In one year, Nigeria has won the unenviable health-related trophies.

It is a double whammy of most dangerous place to give birth and a country with lowest life expectancy in the globe.

A few months ago, the BBC declared that the most populous black nation in the world was the most difficult place to give birth due to lack of medics and poor facilities.

A few days ago, the UN World Population Projects 2025 Report indicated that Nigeria has the lowest life expectancy in the world. It goes without saying that if you live in Nigeria; you are just waiting to die.

The 2019 Verbal and Social Autopsy Study (2019 VASA) showed that infectious diseases dominated the causes of deaths of children under the age of five in Nigeria.

Malaria and diarrhea were the top two causes of death while pneumonia and meningitis were other major causes of death in children aged 1-59 months, according to the Nigeria Child Survival Action Plan (2025-2029).

In the 87-page document paper, malnutrition is among the major causes of under-five mortality and also identified as the major risk factor for Tuberculosis (TB) for this age-group in Nigeria.

The World Health Organisation (WHO) estimates that malnutrition contributes to 45 percent of under-five deaths.

Death rates in children varied greatly by zone. Child deaths aged 1-4 years were highest in the Northwest (117 per 1000 births), high in the Northeast (65 per 1000 births) and much lower in the other zones (20-39 per 1000 births).

Nigeria is officially not at war, but life expectancy in Africa?s most populous country is currently worse than Chad, South Sudan, and the Central African Republic.

Nigeria currently tops 25 countries with the lowest life expectancy (at birth) in the world, according to data from the UN?s World Population Prospects, with Nauru, a small island nation located in the Central Pacific Ocean with population of about 11, 947 (2024), as the only non-African country on the list.

The average life expectancy of a country reflects the cumulative impacts of economic development, quality of life, healthcare systems, and various other factors that affect overall well-being.

Across the globe, life expectancy differs sharply between high-income and low-income countries.

According to data from the UN Population Projects published in June, Nigeria?s average of 54.6 years is around 32 years lower than Monaco?s, where people live the longest.

Nigeria ranks among Africa?s largest economies, but life expectancy is shortened by widespread diseases, high poverty rates, and lack of adequate infrastructure.

With potential for economic growth and infrastructure development, Africa?s life expectancy is projected to improve to 66 years by 2035 and over 68 years by 2050, although it would remain below the global average of 73.5 years, while the likes of Hong Kong, Japan and South Korea lead the globe at 85.77 years, 85 years, and 84.53 years respectively.

?Nigeria being the country with the lowest life expectancy in the world calls for sober reflection. While our nation?s macroeconomic indices are becoming quite impressive, the microeconomic indices have remained sticky in the negative axis,? Moses Lawal, a Lagos-based development agent, said.

He said that for the country to have a higher life expectancy, both the government and individuals have very huge parts to play. Also, there is a need for Nigerians to take conscious efforts at regulating their health choices.

Lawal said that individual citizens should make a decision to live smarter and healthier. ?Embracing health insurance for example is a smarter way of living, than paying out of pocket for every medical need.?

According to him, healthy living through regular exercises and avoiding a sedentary lifestyle are other recommended options within the control of an individual to have a longer life expectancy.

?While the big companies have started declaring huge profits and smiling to the banks, the same cannot be said of most MSMEs and individuals in the lower class, as they are practically gasping for breath.

?As Ngozi Okonjo-Iweala, the Director-General of the World Trade Organization (WTO) suggested, all tiers of government should henceforth invest in social safety nets for individuals, while MSMEs should easily access single-digit loans,? he said.

According to Lawal, the recently-signed Tax Reform Act is expected to ease tax burdens for many of the below-average citizens. While the exemption of essential commodities from VAT will equally make life better for the most-impacted, and in turn increase life expectancy of Nigerians.

?Nigeria remains one of the most challenging or ?worst countries? to safely give birth. This is a reality that urgently calls for some intentional change. First, we must understand that it is critical to commit to some core principles?chief among them is upholding the universal right to safe childbirth. If Nigeria places genuine priority on this right, we can transform outcomes and save the lives of countless mothers and babies,? Rebecca Ejifoma, health journalist & SDG advocate, told BusinessDay.

According to her, life expectancy in Nigeria should not be scraping the bottom when Nigerians carry so much potential. She said that until the government gives priority to health, the future of the people will keep paying the price.

She said that life expectancy should not be a lottery determined by place of birth. Hence, the issue is not merely about childbirth or longevity, but about serious gaps in the country?s development architecture, which calls for urgent multi-sectoral reforms, equitable investments in health, and accountability mechanisms that ensure Nigeria?s most vulnerable (mothers and children) are not left behind.

?We must first accept that every pregnant woman is entitled to and deserves care ?irrespective of her background. These rights go beyond the usual medical care; these are respect for personal choices and preference, protection of human dignity, providing equal access to high-quality and timely healthcare.

?Safe childbirth is not just a medical issue; it is a matter of social justice and human rights. If we uphold these basic principles, Nigeria can move away from being seen as one of the most dangerous places to give birth, toward becoming a nation where every mother and child are valued and protected by all,? Ejifoma said.

Childhood mortality

Over the past two decades, Nigeria has made significant progress in reducing child mortality but unfortunately, the country has been unable to achieve Millennium Development Goal 4 (MDG 4) for child survival and still grapples with unacceptably high under-five mortality rates.

The 2023-24 Nigeria Demographic and Health Survey (NDHS) showed that the under-five mortality rate for the 5-year period preceding each survey rose from 193 deaths per 1,000 live births in the 1990 NDHS to 201 deaths per 1,000 live births in the 2003 NDHS and has since generally decreased, to 110 deaths per 1,000 live births in the 2023?24 NDHS.

However, the reduction in the under-five mortality rate in Nigeria is significantly slower than what is needed to achieve the Sustainable Development Goals (SDGs) target of reducing child mortality to at least as low as 25 deaths per 1,000 live births and neonatal mortality to at least as low as 12 deaths per 1,000 live births by the year 2030.

Nigeria with an annual death of 850,000 of children is the highest contributor to the overall global burden of under-five mortality. However, the tragedy is that almost all of these childhood deaths could be avoided with well-known, tested and cost-effective interventions.

The rates of child mortality have declined globally in the last two decades, however, children in lower middle-income countries, fragile and conflict-affected situations, and poor households all remain particularly vulnerable to premature and preventable deaths.

If these child mortality trends persist, Nigeria may struggle to meet the Sustainable Development Goal (SDG) child mortality targets of reducing neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births by SDG end line in 2030.

Government action to bridge gaps

At the 75th World Health Assembly, the panel of Ministers of Health and other global health leaders agreed on the immediate need for urgent evidence-based action in 54 target countries including Nigeria to tackle the challenges of child survival.

Accordingly, the aim is to accelerate under-five mortality reduction in these target countries by prioritising programmatic and health system challenges that hamper progress on child survival. ?Children have no voice, and their health needs are overshadowed by other conflicting priorities.?

According to the 2025-2029 Action Plan, renewed commitment and emphasis on childhood mortality reduction in line with the SDG 3.2 target warrants an accelerated plan that accommodates the most important life-saving interventions that will lead to childhood mortality reduction in Nigeria.

?I am pleased to present this plan, which highlights the collaborative effort of various stakeholders in the child health space under the oversight of the Federal Ministry of Health and Social Welfare in the development of the NCSAP,? Muhammed Ali Pate, the coordinating Minister of Health and Social Welfare, stated.

He added that by implementing the accelerated actions highlighted, national and subnational can redress the major health system barriers and amplify the facilitators and enablers for scaling up quality integrated child-centred services and accelerating progress towards sustainable development goals for children.

The minister also called for collective commitment and action by all stakeholders in the healthcare value-chain to collaborate in addressing all the determinants of inequitable and unequal distribution of child health outcomes for every Nigerian child.

?It is our responsibilities as stakeholders in the field of child health to change the course of actions by transforming policy parameters into tangible and measurable actions that improve the health and well-being of Nigerian children along the continuum of care and life course.? (BusinessDay, excluding headline

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