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Background Nigeria suffers from one of the world’s highest child mortality rates, with about 900,000 deaths in a single year, despite being classified as a middle-income country. Over the past few years, substantial efforts have been made to reduce child mortality, with under-five mortality declining by 31.6% between 1990 and 2018. However, this decline is slower than needed to reduce child mortality significantly. This study presents the social autopsy component of the 2019 verbal and social autopsy (VASA) survey to provide an in-depth understanding of the social determinants of under-five mortality in Nigeria. Methods The study was a cross-sectional inquiry into the social determinants of neonatal and 1-59 months child deaths from the 2018 Nigeria Demographic and Health Survey (NDHS) weighted to represent the Nigerian population. The social autopsy survey asked about maternal care for neonates and 1-59 months children during the final illness. Results Child mortality in Nigeria in children aged 1-59 months is strongly associated with levels of wealth, place of residence, and maternal education. The association of these same socio-economic factors with neonatal mortality is weaker. While there were significant associations with wealth quintiles and geopolitical zones, higher maternal education was not significantly associated with lower neonatal death rates. Maternal complications in pregnancy and/or labour and delivery were common and strongly associated with stillbirths and deaths in the first two days. Severity scores at the inception of the illnesses did not show differences between children who only received informal care versus those who went to formal care providers. The main barriers to care were distance, cost, transport, and the need to travel at night, and these barriers were interlinked. More distant facilities usually required vehicle transport, which was expensive for low-income families. Travelling for an emergency at night was even more difficult in terms of finding and paying for transport and involving problems with insecurity and bad roads. Conclusions The family, community, and health system factors related to neonatal and 1-59 months child deaths in Nigeria were highlighted in this study. Deaths were commonly associated with numerous factors, each of which could contribute to the sequence of events resulting in a preventable death.

Background: The knowledge about the International Code of Marketing of Breastmilk Substitutes and relevant subsequent World Health Assembly (WHA) Resolutions (the Code), its implementation and enforcement are essential in promoting, protecting and supporting breastfeeding, especially exclusive breastfeeding for the first six months of life and optimal infant and young child feeding. Violations by various stakeholders remain a perennial problem within and outside Nigeria with the main reason being lack of information of the Code and its relevance to child survival, growth and development. Aims: To share the findings from data collected during the sensitization of stakeholders on the International Code of Marketing of Breastmilk Substitutes in four States in the UNICEF Rivers Field Office, southern Nigeria. Study Design: Prospective study. Place and Duration of Study: September-October 2017, Southern, Nigeria. Methodology: Stakeholders from 4 southern States in Nigeria attended the sensitization meetings. A pre- and post-tests were administered to assess the knowledge they acquired from the workshops. Results were analysed using percentages and test of significance. Results: The two-day meeting for each State held in September and October 2017 for a total of 296 participants out of whom data on 237 (80%) participants were analysed for presentation. Over 95% respondents had not read the Code and the Nigerian Regulations 2005, did not know the contents and their responsibility towards its implementation before the meeting. At the post test, the performance of the participants significantly improved (p

Although the ever-breastfeeding rate in Nigeria is over 98%, there are some women who may not be able to lactate despite the desire and motivation to do so. Some of the reasons for this failure include lack of skilled support and inherent failure to lactate. We report .the case of a 29-year old graduate, who, despite adequate breast development, motivation to breastfeed and frequent suckling of the newborns, failed to lactate in four consecutive deliveries. Her last postpartum prolactin level was 260µ Units/L. She refused all methods of contraception and consequently delivered four term babies in a period from 1998¬ - 2004 [a period of 6 years] with inter-delivery intervals of 16.5, 36 and 18 months respectively and a mean of 23.5 months. Lactational failure, although uncommon in Nigeria, constitutes a medical indication for the use of breast milk from a wet nurse or breast milk substitute. In view of the high re-lactation rate by affected women when offered skilled assistance, there is need to identify and refer early affected mother-baby pairs to prevent total and consecutive failure to lactate. In event of failure to relactate, safe birth spacing methods should be offered to prevent short inter-delivery intervals with its attendant risks. Similarly, safe and affordable methods of feeding should be provided for the infant to prevent malnutrition and associated problems. Nigerian Medical Practitioner Vol. 49(1&2) 2006: 10-13

Context : Birth traumas associated with poor obstetric services contribute significantly not only to the high perinatal morbidity and mortality, but also to long-term sequelae in the survivors in many developing countries. Birth asphyxia, one of the commonest sequelae of such injuries, has remained a common cause of neonatal deaths in this setting. These injuries however remain under-reported, hence this report. Objectives : To determine the incidence, types and associated factors in mechanical birth injuries in babies delivered at the University of Port Harcourt Teaching Hospital (UPTH) in the Niger Delta from January 1989-December 1998. Design : A retrospective analysis of hospital records of deliveries during the study period. Setting : The Labour and Isolation Wards for delivery records and the Special Baby Care Unit's records on UPTHdelivered babies. Subjects and Methods : All mother-baby pairs delivered at UPTH during the study period were studied. For each mother-baby pair the following data were obtained: biodata, obstetric records and examination findings on the babies. Further analysis was on neonates with mechanical birth traumas. Fisher's Exact and Chi square tests were used for data analysis. Results : Of 16, 631 livebirths, 50 babies had mechanical birth injuries, giving an incidence of 3.1/1000 livebirths. Mechanical birth injuries were commoner in normal weight, term male babies, whose mothers were unbooked and or nulliparous. The common injuries were cephalhaematoma (48%), Erbs' palsy (14%) and facial ecchymoses. Conclusions : Mechanical birth injury remains a problem in this setting. The contributory factors to birth injuries were similar to those in other developing countries. Keywords : mechanical birth injuries, Niger Delta Tropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 50-55