ABSTRACT
This study examined infant mortality as a gross violation. The study used qualitative method.
The study revealed that; National health policy, accelerated child survival and development: strategic framework and plan of action, National reproductive health policy and strategy, National child health policy, and policy on the health and development of adolescents and young people in Nigeria, among others are the identified government policies on infant mortality in Nigeria; breastfeeding and vaccination, family planning, training of birth attendants and vitamin A supplementation, sensitization and to increase awareness among prospective parents, providing effective monitoring and treatment of chronic diseases in women, and provision of health education and preconception counseling were the identified ways of reducing infant mortality; the identified the following as challenges to the prevention of infant mortality which are, lack of poor child birth care, preventive and curative care in postnatal period, sanitation, lack of water supply, child spacing and parity are great challenge towards the effort to reduce child mortality; the absence of strong service delivery, lack of training and counseling of nurses were identified as impediments to effort to reduce child mortality.
It is concluded that, government should ensure that qualified and skilled personnel are posted both urban and remote areas with adequate funding and salary in order for them to discharge their duties effectively and to minimize infant mortality across the country.
The study is further recommended that; the welfare of the health workers in general should be a priority of all government tiers and to be improved in order to attract and retained skilled manpower into the state civil service; the salary structure of the medical personnel should be reviewed upwards and the compulsory one year posting of final year midwives should be encouraged at the local government level; there should be proper legislation at the state level to back up government policies should be encouraged; there should be adequate policies and programmes in order to improve maternal and child health in Nigeria; adequate funding should be budgeted for free maternal care and to be injected into the programme, as the impact will be felt across the country; there should be adequate training and counseling of medical personnel in order to adequately cater for the needs of pregnant women.
CHAPTER ONE
1.1. Background to the Study
Child/Infant mortality is not a new concept in the social and medical sciences. However, it poses severe threats to human survival most particularly in the future generations. There is a saying that, the future of any society relies on the health condition of the women and the young population, (Odunlami, 2016). The sustenance of the society and the economy largely depends on these two groups to this end, their health and security is of utmost importance in order to avert feelings of sadness, depression and loss of lives. According to Myles (1953), the maternal mortality rate is the number of death registered during year of women dying from cause attributed to pregnancy and child birth for 1,000 registered total (life and still births) in the year while infant/child mortality rate is the number of deaths registered during the year of age per 1,000 registered births in the year. This is to say that, maternal mortality is simply deaths occurring from complications during pregnancy, labour delivery or child birth, while infant/child mortality can be any death arising under one year or five years of age, (Goutas, 2014).
Mothers and children are at highest risk for disease and death. While motherhood is often a positive and fulfilling experience, for too many women, it is linked with ill–health and even death, (Olatoye, 2015). The death of a woman during pregnancy, labor or pueperium is a tragedy that carries a huge burden of grief and pain, and has been described as a major public health problem in developing countries especially in Nigeria, (Aluko, 2014). Women have a huge impact on their families’ welfare. Deaths of infants/children under the age of 5years are peculiar and closely related to maternal health. One million children die every year simply because their mother has died, and the risk of death of children less than 5years doubles if mothers die in childbirth, (Shettima, 2014). More than 23,000 children die on daily basis and every minute a woman dies in child birth. Worldwide, every year about 500,000 women die due to child birth and over 9 million children under age five die mostly from preventable and treatable diseases, (WHO, 2006).
Nigeria is the most populous Black Country in Africa with over 140 million people including 75million children. The child mortality rate in Nigeria is very significant and has several implications for the attainment of the MDGs, (Tenuola, & Shaibu, 2013). It has been noted that, Nigeria is lagging behind in achieving universal coverage of key maternal and child health intervention and will unlikely meet the target of the MDGs, (Olatoye, 2015). According to UNICEF Executive Director, Ann Veneman, “midway to 2015 deadline for MDGs, Nigeria continues to record unacceptably high maternal, newborn and child mortality”. Nigeria ranks as one of the 13 countries in the world with the highest maternal mortality rate and is still not listed among the 10 countries seen to have made rapid progress to meet the goals, (Odunlami, 2016).
Apart from the death rate being recorded due to malaria fever of both pregnant women and children, it was as well reported on the Africa Independent Television (AIT) on the 6th August 2015 at the 8:00pm news that Nigeria spends over 130 billion naira on malaria control. Alubo (2014) opined that, women in Nigeria suffer from all kinds of ailment and ill conditions and run the risk of sudden deaths in child birth. The main causes of this sudden death in child birth are obstructed labour, uterine infection, anaemia, ectopic pregnancy and cepsis, etc. According to Alubo (2014), these complications account for maternal mortality during labour and after child birth. All the factors by Alubo, as well as the previous explanations of various scholars of the concept under study showed that women suffer undue hardship during and after pregnancy. To put it right, a lot of factors and complications can result to maternal and infant mortality as stated all through but of interest is the gross violation of human right in infant mortality and it is of sociological importance to identify how gross violation of human rights affect the health of the mother and the child and the definite responses of government.
As aforementioned, the causes of infant mortality in Nigerian cannot only be blamed on preventable and treatable diseases. It is important that, one takes into account the health care service, the rate of poverty, level of education of parents and children, available of water, food clothing and shelter, (Odunlami, 2016). Human right documents are applicable to all human beings as seen in article 2 of the Universal Declaration of Human Right (which was adopted by the United Nations General Assembly on the 10th of December, 1948 and was as a result of all atrocities committed against human during world war 11), which state everyone is entitled to all the right and freedom set forth in the declaration of any kind such as race colour, sex, language religious political or other opinion national or social origin property, birth or other status.
This human right document is not necessarily child specific and has failed to address the exceptional needs of the children within the society hence the need for an international law, international institution or international convention that is centered mainly on the right of children within the society as well as in the international community. However, on the 29th of November 1989, the United Nation General Assembly adopted the convention on the right of the child (CRC). At the regional level, the organization of African unity also adopted the African union charter on the rights and welfare of the child (CRCW) in the July of 1990, (UN General Assembly, 1948).
Both international instruments contain universal set of standard and principles for the development, survival, protection and participation of the children, (UN, 2015). It reflects children as human beings and subjects of their own right. They outline the human right to be respected and protected for every child under the age of 18. The rights of children in Nigeria are still suffering from gross violation by not only the government but as well by parents and other members of the public, (Tenuola, & Shaibu, 2013). Children in Nigeria are faced with violence, harmed health practice, child marriage, child trafficking, child abuse, infanticide, lack of access to education and health care, low standard of living, lack of access to nutritional service, food water which makes them susceptible to mortality, (Aigbe, & Zannu, 2012). The seeming high and persistent nature of this arguable gross violation of human rights has continued to strain development in Nigeria, posing a major security challenge for not just Nigeria as an independent state but as well negatively affects the images and influence of Nigeria as a member in the larger international society.
Therefore, it is against this background that this review examines infant mortality and a gross violation, using Gombe State, Nigeria.
1.2. Statement of the Problems
Infant mortality revolves around primary care and primary healthcare inadequacies, and are largely due to poverty, illiteracy, and unemployment driven, generally centering on low maternal welfare. It generally manifests childhood stunting due to household poverty induced malnutrition, (Odunlami, 2016). Childhood may be devoid of physical, mental and psychological wellbeing, acceptable intelligence quotient, cognitive ability, good education and expected psycho-social development, (Dower, 2015). A healthy nation is a wealthy nation. Every human life, infant or child, is precious. Nigeria needs to create wealth through good health policies and programmes.
According to the estimates developed by the United Nations Inter-Agency Group for child mortality, the rate of child mortality in Nigeria has reduced from 130 deaths per 1000 live birth in the 1990s to 113 death per 1000 live birth as at 2014. Though, Nigeria has made little progress in the reduction of child mortality, however, one cannot deny the fact that much work still needs to be done. Although, many individuals might be quick to associate the causes of infant mortality in Nigeria to disease, it is pertinent to note that infant mortality in Nigeria is now vying toward the violation of child’s right, (Federal Government, 2018). The survival of the children within the society is now intertwined with the responsibility of the government and the family.
The 2003 child’s rights act signed into law by the federal republic of Nigeria provided in its article 13 (3) a-b that, “every government in Nigeria shall endeavor to native infant and child mortality rate, ensure the provision of necessary medical assistance and health care services to all children with emphasis on the development of primary health care”, (Child Right Act, 2003). From the provision above, one can understand that firstly, the government of Nigeria is enjoined to dedicate the appropriate and available resources to the development of the health care services of the country to ensure that every Nigerian child attains the best attainable state of health, (WHO, 2017). However, in Nigeria, all resources that should be used in the development of the health sector end up in the pocket of a few individuals or elites in the society, while the people as well as children continue to experience avoidable deaths.
The health care system in Nigeria is such that only the wealthy individuals have access to proper medical assistance while those with paucity of funds continue to suffer. In such situation, these individuals are forced to seek the attention of quack doctors who in turn misdiagnose them, prescribe fake, wrong or substandard medication, (Tenuola, & Shaibu, 2013). The act and human right instruction adopted in Nigerian dished out a lot of standards to be considered to ensure the promotion of human rights but it is evident that most of these rights are neglected and some violated.
It is based on the above that, this study seek to examine infant mortality as a gross violation, and to understand the implications this situation has for sustainable development and security in Nigeria.
1.3. Research Objectives
The primary aim of this study is to assess infant mortality as a gross violation in Gombe State, Nigeria. The specific objectives will be to:
- examine the effect of infant mortality in Gombe State
- determine the government policies on reducing infant mortality in Gombe State
- identify the causes of infant mortality in Gombe State
- find out the level of the prevalence of infant mortality in Gombe State
- suggest ways of reducing infant mortality in Gombe State.
1.4. Research Questions
Based on the above research objectives, the following research questions will be poised.
- To what extent is the effect of infant mortality in Gombe State?
- Are there any government policies on the reduction of infant mortality in Gombe State?
- What are the causes of infant mortality in Gombe State?
- What is the prevalence of infant mortality in Gombe State?
- What are the possible ways of reducing infant mortality in Gombe State?
1.5. Significance of the Study
The findings of this study will help policy makers and relevant government authorities improve on development programmes thereby taking adequate steps towards reducing and alleviating maternal and infant death in our society.
Furthermore, it is hoped that the findings from the study will enable medical officials and expectant mothers to embark on preventive measures against such mortality.
In addition, this study will equip men with the necessary information concerning infant and maternal mortality in the society such that they will begin to provide more and adequate care for their wives, mothers and children (both born and unborn). These ones represent the future of the society.
The findings of this study will be significance to parents in sense that, it will help parents identify the dangers of child vulnerability in Nigeria, and to seek policies that will help prevent infant mortality in Nigeria.
The findings of this study will serve as a reference point for other researchers who might want to carry out future research in this regard.
1.6. Scope of the Study
The scope of this study is to assess infant mortality as a gross violation in Gombe State, Nigeria. This study is based on qualitative design which is designed to extract in-depth and pertinent information. Qualitative research method is consistent with exploring and understanding the characteristics of a group of people or individuals in a given environment in relations to a social or human problem, (Creswell, 2014). Qualitative methodology is known to be the most appropriate research design since it aligns with the research questions, purpose and topic (Creswell, 2014).
1.7. Methodology of the Study
The methodology of this study will be qualitative in nature using secondary sources of information. The secondary sources shall be through journals, reports, articles, newspapers, treaties, textbooks and various statutes which would be obtained from online sources. The issue under discussion is a global menace which cuts across several countries, although there have been few or little literatures on the subject matter, this shall be referred to in discussing the topic at hand.
1.8. Operational Definition of Terms
Infant: according to the Oxford dictionary of law (7th edition), an infant is defined as a child under the age of 18.
Mortality: Means death and dying, the irreversible caesarian of life and the imminent approach of death.
Infant mortality: refers to the death of newborns during their first year of birth, per thousand of live births within a geographical region or location. On the other hand, infant mortality is the death of children before the age of five years.
Human Rights: these are the right of children i.e. human under the age of 18.
Child: children, a young person birth to the age of 7 full physical development, a boy or a girl; a child of size.
