Chijioke Iremeka
Amid calls by the United Nations Children’s Fund for countries to show more commitment so as to attain Sustainable Development Goal 3 by 2030, physicians said more effort is required than ever to reach the target goal of children’s survival and preservation.
The SDG Goal 3 targets to end preventable deaths of newborns and children under five years of age by 2030, with all countries aiming to reduce neonatal mortality to at least 12 per 1,000 live births and under-5 mortality to, at least, 25 per 1,000 live births.
Experts said six years before the SDGs targets, achieving Universal Health Coverage in Nigeria was a critical component of SDG 3, which aims at ensuring healthy lives and promoting well-being for people of all ages.
They held that more effort is needed across the country to achieve this goal, stressing that the government at all levels needs to show genuine concern for this struggle and stop paying lip service to the country’s healthcare sector.
According to the United Nations, SDGs are the blueprint to achieving a better and more sustainable future for all and addressing the global challenges facing the world that include poverty, inequality, climate change, environmental degradation, peace, and justice.
The UN noted that the 17 SDGs are interconnected, but in order not to leave anyone behind, it is important that the world achieve all by 2030.
To this end, the UN and UNICEF said that the countdown to 2030 initiative has been established to regularly track and monitor progress in countries facing the greatest burden of maternal and child mortality.
According to them, over the past two decades, there have been significant improvements in reducing maternal and child mortality, but progress has slowed in recent years.
They said that to be abreast of these efforts, the UN’s Countdown 2030 regularly updates its country profiles and dashboards with the latest available data for 145 countries on demographics, nutrition, coverage of key reproductive, maternal, newborn, adolescent, and child health interventions, equity, policy, systems, and financial flows.
Speaking exclusively with PUNCH Healthwise in different interviews, the physicians maintained that with such data, stakeholders can see whether progress is being made or whether there was stagnation in recent years so as to target their efforts accordingly.
A professor and Consultant Public Health Physician at the University of Ilorin Teaching Hospital, Kwara State, Tanimola Akande said 2030 SDG Goal 3 is a laudable goal towards getting countries to take steps towards reducing neonatal mortality to as low as 12 per 1, 000, and reducing under-five mortality to as low as 25 per thousand.
The don, who was at various times Head of the Department of Epidemiology and Community Health, University of Ilorin, Kwara State, said Nigeria has improved with a reduction in under 5 mortality rate to about 117 per thousand recently.
While saying that several programme interventions made this possible, he stressed that a lot is still required to achieve the SDG target as there are still pockets of deaths from diarrhoeal diseases in the country.
On Primary Health Care as the bedrock of the country’s National Health Policy, he said it is also a major healthcare delivery strategy that can make quality healthcare accessible and affordable to citizens without financial hardship.
“Therefore, with a weak Primary Health Care system, the achievement of PHC will be a mirage. UHC can only be achieved in Nigeria if we have a well-revitalised PHC system.
“Nigeria has developed policies and strategies towards achieving UHC. Some of them include revitalisation of PHC through making about 10,000 PHCs functional to deliver quality health care, the Basic Health Care Provision Fund, which makes funds available to PHCs to support health care delivery,” Akande said.
According to him, several other interventions are ongoing, lamenting that the level of funding in the country remains low.
He added, “To meet the target, the UHC a lot more needs to be done at all levels of government. There is a need for more political commitment to funding health care at all levels.
“The issue of shortage of health workers to be well addressed. Commitment and attitude of health workers need to improve significantly towards improving performance and improved health outcomes.”
More so, the Chairman of the South-West Chapter of the Nigerian Medical Association, Dr Babatunde Rosiji, said fewer health facilities and insufficient funding hinder the improvement of healthcare services and reduce the population’s access to affordable healthcare.
He said this would increase the provision of low-quality healthcare services, especially at the PHC level.
Rosiji, who is also a Consultant Gynaecologist and Obstetrician, said low standard healthcare often leads to unsatisfactory services.
He noted that it would deteriorate the health status of patients, resulting in complications that may bring about millions of premature deaths.
According to him, due to low public health expenditures, the average citizen’s health has not improved; instead, it has remained consistently low.
He also said investment in PHCs and health workers’ welfare would stop the japa syndrome.
Rosiji, “Infant and child mortality rates in Nigeria are among the world’s highest. This demonstrates the need to improve the healthcare sector outcomes and workers’ welfare. Health outcomes also influence economic growth.
“Poor health conditions reduce productivity and worsen economic performance, whereas better health has the opposite effect. To improve this, emphasis must be placed on PHCs as well as health workers’ welfare.
“Spending on workers who would man these PHCs would also help to attract them to the rural areas where the masses are. We need to attract doctors to the rural areas where the impact of health spending is not felt.
“If doctors are attracted to the rural areas, there won’t be the need for unnecessary crowding of tertiary facilities by patients for primary care-related cases.
“The people will know that they will meet a doctor at the PHCs in their communities and there won’t be a need to rush to tertiary facilities during emergencies. With this, we would have eliminated avoidable deaths among the rural dwellers.
“Of course, you can’t talk about quality healthcare services for the people without talking about health insurance for all, to end out-of-pocket spending, which impoverishes the masses further.
“Also, in budgeting, we need to place it side by side with the exchange rate. For me, we need to come to the point where funding will reduce the masses’ spending on medical services. Drugs and treatment should be affordable to all.”
He added, “These are the things good funds allocation would help us to achieve. Once the masses can get cheap services and medications, then our health financing is working.
“The government should be able to marry health financing to the facilities and human resources in the healthcare system. Poor health workers’ welfare is affecting the sector.
“Of course, the poor welfare of these practitioners and poor work environment also affects them. These are some of the reasons they are leaving the country. For us to tackle this problem, let the government replicate what is obtainable where they are going, so they can stay back. Poor facilities lead to brain drain and brain drain is a cancer. If we don’t deal with it together, it will consume all of us.”
Meanwhile, the WHO and UNICEF on Monday reported that the global child vaccination rates remained below pre-pandemic levels last year.
They held that in 2023, 84 per cent of children globally were fully vaccinated against diphtheria, tetanus, and pertussis or whooping cough, a triple vaccination considered a key indicator of child vaccination rates.
According to the report, the figure represents a slight decrease compared to pre-pandemic levels recorded in 2019, saying that the number of children without a single dose of the triple vaccination increased to 14.5 million last year, up from 12.8 million before the pandemic began.
It noted that many places experienced delays and disruptions in their vaccination programmes during the COVID-19 pandemic.
The WHO expert, Katherine O’Brien, said, “In some countries, the number of vaccine sceptics increased in the wake of the pandemic,” stressing that this development is resulting in the deaths of children.
She said that scepticism about vaccination in wealthier countries also affects other regions, especially when people with migration backgrounds based in Europe spread misinformation in their home countries.
The expert noted that a lack of trust in healthcare facilities and limited access to vaccines also hinder progress in immunisation in low-income countries.
According to the WHO and UNICEF, armed conflicts are another obstacle, with more than half of all children without immunisation living in countries characterised by instability, violence, and vulnerability.
They noted that over 100 countries have been affected by measles outbreaks in the past five years.
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