Chapter One
Introduction
1.1 Background of the Study
World leaders at the Millennium Summit in September 2000 adopted the Millennium Declaration, committing their nations to reducing poverty; improving health; and promoting peace, human rights, and environmental sustainability. The Millennium Development Goals (MDGs) are a set of eight goals which member states of the United Nations are committed to achieve by the year 2015 and were unanimously accepted as the framework for measuring progress in development. Specifically, the MDGs are a global pact between developing and developed countries (Amina az-Zubair 2009). They represent a bold attempt at changing the current skewed and undesirable global development patterns and lead many developing countries into the desirable level of equitable economic development (Richardson et al 2008). The eight MDGs are: Eradicate Extreme Poverty and Hunger, Achieve Universal Primary Education, Promote Gender Equality and Empower Women, Reduce Child Mortality, Improve Maternal Health, Combat HIV, Malaria and Other Diseases, Ensure Environmental Sustainability and Develop a Global Partnership for Development (MDGs 2000).
Since the 2000 summit, nations of the world have adopted different strategies to meet the 2015 target. Nigeria for instance, came up with the National Economic Empowerment and Development Strategy (NEEDS), Universal Basic Education (UBE) and to facilitate the attainment of these goals created the Office of the Senior Special Assistant to the President on MDGs (OSSAPMDGs).
This office is primarily mandated to establish a virtual poverty fund (VPF) that will channel resources derived from the Debt Relief Gains (DRG) to MDGs related projects and programmes (Emenalo 2010). Nigeria has also been carrying out a lot of expenditure to meet the 2015 target. According to Hajiya Amina az-Zubair (2009) former Senior Special Assistant to the President on the MDGs, three hundred and twenty billion naira only (₦320 bn) was appropriated for the period 2006-2008 to scale-up investments in achieving the MDGs. This represented 16% of the cumulative Federal Capital Budget for that period. However, many women and children still die in Nigeria when compared to most other countries. About 53,000 women die every year, which means one woman dying every 10 minutes.
They die from complications during pregnancy and delivery, which include: Excessive bleeding (or Haemorrhage), Infections, Pregnancy-induced high blood pressure leading to convulsions, Unsafe abortion, Anaemia, Malaria, and Obstructed labour The situation of children is even worse. About 1 million children under the age of 5 years die every year. That translates into 114 deaths every hour. One out of every four of these deaths (about 250,000) is of a newborn—a baby less than one month old! These children die mainly from: Complications of low birth weight; Inability to begin breathing after birth (asphyxia); Infections; Malaria; and Pneumonia. Most of them die on the first day or the first week of life. The situation is tragic because we fail to provide these children with interventions that are, effective, available, affordable and with wide coverage especially in settings where there are difficulties in providing funds and personnel. The childhood killers include diarrhoea, measles and other vaccine-preventable diseases, as well as HIV/AIDS.
Malnutrition is associated with more than half of these deaths. The current situation of women and children is such that if we do not arrest the trends in maternal and child health, Nigeria will not attain the 4th and 5th MDGs. Current efforts can only lead to reduction of the present child death rate of 195 in every 1,000 live births to just 176 by 2015, instead of the nation’s MDG 4 target, which is 77 deaths out of every 1,000 live births. Similarly, with current efforts, deaths among women due to pregnancy and childbirth, which at present is an unacceptable 800 in every 100,000 live births, will only drop to 540. This is a far cry from MDG 5, which is to reduce such deaths to 250 per 100,000 live births.
Maternal and Child mortality is not an uncommon event in several parts of the developing world. Mothers and children are at highest risk for disease and death. While motherhood is often a positive and fulfilling experience, for too many women, it is associated with ill–health and even death (Olatoye, 2009). The death of a woman during pregnancy, labor or pueperium is a tragedy that carries a huge burden of grief and pain, and has been described as a major public health problem in developing countries. Women have an enormous impact on their families’ welfare. Deaths of infants/children under five are peculiar and closely related to maternal health. One million children die each year because their mother has died, and the risk of death of children less than five years doubles if mothers die in childbirth.
More than 25,000 children die every day and every minute a woman dies in child birth. Worldwide, every year about 500,000 women die due to child birth and over 9 million children under age five die mostly from preventable and treatable diseases (WHO, 2003). Available evidence indicates that Northern part of the country accounts for the highest burden of mortality among women and children in Nigeria (Udofia and Okonofua, 2008; Prata et al., 2008).
This unhealthy trend has become a matter of great concern, calling for concerted approach for all and sundry. The Millennium Development Goals (MDGs) by the global community focuses attention, resources, and action on improving the well-being of all peoples. Two of the goals (MDGs 4 and 5) were to reduce the childhood mortality rate and maternal mortality ratio, by two-thirds and three quarters (75%) respectively between 1990 and 2015. It is expected that decline in child/maternal mortality must accelerate substantially in the period to 2015, if any country is to reach these goals.
Nigeria is the most populous Black Country in Africa with about 160 million people including 75 million children (Ogbonaya and Aminu, 2009). The child and maternal mortality rate of this country is very significant and has implications for the attainment of the MDGs. It has been noted that Nigeria is lagging behind in achieving universal coverage of key maternal and child health intervention and will unlikely meet the target of the MDGs. According to UNICEF Executive Director, Ann Veneman, “midway to 2015 deadline for MDGs, Nigeria continues to record unacceptably high maternal, newborn and child mortality”. Nigeria ranks as one of the 13 countries in the world with the highest maternal mortality rate and is still not listed among the 10 countries seen to have made rapid progress to meet the goals.
1.2 Statement of Problem
Poverty and the people’s inability to pay for health care in Nigeria is one of the major factors behind the high maternal and Under-5 mortality rates. Indeed, despite the enormous income from oil over the last 40 years, more than 60 per cent of Nigerians are still poor, and the majority of these are women living in the rural areas, where the maternal mortality rate is more than double that in the urban areas. Health consumers generally have to pay for treatment at the point of delivery, but the majority cannot do so because they do not have the means or any form of health insurance. The cost of health care therefore greatly limits access for the vast majority of poor people who need it the most. To arrest the trend of maternal and child, there has been a need for new thinking, which led to the development of the MDGs intervention programmes.
Furthermore, every single day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age (Ayo, 2005). This makes the country the second largest contributor to the under–five and maternal mortality rate in the world. Underneath the statistics lies the pain of human tragedy, for thousands of families who have lost their children. Even more devastating is the knowledge that, according to recent research, essential interventions reaching women and babies on time would have averted most of these deaths.
Although, analyses of 2010 show that the country is making progress in cutting down infant and under-five mortality rates, the pace still remains too slow to achieve the Millennium Development Goals of reducing child mortality by one third by 2015. Preventable or treatable infectious diseases such as malaria, pneumonia, diarrhoea, measles and HIV/AIDS account for more than 70 per cent of the estimated one million under-five deaths in Nigeria (UNDP,2006).
Malnutrition is the underlying cause of morbidity and mortality of a large proportion of children under-5 in Nigeria. It accounts for more than 50 per cent of death of children in this age bracket. The death of newborn babies in Nigeria represents a quarter of the total number of death of children under-five. The majority of these occur within the first week of life, mainly due to complications during pregnancy and delivery reflecting the intimate link between newborn survival and the quality of maternal care. Main causes of neonatal deaths are birth asphyxia, severe infection including tetanus and premature birth.
In view of the above, questions that agitates the researchers mind are:
i.What is the impact of MDGs intervention in reducing child mortality rate in Nasarawa state?
ii.What is the Government doing to fast track the activities of MDGs in achieving the target of reducing child mortality in Nasarawa state?
iii.What are other variables affecting child mortality?
iv.What have the government done and what are they doing in order to reduce child mortality?
1.3 Objectives of the Study
The broad objective of this study is to evaluate the impact of MDGs intervention on child mortality rate in Nigeria, with a particular reference to obi Local Governmet Area Nasarawa state; while the Specific objectives are as follows:
i.To ascertain the level of MDGs intervention and how it has impacted on the child mortality rate in Nasarawa state.
ii.To examine what Government is doing to fast track the activities of MDGs in achieving the target of reducing child mortality in Nasarawa state
iii.To discuss other variables affecting child mortality
iv.To examine what government has done and what they are doing in order to reduce child mortality
1.4Statement of Hypothesis
The hypothesis for the study is stated below;
H0: MDGs intervention has no significant impact on child mortality in Nasarawa state.
H1: MDGs intervention has a significant impact on child mortality in Nasarawa state.
1.5Significance of the Study
This study will be relevant in the following ways:
First, the study will serve a number of purposes for all the relevant stakeholders. Secondly, it will provide a handy volume containing a collection of research efforts of different scholars in the field of child mortality and MDGs, Thirdly, many studies do not adequately bring out the policy implication of their results; this study will fill that gap. Fourthly, the study will serve to demonstrate how some of the challenges facing MDGs and Child mortality can be overcome. In addition, it will assist the Nasarawa state government and policy makers on how to come up with policies and programmes that will benefit the rural poor and women. Finally, it is believed that the study will not only contribute to the existing literature on MDGs and child mortality, but it will also provide policy makers with relevant information on how best to initiate policies and programmes that will reduce child mortality.
1.6Scope of the Study
The study focused on the impact of MDGs intervention on child mortality rate obi Local Government Area, Nasarawa state (2001-2014).
1.7Limitations of the Study
The major constraint of this research work was sourcing for the relevant information from health sector in Nasarawa state, MDGs office, Central Bank of Nigeria, National Bureau of Statistics, Public and Private Sector within Nasarawa State. Some of the institutions or departments were unable to release some vital information considered as critical to the survival of the organization. In addition, inadequate financial resources which affected the sourcing and collection of all relevant information needed for this research work was a constraint. The cost of visiting institution such as CBN and Nasarawa State Ministry of health to obtain relevant information was also a constraint.
1.8 Plan of the Study
This research work is divided into 5 chapters, Chapter one (1) contain the General Introduction, Chapter two (2) reviews the related literature and provides the conceptual, empirical and theoretical frame work, Chapter three (3) contains the methodology of the study, Chapter four (4) analyze and interpret the data, Chapter five (5) summarizes, concludes and makes necessary recommendations
1.9 Definition of Terms
Some Key terms used in this study are defined as follows:
Maternal Death: World Health Organization (WHO) 2006, defines maternal death as the death of women while pregnant or within 42 days of termination of pregnancy irrespective of the duration and site of the pregnancy from any cause related to, or aggravated by the pregnancy or its management but not from accidental or incidental causes.
Child mortality on the other hand, is the death of a child under five years, while infant mortality is the death of a child under 1 year.
MDGS: This is goals geared towards the reduction of poverty and encouragement of rapid progress in the improvement of the world.
Call 07032879723 or send mail to michaelonjewu@yahoo.com for the complete project
No comments:
Post a Comment