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No, more than 99% of Nigerian children under 5 don’t die every year

Non-profit organisation Connected Development had many sitting right up with this startling claim about mortality in Africa’s most populous country. Thankfully, it’s incorrect.

  • According to the most recent estimates, from 2016, of both deaths per age group and overall population size, 2.8% of children under five died in that year.

  • The United Nations estimated that in 2019 the mortality rate for Nigerian children under five was 117.2 per 1,000 live births, with mortality rates for boys higher than for girls.

  • Public health experts reiterated that the under-five mortality rate in Nigeria was still unacceptably high, because of a weak health system and poverty, among other factors.

To mark World Health Day in April 2021, Nigerian non-profit organisation Connected Development made an alarming claim about child mortality.

“In commemoration of #WorldHealthDay2021, we are reminded that annually, Nigeria loses over 99% of children below the age of five due to dilapidated health care services,” the organisation tweeted.

Connected Development, which focuses on helping vulnerable communities, blamed poor health care, especially at the primary level, for this.  

But do nearly all children in Africa’s most populous country die before they reach the age of five? We looked at the data.

‘We will be more diligent with statistics,’ say Connected Development

Africa Check contacted the organisation for the source of this figure. In response to our query, it pulled down the tweet.

“The tweet was an unauthorised post and has now been taken down. We apologise for the error and will be more diligent with the statistics we share subsequently,” said communications director Kevwe Oghide in an email.

But how many children younger than five die in the country every year? Experts directed us to three sources of data:

What the data shows

The United Nations (UN) estimates show that about 857,899 children younger than five died in Nigeria in 2019. The data also shows that Nigeria has not had more than a million deaths in the age group in any year since 1970. It’s highest count was 928,421 children in 1998. 

Does the estimate of deaths account for 99% of children under five? For the most recent population data by age group, one has to go back to 2016. The country’s national statistics office estimated that, based on 2006 census data, there were 31.1 million children younger than five in 2016.

The UN’s data showed that 877,838 children in this age group died in 2016. This works out to 2.8% of the total number of children, far less than 99%. The biggest causes of deaths were infectious diseases and birth-related complications.

Mortality rates paint worse picture, but nowhere close to 99%

Under-five mortality rates in the country tell a different story, though they don’t come close to 99%. This rate is a measure of the probability, per 1,000 live births, of a newborn baby dying before reaching the age of five.

The UN estimated Nigeria’s mortality rate in 2019 to be 117.2 per 1,000 live births

Boys were more likely to die than girls. The mortality rate for boys was 123.6 per 1,000 live births, compared to 110.4 for girls. (Note: For how the international health organisation estimates this, read here.

There were also regional differences, with northern Nigeria having higher under-five mortality rates than the south.

Local surveys show similar numbers

The 2016/17 Multiple Indicator Cluster Survey estimated the under-five mortality rate at 120 deaths per 1,000, by considering the five years before the survey.

The 2018 demographic and health survey found the rate to be 132 deaths per 1,000 live births, or just over 13%. 

None of the surveys supports the claim that nearly all children under five in Nigeria die every year.

Tanimola Akande is professor of public health at the University of Ilorin, north-central Nigeria. He told Africa Check the claim was improbable.

“That statistic is absolutely wrong. However, the under-five mortality rate in Nigeria is high compared to other countries,” he said, attributing this to weakness in the entire health system.

Several factors at play for high rates

“Yes, many of our primary healthcare centres are dilapidated and lack personnel. In some cases, the medical doctors stationed in the centres are hardly available,” Akande said. 

But there are several other factors that make the rate high, he said. This included the health-seeking behaviour of Nigerians, low literacy rates and cultural and religious practices. 

Others are low immunisation and health insurance coverage, difficulties in accessing health facilities in rural areas, and poverty.

99% under-5 mortality impossible ‘even without any form of health care’

The claim by the organisation was alarmist, Best Ordinioha, a professor of community medicine and public health at the University of Port Harcourt in southern Nigeria, told Africa Check.

“Even without any form of health [care] it is almost impossible to have 99% under-five mortality. Also, it’s important to note that primary health care goes beyond medical care to include things like water supply, sanitation and proper nutrition.” 

Ordinioha agreed that primary care was neglected and inaccessible to many in Nigeria. 

The country is not immune to such startling claims. In 2017 the New York Times claimed that insecurity in the northeast was “so bad that almost all children under five have died”.

Conclusion: Nigeria’s under-five deaths not at 99% every year, as organisation claimed  

To mark World Health Day in 2021, Connected Development, a non-profit organisation, claimed that every year Nigeria loses over 99% of its children below the age of five, blaming poor healthcare.

Data from the UN and two nationally representative surveys does not show mortality this high. We rate the claim as incorrect.

The organisation has since taken down the claim.

 

Photo: PIUS UTOMI EKPEI / AFP

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