Monday, 15 December 2008

Child Development Index (CDI) ranks Nigeria amongst the worst countries worldwide in terms of child health & development

Nigeria's Index Score :
1990-1994 49.37
1995-1999 43.06
2000-2006 40.53

Sub-Saharan Africa’s Regional Index Score :
1990-1994 43.4
1995-1999 41.0
2000-2006 34.5

CDI Ranking 126th of 137 countries (in 2000-06)

Save the Children UK has introduced the first ever multi-dimensional tool to monitor and compare the well-being of children around the world. More than 135 developed and developing countries worldwide have been assessed through the following methodology:
Each country has been given a score from 0-100, resulting in its ranking. The score is compiled by adding up each country’s performance in 3 child-specific areas: child mortality, child malnutrition, and primary school enrolment. A low score and ranking are best, representing a low level of child deprivation. Niger has the worse score, at 58, ranking 137th of 137 countries in 2000-06.

Nigeria’s Child Development Index score and its ranking are shown above; they are high, indicating a high level of child deprivation. It scores worse than the most recent Sub-Saharan Africa average score of 34.5, and much worse, predictably, than the world score of 17.5 in 2000-06. Nigeria is categorised as a low income country and its score is also higher than the average low income group score of 29.2.

Nigeria’s overall improvement of 18% is slower than the Sub-Saharan Africa (SSA) regional rate of improvement of 20.5% over all three periods, which is well below the world average improvement of 34%. Worst still, Nigeria ’s rate of improvement has stalled drastically; from a 12.8% improvement between the first and second period to a meagre 5.8% improvement between the second and last periods. This is in reverse to the SSA performance, which accelerated after the middle period.

Until recently, Nigeria was one of the most highly indebted countries in the world. At the same time, aid was scarce when it is considered that it is Africa ’s most densely populated country with over 140 million people. While Nigeria is one of the world’s largest oil producers, the country’s oil income amounts to just 24p per person per day.Shackled by a long history of military dictatorship, instability and corruption, the country has failed to integrate the commitment and resources necessary to achieve meaningful progress.

Looking at the individual indicators that make up the Index we see that although there does not seem to be a particular indicator driving Nigeria ’s results,the greatest improvements have been made in terms of the nutrition indicator, with a 20% positive change. Their education indicator has improved by 18% overall but as of 2005, only 63.4 % of all primary school-aged children were enrolled. Most worrying is the country’s under-5 mortality rate which remained at 191 deaths per 1,000 live births in 2006. Despite such a disturbingly high rate, Nigeria ’s improvement on this indicator has only improved by 17% overall. A 23% positive change between the first and second periods lost momentum and actually regressed by 9% between the second and last periods.

It is most interesting to compare how each country ranks in CDI Index with how each ranks in the UN’s Human Development Index (HDI). Nigeria comes 117th in a ranking of all 137 countries using the HDI, but 126th in the Child Development Index. This means that there is a significant difference between child well-being and adult well-being. In this case, Nigeria performs worse in terms of the CDI then the HDI.

The comparisons of CDI Index with income ranking and HDI ranking demonstrate that child well-being can often present a very different picture from traditional measures; this is why the Child Development Index should be disseminated throughout the world and used to help hold governments accountable on child well-being.

Friday, 12 December 2008


To join forces in the fight against abysmally high maternal and infant mortality in Nigeria the PARTNERSHIP FOR MATERNAL, NEWBORN AND CHILD HEALTH has been inaugurated in April 2008. The partnership includes not only various departments of the Federal Ministry of Health (such as Family Health, Nutrition, Child Health, Publicity Department), but also involves developmental partners as WHO and UNICEF, national and international non-governmental organizations and representatives of the private sector.

The first meeting introduced a new approach to curb maternal and child morbidity and mortality: The Integrated Maternal, Newborn and Child Health Strategy (IMNCHS). This strategy aims at a multi-sectoral partnership to address Nigeria’s grave problems within the health care delivery system through involvement of all participants: Health workers, nurses, pharmacists, community leaders, politicians, media executives.

The second meeting was held to make sure that the IMNCHS is effectively implemented and the partnership presented their activities in 2008, indentified key activities for 2009 and tried to build a concensus on the way forward. It was stated by the technical working group that Nigeria is still far from making progress towards achieving the Millennium Development Goals 4 & 5. But they also had good news to announce: The IMNCHS Document has been fully developed and trainings for service providers, midwives and journalists have been conducted so far. Furthermore, the Midwives Service Scheme (MSS) is about to start, a program that will recruite fresh fresh graduates from midwive schools and unemployed midwives to deploy themto underserved areas. WHO presented their NYSC Doctors Initiative which trains doctors to manage Emergency Obstetric Care (OEC).

But it was stressed that the main impediment towards ensuring quality health care is the lack of human resource. Other barriers are inadequate state data for monitoring progress, inequitable distribution of health workers, poor referral system, poor routine immunization, low level of health literacy and poverty as a cross-cutting issue, especially in terms of user fees.

The advocacy working group presented the engagement of Nigeria’s first ladies (First ladies MNC Initiative), formation of partnership with private sector organizations such as banks and development of advocacy materials. High level advocacy visits have been conducted by members of the advocacy committee and two TV appearances dealt with the PARTNERSHIP FOR MNCH so far.

But it was stressed that more public attention must be drawn to the poor health of mothers and children in the country. As Prof. Ladipo, Chairman of the advocacy and resource mobilization working group put it: “It is essential to improve the health literacy of our population and saturate the public with health information. We need weekly stories on maternal and infant mortality!”

Allocation of appropriate funds proved as a major obstacle, too. In these respect it was decided to shift more focus on advocacy visits to ministries, state governers, and media owners in 2009. In addition to that a database of all present and potential partners is to be developed, and information on activities and events of partners are to be communicated timely and amongst all partners to reach broad participation and mutual attention. Scale up of media trainings on IMNCHS was approved by all partners, and short & easy-to-remember slogans on Safe Motherhood are to be developed and aired frequently, following the example of HIV/AIDS messages.

After hours of fruitful discussions, a communiqué was approved and finally presented to the Permanent Secretary of Health Division, Dr. Abdullahi Salami. Looking at achievements and challenges, informing on possible solutions to the latter and pleading for support in their implementation, the communiqué stressed the importance of the involvement of local governments and interventions at community level. Dr. Salami expressed gratitude on behalf of the ministry for the meeting, which has suceeded in bringing together ideas and strategies of various players and was an important step in forming an effective synergy of actors trying to achieve the MDG’s. He closed the meeting with an appeal stressing the responsibility of everybody:

“Change begins with you and me. It is a shame where Nigeria stands today in terms of maternal and child health, looking at all her natural and human resources.”

*Sofia Krauss