Mrs Usman is one of the caregivers that recently benefited from the WHO-Federal Government integrated Community Case Management (iCCM) project that scales up provision of essential packages for child survival in communities. “We are grateful to WHO Nigeria and the Government for this community based intervention. Without this project, it would have been tough for us and our children”, she adds.

In line with Mrs Usman’s plea, despite recent improvements, maternal and child mortality remain critical public health issues in Nigeria with unacceptably high health outcomes indicators.

According to the Nigeria Demographic Health Survey (NDHS, 2018), the under-five mortality rate in Nigeria is 132 per 1,000 live births meaning that 1 in 8 Nigerian children never reach the age of 5. Infant deaths, which account for half of child mortality have declined from 87 per 1000 live births in 1990 to 67 in 2018. One (1) Nigerian woman dies in childbirth every 10 minutes, and 1 Nigerian child under-5 years of age dies every minute.

It is apparent through the elevated mortality rates that the lack of access to quality delivery services is an issue of immense importance in Nigeria. Problems such as cost for treatment, deplorable state of the health facilities, distance to health facility lack of awareness and knowledge for informed decisions and referral are some of the many difficulties stated by caregivers in describing difficulty with accessing healthcare.

Integrated Management of Childhood Illness (IMCI) and iCCM are the key child survival thrust being used by the Nigerian Government to address the unacceptably high under-5 morbidity and mortality indices.

Dr Bose Adeniran, Head of Child Health Department, Federal Ministry of Health (FMoH) stated that “Child mortality has been a long pending issue in Nigeria and a lot of mothers are not aware of the causes and or prevention.”

She added that “iCCM is a complete package focusing on prevention and also on curative and I think that is what our children need. In Abia and Niger States, we now have local evidence that this (iCCM) is the way to go as it relates to addressing the unacceptably high under-five mortality rate in Nigeria”

Substantial global progress has been made in reducing child deaths since 1990. The total number of under-5 deaths worldwide has declined from 12.6 million in 1990 to 5.3 million in 2018. On average, 15 000 children under-5 die each day compared with 34 000 in 1990. Since 1990, the global under-5 mortality rate has dropped by 58%, from 93 deaths per 1,000 live births in 1990 to 39 in 2017 This is equivalent to 1 in 11 children dying before reaching age 5 in 1990, compared to 1 in 26 in 2018.

“With numerous World Health Organization’s (WHO) supports to Nigeria, many caregivers, especially in the rural areas are now aware of the available essential package of interventions for child survival along the continuum of care”, says Dr Joy Ufere, WHO, Family and Reproductive Health Cluster.

She added that “WHO will continue to provide leadership role to monitor the implementation of these interventions towards reducing Under-5 morbidity and mortality across Nigeria.”