ADDRESS PRESENTED BY THE DR. EKANEM N. EKURE, THE PRESIDENT OF THE PAEDIATRIC ASSOCIATION OF NIGERIA, AT THE 56TH ANNUAL GENERAL METING AND SCIENTIFIC CONFERENCE OF THE ASSOCIATION IN GOMBE.
Gentlemen of the Press,
I welcome you all to this press conference in commemoration of the 56th Annual General Meeting and Scientific Conference of the Paediatric Association of Nigeria taking place in the beautiful city of Gombe, the Jewel of the Savannah. This conference which will take place between 20th and 24th January 2025 according to the tradition of the association, will be attended by delegates from the various parts of the country, from within Africa and other parts of the world.
This conference is a yearly event where paediatricians, other health workers who work with children and professionals in non-health -related fields but who are interested in the affairs of children, discuss the current state of affairs of Nigerian children and make appropriate recommendations with the optimal health of the Nigerian child in focus in line with appropriate local and global best practices. Paediatricians are child advocates and thus, this annual conference is our obligation to the health and general well-being of Nigerian children. This year’s conference is themed “Intersectoral collaboration in advancing child health and conference”. This is to showcase the vital role, as well as the need for stronger collaborations among the various sectors of the polity in ensuring the optimal health and general well-being of Nigerian children. In addition, we are honoured to have the President of the International Paediatric Association (IPA), Dr Naveen Thacker, in attendance, at this conference. This is a testament to the huge role the Paediatric Association of Nigeria is playing in the affairs of children on a global scale.
The current executive council of the Paediatric Association of Nigeria has in the last one year, worked tirelessly to bring to global attention, the peculiar situations of the Nigerian child. Therefore, at various times, we have had to engage the press in line with our duties as child advocates. The last national day was a perfect opportunity to review the state of the Nigerian child, partly to celebrate the Nigerian child and then, to appreciate the government for grounds covered so far in improving the lots of the Nigerian child and to remind them of the grounds yet to be covered. The unfortunate massive flooding in parts of the country, the detention of children legally and illegally across the land and the recent stampedes during festivities, which involved children were used to highlight the deficiencies in the implementation of the Child Rights Act in many states of the country, the worsening effect of the national economic depression on children as well as the deficiencies in the country’s state of emergency preparedness, especially as it relates to children.
As a quick reminder, the demography of Nigeria is peculiar and it is the reason behind our staggering child-related health statistics. Nigeria is the most populous African country and the seventh most populous, globally. The estimated national population is 227 million (in the year 2024) with a growth rate of 2.53%, a birth rate of 34.19 births/1000 population and a death rate of 8.7 deaths/1000 population. Therefore, the Nigerian demography is by default, that of a largely young population. For emphasis, close to 42% of the population is made up of people under the age of 15 years. Unfortunately, less than half of births (40%) are still registered in Nigeria, leaving out a bigger proportion unaccounted for. The Paediatric Association of Nigeria, is primarily concerned about the health and well-being, education, social protection and economic prospects, of this huge proportion of the national population. Therefore, effective implementation of the various national and global interventions targeted at improving the health and well-being of Nigerian children must necessarily be pivoted on accurate data bases and inter-sectoral collaborations.
Nigeria remains one of the leading contributors to the global childhood mortality rates. The under-five mortality rate in Nigeria was 110/1000 live births in 2023 compared to 132/1000 live births in 2018. The leading causes of childhood deaths being neonatal conditions, acute respiratory infections, malaria, diarrhoeal diseases, vaccine preventable diseases and HIV/AIDS. The infant mortality rate also marginally declined from 67/1000 live births in 2018 to 63/1000 live births in 2023 whereas neonatal mortality rate increased from 39/1000 live births in 2018 to 41/1000 live births in 2023. These statistics show the major role played by newborn deaths in under-five deaths from conditions such as complications of prematurity, severe intrapartum events, serious bacterial infections, hyperbilirubinaemia and congenital malformations. Therefore, to further reduce under-five mortality rates in Nigeria, more emphasis needs to be put on improving perinatal survival. Skilled assistance at birth, prevention of preterm delivery and when preterm delivery is inevitable, appropriate measures to improve lung maturation and prevent infections, are germane. This calls for further increasing the proportion of deliveries benefitting from skilled birth attendance from the current 46% and the proportion of babies receiving postnatal check within two days of birth, from the current 43%. More efforts need to be put into further reducing childbirths outside hospitals and increasing skilled birth attendance. This requires huge political will and strong collaborations between government agencies, health planners and healthcare providers. The Paediatric Association of Nigeria has been impactful in conducting Helping Babies Breathe and Neonatal Resuscitation trainings for health care providers, at the grassroots and higher tiers of healthcare delivery respectively. These trainings have been going on since 2005. These efforts are geared towards empowering more health care providers to assist newborn babies at birth, thus reducing perinatal and neonatal deaths. It is obvious more needs to be done in this regard.
One of the major issues on the front burner of the Paediatric Association of Nigeria is the persistent low vaccine coverage rates. Overall, only 39% of Nigerian children, aged 12-23 months, were fully vaccinated in 2023. While the proportion of children who were fully vaccinated marginally rose from 31% in 2018 to 39% in 2023, the proportion of children with no vaccination was almost doubled, rising from 19% in 2018 to 31% in the same period. This emphasises the problem of the “zero-dose immunization” children, which incidentally formed the fulcrum of the last conference of the association which took place in Lagos. The “zero-dose immunization” children are children who have never received any vaccine. They are in urban slums, areas of conflicts and strife, and geographically hard-to-reach areas. This population of children are themselves at risk of the devastating effects of vaccine-preventable diseases just as they form a huge reservoir of these diseases with a formidable threat to the general population. It is one of plausible reasons for the recent outbreaks of some vaccine-preventable diseases in parts of the country. All hands are on deck to tackle the problem of “zero-dose immunization” children at the national and local levels and PAN, like other stakeholders, is strongly involved in this exercise.
One of the major scientific breakthroughs of this generation is the discovery and clinical use of a vaccine in the prevention of cancer of the cervix. This cancer, which is linked to sexual exposure to the Human Papillomavirus, is responsible for up to 8,000 annual deaths among Nigerian women. This Human Papillomavirus vaccine is scientifically proven to be effective and safe with very few insignificant side effects. In countries like Australia where the vaccine has been in use for many years, infertility among vaccine recipients has not been reported. Therefore, this vaccine is recommended for girls between 9 and 14 years while older women are encouraged to screen for cervical cancer. Unfortunately, the roll-out of the Human Papillomavirus vaccine was met with remarkable vaccine hesitancy in Nigeria and this stimulated the International Paediatric Association (IPA) to show interest in the Nigerian situation. The IPA and PAN are currently collaborating in solving the problem of vaccine hesitancy generally but specifically, with respect to the Human Papillomavirus vaccine through highly coordinated chains of trainings and advocacies. This effort was kickstarted with a national training workshop of health workers, immunization officers, representatives of the press and social media influencers, designated as “immunization champions”. This was followed up with regional workshops across the six geo-political zones of the country in April 2024 to further increase the percolation of accurate information about the Human Papillomavirus vaccine down to the general public. This is aimed at increasing the quality of awareness about the efficacy and safety of vaccine in order to ultimately reduce related hesitancies. This Gombe conference promises to offer a platform for the “immunization champions” drawn across the country, to meet, give reports, compare notes, evaluate progress made so far and make plans for stronger impacts, at the meeting we call the “Experience Sharing Workshop”.
Malnutrition is a direct or underlying factor in about 45% of childhood deaths in Nigeria. The burden of malnutrition in Nigerian children is alarming as it reflects in a direct manner, the state of the national economy. The recent challenges of low exchange rates, high cost of fuel and low wages have jointly reduced the financial capability of many families. With low family finances, food security dwindles, food supply becomes inadequate and children bear the brunt. The proportion of under-five children with stunting had increased from 37% in 2018 to 40% in 2023 – that being the highest prevalence rate in the world. It is important to state that stunting reflects prolonged starvation and it has several far-reaching consequences such as increased risk of death, poor cognitive development among survivors, poor school performances, low productivity in adulthood and ultimately, and low contributions to the national economy. Similarly, children with borderline nutritional status, known as underweight, increased from 22% in 2018 to 27% in 2023, reflecting that more children are at risk of severe malnutrition. In addition, about two million Nigerian children reportedly suffered from severe acute malnutrition, a major killer of under-five children, in 2023. The increasing burden of malnutrition in Nigerian children may be a direct consequence of reduced farming activities as a result of climatic challenges, natural disasters such as flooding and insecurity. Appropriate breastfeeding practices, particularly exclusive breastfeeding, lay the foundation for good childhood nutrition. Unfortunately, the exclusive breastfeeding rate remains abysmally low among Nigerian children less than six months of age, stagnating at 29% from 2018 to 2023. In addition to the well-known negative effect of ignorance on breastfeeding practices, increasing economic pressure forcing mothers out of their homes to source additional financial supports for the family may be a major contributing factor to the low rate of exclusive breastfeeding in Nigeria. Therefore, improving the finances of the family may have a positive strong impact on the prospects of exclusive breastfeeding as well as infant nutrition among Nigerian children.
The Paediatric Association of Nigeria is passionate about ensuring the implementation of the Child Rights Act of 2003 across all the states of the Nigerian nation. Adhering to the provisions of this law will ensure adequate feeding, education and social protection of the average child in Nigeria. Despite the fact that primary or basic education is free and compulsory in Nigeria, only 67% of young children are enrolled into schools. It is important to note that one out of every five children who are out-of-school in the world is in Nigeria. Unfortunately, girls are worse affected just as the global child bride populations are concentrated in Africa. Therefore, parents must be enlightened about the rights of the child to good nutrition, good health care and basic education in the minimum. The government must also ensure safety and adequate protection of the child in the community.
Gentlemen of the press, all the issues highlighted above and more, in various ramifications, will be discussed extensively during this conference. From the proceedings of the conference, a communique will be drawn and this will be made available to the public as well as to the government for consideration of the recommendations arising from the deliberations.
On behalf of the Paediatric Association of Nigeria, I welcome you all once again to the 56th Annual General Meeting and Scientific Conference of the association, holding at the International Conference Centre, Gombe.
Long live the Federal Republic of Nigeria.
Long live the Paediatric Association of Nigeria.
Long live the Nigerian Child.
