUDGET
LINE for the procurement of these Essential Drugs (Amoxicillin DT and
Zn-LO-ORS) that have been shown to reduce Pneumonia and Diarrhoea Deaths
Globally and Nationally;
·
Timely release and judicious use of funds allocated for the procurement
of these Essential Medicines as captured in the budget.
The PACFaH team is optimistic
that the implementation of these advocacy requests will drastically reduce the
unfavourable Maternal and Childhood Mortality from avoidable Maternal Deaths
via increased uptake of Family Planning Commodities, Childhood Deaths due to
Malnutrition, Vaccines preventable Diseases and Treatable Pneumonia and
Diarrhoea in Nigeria.
Distinguished Gentlemen
of the Press, we once again affirm our belief that Access to Quality Healthcare
is a fundamental Right of the African Child.
The Healthier the Mother;
the higher the chances of the Child survival and protection
Immunization is the Right
of the African Child and the responsibility of us all; working together, we can
close the Immunization gaps.
Let us end Malnutrition;
proper and adequate Nutrition is a basic Right of the African Child.
This is the right time to
end preventable and treatable Childhood Pneumonia and Diarrhoea Deaths; Let us
join hands as Men and Women of Honour. #EndPneumonia #End Diarrhoea
Thank you for your
attention.
Signed:
Chioma
Kanu,
Program Manager,
Civil Society Legislative
Advocacy Centre (CISLAC)
Dr.
Hassana Adamu
Program Manager,
Health Reform Foundation of
Nigeria (HERFON)
Diana
E. Edema-Sillo,
Program Officer/Manager,
Community Health Research
Initiative (CHR)
Sunday
Okoronkwo,
Program Manager,
Civil Society Scaling up
Nutrition in Nigeria (CS-SUNN)
David
E. O. Akpotor,
Senior Program Officer,
Pharmaceutical Society of
Nigeria (PSN)
