According to data, Nigeria is a `country of the young’ with almost half the entire 180 million strong population, 46 per cent, currently under the age of 15. The current total for children under the age of 5 stands at nearly 31 million while each year at least 7 million babies are born. While a little over one in three of Nigeria’s whole population lives below the poverty line, among children this proportion surges to 75 per cent.
When considering the low levels of birth registration, in some areas up to 62 per cent, known data about child health issues are likely to underestimate the true scale. A 2016 national campaign linked to healthcare services resulted in the registration of about seven million children, but large population growth is impacting progress.
Nigeria’s 40 million women of childbearing age (between 15 and 49 years of age) suffer a disproportionally high level of health issues surrounding birth. While the country represents 2.4 per cent of the world’s population, it currently contributes 10 per cent of global deaths for pregnant mothers. Latest figures show a maternal mortality rate of 576 per 100,000 live births, the fourth highest on Earth. Each year approximately 262,000 babies die at birth, the world’s second highest national total. Infant mortality currently stands at 69 per 1,000 live births while for under-fives it rises to 128 per 1,000 live births. More than half of the under-five deaths – 64 per cent – result from malaria, pneumonia or diarrhoea. Investment in this sector has been high in recent years although the proportion of patients able to access appropriate treatment remains low.
The rate of those mothers feeding new-borns exclusively with breastfeeding for the first six months of life which remains stuck at around 17 per cent of infants, unchanged over the last decade. Only 18 per cent of children aged 6-23 months are fed the minimum acceptable diet. While the government has sought to improve access to primary health care nationwide, committed to reaching a network of at least one PHC facility in each of the country’s 10,000 administrative wards, the work is still far from complete. Coverage can be patchy, bottlenecks in healthcare provision severe.
Poor access to water, sanitation and hygiene (WASH) remains a major challenge, contributing significantly to high levels of diarrhoea-related deaths. As of 2015, 57 million Nigerians were without access to improved water sources, while 130 million people without access to improved sanitation. An estimated 25 per cent of Nigerians practice open defecation on a daily basis.
Nigeria accounts for more than one in five out-of-school children anywhere in the world. Although primary education is officially free and compulsory, only 67 per cent of eligible children take up a place in primary school. If a child misses school for even a short time there is only a low chance, only about 25 per cent, that the child will ever return.
Girls suffer more than boys in terms of missing out on education. In the north-east of Nigeria only 41 per cent of eligible girls receive a primary education, 47 per cent in the north-west. Social attitudes can also impact negatively on education rates especially in northern Nigeria. In north-eastern and north-western states, 29 per cent and 35 per cent of Muslim children, respectively, attend Qur’anic education, which does not include basic education skills such as literacy and numeracy. These children are officially considered out-of-school by the Government.
Nigerian children are vulnerable to a wide range of abuses and harmful traditional practices. The national legal framework for child protection is the Child Rights Act 2003, but to date, only 23 of 36 states have adopted the Act. Implementation is patchy with many local authority bodies unaware of their duties under the law. A national survey in 2014 found that 6 out of 10 children reported having suffered one or more forms of violence before reaching 18 years of age, with 70 per cent of those experiencing multiple incidents of violence. The country has the largest number of child brides in Africa: 23 million girls and women were married as children.
At 27 per cent, the prevalence of female genital mutilation/cutting (FGM/C) among girls and women aged 15-49 years is lower than in many countries where the practice is carried out, but Nigeria still has the third highest absolute number of women and girls (19.9 million) who have undergone FGM/C worldwide. It is more commonly practised in the south, driven by grandmothers and mothers-in-law aiming to curb promiscuity, prepare girls for marriage and conform to tradition.
With millions displaced by conflict in some parts of northern Nigeria, already significant challenges in healthcare, WASH and education have all been intensified. While accurate, up-to-date data is difficult in a fluid situation where so many millions have left their homes, one clear truth is that children have been affected acutely by the turmoil.