From Juliana Taiwo-Obalonye
Martins Dohlsten is Health Manager, United Nations International Children’s Emergency Fund (UNICEF). He recently spoke with Daily Sun in Calabar, Cross River State. Excepts:
Can you provide an overview of UNICEF’s role in addressing newborn health challenges globally and specifically in Nigeria?
UNICEF Nigeria prioritises newborn care due to stagnant neonatal mortality rates over the past decade, indicating significant gaps that require urgent attention. To address this, UNICEF has established seven Level 2 newborn units nationwide, providing advanced care for small and sick newborns. These units have been rehabilitated, equipped, and staffed with trained nurses. Aligning with the Coordinating Minister of Health and Social Welfare, Muhammad Ali Pate’s vision, UNICEF aims to enhance maternal and newborn health services across the country, ensuring effective implementation of health strategies and support systems.
What are the most recent statistics on the number of sick newborns in Nigeria?
When examining small and sick newborns, it’s important to recognize that there are various data sources that highlight different underlying causes for their classifications. One primary factor is prematurity, which often leads to low birth weight. Additionally, other issues may contribute, such as infections or respiratory difficulties due to underdeveloped lungs.
Regarding current statistics, I don’t have the latest figures at hand. However, it is evident that when we analyse the health outcomes-specifically mortality rates-of these vulnerable infants, we have not observed significant improvements. This lack of progress underscores the urgent need for increased attention and intervention in this area. Let me know if you need any further adjustments!
When do we start to see improvements in comparison to earlier data?
Yes, the Nigerian Health Demographic Survey (NDHS) has been conducted since 1990, with a new edition expected this year, although the data is still being validated. Analysing trends from 1990 to 2018, neonatal mortality rates have not shown significant decline, which is concerning. This stagnation in progress highlights the need for continued focus on improving health outcomes for newborns in Nigeria.
Are there any noticeable trends or disparities in sick newborn cases across urban and rural settings?
The NHS also provides state-level data, allowing us to pinpoint where most newborns and under-five mortality occurs. There is considerable diversity across Nigeria; for instance, states in the northwest and northern regions generally exhibit higher mortality rates compared to the southwest, which has seen more improvements. By analyzing this data, we can identify specific states with elevated mortality levels. Overall, it appears that many northern states tend to have the highest mortality rates.
What role do socio-economic factors play in the health outcomes of newborns in Nigeria?
It’s crucial to recognize that many health outcomes are influenced by factors beyond the healthcare sector. For instance, the current economic situation in the country poses significant challenges for many expectant mothers, which can directly impact their health and that of their children.
Health-seeking behaviours play a vital role as well; mothers who prioritise attending antenatal care and maintaining a healthy lifestyle during pregnancy are more likely to give their children a strong start in life. Conversely, if a mother does not attend antenatal visits; she is less likely to deliver in a healthcare facility, which increases the risk for her child. These children may also be at higher risk of being “zero-dose,” meaning they do not receive essential vaccinations.
Additionally, data from the NDHS indicates a correlation between maternal education levels and child mortality outcomes. Mothers with lower educational attainment are less likely to deliver in healthcare facilities, which in turn raise the risk of their children not surviving to age five. This highlights the interconnectedness of education, healthcare access, and child health outcomes.
How critical is oxygen and the treatment of sick newborns?
Yes, I believe COVID-19 has heightened awareness of the vital role oxygen plays, not just for COVID-19 patients but also for small and sick newborns. Many of these infants struggle with underdeveloped lungs and require assistance with breathing, making oxygen essential for their care. Numerous conditions affecting small and sick newborns necessitate oxygen treatment for survival. Therefore, ensuring the availability and proper administration of oxygen is crucial for improving outcomes for these vulnerable infants.
What is the current status of oxygen supply in healthcare facilities, and are there sufficient delivery devices such as concentrators and ventilators available?
Yes, if we consider the country as a whole, there has been significant investment in oxygen production, including the establishment of various oxygen plants across Nigeria. This has become a key focus area. However, it is equally important to ensure that these investments are operationalized effectively and that the oxygen supplied translates into meaningful impacts for those in need.
As you mentioned, administering oxygen requires various types of equipment and the necessary skills to maintain and operate that equipment. Currently, this area has received considerable attention. UNICEF has been actively supporting several states to ensure that all components of the oxygen supply chain-from the plants to the delivery systems-are in place to benefit small and sick newborns. We are committed to enhancing the infrastructure needed for effective oxygen delivery and improving health outcomes for vulnerable populations.
What specific interventions has UNICEF implemented in improving newborn care and oxygen availability?
UNICEF has made significant strides in improving neonatal care across Nigeria by establishing nine oxygen plants nationwide, including two fully powered by solar energy. In addition, seven level 2 newborn units have been set up to provide specialized care for small and sick newborns facing complications.
To enhance the effectiveness of these facilities, UNICEF has focused on capacity building for healthcare staff, offering training in essential and comprehensive newborn care, as well as management of conditions like hypoxemia and pneumonia, which require oxygen treatment.
Furthermore, UNICEF is collaborating with the Federal Ministry of Health to develop strategies and guidelines through the National Oxygen Desk, ensuring a coordinated approach to oxygen delivery across the country. These initiatives aim to streamline healthcare services and improve outcomes for vulnerable newborns and children throughout Nigeria.
How has UNICEF been collaborating with its partners, including NGOs, the private sector, and state governments on newborns and sickly?
Yes, the establishment of the oxygen plants has been a collaborative effort with IHS Towers Nigeria, a private sector company, and supported by the governments of Canada and Norway. This partnership exemplifies our approach, as we work closely with state governments throughout the process. Once the plants are handed over and commissioned, we continue to assist the states in operationalizing and sustaining these facilities during the transition period.
Additionally, the newborn units have been developed with funding from the Bill and Melinda Gates Foundation and USAID. These collaborations highlight UNICEF’s commitment to working with various partners to enhance healthcare infrastructure and improve outcomes for vulnerable populations.
How have these collaborations improved newborn health and access to oxygen?
While these investments are crucial, they represent only part of the overall solution. Establishing oxygen plants and newborn units is essential, but for these initiatives to effectively improve lives, we also need an adequate number of healthcare workers, equipment, and supplies. Additionally, it is vital for mothers and their babies to seek care at these facilities.
This holistic approach highlights that while our interventions are critical, there are other areas that require support to maximize our impact and achieve the desired outcomes for newborn health.
What immediate actions are needed to address these gaps, and how can stakeholders tackle the existing challenges?
I believe our focus now should be on advocating for small and sick newborns and addressing the existing gaps in care. Fortunately, Hon. Coordinating Minister of Health and Social Welfare, has prioritized maternal and newborn health, which highlights key areas the Federal Ministry aims to address. This commitment is also reflected in the sector-wide approach to reducing maternal mortality. As partners, we need to align our efforts with this vision and collaborate effectively to contribute to this shared goal with the Federal Ministry.
What is the purpose of involving the media in the Calabar field trip, and how will it enhance their reporting on this issue?
The media plays a vital role in addressing issues, raising awareness, and documenting progress. One critical area in Nigeria is the need for more mothers to deliver in healthcare facilities, seek antenatal care during pregnancy, and access postnatal care after delivery. We believe the media can significantly contribute by raising awareness about the importance of these services. By doing so, they can help build stronger trust in healthcare institutions as we work together to provide high-quality services.
What are your key takeaways from the media feedback, and how do you plan to address their concerns?
No, it’s always valuable to receive input, concerns, and questions, as they often align with the bottlenecks we need to address to create a meaningful impact. One key issue discussed was the affordability of care, particularly the out-of-pocket expenses that mothers and babies face. This includes challenges related to transportation to healthcare facilities, as well as costs associated with certain services and supplies.
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