Nigeria moves to tackle pneumonia

• as Save The Children launches ‘INSPIRING’ project

In a bid to save children from the scourge of pneumonia now rated as the second biggest killer of under-5 children worldwide, Save The Children International has commenced the implementation of its Integrated and Sustained Childhood Pneumonia and Infectious Disease Reduction in Nigeria (INSPIRING) project n two states of the country.

To kick start the project, a situation analysis on the disease in the two states was unveiled in Lagos on Wednesday September 25 at a ceremony attended by stakeholders and government officials.

Pneumonia reportedly killed 880,000 U-5 children globally in 2016 alone. Half of these were recorded in only 5 countries, one of which is Nigeria which also recorded about 19/1000 deaths of U-5 children in 2016. The INSPRING report estimates that  Jigawa state records about 14,988 cases of pneumonia while Lagos state records about 17, 955 cases every year.

Unveiling the report the State  Child Survival Strategic Coordinator, Dr. Saida Ogaga, representing the Commissioner of Health,  Prof. Akinola Abayomi,  commended Save the Children for its timely intervention through the pneumonia project saying it is coming at a time the state government needs to showcase its efforts and child survival activities in the state.

She pledged the state government’s commitment to support the project and any other programme aimed at promoting health and well being of the people in the state.

Dr. Ogaga expressed hope that the INSPIRING intervention would be on an integrated approach, encompassing detection, treatment and prevention.

Explaining why Save the Children decided to focus on pneumonia, the organisation’s Chief of Party, INSPIRING  Project, Dr. Adamu Isah  said  the disease remains the biggest killer of children under 5 both globally and in Nigeria.

“If you look at the Global Health Observatory in 2016 they are saying out of 5.6 million U-5 deaths in the world, about a million was caused by pneumonia. What is more important is that five countries contributed more than  half of that million. Our dear Nigeria is one of those countries and 18% of mortality which translates to 127,000 deaths, or even more, is connected to pneumonia. So certainly it is a serious problem which is under-diagnosed, under-recognized, under- treated and under-reported.

“A UNICEF report in 2015 shows that actually 61% of all cause mortality in children U-5 happened from day zero to the first year of life so, most of the death we are seeing in under-5 is actually within their first year of life. Pneumonia cause specific is even greater. 67% of the deaths caused by pneumonia happened when the children were less than a year old. It happened in the grassroots, the slums and many other places.” He said.

Dr. Isah further cited the Global Health Observatory report which showed that cases of many diseases declined during the 15-year period between 2000 and 2015 worldwide, with measles declining by 85 per cent, HIV/AIDS by 61% and malaria by 60 %. He said the report also revealed that only pneumonia did not decline appreciatively, recording only 47% decline in fifteen years.

On the rational for choosing Jigawa and Lagos states for the project, he described the two states as very far apart and with different cultural background but with a high number of pneumonia cases and deaths among children.

“One is rural, agrarian. Conservative, (situated) around the Sahel region – almost close to the Sahara, with high number of very young people, high fertility rate and many other things. The other is almost by the coast; it is the commercial centre of the country with a lot of rich and poor people and slums.  It is the home of Nollywood, music and a lot of other things.”

He announced that the project would adopt the Global Action for the control of pneumonia, as recommended by WHO and UNICEF, which involves promotion, prevention, treatment diagnosis, among others,  in its implementation in the two states.

“We are going to try as much as we can, to support the states in doing that. In Jigawa which we consider a rural community, we are going to have a lot of community engagements. We want to change their perception and health seeking behavior and establish a linkage between the primary health care centres, where we want to work, with the secondary health care facilities to ensure there’s a two-way referral facilities.

“In the case of Lagos which is more of an urban state, we want to focus more on the use of technology. We want to bring in pulse oximeters and oxygen system. Where they have, we want to improve on it and provide, where they there is none.”

Dr. Isah urged all stakeholders to join Save the Children and do the needful to “to control this terrible problem of pneumonia.”

Presenting the final report of the INSPIRING Situational Analysis, Prof. Adegoke Falade a renowned professor of peadiatrics at the College of Medicine, University of Ibadan disclosed that the analysis was designed to generate gender-sensitive evidence on the current state of pneumonia in children aged 0-59 months in Jigawa and Lagos states.

Key findings of the analysis, according to him include, among others:

• Care-seeking for children with pneumonia was poor in both states, with only 38.7% and 31.4% of caregivers from Jigawa and Lagos recognizing at least one symptom of pneumonia.
• Vaccine coverage with PVC-10 (vaccine) was high in Lagos but low in Jigawa
• There were clear differences in the type of facilities available in Lagos and Jigawa with more private providers in Lagos and more primary providers in Jigawa.
• Oxygen and pulse oximeters were not universally available across secondary care and were less available along with other IMCI equipment in Jigawa.
• Knowledge of pneumonia was generally poor amongst community members and was associated with several misconceptions around the origin of the illness – and therefore their subsequent decision to seek care.
• There was consistent message from stakeholders that there is lack of pneumonia specific policies and guidelines and a lack of pneumonia champions to push for strong political actions.

The project will be implemented in Kiyawa and Ikorodu  Local Governments of Jigawa and Lagos States respectively.