Nigeria

Situation Analysis
Impacts and costs
Estimated Impact in General Mortality and Incremental Cost
Mortality reduction MDG 4 & 5 Additional cost per
capita (US$)
Cost per live
saved (US$)
Number of childrens
live saved
Phase I (2007-2009) <5 year= 35.1% NNMR= 16.5%
MMR= 28.5%
10.85 1,770 442,695
Phase II (2010-2012) <5 year= 59.8% NNMR= 37.1%
MMR= 65.7%
19.05 2,605 840,228
Phase III (2013-2015) <5 year= 75.5% NMR= 54.1%
MMR= 85.0%
34.0 4,024 1,158,021
Estimated scal space and costing assumptions
Assumptions Scenario 1:
low case scenario
Scenario 2:
medium case scenario
Scenario 3:
high case scenario
Growth 6.8 % annual growth (-3.2% per capita) 6.8 % annual growth (-3.2% per capita 6.8 % annual growth; uctuates and sta-
bilizes at 8.3% annual (-3.2% per capita)
Domestic revenue 43.7 % of GDP in 2007, 42.6 in 2008
and 41.3 in 2009, then stable
43.7 % of GDP in 2007, 42.6 in 2008
and 41.3 in 2009, then stable
Increases by 3.0% to reach 56.1% by
2015
Budget support Increases to 8% of GDP Increases to 8% of GDP Increases to 8% of GDP
Allocation to health Stable at 5.8% of total budget Increases to 10% by 2015 Increases to 10% by 2015
Private Expenditures Increases by 1% Increases by 1% Increases by 5 %
Earmarked aid to
health
Doubles until 2015 (8% annual
increase)
Doubles until 2015 (8% annual
increase)
Doubles until 2015 (8% annual increase)
These additional estimates correspond to additional costs of 69%, 34% and 32% of the incremental public scal space for health by
2015 for the low, medium and high scal spaces respectively.
in the low case scenario it will be around $ 26.5 and will increase gradually to peak at $ 39 in 2016;
in the medium scenario it will be around $ 28.4 in 20 08 and will increase gradually to $ 80.4 in 2016;
in the high case scenario it will be around $ 29.2 in 2008 and will increase to $ 85.4 by 2016.
Basic indicators Health indicators
Total population: 140 millions inhab. Under-5 mortality rate : 195 per 1000 live births
Life expectancy at birth (years): 48 Infant mortality rate:100 per 1000 live births
GNI per capita (US$): 560 Neonatal mortality rate: 53 per 1000 live births
Population under 5: 20.1 millions inhab. New born low birth weight: 14%
Population growth rate : 3.2% Antenatal care coverage: 58%
Child marriage 1987-2005: 43% Maternal mortality ratio: 800 per 100,000 live births
Female as a % of males primary school, net: 89% Routine EPI vaccines nanced by government: 100%
About 1,000,000 Nigerian children die each year before their fth birthday
Annually an estimated 44,800 Nigerian women die from pregnancy related complications out of 5,600,000 pregnancies
Although many of these causes are preventable, the coverage and quality of health care services in Nigeria continue to fail women and
children. The key problems are both technical and operational.
Major causes of under ve and maternal mortality
Malnutrition
56%
Malaria 25%
Diarrhoeal
disease 4%
Other 6%
Preterm birth 23%
Congenital 7%
Tetanus 10%
Sever
infection 23%
Birth
Asphyxia 26%
Neonatal 26%
Diarrhea 16%
Measles 6%
HIV 5%
Pneumonia 21%
Major causes of under five mortality
Neonatal causes
The Integrated Maternal Newborn and Child Health Strategy (IMNCH)
Strategy for National Coordination and Roll out to states and Local Government Areas
Partnership for Integrated Maternal, Newborn and Child Health Strategy
Monitoring and Evaluation of Maternal, Newborn and Child Health Strategy
Selected evidence-based interventions
Neonatal Malaria Pneumonia Diarrhea
Family
oriented
community
based
services
Clean delivery and
core care
Putting to breast
within 30 min of
delivery
Temperature
management
Use of ITN
by under-5
children
Antimalarial
treatment
Use drinking
water
Zinc for diarrhea
management
Oral rehydration
therapy
Exclusive breastfeeding for children 0-5 months
Supplementary & Therapeutic feeding for malnourished children
Population
oriented
outreach and
schedulable
services
Tetanus immunization
Prevention and
treatment of anaemia
in pregnancy
Antenatal care
ITN for under
ve through
EPI and ANC
Individually
oriented
clinical
services
Resuscitation of
asphyctic newborn
Management of
neonatal infections at
PHC level
Skilled delivery
ACT for
children
Antibiotics
for U5
pneumonia
Antibiotics for
diarrhoea
Strategy to achieve the MDGs
ACHIEVING THE MDGs IN
Harmonization for Health in Africa (HHA)
Kakemono prepared in close collaboration with CESAG - UNICEF
Anemia 11%
Obstructed Labor 11%
Major causes of maternal mortality
Eclampsia 5%
Complicated
abortion 11%
haemorrhage 23%
Malaria 11%
Other 11%
Puerperal infection 11%
About 74% of these occur in the 1st week of life mainly due to pregnancy and delivery related complications
Example of Evidence based
interventions will contribute to
reach adequate coverage.
Preventive infant & Child care
Baseline
Phase 1
Phase 2
Phase 3
100%
0%
20%
40%
60%
80%
Vaccines
in stock
Availability
nurses/
midwives
Access
to EPI
DPTI
Fully
imunized
1-2 yrs
Fully
imunized
at 1 yr