Public Hospital-Based Care of Small Newborns in Nigeria

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Although Nigeria has made significant progress in reducing under-5 mortality, it did not meet the child mortality target specified by Millennium Development Goal. About one-third of deaths to children under 5 in Nigeria occur in the first month of life, with complications of prematurity, complications during birth, and infections the leading causes of these deaths. Most of these deaths are preventable with proven and cost-effective interventions.

One such intervention is kangaroo mother care (KMC), which some Nigerian hospitals began adopting after 2008. At the 2014 meeting of the Kangaroo Mother Care Acceleration Partnership in Rwanda, the Nigerian delegation drafted a country plan that called for an operational guide to facilitate effective introduction and scale-up of facility-based KMC. To develop the guide, the delegation agreed that a national assessment of KMC implementation was needed. This report provides the findings and suggested recommendations emanating from the study, which was carried out in 2016.

The study was conducted in two phases. The first phase was a telephone-administered survey of 757 public tertiary and secondary hospitals about the provision of care for small newborns, including facility-based KMC. The second phase comprised two separate data collection activities: an in-depth assessment of 36 hospitals — six hospitals per state in each of six geopolitical zones — and semi-structured individual interviews with 22 key informants representing different roles within the health system.

The survey, hospital assessment, and key informant interviews provide an extremely rich picture of newborn care in Nigeria and highlight many areas for improvement. This report includes detailed recommendations for action at many levels to enhance care, including better-equipped facilities, increased training, smarter staff management, community awareness-raising, and closer coordination among government, development partners, and hospitals.

While there are examples of good quality care for small or preterm babies that include KMC, Nigeria will need to pay greater attention to addressing the many factors hindering provision of high-quality KMC and comprehensive care for small newborns in order to meet the targets established in the SDGs.