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1 November 2011 Resources for the Awareness of Population Impacts on Development tI FEDERAL GOVERNMENT OF NIGERIA The Change We Seek

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Page 1: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

1 November 2011

Resources for the Awareness of Population Impacts on Development

tI FEDERAL GOVERNMENT OF NIGERIA

The Change We Seek

Page 2: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

2

Improving Our Health

Photo by Bill & M

elinda Gates Foundation

Raise Our Quality of Life

Federal Ministry of Health

Government of Nigeria

November 2011

Page 3: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

3

Nigeria in Perspective

Why Fertility Affects Health

Two Paths

Our Choice

Outline

2

4

3

1

Phot

o by

Die

tmar

Tem

ps

Page 4: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

4

Large Population Size of countries according to population size

Source: www.worldmapper.org

In P

ersp

ectiv

e

Nigeria

Page 5: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

5

High Maternal Mortality Size of countries according to number of maternal deaths

Source: www.worldmapper.org

In P

ersp

ectiv

e

Nigeria

Page 6: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

Sources: Global estimates and 2008 Nigeria Demographic and Health Survey. Goal is from National Health Strategic Development Plan 2010-2015.

MDG Goal #5: Lower Maternal Mortality Why is Nigeria failing to meet its goal?

In P

ersp

ectiv

e

6

Page 7: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

7

High Child Mortality Size of countries according to number of child deaths

Source: www.worldmapper.org

In P

ersp

ectiv

e

Nigeria

Page 8: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

MDG goal

0

50

100

150

200

250

1990 1995 2000 2005 2010 2015

Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s

Sources: 1990, 1999, 2003, and 2008 Nigeria Demographic and Health Surveys

MDG Goal #4: Lower Child Mortality Why is Nigeria failing to meet its goal?

In P

ersp

ectiv

e

8

Page 9: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

9

Photo by Joachim H

uber

Sources: 2008 Nigeria Demographic and Health Survey (NDHS)

Child Mortality Rates Child deaths per 1,000 live births

In P

ersp

ectiv

e

Page 10: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

10

Teenage Mothers Size of countries according to number of teenage mothers

Source: www.worldmapper.org

In P

ersp

ectiv

e

Nigeria

Page 11: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

11

Government Spending on Healthcare Size of countries according to healthcare spending

Source: www.worldmapper.org

In P

ersp

ectiv

e

Page 12: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

12 Source: www.gapminder.org

Health Comparison, 2010 Many countries with less wealth than Nigeria have achieved better health

In P

ersp

ectiv

e

Bangladesh

Nigeria Chad

Senegal

Guinea Ghana

Malawi Why?

Page 13: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

13 Sources: Most recent Demographic and Health Surveys

Fertility Comparison Nigeria and selected countries

Nigeria has very high fertility compared to other nations, whether they are Muslim, Christian, richer or poorer, larger or smaller …

In P

ersp

ectiv

e

Page 14: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

14

Current Fertility by Zone Average number of live births per woman

Source: 2008 NDHS

In P

ersp

ectiv

e

North West 7.3

South West 4.5

North Central 5.4

North East 7.2

South East 4.8

South South 4.7

Nigeria 5.7

Page 15: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

15 Sources: Most recent Demographic and Health Surveys

Modern Contraceptive Use Fertility is high mainly because contraceptive use is low

In P

ersp

ectiv

e

Page 16: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

16

Unmet Need for Spacing, Limiting

Source: 2008 NDHS

In P

ersp

ectiv

e

When a woman expresses desire to space or limit births, but is not using any method to do so

One in five married Nigerian women has unmet need

This is over 6 million couples who are not receiving services

Unmet Need

Page 17: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

17

Most of the developing world is leaving Nigeria behind.

Source: Gapminder World

Lower Fertility… Fewer Child Deaths

Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s (lo

g sc

ale)

400

40

100

0

10

Births per Woman (average) 2 4 6 8

In P

ersp

ectiv

e

Page 18: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

18 Source: Gapminder World

Lower Fertility… Fewer Child Deaths

Most of the developing world is leaving Nigeria behind.

Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s (lo

g sc

ale)

400

40

100

0

10

Births per Woman (average) 2 4 6 8

In P

ersp

ectiv

e

Page 19: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

19 Source: Gapminder World

Lower Fertility… Fewer Child Deaths

Most of the developing world is leaving Nigeria behind.

Chi

ld D

eath

s pe

r 1,0

00 L

ive

Birth

s (lo

g sc

ale)

400

40

100

0

10

Births per Woman (average) 4 6 8 2

In P

ersp

ectiv

e

Page 20: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

20

Nigeria in Perspective

Why Fertility Affects Health

Two Paths

Our Choice

Outline

2

4

3

1

Phot

o by

Die

tmar

Tem

ps

Page 21: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

21

Too closely spaced Too young Too old Too many

Source: 2008 Nigeria DHS

High-Risk Births Cause Poor Health Births are “high risk” when…

Hea

lth

Page 22: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

22

Too Closely Spaced

Hea

lth

22

Phot

o by

Rai

ner W

ozny

, Hei

nric

h Bö

ll Fo

unda

tion

Page 23: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

23 Source: 2008 Nigeria DHS

Birth Spacing Improves Health Longer spacing leads to fewer child deaths

Hea

lth

Years Since Last Birth

Page 24: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

24

Birth Spacing Saves Lives

Hea

lth

Greater Availability & Use of Child Spacing

Commodities & Services

Fewer High-Risk Births

Fewer Maternal and Child Deaths

Page 25: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

25

Too Young or Too Old More children die when mother is younger or older

Hea

lth

Photo by Mike Blyth

Page 26: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

26

Many Girls Marry Before Age 15

Source: 2008 Nigeria DHS

Hea

lth

Among Nigerian women ages 25 to 49 years,

one in four was married by age 15

Photo by Joachim H

uber

Page 27: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

27 Source: 2008 Nigeria DHS

Teenage Girls Who Experience Pregnancy Selected states

Hea

lth

Nigeria 23%

Photo by BBC W

orld Service

Page 28: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

28 Source: 2008 Nigeria Demographic & Health Survey

Child Mortality Children of younger and older mothers are more likely to die

Hea

lth

Page 29: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

Too Many

29

Hea

lth

29

Photo by Teseum

Page 30: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

30 Source: 115 Demographic and Health Surveys and WHO/UNESCO/UNFPA.

Fewer Children, Lower Maternal Mortality 115 developing countries illustrate this point …

Hea

lth

Nigeria

Brazil

Chad

Ghana

Page 31: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

Fewer high-risk births leads to:

Fewer infant and child deaths

Lower maternal complications and fewer maternal deaths

Achievement of MDGs #4 and #5

31

In Summary Lower fertility leads to better health, progress on MDGs

Photo by Mike Blyth,

Hea

lth

Page 32: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

32

Nigeria in Perspective

Why Fertility Affects Health

Two Paths

Our Choice

Outline

2

4

3

1

Phot

o by

Die

tmar

Tem

ps

Page 33: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

33

Two

Path

s

“Low Fertility” Scenario: Nigeria meets its National Strategic Plan targets Contraceptive use rises 2

percentage points each year

Takes 10 years to meet current unmet need

“High Fertility” Scenario: Nigeria’s current path

Photo by Jeffrey Smith

Phot

o by

IITA

Imag

e Lib

rary

31

Page 34: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

5.7

5.2

2.0

0

2

4

6

2010 2020 2030 2040

Birth

s pe

r Wom

an (a

vera

ge)

Source: Spectrum projections for Nigeria

Two Paths Fertility projections under two scenarios

Two

Path

s

34

Low Fertility

High Fertility

Page 35: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

35

Photo by Joachim H

uber

Sources: Spectrum and MDG Model projections for Nigeria

Meeting Unmet Need Prevents Child Deaths During the first decade (2011–2021) meeting unmet need prevents millions of deaths

Two

Path

s

1.5 million child deaths averted

0

Page 36: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

36

Photo by Lindsay Mgbor/D

epartment for International D

evelopment

Sources: Spectrum and MDG Model projections for Nigeria

Meeting Unmet Need Saves Lives Mothers’ lives would also be saved (2011–2021)

Two

Path

s

31,000 lives saved

Page 37: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

37

Photo by Soumik Kar

Sources: Spectrum and MDG Model projections for Nigeria

Meeting Unmet Need Averts Maternal Morbidity 2011–2021

Two

Path

s

700,000+ women avert

morbidity

0.0

Page 38: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

93

210

164

0

100

200

2010 2020 2030 2040

Thou

sand

s of

Mid

wiv

es

Source: Spectrum projections for Nigeria

Midwives Required Fewer births, less pressure on midwives

38

Low Fertility

High Fertility

Two

Path

s

Page 39: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

Source: Spectrum projections for Nigeria

Health Expenditures Fewer patients, less pressure on budgets

39

Low Fertility

High Fertility

Cumulative Savings Naira 47 Billion

Two

Path

s

Page 40: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

40

1.5 million child deaths averted (MDG #4)

31 thousand maternal lives saved (MDG #5)

Lower maternal and child health complications

Less burden on midwives and other resources to meet ALL the MDGs

In Summary Lower fertility in Nigeria means during the next 10 years would result in…

Photo by Jeremy W

eate

Two

Path

s

Page 41: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

41

Nigeria in Perspective

Why Fertility Affects Health

Two Paths

Our Choice

Outline

4

3

2

1

Phot

o by

Die

tmar

Tem

ps

Page 42: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

Help our people plan safer pregnancies

Provide commodities and services to meet the need for birth spacing, timing, and limiting

Meet the MDGs

Raise our QUALITY of life

42

It’s Our Choice

Photo by PJotter

Our

Cho

ice

Page 43: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

Help Nigerians achieve their desire for healthier families through access to family planning by: Signing the National Health Bill to help fund primary health care in Nigeria Approving a permanent annual budget line item for family planning starting in 2012 Releasing the committed 2011 MDG funds for family planning commodities

43

Let’s Take Action Our

Cho

ice

Photo by by Banjii

Page 44: The Change We Seekpdf.usaid.gov/pdf_docs/pnaeb647.pdf4 Large Population Size of countries according to population size Source:  In Perspective

44

Thank You

The Change We Seek: Raising Our Quality of Life

RAPID Nigeria

Photo by Kate Dixon