Nigeria could avert 3,597,700 under-five million deaths by 2030 with a 16.5% annual mortality reduction, according to a United Nations Children’s Fund (UNICEF) report.
Martin Dohlsten, Health Manager, UNICEF Nigeria revealed during a review of child mortality in Western and Central Africa that Nigeria ranks the highest in the region for newborn and child mortality.
Dohlsten, speaking on Thursday at a two-day media dialogue on Sick and Small Newborn and Zero Dose in Cross River State, stressed that failure to meet the necessary acceleration could derail global efforts to meet SDG targets due to Nigeria’s sheer population size.
“To achieve the 3.2 target by 2030, Nigeria needs to rapidly accelerate under-five mortality rate reduction from 1.8% to 16.5% per year.
“If Nigeria was to get back on track to achieve SDG 3.2 target, over 3,597,700 under-five deaths could be averted by 2030,” he explained.
Neonatal deaths dominate under-five mortality
.Dohlsten noted that neonatal deaths, occurring within the first 28 days of life, account for 32% of all under-five deaths in Nigeria.
The Health Manager highlighted the leading causes of neonatal deaths include prematurity and birth asphyxia. Among children aged 1 month to 59 months, respiratory infections such as pneumonia, diarrheal diseases, and malaria are the primary killers.
Dohlsten said the critical role of maternal health and care in reducing child mortality.
“Preventing these deaths starts with the mother—during pregnancy, antenatal care, and ensuring proper nutrition. Where a mother delivers her baby is vital, but equally important is the quality of care she receives at the facility,” he said.
The report emphasizes the need for Nigeria to address healthcare system gaps, improve facility readiness, and strengthen maternal and child health programs.
“Nigeria’s progress is crucial not just for the country but for global success in meeting child mortality targets,” Dohlsten concluded.
Immunization challenges and the zero-dose crisis
The media dialogue also focused on immunization needs and addressed the growing challenge of zero-dose children in Calabar, emphasizing the socio-economic, cultural, and logistical barriers to immunization.
Dr. Olusoji Akinleye, Health Specialist at UNICEF Enugu Field Office, explained that nearly 50% of zero-dose children live in rural, urban poor, or conflict-affected areas.
“Zero-dose children serve as markers of marginalized communities facing multiple deprivations,” he said.
He identified poverty, with two-thirds of zero-dose children coming from households surviving on less than US$1.90 per day, as a major barrier to immunization.
Dr. Akinleye also emphasized the significant impact of gender and education on immunization rates, noting that communities with high numbers of zero-dose children often have up to three times as many mothers without formal education.
“Maternal health plays a crucial role as well; mothers of zero-dose children are 45% less likely to attend four or more antenatal visits,” he added.
He also stressed that immunization has been one of the most innovative medical interventions, saving millions of lives and significantly improving life expectancy.
“It has eradicated diseases like smallpox and has contributed to a global reduction in child mortality.
“Vaccines have turned diseases that once devastated populations, like cholera and polio, into rare or nearly nonexistent threats,” Dr. Akinleye observed.
He raised concerns about the recent global decline in immunization coverage, pointing to factors such as economic challenges, difficulties in vaccine production, and growing vaccine hesitancy as contributors to this troubling trend.
Cross River State’s efforts and challenges in immunization
Dr Vivian Otu, the General Director, Cross River State, Primary HealthCare Development Agency highlighted the state’s efforts to improve immunization coverage.
“We have seen a remarkable reduction in the number of zero-dose children, thanks to the support from UNICEF. Their assistance has been invaluable in reaching the most vulnerable children,” she said.
According to Otu, despite the reduction in zero-dose children, the state has experienced a concerning decline in the number of children receiving the Pentavalent-3 (Penta-3) vaccine.
“In 2024, 105,555 children were reached with the Penta-3 vaccine, compared to 141,653 in 2023.
“The decline in Penta-3 coverage to frequent vaccine stockouts and a lack of adequate funding for routine immunization programs,” Otu attributed.
Otu also highlighted that one of the main issues the state faces is logistics.
“There are challenges in moving vaccines from the central warehouse to Cross River State, and these delays have affected our ability to provide consistent immunization coverage,” she stressed.