Early this month I took my first trip to Abuja, Nigeria. Despite visiting almost 60 countries with Save the Children, I had never been to the West African nation. It is a country of over 162 million, one of the most populous in the region and seventh most populous in the world. With an average family size of almost 7, it has the highest population growth in Africa-today, one out of every four inhabitants of the African continent is a Nigerian. While Nigeria may top the charts in these ways, it also unfortunately has the second-highest number of under-5 deaths. I wanted to understand about why so many children, and especially newborns, are dying in Nigeria.
What I found was a country of great contrasts, on the verge of development but held back by a weak health system, corruption, high rates of HIV/AIDS infection, and civil unrest. For children this is a dangerous mix. Infant mortality is very high at 97 deaths per 1000 live births, most children have dropped out of school by the 5th grade and the country is not on track to meet the Millennium Development Goals (MDGs)-goals to meet the needs of the world’s poorest populations-by 2015. The on-going fighting with the Islamist group Boko Haram in the north continues to take the government’s attention (and dollars) away from development activities that could help families.
But there were glimmers of hope, too, as I met with our team on the ground and with US and Nigerian officials. The President, Dr. Goodluck Jonathan, has pledged to commit more resources to health care and education. Polio cases continue to spike but have been controlled in the last year. And the US government continues to support large programs focused on children and families affected by HIV/AIDS, including hundreds of thousands of AIDS orphans. The popular Finance Minister, Ngozi Okonjo-Iweala, has been very engaged with the post-2015 MDG agenda as a member of the High Level Panel and there are many in the international community pulling for Nigeria’s sustained and increased progress.
This progress can be seen in many Nigerian villages. One of the specific programs I learned more about-and one that may hold the key to reducing the deaths of Nigerian babies-was the use of chlorhexidine, a medicine used on the umbilical cord of newborns to prevent infection. In rural areas and especially during at-home births, health workers are encouraging mothers to abandon traditional methods of treating the cord with mud (or even cow dung) in favor of this inexpensive cream. Chlorhexidine prevents infection, one of the leading causes of newborn deaths. If this intervention works, it not only starts saving babies right away but it also paves the way for health workers to introduce new information and interventions to mothers that will eventually lead to even more lives saved.
Nigeria has a long way to go to shed its second-from-the-top ranking and get to a higher place, where babies are brought safely into the world and children grow healthy and strong. Last week in Abuja, I saw glimmers of hope that they may be on the way.