By Abubakar Jimoh
In Nigeria, pneumonia and diarrhoea remain major killers of
children under 5 years, accounting for about 400,000 preventable deaths,
annually.
While an estimated 6.7 million cases of childhood pneumonia
are reported annually, Nigeria reportedly has the second largest burden of the
disease after India which has about ten times Nigeria population. Pneumonia and
diarrhoea are estimated to constitute 16% and 19% respectively of all causes of
death in children below the age of 5.
In 2010, in a report titled Integrated Management of
Childhood Illness by World Health Organization (WHO), diarrheal diseases were
observed amongst the most frequent childhood illnesses and leading cause of
preventable death, especially among children under five in developing countries
with Nigeria included. According to WHO, “acute diarrheal diseases are one of
the main problems affecting children in the world, reducing their well-being
and creating considerable demand for health services.”
A study conducted by the United States National Center for
Biotechnology Information (NCBI) in 2014 to develop context-specific strategies
to improve care-seeking for childhood illness, Nigeria was identified as a high
burden country with low rate of related treatment coverage, particularly in the
grassroots.
The study concluded that while simple, inexpensive treatments
are available for pneumonia and diarrhoea, yet too few children receive
appropriate and timely care, particularly in high burden country like Nigeria
and in the most deprived settings due to a range of interrelated
factors—insufficient supply of life-saving commodities and trained health
workers, poor geographic access to services, poor quality of care, as well as
user-related financial and non-financial barriers.
In 2015, 5.9 million children around the world were projected
would die before reaching their fifth birthday by WHO. 1 Of these 5.9 million
deaths, pneumonia was responsible for 16% and diarrhea was responsible for 9%,
making them two of the leading killers of children worldwide. Together, these
diseases claimed the lives of nearly 1.5 million children under the age of five
in a single year.
In another 2015 Progress Report on Pneumonia and Diarrhoea
report published by the International Vaccine Access Center (IVAC) in
collaboration with Johns Hopkins Bloomberg School of Public Health, it was
revealed that lives of six children are lost with each passing minute. The
report observes that although the number of child deaths in 2015 decreased
compared to 2013 (6.4 million), the overall contribution of pneumonia and
diarrhea to those deaths has remained rather steady (15-16% for pneumonia and
9% for diarrhea) over those two years.
In addition, the report bemoans pneumonia and diarrhea mortality
in young children as they continue to be disproportionately concentrated in a
few countries, year after year with 72% of the global burden of pneumonia and
diarrhea child deaths occur in just 15 countries, even though they are home to
only 55% of the world’s under-five population.
It is on the above premise that the Pharmaceutical Society of
Nigeria (PSN) under the aegis of Partnership for Advocacy in Child and Family
Health in Nigeria (PACFaH) notes that the global drive to halt unfavorable and
preventable under-5 death statistics led to the inauguration of the United Nations
Commission on Life-Saving Commodities (UNCoLSC) for Women and Children in 2010
with overall goal to increase access to essential life-saving commodities in 50
of the World's poorest and high burdened countries across the world.
As the UNCoLSC recommends effective guidelines (such as the
adoption of Amoxicillin Dispersible Tablets and Zinc/Lo-ORS) as first line
treatment of pneumonia and diarrhoea respectively to prevent the death of
children under-5, PSN-PACFaH is seriously worried over impending challenges
confronting effort to successfully combat the childhood killer diseases such as
lack of budget line item by governments at all levels for the procurement and
administration of life-saving commodities, poor political commitment and
awareness.
Also, WHO in 2010, recommended 'Flexible Solid Oral Dosage'
forms as the optimum formulation for Children's medicines administered orally,
as they have proven effective and durable than liquids/paediatric suspensions,
in addition to being less bulky to ship and store, especially in the grassroots.
It has become imperative for Nigerian Government to
institutionalise the UNCoLSC recommendations especially the Pneumonia and
Diarrhoea component that she co-chaired and signed in 2012.
According PSN-PACFaH, while preventive measures against
pneumonia and Diarrhoea like vaccinations, exclusive breastfeeding, regular
handwashing, vitamin A supplementation and proper nutrition are encouraged,
however, these may not be sufficient to stop the rising under mortality in the
country. Hence, full implementation of the UNCoLSC recommendations on Childhood
Pneumonia and Diarrhoea has become imperative.
Similarly, training and retraining programmes for the Front
Line Health workers to acquire the current knowledge and skills to effectively manage
childhood Pneumonia and Diarrhoea using Amoxicillin DT, and Zinc/ORS
respectively are paramount to successfully win battle against the diseases.
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