Every year, Nigeria loses approximately 850,000 newborn and under-five children to causes that could have been prevented. This staggering number represents not just statistics on paper, but hundreds of thousands of families experiencing loss, communities losing their future generation, and a nation grappling with a public health emergency that demands immediate and sustained action.
The Coordinating Minister of Health and Social Welfare, Muhammad Pate, disclosed these sobering figures on Wednesday in Abuja during the joint national commemoration of the 2025 World Pneumonia Day and World Prematurity Day. The event marked a critical moment in Nigeria’s fight against child mortality, launching two major policy documents aimed at reversing these tragic trends.
Understanding Nigeria’s Child Mortality Burden
Nigeria has made measurable progress in reducing deaths among children under five years old, but the country remains significantly off track to meet global targets for child survival. According to data from the Nigeria Demographic and Health Survey, the country’s under-five mortality rate declined from 201 deaths per 1,000 live births in 2000 to 110 deaths per 1,000 in 2023. This represents a 45 per cent drop over two decades, which demonstrates that progress is possible when resources and attention are directed appropriately.
However, despite this modest improvement, Nigeria is not yet on track to achieve the Sustainable Development Goal target of a rate less than 25 per 1000 live births by 2030. The current rate of 110 deaths per 1,000 live births means that for every 1,000 babies born in Nigeria, approximately 110 do not survive to their fifth birthday. This places an enormous burden on families, healthcare systems, and the nation’s development prospects.
Minister Pate explained that of the 850,000 annual child mortality cases, about 280,000 newborns die within the first 28 days of life due to complications from premature birth. Additionally, 162,000 deaths are linked to childhood pneumonia every year. These two conditions alone account for more than half of all preventable child deaths in the country, highlighting where intervention efforts must be concentrated.
The Forgotten Killer: Childhood Pneumonia
Childhood pneumonia has been described by Minister Pate as “the forgotten killer of under-fives.” While the global community has mobilised strongly against malaria, polio, tuberculosis, and HIV, pneumonia has not received comparable attention despite being a major contributor to child mortality worldwide. Global estimates indicate that around 100 million childhood pneumonia cases occur annually, resulting in more than 808,000 related deaths across the world.
Low- and middle-income countries, particularly those in sub-Saharan Africa, bear the brunt of this burden. Nigeria and 14 other countries account for nearly three-quarters of the global childhood pneumonia mortalities. This concentration of deaths in a relatively small number of countries suggests that targeted interventions in these nations could dramatically reduce global child mortality rates.
The good news is that progress is being made. The ministry’s partnership with the Every Breath Counts Coalition and the Paediatric Association of Nigeria has helped to reduce child deaths in recent years through the development of an In-Patient Pneumonia Treatment Algorithm. This clinical tool has strengthened the skills of secondary and tertiary healthcare workers in managing severe and complicated pneumonia cases. To a great extent, it has accounted for the drop in the under-five mortality rate from 132 per 1,000 in 2018 to 110 per 1,000 live births in 2024.
The Slower Progress on Newborn Survival
While progress on reducing child mortality has been encouraging, progress in reducing newborn deaths has been much slower. A retrospective assessment of data over the past 35 years shows only a single-digit drop in neonatal mortality, from 42 per 1,000 live births in 1990 to 41 per 1,000 live births in 2024. This glacial pace of improvement indicates that newborn survival requires different strategies and more intensive interventions than those used for older children.
One of the country’s emerging challenges contributing to child mortality is birth defects, which have become an under-recognised but significant cause of neonatal and under-five mortality. Government data shows that the proportion of neonatal deaths linked to birth defects rose from one per cent in 2014 to three per cent in 2019. Hospital-based studies across the six geopolitical zones show prevalence rates ranging from 2.3 to 39.9 per 1,000 live births, demonstrating significant regional variations that require tailored responses.
New Policy Frameworks to Accelerate Progress
To accelerate progress in reducing child mortality, the ministry developed the Nigerian Child Survival Action Plan after extensive consultation with key partners. The plan aims to reduce under-five mortality to fewer than 25 deaths per 1,000 live births by 2030 through a multi-sectoral approach that integrates health, education, nutrition, and child protection. This comprehensive approach recognises that child survival is not solely a health issue but requires addressing factors across multiple sectors that influence children’s developmental potential and survival.
The ministry also launched the National Birth Defect Surveillance Guideline 2025, which provides a standardised framework for detecting and managing birth defects across healthcare facilities nationwide. This guideline represents an important step in addressing a previously overlooked contributor to child mortality.
Minister Pate emphasised that there is no room for complacency in implementing these frameworks. The Ministry will continue to explore innovative partnerships that will translate these policy efforts into effective action for child survival. Achieving the plan’s goals will require leadership, targeted human and financial resources, and a strengthened health system to ensure that the most vulnerable and poor children get the greatest benefits.
The Path Forward: What Policymakers Must Know
The government is intensifying efforts to strengthen primary healthcare delivery at community levels and expand newborn and child survival interventions. These interventions include oxygen therapy for children with pneumonia, Kangaroo Mother Care for premature infants, and early breastfeeding promotion to boost newborn immunity. The ministry is also enhancing data-driven decision-making to guide equitable investments and close service delivery gaps across the country.
The Permanent Secretary of the ministry, Daju Kachollom, called for renewed commitment to ensure that no child, regardless of geography or circumstance, is left behind. This commitment must extend beyond government ministries to include development partners, civil society organisations, healthcare workers, and communities themselves.
UNICEF’s Health Manager for Maternal, Newborn, Child, Adolescent Health and HIV in Nigeria, Martin Dohlsten, reinforced this message by stating that pneumonia and prematurity remain major contributors to child deaths globally and in Nigeria. The themes for 2025 underscore the collective responsibility to ensure that every Nigerian child has the opportunity not just to survive, but also to thrive.
By commemorating World Pneumonia Day and World Prematurity Day under a unified event, stakeholders reaffirmed their shared vision for a future where no child in Nigeria dies from preventable causes and every newborn gets the best possible start in life. Achieving this vision requires sustained collaboration, adequate funding, political will, and evidence-based interventions that reach the communities and families most in need.
Conclusion
The battle against child mortality in Nigeria requires sustained attention, resources, and coordinated action across all sectors of society. While progress has been made, the loss of 850,000 children annually to preventable causes represents an unacceptable tragedy that must galvanise policymakers, healthcare providers, and development partners into urgent action.
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