rapid nigeria presentation: fertility and mch version · rapid nigeria presentation: fertility and...
TRANSCRIPT
1 November 2011
2
Improving Our Health
Photo by Bill & M
elinda Gates Foundation
Raise Our Quality of Life
Federal Ministry of Health
Government of Nigeria
November 2011
3
Nigeria in Perspective
Why Fertility Affects Health
Two Paths
Our Choice
Outline
2
4
3
1
Phot
o by
Die
tmar
Tem
ps
4
Large Population Size of countries according to population size
Source: www.worldmapper.org
In P
ersp
ectiv
e
Nigeria
5
High Maternal Mortality Size of countries according to number of maternal deaths
Source: www.worldmapper.org
In P
ersp
ectiv
e
Nigeria
Sources: Global estimates and 2008 Nigeria Demographic and Health Survey. Goal is from National Health Strategic Development Plan 2010-2015.
MDG Goal #5: Lower Maternal Mortality Why is Nigeria failing to meet its goal?
In P
ersp
ectiv
e
6
7
High Child Mortality Size of countries according to number of child deaths
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 1,0
00 L
ive
Birth
s
Sources: 1990, 1999, 2003, and 2008 Nigeria Demographic and Health Surveys
MDG Goal #4: Lower Child Mortality Why is Nigeria failing to meet its goal?
In P
ersp
ectiv
e
8
9
Photo by Joachim H
uber
Sources: 2008 Nigeria Demographic and Health Survey (NDHS)
Child Mortality Rates Child deaths per 1,000 live births
In P
ersp
ectiv
e
10
Teenage Mothers Size of countries according to number of teenage mothers
Source: www.worldmapper.org
In P
ersp
ectiv
e
Nigeria
11
Government Spending on Healthcare Size of countries according to healthcare spending
Source: www.worldmapper.org
In P
ersp
ectiv
e
12 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?
13 Sources: Most recent Demographic and Health Surveys
Fertility Comparison Nigeria and selected countries
Nigeria has very high fertility compared to other nations, whether they are Muslim, Christian, richer or poorer, larger or smaller …
In P
ersp
ectiv
e
14
Current Fertility by Zone Average number of live births per woman
Source: 2008 NDHS
In P
ersp
ectiv
e
North West 7.3
South West 4.5
North Central 5.4
North East 7.2
South East 4.8
South South 4.7
Nigeria 5.7
15 Sources: Most recent Demographic and Health Surveys
Modern Contraceptive Use Fertility is high mainly because contraceptive use is low
In P
ersp
ectiv
e
16
Unmet Need for Spacing, Limiting
Source: 2008 NDHS
In P
ersp
ectiv
e
When a woman expresses desire to space or limit births, but is not using any method to do so
One in five married Nigerian women has unmet need
This is over 6 million couples who are not receiving services
Unmet Need
17
Most of the developing world is leaving Nigeria behind.
Source: Gapminder World
Lower Fertility… Fewer Child Deaths
Chi
ld D
eath
s pe
r 1,0
00 L
ive
Birth
s (lo
g sc
ale)
400
40
100
0
10
Births per Woman (average) 2 4 6 8
In P
ersp
ectiv
e
18 Source: Gapminder World
Lower Fertility… Fewer Child Deaths
Most of the developing world is leaving Nigeria behind.
Chi
ld D
eath
s pe
r 1,0
00 L
ive
Birth
s (lo
g sc
ale)
400
40
100
0
10
Births per Woman (average) 2 4 6 8
In P
ersp
ectiv
e
19 Source: Gapminder World
Lower Fertility… Fewer Child Deaths
Most of the developing world is leaving Nigeria behind.
Chi
ld D
eath
s pe
r 1,0
00 L
ive
Birth
s (lo
g sc
ale)
400
40
100
0
10
Births per Woman (average) 4 6 8 2
In P
ersp
ectiv
e
20
Nigeria in Perspective
Why Fertility Affects Health
Two Paths
Our Choice
Outline
2
4
3
1
Phot
o by
Die
tmar
Tem
ps
21
Too closely spaced Too young Too old Too many
Source: 2008 Nigeria DHS
High-Risk Births Cause Poor Health Births are “high risk” when…
Hea
lth
22
Too Closely Spaced
Hea
lth
22
Phot
o by
Rai
ner W
ozny
, Hei
nric
h Bö
ll Fo
unda
tion
23 Source: 2008 Nigeria DHS
Birth Spacing Improves Health Longer spacing leads to fewer child deaths
Hea
lth
Years Since Last Birth
24
Birth Spacing Saves Lives
Hea
lth
Greater Availability & Use of Child Spacing
Commodities & Services
Fewer High-Risk Births
Fewer Maternal and Child Deaths
25
Too Young or Too Old More children die when mother is younger or older
Hea
lth
Photo by Mike Blyth
26
Many Girls Marry Before Age 15
Source: 2008 Nigeria DHS
Hea
lth
Among Nigerian women ages 25 to 49 years,
one in four was married by age 15
Photo by Joachim H
uber
27 Source: 2008 Nigeria DHS
Teenage Girls Who Experience Pregnancy Selected states
Hea
lth
Nigeria 23%
Photo by BBC W
orld Service
28 Source: 2008 Nigeria Demographic & Health Survey
Child Mortality Children of younger and older mothers are more likely to die
Hea
lth
Too Many
29
Hea
lth
29
Photo by Teseum
30 Source: 115 Demographic and Health Surveys and WHO/UNESCO/UNFPA.
Fewer Children, Lower Maternal Mortality 115 developing countries illustrate this point …
Hea
lth
Nigeria
Brazil
Chad
Ghana
Fewer high-risk births leads to:
Fewer infant and child deaths
Lower maternal complications and fewer maternal deaths
Achievement of MDGs #4 and #5
31
In Summary Lower fertility leads to better health, progress on MDGs
Photo by Mike Blyth,
Hea
lth
32
Nigeria in Perspective
Why Fertility Affects Health
Two Paths
Our Choice
Outline
2
4
3
1
Phot
o by
Die
tmar
Tem
ps
33
Two
Path
s
“Low Fertility” Scenario: Nigeria meets its National Strategic Plan targets Contraceptive use rises 2
percentage points each year
Takes 10 years to meet current unmet need
“High Fertility” Scenario: Nigeria’s current path
Photo by Jeffrey Smith
Phot
o by
IITA
Imag
e Lib
rary
31
5.7
5.2
2.0
0
2
4
6
2010 2020 2030 2040
Birth
s pe
r Wom
an (a
vera
ge)
Source: Spectrum projections for Nigeria
Two Paths Fertility projections under two scenarios
Two
Path
s
34
Low Fertility
High Fertility
35
Photo by Joachim H
uber
Sources: Spectrum and MDG Model projections for Nigeria
Meeting Unmet Need Prevents Child Deaths During the first decade (2011–2021) meeting unmet need prevents millions of deaths
Two
Path
s
1.5 million child deaths averted
0
36
Photo by Lindsay Mgbor/D
epartment for International D
evelopment
Sources: Spectrum and MDG Model projections for Nigeria
Meeting Unmet Need Saves Lives Mothers’ lives would also be saved (2011–2021)
Two
Path
s
31,000 lives saved
37
Photo by Soumik Kar
Sources: Spectrum and MDG Model projections for Nigeria
Meeting Unmet Need Averts Maternal Morbidity 2011–2021
Two
Path
s
700,000+ women avert
morbidity
0.0
93
210
164
0
100
200
2010 2020 2030 2040
Thou
sand
s of
Mid
wiv
es
Source: Spectrum projections for Nigeria
Midwives Required Fewer births, less pressure on midwives
38
Low Fertility
High Fertility
Two
Path
s
Source: Spectrum projections for Nigeria
Health Expenditures Fewer patients, less pressure on budgets
39
Low Fertility
High Fertility
Cumulative Savings Naira 47 Billion
Two
Path
s
40
1.5 million child deaths averted (MDG #4)
31 thousand maternal lives saved (MDG #5)
Lower maternal and child health complications
Less burden on midwives and other resources to meet ALL the MDGs
In Summary Lower fertility in Nigeria means during the next 10 years would result in…
Photo by Jeremy W
eate
Two
Path
s
41
Nigeria in Perspective
Why Fertility Affects Health
Two Paths
Our Choice
Outline
4
3
2
1
Phot
o by
Die
tmar
Tem
ps
Help our people plan safer pregnancies
Provide commodities and services to meet the need for birth spacing, timing, and limiting
Meet the MDGs
Raise our QUALITY of life
42
It’s Our Choice
Photo by PJotter
Our
Cho
ice
Help Nigerians achieve their desire for healthier families through access to family planning by: Signing the National Health Bill to help fund primary health care in Nigeria Approving a permanent annual budget line item for family planning starting in 2012 Releasing the committed 2011 MDG funds for family planning commodities
43
Let’s Take Action Our
Cho
ice
Photo by by Banjii
44
Thank You
The Change We Seek: Raising Our Quality of Life
RAPID Nigeria
Photo by Kate Dixon