Nigeria has prioritized maternal survival as outlined by the fifth Millennium Development Goal (MDG) for maternal health.

After several years of advocacy and action, the number of maternal deaths in Nigeria still ranks second highest in the world. The estimated national Maternal Mortality Ratio (MMR) in Nigeria is 800 per 100,000 live births, resulting in 47,000 maternal deaths each year. For every woman who dies of maternal causes at least six newborns die and a further four babies are stillborn.

Recent progress has been made towards reducing child mortality but Nigeria is currently off tracks for MDG4 for child survival. Nigeria has achieved only an average of 1.2 per cent reduction in under-five mortality per year since 1990 yet needs to achieve an annual reduction rate of 10 per cent from now until 2015 to meet MDG4 for child survival. Given that its population is the largest in Africa, Nigeria’s failure to make inroads regarding MDGs significantly influences sub-Saharan Africa’s achievement of these goals as a whole and contributes disproportionately to global childhood mortality. About 5.9 million babies are born every year in Nigeria, and over one million of these children die before the age of five years.

There has been no measurable progress in reducing neonatal mortality in Nigeria over the past decade. Approximately one quarter (24 percent) of all under-five child deaths occur in the neonatal period, or the first month of life. In Nigeria alone, 280,000 newborns die every year – 778 deaths each day. Many of these deaths occur at home and are therefore unseen and uncounted in official statistics. The majority of new born deaths occur within the first week of life, reflecting the inextricable link between newborn survival and the quality of maternal care.

Why do Nigerians newborn die:

Despite the grim statistics, most of these newborns deaths are preventable. Birth asphyxia (27 percent), complications of preterm birth (25 percent), severe infections

(23 percent) and tetanus (8 percent) are the leading causes of death. Existing knowledge, technology and improving the quality and coverage of essential services can reduce neonatal mortality and save thousands of Nigerian newborn lives, without intensive care.

Status of newborn care in Nigeria:

The state of Nigeria’s newborns reflects the inadequacy and inaccessibility of the country’s overall health services. WHO has ranked Nigeria’s health system functioning 187th out of 191 countries. The Federal Ministry of Health articulated this concern in the improved maternal, newborn and child health strategy and seeks to promote maternal, newborn and child health throughout the continuum of care. This continuum connects care before pregnancy and throughout pregnancy, childbirth, postnatal and child health services.

In Nigeria, almost all key packages along the continuum of care have coverage of less than 560 percent, apart from one visit of antenatal care. Generally coverage is higher for outreach services such as antenatal care.

Antenatal care coverage is not much below the average for Africa, but immunization coverage is much lower, for example, across African countries the average DPT3 immunisation coverage is 72 percent. Yet in Nigeria coverage is just 49 percent. Encouragingly, new household survey data are pointing to 10 percent increase in coverage of skill attendance between 2003 and 2007, though national averages hide wide variations between states, urban and rural populations and between the rich and the poor, for example, three states in Nigeria have skilled attendance coverage over 90 percent, yet there are seven states where less than 10 percent of women give birth with a skilled attendant present.