STATE OF THE WORLD’S CHILDREN 2008

8/8/2019 STATE OF THE WORLD’S CHILDREN 2008

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Introduction

Definition of terms

Chapters

Definition of terms Comparative statistics

Challenges of the sub-saharan region

Challenges facingNigeria

Suggestions

Conclusion



What is a child·s life worth? SOWC is an Annual publication of UNICEF

in dec every year 2008 report published in december 2007,

contains data till dec. 2006 Published every year since the 1960·s. This

year for the first time STATE OF AFRICANCHILDREN was also published

Not just a collection of data! All the more important now because of the

MDGs 2008 is like mid-point to the 2015 end point



Each edition has atheme and subtheme.

2008 edition

164 page document Contains five chapters Ends with extensive

statistical annexure onperformance indicators

Then ranks 191 countriesbased on U5MR 2009 edition focuses on

maternal and newborncare



Note that globaleconomic crisis hadn·tyet occurred at this

time! SOWC helps to identify

countries with indicesthat impede growth

Other similar publications includeWHO·s ¶World HealthReport·



9.7 million children died b4 their 5th birthday in 2006 In 1960 it was 20 million 26,000 under 5 die every day 18 every minute! 810 b4 end of this 45 min seminar! Its not all gloomy, some regions have improved Causes and solutions are well known and documented Simple reliable and affordable solutions Challenge is to get them to the millions that need them

¾ Insecticide treated nets¾ Mama packs for safe delivery

Continuum of care¾ Time : pregnancy, childbirth, postpartum, infancy, childhood¾ Place : home, community, outreach, facility based care











Interventions haveevolved over time¾ EPI (1974): disease

control e.g. small pox¾

Alma ata (1978):comprehensive PHC¾ GOBI (1980·s): selective

PHC¾ Integrated approaches

(1990·s till date):Bamako initiative, IMCI,IMCNI etc

Lesson learnt: No singleapproach is applicablein all circumstances.



Based on:¾ Cohesive and inclusive community organisation

and participation

¾ Support and incentives for community healthcare workers

¾ Adequate programme supervision and support¾ Effective referral systems¾ Cooperation and coordination with other

programmes and sectors¾ Secure financing¾ Integration with district and national

programmes









Joint frame work dev by World Bank, WHO,UNICEF

5 point action plan¾ ACTION 1: realign programmes for diseases

¾ ACTION 2: make maternal and child healthcentral

¾ ACTION 3: improve financing

¾ ACTION 4: obtain national political commitment

¾ ACTION 5: create conditions for harmonizationof global health progs.

Central theme ² UNITY.



MDGs are not utopiantargets! They are wellthought out.

Currently representmankind·s best hope

30million children and 2million mother·s lives canbe saved b/w 2005 ²

2015

Reachable targets ifpolitical will is there



Six pivotal areas urgently need unifiedresponse1. Create a supportive environment for maternal,

newborn and child survival and health2. Develop and strengthen the continuum of care3. Scale up packages of essential services by

strengthening health systems and communitypartnerships

4. Expand the data, research & evidence base5. Leverage resources for mothers, newborn and

children6. Make maternal, newborn and child survival a

global imperative.







1. Need to Focus on communities & countieswith highest child mortality rates

2. Merits of packaging essential services

together to improve coverage3. Vital importance of community partnerships

4. Imperative of providing a continuum of care

5. Benefits of a strategic results oriented

approach to health system development6. Crucial role of political commitment,

national & international leadership

7. Necessity for greater harmonization of global

health progs & partnerships.



Nigerian examples of success not givenin report!

Certain plans and projections nowaffected by world economic crisis

Too much technical stuff and data, littlein the way of practical implementations

2009 report shows even more damningfigures

Prof Dora Akunyili·s rxn: Nigeria still indenial



UNICEF, UN, WHO, WORLD BANK, UNDPetc

Demographic & health surveys Multiple Indicator Cluster Surveys (MICS)

¾ Since 1995, nearly 200 surveys in 100countries

¾ 50 countries surveyed in 2005-2006.



Under 5 mortality rate :probability of dying b/wbirth & exactly 5 years ofage expressed per 1000 livebirths

I nfant mortality rate :probability of dying b/wbirth & exactly 1 yr of ageper 1000 live births

N eonatal mortality rate :probability of dying duringthe 1st 28 completed days of

life per 1000 live births Maternal mortality ratio :

annual no of deaths ofwomen from pregnancyrelated causes per 100,000live births.



Life expectancy at birth :no of yrs newbornchildren would live ifsubject to the mortalityrisks prevailing for a cross

section of the populationat the time of birth C rude death rate : Annual

no of deaths per 1000 ofthe population

C rude Birth rate : Annual

no. of births per 1000 ofthe population

Y outh literacy rate : No ofliterate persons aged 15 ² 24 expressed as a % ofthe total population in

that age group.



Gross Domestic Product: GDP is the sum ofvalue added by all resident producers + anyproduct taxes (less subsidies) not included inthe valuation of output. GDP per capita =GDP/ mid yr pop.

Gross Na tional Income: GDP + net receipts ofprimary income (compensation of employeesand property income) from abroad. GNI per capita = GNI/ mid yr pop. Expressed in dollars

T otal Fertility rate: No of children who wouldbe born per woman if she had lived to the endof her childbearing yrs & bore children at eachage in accordance with age specific fertilityrates.



































Sub saharan Africa: all counties south of the saharadesert except Djibouti, Sudan and South Africa

S.S Africa + South Asia = 95% of maternal deaths, 90% ofneonatal death & 82% of U5M

Nigeria & India singlehandedly contribute 1/3 of allmaternal deaths worldwide 1 in 9 maternal deaths occur in Nigeria 1 million under 5 children die annually in Nigeria 71% of population live on < 1$ a day

In Nigeria¾ Only 48% have access to clean water ¾ Only 44% use improved sanitation facilities¾ 6% of under 5 sleep under mosquito nets¾ 1% sleep under ITN¾ 34% suffering malaria receive proper antimalarial drugs

MDGs are far from sight!



Corruption

Lack of political will

Disruption of health systems by:¾ HIV, natural disasters and armed conflict

Weak links b/w communities & health systems

Shortage of trained skilled health workers

Poor funding

Poor coordination

Lack of laws to protect children

Poor female education & empowerment

Global economic meltdown



The world seems to have given up on us! Are the 2015 goals still achievable? YES. We must start now with:

1. Concerted & holistic intergovt, interagency, interministerial approach2. Work harder on IMNC Health strategy

x Immunization

x Nutritional supplements e.g vitamin Ax ITNsx PMTCTx Safe drinking water

x Basic sanitationx Care for pregnant women

3. Public enlightenment4. Curb corruption5. Upgrade and equip health facilities6. Provide extra incentive for health workers7. More funding for health, less dependence on aid8. Child protection laws



Be informed

Brainstorm on ways to bridge the gap b/wproblem & solution

Form partnerships

Educate those around you

Never keep quiet! Be an advocate for

children Never be part of the problem be part of the

solution

BELEIVE that things can and will change



SOWC 2008 is not just a collection ofdepressing statistics. It should be a call toarms.

Basis for action which are RESEARCH &DATA evaluation WELL ESTABLISHED!

The frame work which are COMMUNITYPARTNERSHIPS, THE CONTINUUM OF CARE,AND HEALTH SYSTEM STRENGHTENINGWELL DEFINED!

The means are thus in our hands All that is needed is will and action!











What is a child·s life worth?

How many children have died

worldwide in the course of this seminar? ¶there is no enterprise more noble or

reward more precious than saving thelife of a child·





UNICEF, The State Of the World·s Children 2008:Child Survival. New York, Dec 2007

UNICEF, The State of the World·s children 2008

in 20 questions (and answers) UNICEF, The State of African Children 2008:

Child Survival. Dec. 2007 World Health Organisation: World Health

Reports 1996-2007. Home page.

Indian Pediatrics: vol 45 pg 222-223, Mar 172008

All Africa.com: Nigeria: Country and highmaternal and child mortality, Feb 11 2009.





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STATE OF THE WORLD’S CHILDREN 2008