In renewed efforts to vaccinate children traversing in and out of Nigeria, the World Health Organization (WHO) is supporting the government in an initiative to improve supplemental and routine immunization activities in the North Western region, which has a significant nomadic population.
Nomadic pastoralists live beyond the reach of established health care programs that are designed to serve sedentary populations. As a result, these groups are often under-immunized and out of the reach of existing disease surveillance activities.
Speaking on the intervention, Mallam Gwanda Mairakuma of Maiadua local government in Niger Republic said that, “with this intensified commitment, vaccination activities have reduced the number of complications associated with Measles infection on our children”.
Tracking nomadic populations
Difficulties have been experienced in the past in tracking and reaching nomadic populations with services such as sensitization on early disease reporting, immunization activities and access to general healthcare services due largely to the nature of their movement, which often involves settling in hard-to-reach transit camps.
Reaching the nomadic population in the cross border areas of the North Western region has been particularly difficult due to the nature of the population which involves settling in hard to reach and sometimes security compromised areas, making the zone the highest with under-immunized children in the country. Jigawa and Katsina states in particular are maximizing efforts in reaching these populations by identifying major migrant groups and characterizing the movement of nomadic populations in the region for effective administration of vaccines.
In collaboration with Katsina State government, WHO has intensified efforts to reach nomadic communities across the state with immunization services, sensitization on prompt disease reporting and on the need to access health care services. The nomadic settlements span across 14 Local Government Areas (LGAs), wards and settlements passing through international borders with Niger republic. LGAs with nomadic routes include: Baure, Dutsinma, Kafur, Ingawa, Kaita, Jibia, Mashi, Charanchi, Musawa, Batsari, Maiadua, Zango, Danja, Kusada LGAs among others.
These communities are among the most marginalized, hard to reach and nomadic in nature who migrate across LGAs, States and international borders due to their transitory movement and settlement in camps and hamlets. The State conducts series of activities to enhance immunity and interrupt transmission of Polio and other priority diseases along transit exit points and settlements with nomadic routes through immunization. Jigawa State also shares international borders with Niger republic in two LGAs namely, Sule tankarkar and Maigatari.
“WHO Nigeria supported a 10km strip vaccination along Nigeria-Niger border, using mOPV2 in October 2018 which was conducted along with vaccination at border cross points in March through April 2019,” says Dr Audu Sunday, WHO Jigawa State Coordinator.
“WHO has also supported Jigawa state to establish in-between round vaccination teams providing routine immunization, polio vaccination and Measles vaccines along the border cross points as well as the Maigatari international market. Disease surveillance officers of both countries also conduct joint visits to health facilities in communities at the border using Standard operating procedures for cross border notification of VPDs,” he adds.
High numbers of high risk children vaccinated
In Katsina state, 1,645 eligible nomadic children were reached during nomadic vaccinations in Ingawa and Maiadua LGAs between April and June 2019 from the conduct of Outbreak Response (OBR) and in between rounds, respectively.
For the same period in Jigawa State, 6,280 Nigerien and 5,115 Nigerian children were vaccinated at the border crossing points. At least 8,608 children were vaccinated with mOPV2 in the 10km strip outbreak response in October 2018 in two districts of Niger Republic (Dungas and Magaria).
Meanwhile, for in-between round activities at the border 10,183 children received bivalent oral polio vaccine (bOPV) while 3,358 were vaccinated with Inactivated Polio Vaccine (IPV) as well as 1,035 with measles vaccine.
The Director Primary Health Care (DPHC) Jigawa State, Dr Shehu Sambo during a supportive supervision to Miga LGA appreciated WHO’s support in establishing the nomadic vaccination. “We are happy with WHO’s support and encourage health workers to take the opportunity to improve routine immunization coverage across the State.”
Support for Polio eradication to Nigeria through WHO, is made possible by funding from the Bill & Melinda Gates Foundation, Department for International Development (DFID – UK), European Union, Gavi, the Vaccine Alliance, Government of Germany through KfW Bank, Global Affairs Canada, United States Agency for International Development (USAID), Community Chest Korea, KOFIH (Korea), Rotary International and the World Bank.
FG, WHO collaborate to curtail child mortality
In Njediko community of Niger state, Mrs Aishatu Usman says, “Without this care, where would we go to when our children are sick since there is no hospital nearby?”.
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.”
Oyo Partners NGOs on Eye Surgery, Treatment
Oyo State Governor , Engr. Seyi Makinde has advocated medical check up as preventive measure to reduce incidence of Secondary Health Care in the society especially as human sight was concerned.
Governor Makinde made this known in his address delivered at the Free Eye Outreach and Cataract Surgery, jointly organised by Oyo State Ministry of Health, Ophthamological Society of Nigeria, Oyo State branch, Organization of Tadhomum Muslimim, Nigeria, a Saudi Based Humanitarian Organization known as Al Basar International Foundation, and other non-governmental organizations to mark 2019 World Sight Day, which took place at the State Hospital, Ring road, Ibadan and at the State Hospital in Oyo town.
The Governor who was represented in Ibadan and Oyo centers by the Permanent Secretary, Ministry of Health, Dr. Muftau Ayoola and his counterpart at the Hospital Management Board, Mrs. Bola Oloko respectively said the present administration was not focusing only on provision of curative services but to improve awareness on preventive steps for people of the state to be sound and healthy.
He noted that concerted efforts would be made in ensuring that free health care system would be a permanent thing in the state.
“I specially want to appreciate Al Basar International Foundation who has over the years supported the state in this laudable venture.
“Our goal is to really reform the health care system to be able to provide high quality health coverage in a cost effective way and in achieving this, government, individuals and various organizations have roles to play.
“With these in place, i want to assure you that we would be securing an unrivaled legacy in the provision of quality health care service for all and sundry.”
Makinde however called on the organizers of the project to forward a proposal to the government on how to make subsequent editions more effective.
In his Good will message, Aare Musulim of Yoruba, Oyo and Delta States , Alhaji Daud Mankanjuola, represented by Doctor Abdul Jelili Kola Hamad at the State Hospital, Ring road, Ibadan enjoined wealthy people in the country to minimize their investment on luxuries and cue involve in humanitarian services for the benefit of mankind.
In their separate remarks, the President, Organisation of Tadhomum Musulimim, Nigeria, Doctor Kazeem Gbadamosi and a member of Al Basar International Foundation , Saudi Arabia, Mohsen Naif, said the free eye treatment and cataract surgery was done to put smile on the faces of those suffering from the disease, particularly the less privileged among them .
“Eight thousand patients were examined during the medical outreach , Two Hundred glasses were given to those in need at no cost , while Seven Hundred cataract surgeries were done successfully,” Gbadamosi hinted.
While appreciating Oyo State Government for accommodating Al Basar team for period of a week and usage of hospital facilities for the surgery, Doctor Gbadamosi noted that a month follow up treatment would be given to the beneficiaries by medical experts in Nigeria while drugs would be given to ensure patients were totally healthy.
Experts call for mental health education to curb suicide
Psychiatrists have called for mental health education as a tool to curb the rising tides of suicide in Nigeria.
The experts made the call on Friday in Lagos, while commenting on the commemoration of the 2019 World Mental Health.
According to the News Agency of Nigeria (NAN) reports, mental health includes our emotional, psychological and social wellbeing. It affects how we think, feel, and act.
It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.
A Consultant Psychiatrist, Dr Abdur-Rasheed Awesu, who works at the Federal Neuropsychiatric Hospital, Yaba, insisted that there is a need to change the mindset of everyone on how to maintain good health.
He said that family and neighbours need to be up and doing, and as well be up to the task of curbing the tide.
Also, in her comments, Dr Veronic Nyamali, a psychiatrist, emphasized that life should be seen from mixed angles of good, sweet and bad.
Nyamali further counseled that suicide should not be an option to end one’s life, noting that the World Health Organisation (WHO)’s statistics show that one million people died of suicide.
She disclosed that every 40 seconds, someone died and at every two seconds, someone is somewhere attempting to commit suicide.
Nyamali explained that factors associated with suicide include: Biological, Medical, Social, Genetic and psychological.
She said that when these factors occurred, attention should be given to the families of the bereaved, not to be hammering on what the victim used in taking his or her life, such that we all know sniper now.
The psychiatrist urged the governments to put up a unit in the hospital environment to be dealing with cases of suicide as it was being done in accident emergencies in normal hospitals.
Nyamali maintained that the media also have great role to play in the surge and should always help in the areas of information and keeping hope alive for whoever was passing through one challenge or the other.
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