Nigeria’s Health Statistics and Trends

Dr Zipporah Kpamor Being a presentation at the Nigeria Behind the Headlines:

Population, Health, Natural Resources, and Governance Conference organized by

The Woodrow Wilson International Center for Scholars Environmental Change and Security Program, Global Health Initiative, and Africa

Program 25 April 2012

Introduction 1 • Nigeria is a country on the West

Coast of Africa; • It is the most populous black

country in the world • Nigeria has a young population

– 52% live in rural areas • Nigeria is rich in diversity:

– with substantial oil reserves – over 70% poor. – significantly economic growth

unimproved everyday livelihoods. • Nigeria has some of the poorest

health indicators in the world • Why?

Introduction cont’d • Nigeria operates a

Federal System of Government with three levels;

• There are 774 LGAs within the 36 states and Federal Capital Territory (FCT) Abuja.

• The states and FCT are grouped into six geo-political zones:

Source: NSHDP 2009

The Health System • The Nigeria Health System is fashioned after the

3 tiers of Government • Players

– Government – Non- Government Players: – Donors – USG; DFID, Global Fund

• PHC – adopted to provide health for all Nigerians. – Very little community participation

• Quality of care needs substantial improvement.

Trend and Targets of Selected Health indicators

Indicator 2003 2008 2015 Target

Population 124 million 158 million* Life expectancy at birth 46.5 47 years 70 years TFR 5.7 5.7 children Modern method CPR 8% 10% 36% Unmet need for FP 17% 20% 0% Maternal Mortality Ratio 800/100,00

0 LB 545/100,000 LB

136/100,000 LB

Women with at least 4 antenatal care (ANC) visits

48% 45%

Births delivered by a skilled provider

43% 39% 100%

Sources: 2003 NDHS; 2008 NDHS; UNDESA, 2010*; FMOH**

Trends and Targets of Selected Health Indicators cont’d

Indicator 2003 2008 2015 Target

Infant mortality rate (IMR) 100/1000LB

75/1,000 LB

30/1000 LB

Under-five MR 201/1000LB

157/1,000 LB

75/1000 LB

Proportion of 1 year old children immunized against Measles

60% 41 % 95%

Children under 5 who are underweight for age

29% 23% 18%

Children under 5 who slept under an ITN the night before the survey

1.2% 23% 60 %

HIV prevalence 5.0% 4.1% ** 1% Sources: 2003 NDHS; 2008 NDHS; UNDESA 2010*; FMOH**; MDG 2010 Report

7

Grew 12 fold in a century!

Source: PRB

Population of Nigeria Rapid Growth

8

Large Population

Source: www.worldmapper.org

In P

ersp

ectiv

e

Nigeria

9

Projected Population 2050 Why is Nigeria failing to meet its goal

Source: www.worldmapper.org

Nigeria

6.3 5.7

4.0

3.0 2.7 2.5 1.9

0

2

4

6

8

Chad Nigeria Ghana Egypt India Brazil Iran

Birt

hs p

er W

oman

(ave

rage

)

10 Source: 2008 NDHS

Fertility Comparison Nigeria and selected countries

Nigeria has a very high fertility compared to other nations, whether they be Muslim, Christian, richer or poorer, larger or smaller … Why?

In P

ersp

ectiv

e

11

Maternal Mortality

Source: www.worldmapper.org

In P

ersp

ectiv

e

Nigeria

MDG goal

0

200

400

600

800

1,000

1,200

1990 1995 2000 2005 2010 2015

Mat

erna

l Mor

talit

y R

atio

Sources: 1990, 1999, 2003, and 2008 NDHS; MDG 2010 Report

MDG Goal #5: Lower Maternal Mortality Why is Nigeria failing to meet its goal?

In P

ersp

ectiv

e

12

13

Child Mortality

Source: www.worldmapper.org

In P

ersp

ectiv

e

Nigeria

MDG goal

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015

Chi

ld D

eath

s pe

r 100

0 Li

ve

Birt

hs

Photo by Joachim

Huber Sources: 1990, 2003, and 2008 NDHS; MDG 2010 Report

MDG Goal #4: Lower Child Mortality Why is Nigeria failing to meet its goal?

In P

ersp

ectiv

e

14

15

Government Spending on Healthcare

Source: www.worldmapper.org

In P

ersp

ectiv

e

40

50

60

70

500 1,500 2,500

Life

Exp

ecta

ncy

at B

irth

(yea

rs)

GDP per Person in US Dollars (purchasing power adjusted)

16 Source: www.gapminder.org

Health Comparison, 2010 Many countries with less wealth than Nigeria have achieved better health

In P

ersp

ectiv

e

Bangladesh

Nigeria Chad

Senegal

Guinea Ghana

Malawi Why?

17

HIV Prevalence

Source: FMOH 2010

GON’s Response thus far

• Political will – country ownership • Policies, Guidelines; Coordination

bodies o National Strategic Health Development

Plan (NSHDP) 2010-2015 o National Policy on Population for

Sustainable Development (NPPSD) o National Primary Health Care

Development Agency (NPHCDA) o MDG Office - Oversight of Public

Expenditure in Nigeria (OPEN) o NEEDS; NAPEP

• Health Bill

What must Nigeria do?

• Ensure leadership, governance, management and accountability

• Improve Human Resources for Health (HRH)

• Improve delivery of the highest impact interventions, particularly at the PHC level

• Reduce poverty – Poverty – Ignorance – Disease

• Curb Population growth