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Page 1

NEWBORN HEALTH
in the context of the Integrated Maternal, Newborn
and Child Health Strategy
Revised 2nd edition, 2011

Saving Newborn Lives in Nigeria:

FEDERAL REPUBLIC
OF NIGERIA

MINISTRY OF HEALTH

Page 2

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SAVING NEWBORN LIVES IN NIGERIASAVING NEWBORN LIVES IN NIGERIA

Suggested citation: Federal Ministry of Health. Saving newborn lives in Nigeria: Newborn health in the
context of the Integrated Maternal, Newborn and Child Health Strategy. 2nd edition. Abuja: Federal
Ministry of Health, Save the Children, Jhpiego; 2011.

This publication is made possible in part through support provided by Saving Newborn Lives/Save the
Children US, through a grant from the Bill & Melinda Gates Foundation; and the Maternal and Child Health
Division, Office of Health, Infectious Diseases and Nutrition, Bureau for Global Health, US Agency for
International Development, under the terms of the Leader with Associates Cooperative Agreement GHS-
A-00-04-00002-00.

The content of this publication and opinions expressed herein are those of the authors and do not
necessarily reflect the views of partner agencies or organisations. This publication may be used or
reproduced for educational or non-commercial purposes, provided that the material is accompanied by an
acknowledgement.

Cover photo credit: Pep Bonet, Save the Children, 2010.
Layout by The Miracle Book, Cape Town, South Africa.
Printing by Yaliam Press Ltd. Abuja, Nigeria.

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SAVING NEWBORN LIVES IN NIGERIA

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SAVING NEWBORN LIVES IN NIGERIA

Ward Minimum Healthcare Package (WMHCP), 2001
This package includes a set of PHC interventions and services that address health and health-related problems.
It aims to enable substantial health gains at a low cost to the government and its partners. Currently, this
package serves as a measure of progress for most health interventions at the PHC level. Neonatal care
components of the WMHCP involve skilled care at childbirth, cord care, early breastfeeding and temperature
management. It also consists of resuscitation and management of neonatal infections through referral and
outreach services. Community-based care of low birth weight babies is also included.85

National Policy on Food and Nutrition, 2001 (reprinted in 2005)
The goal of this policy is to improve the nutritional status of all Nigerians, with particular emphasis on the
most vulnerable groups, ie, children, women and the elderly. It aims to reduce household food insecurity,
improve feeding practices, increase human resources providing nutrition services, and improve understanding
of nutrition problems and the capacity to address them, through the promotion of coordinated activities and
appropriate resources allocation. It is currently being reviewed in the light of the new WHO recommendations
on infant feeding and HIV/AIDS

National HIV/AIDS and PMTCT Policy and Strategic Plan, 2003
This policy and the strategic plan aim to control the spread of HIV in Nigeria. They aim to provide equitable
care and support for those infected by HIV, and to mitigate its impact to the point where it is no longer
of public health, social and economic concern, so that all Nigerians will be able to achieve socially and
economically productive lives free of the disease and its effects. One of the targets is to halve mother-to-
child transmission of HIV by 2010.

Health Sector Reform Programme, 2004
The Health Sector Reform Programme established a framework for improving service delivery including
its goals, targets and priority interventions. There were seven thrusts established for the reform. They
include:

improving the stewardship roles of government1.
strengthening the national health system and its management2.
reducing the burden of disease3.
improving health resources and their management4.
improving access to quality health services5.
improving consumer awareness and community involvement 6.
promoting effective partnership, collaboration and coordination.7.

Although some MNCH indicators (eg, the proportion of pregnant women attended to by skilled attendants at
birth; the number of BEmOC and CEmOC facilities available per 500,000 people) were included as indicators
for the programme, newborns were not mentioned in the document and the programme failed to include
neonatal mortality as an indicator.

National Plan of Action on Food and Nutrition, 2004
Attached to the Policy on Food and Nutrition, this plan was designed to introduce a new focus, and to
effectively integrate and coordinate all the food and nutrition programmes in all sectors. Furthermore, it aims
to vigorously advance a national nutrition agenda that will recognise and respond effectively to regional, zonal
and specific needs, in accordance with the National Policy on Food and Nutrition.

National Policy on Infant and Young Child Feeding (IYCF) in Nigeria, 2005
The goal of this policy is to ensure the optimal growth, protection and development of the Nigerian child
from birth to the first five years of life. It addresses topics related to breastfeeding, complementary feeding,
IYCF in the context of HIV, use of milk substitutes, improved counselling, awareness-raising and the capacity-
building of health staff.

National Child Health Policy, 2006
This policy is implemented within the framework of the National Health Policy, health sector reforms
and other policies relevant to child health. Its overall goal is to ensure the survival and healthy growth and
development of the Nigerian child, including newborns, under-fives and school-age children. One of the
policy objectives is to halve the 1990 neonatal mortality rate by 2015, through the provision of emergency
obstetric care, immediate newborn care, including resuscitation at all levels, and emergency newborn care
for illness. However, neonatal mortality was not included in the framework’s monitoring indicators. The

CHAPTER 4: NEWBORN HEALTH POLICIES AND PROGRAMMES

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policy also outlines child healthcare financing and supports the acceleration of the National Health Insurance
Scheme (NHIS) and the establishment of community-based health insurance schemes to remove financial
barriers.

Accelerated Child Survival and Development (ACSD): Strategic Framework &
Plan of Action, 2006–2010
The main goal of the ACSD plan is to produce healthy children who will achieve their optimal potential in all
areas. The strategy specifically aimed to reduce neonatal morbidity and mortality by 30% by 2010 – a goal
which has not yet been met.

The Roadmap for Accelerating the Achievement of MDGs Related to Maternal
and Newborn Health, 2006
Nigeria is one of many African countries that developed its own roadmap to accelerate the reduction
of maternal and newborn mortality and achieve the MDGs. The roadmap specifies strategies, priority
interventions and services required to achieve these objectives. It outlines several neonatal indicators for the
purpose of monitoring and evaluation, including neonatal and early neonatal mortality, as well as determinants
of neonatal deaths, facilities with functional newborn resuscitation and PNC attendance rates. The roadmap
also includes follow-up actions and an implementation framework with benchmarks and a log frame.

Policy on the Health and Development of Adolescents and Young People in
Nigeria, 2007
The goal of this policy is to promote optimal health and development among adolescents and other young
people in Nigeria. Targets to be achieved by 2015 include a 50% reduction in the incidence of unwanted
pregnancies among young females, a 50% reduction in the rate of marriage among young people under the
age of 18, and a 75% reduction in the maternal mortality ratio among young women.

The National Health bill
At the time of this report going to press, the long-awaited National Health Bill has not yet been signed into
law, though this was expected to happen by the end of 2010. The Bill, having undergone several modifications,
has been passed by the Nigerian Senate and the House of Representatives. If properly implemented, the
National Health Bill has the potential to rapidly increase
Nigeria’s chances of achieving MDGs 4 and 5. The Bill will
create an enabling environment for the coordination of
primary healthcare in Nigeria. It will ensure more funds are
available for infrastructure, service delivery, procurement
and maintenance of the Health Management Information
System. To address the issue of equitable distribution of
resources, 50% of the funds provided for in the Bill will
be managed under the National Health Insurance Scheme.
This is one strategy that will need to be closely monitored
in the coming years. To strengthen sustainability, the Bill
provides for the establishment of health committees at
the ward and village levels. The only health system pillar
that may not be adequately addressed by the Bill is that of
human resources. A sustainable solution must be found
to tackle the country’s current severe shortage of clinical
personnel and to ensure appropriate distribution of
personnel to areas where they are most needed.

The Integrated Maternal, Newborn and Child Health Strategy, 2007

To synchronise the many strategies and policies of relevance to MNCH, the FMOH developed the Integrated
Maternal, Newborn and Child Health Strategy in March 2007, and is currently putting it into practice
throughout the country. The IMNCH strategy aims to ensure that the interests of mothers and children do
not compete with each other, and provides opportunities for the integrated implementation of evidence-
based interventions for MNCH. It involves reorienting the health system to ensure the delivery of essential
interventions providing a continuum of care for women, newborns and children.

Pep Bonet/Save the Children

CHAPTER 4: NEWBORN HEALTH POLICIES AND PROGRAMMES

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SAVING NEWBORN LIVES IN NIGERIA

due to preterm birth complications. Internal Journal of Epidemiology 2010:i1–i10.
72. Black RE, Allen LH, Bhutta ZA, et al. Maternal and child undernutrition: global and regional exposures and health

consequences. Lancet 2008;371:243-60.
73. Seres N. Fourth Report on the World Nutrition Situation. Geneva: ACC/SCN in collaboration with IFPRI; 2000.
74. Victora CG, Adair L, Fall C, et al. Maternal and child undernutrition: consequences for adult health and human capital.

Lancet 2008;371:340-57.
75. Bhutta ZA, Ahmed T, Black RE, et al. What works? Interventions for maternal and child undernutrition and survival.

Lancet 2008;371:417-40.
76. Save the Children. Improving Infant and Young Child Feeding. A guidance note for hunger reduction programmes.

London: Save the Children UK; 2009.
77. PAHO. Guiding principles for complementary feeding of the breastfed child. Washington, DC: Pan American Health

Organization; 2001.
78. Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS. How many child deaths can we prevent this year? Lancet

2003;362:65-71.
79. Levy A, Fraser D, Katz M, Mazor M, Sheiner E. Maternal anemia during pregnancy is an independent risk factor for low

birthweight and preterm delivery. Eur J Obstet Gynecol Reprod Biol 2005;122:182-6.
80. WHO. Iron deficiency anaemia: assessment, prevention and control. A guide for programme managers. Geneva: World

Health Organization; 2001.
81. Galloway R, Dusch E, Elder L, et al. Women’s perceptions of iron deficiency and anemia prevention and control in eight

developing countries. Soc Sci Med 2002;55:529-44.
82. UNICEF congratulates the Government of Nigeria for achieving universal salt iodization. United Nations Children’s

Fund (UNICEF), 2007. (Accessed at http://www.unicef.org/media/media_39607.html.)
83. Save the Children. Hungry for change: an eight-step, costed plan of action to tackle global child hunger. London:

International Save the Children Alliance; 2009.
84. Technical report on Nigeria Reproductive Health Resources and Services at the Primary Health Care level of

government facilities: Federal Ministry of Health, Nigeria and World Health Organization; 2002.
85. Ward Minimum Health Care package: Federal Ministry of Health, Nigeria and World Health Organization; 2001.
86. National Health Accounts: Nigeria. 2010. (Accessed at http://www.who.int/entity/nha/country/nga/en.)
87. Pitt C, Greco G, Powell-Jackson T, Mills A. Countdown to 2015: assessment of official development assistance to

maternal, newborn, and child health, 2003-08. Lancet 2010.
88. Hofmeyr GJ, Haws RA, Bergstrom S, et al. Obstetric care in low-resource settings: what, who, and how to overcome

challenges to scale up? Int J Gynaecol Obstet 2009;107 Suppl 1:S21-44, S-5.
89. National Human Resources for Health Policy. In: Federal Ministry of Health, Nigeria; 2006.
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IntJEpidemiol 2006;35:706-18.
91. Nigeria Health Workforce Statistics. Statistics of Registered Health Workers. Abuja: Nigeria Bureau of Statistics; 2007.
92. Robertson J, Forte G, Trapsida JM, Hill S. What essential medicines for children are on the shelf? Bull World Health

Organ 2009;87:231-7.

REFERENCES

Page 120

FEDERAL REPUBLIC
OF NIGERIA

MINISTRY OF HEALTH

NEWBORN HEALTH
in the context of the Integrated Maternal, Newborn
and Child Health Strategy
Revised 2nd edition, 2011

Saving Newborn Lives in Nigeria:

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