Last Tuesday, March 29, 2022, the Federal Government declared a State of Emergency on Childhood Tuberculosis. This was disclosed in Abuja by the Coordinator, National Tuberculosis, Buruli Ulcer and Leprosy Control Programme (NTBLCP), Dr Chukwuma Anyaike, at the bi-weekly meeting of the Federal Ministry of Health (FMOH) on COVID-19 and other infectious diseases in the country.
The declaration of emergency may be sequel to the fact that about six percent of all forms of notified TB cases in 2021 were Children less than 15 years. The effects of TB on children in terms of morbidity and mortality are more than that of adults and the ugly development may not be unconnected with the difference.
According to World Health Organisation (WHO) reports “Nigeria has recorded a 50 percent inacrease in Tuberculosis (TB) notification from 138, 591 TB cases in 2020 to 207,785 TB cases in 2021.
The world body also stated that “Tuberculosis in children is usually primary, paucibacillary, characterised by difficulties in diagnosis of both drug susceptible and resistant TB. This is associated with poor uptake of preventive therapy for those with latent infection, contacts and people living with HIV and AIDS (PLWHA) in most developing countries like Nigeria”.
However, the NTBLCP coordinator said that these disturbing statistics calls for a change in narrative of the country’s child TB scourge, stressing that, there is need for concerted response from stakeholders.
He noted that the management of TB in children was characterised by difficulties due to both peculiarities of children and the disease.
“With detailed clinical assessment and examination of necessary specimen, in addition to strict adherence to the guideline of the national TB control programme, more cases of TB in children can be prevented, diagnosed, treated and reported”, he said.
Chukwuma said “we now have a National Steering Committee for Childhood TB, which will now be the central advisory body of the programme. It consists of representatives from donor partners in the programme and includes vast expertise in TB research, academia and staff of NTBLCP”.
He also noted that the capabilities of pediatricians and medical officers were being built in the country to improve early diagnosis and prompt treatment of childhood TB.
“We are improving clinical diagnosis by introducing digital chest X-Ray machines with Artificial Intelligence (AI). The Global Fund is supporting this with USAID. The drug formula for children has improved,” he said.
Chukwuma said that the programme was also collaborating with the National Primary Health Care Development Agency to improve on BCG immunisation to primarily protect children from TB, Leprosy and even Buruli Ulcer.
The Director-General Nigeria Centre for Disease Control (NCDC), Dr. Ifedayo Adetifa said the agency was working to strengthen sub-national disease surveillance systems in the country.
He noted that outbreak detection needed a system to succesfully identify an epidemic at the earliest possible stage through complete and timely reported data.
Adetifa said that “the agency’s priorities remained testing, testing and testing.
“Currently, we have increased Rapid Diagnosis Test (RDT) due to an ongoing surge testing project in Ekiti, Sokoto, Kebbi, Abia, Kwara, Akwa Ibom, Edo and Ondo States,” he added.
Here in Rivers State, the statistics shows that as at 2019, there were 202 Childhood (0-18years) cases seen over a four-year study period.
According to the report by Balafama Alex – Hart, Nsirimobu Paul and Ugwu Rosemary of University of Port Harcourt Teaching Hospital, Nigeria, published in Journal of Tuberculosis Research stated out of the cases, 109 (53.96%) were males and 93 (46.04%) females. Majority of them were 1-4 years of age. There were 194 (96.04%) new cases, 6 (2.9%) transfer and 2 (0.99%) retreatment cases. One hundred and six had pulmonary TB, 23 had TB adenitis, 10 had TB spine, 3 had TB abdoma and 3 had TB meningitis. TB/HIV co infection rate was 48.45%. One hundred and eight completed treatment, 10 were cured, 22 died, 46 defaulted and 16 were transfered out.
In their conclusion, pulmonary TB was the commonest type of TB found and treatment success rate was just above average.
Tuberculosis is a leading cause of death in young children and the risk of progression from infection to disease is higher in very young ones, especially among those with Human Immuodeficiency Virus (HIV) infection.
Infants become infected when they are exposed to Mycobacterium tuberculosis when exposed in several ways. According to Brenda Tesini, MD, University of Rochester School of Medicine and Dentistry in 2020 said that before birth, infection occurs if the bacteria cross the placenta and infect the fetus. During birth, infection occurs if the newborn breaths in or ingests infected fluid from the birth canal. After birth, infection occurs if the newborn inhaled infected droplets that have been coughed or sneezed into the air by family members or nursery personnel.
About 50% of children born to mothers who have an active tuberculosis infection in their lungs develop the infection during the first year of life unless preventive antibiotics or a vaccine called Bacille Calmette- Guerin (BCG) is given.
Symptoms of TB in newborns include looking ill with fever, reduced energy, difficult breathing or difficult to treat pneumonia. Also, they may have a delay in weight gain or physical growth (failure of thrive). This is because tuberculosis usually affects multiple organs and newborns may also have enlarged liver and spleen.
TB in children can be inactive with no symptoms.When the body no longer keeps the TB bacteria under control, then the child becomes unwell with fever,tiredness, sweating at night time,weight loss,coughing, chest pain and chills. In most cases TB affects the lungs, but it can also affect the lymph glands, brain, kidneys or spine. it is most common for children to have TB that affects multiple parts of the body than it is for adults, and TB is likely to be more serious in children according to reports.
TB can be succesfully treated by taking a full course of antibiotics. A child with TB disease may need to take antibiotics for six months or longer. Sometimes antibiotics used to treat TB can cause side effects but these are less common in children than in adults.
Children with TB rarely die when they receive standard treatment for the disease but 90 percent of children who die from TB worldwide go untreated. Health systems often neglect children with TB because children are less contagious than adults and stopping the spread of TB is priority.
By: Ibinabo Ogolo
Children As An Elixir For Future Development
Children are young human beings below the age of puberty or below the legal age of majority. They are also refered to as minors.
According to the United Nations International Children’s Education Fund (UNICEF), children refer to human beings below the age of eighteen years unless under the law applicable to the child.
In the United Kingdom, in the context of child support, children are refered to as persons under 16 of age or young persons aged between 16 and 20 who are receiving full-time education (which is not advanced education).
Development is the growth or formation of something or the processing of developing or being developed. Proper development of children in any society is the solution to a brighter future. The children of today are the future leaders of tomorrow. They are the society’s future and tomorrow’s citizens. This means that the future of every country depends on the children who will be adults in the future.
Development consists of progressive, coherent and orderly changes. These changes have a definite direction. Development occurs through two main processes, learning and maturation, Development also helps in reduction in poverty, illiteracy, crime rate and other societal vices.
For proper development of children round the world, the United Nations General Assembly in 1959 adopted the Declaration of the Rights of the Child which defines Children’s rights to protection, education and healthcare.
These rights are important agreement by countries who have promised to protect Children’s rights. Nigeria is one of them.
According to research, children learn at birth and they develop and learn at a rapid pace in their early years. This provides a critical foundation for life long progress and the adults who provide for the care and the education of young children bear a great responsibility for their health, development and learning.
Education as part of development is a powerful agent of change. It improves health, livelihoods and contributes to social stability and drives long time growth. It also provides a foundation for development by helping children become better citizens and shows the difference between good and bad. This helps to shape a better society to live in by knowing and respecting rights, laws and regulations. It also helps children and young people to achieve their learning goals and maximise their human potential.
Education can lead to more accurate health beliefs and knowledge thereby having better lifestyle choices, better skills, literacy effective habits and may improve cognitive ability habits, that is brain based skills.
Career development is one of the long developments in the life span experienced by individuals to self actualisation. It is an important key in the lives of children in helping them through the process of thinking and planning for their career as future leaders.
Children should be provided with pratical support inorder to help them identify and explore opportunities in career and subject option they are likely to enjoy. These are vital ways to apply that can help children gain confidence in their ability to succeed in life .
However,starting early gives children the chance to understand their strength, likes and the corresponding career options that are available before they narrow down their choices. According to Paul Hartung, “factors central to live design such as career exploration, career awareness , occupational aspirations and expectation, vocational interests and career adaptability begin during the childhood years.”
Another aspect of future development is through the acquisition of leadership skills by children. These skills allow children to have control of their lives and the ability to make things happen. Leadership instills confidence and helps children solve problems creatively, work in a team and work collaboratively with others. Leadership also gives children many opportunities to develop responsibility. It is key to supporting and sustaining quality in early childhood.
Meanwhile, researchers have suggested that children who receive consistent support and care are more likely to develop a secure attachment style which may continue to influence their social relationship throughout life, while those who recieve less reliable care or nothing at all may develop an anti-valent, avoidant or disorganised lifestyle leading to drug abuse, alcoholism, cultism and others.
To position children globally for better life, the United Nations Sustainable Development Group in 2022 during the World International Day of Education celebration renewed their engagement to transform education and build a better future for children in line with the promises of the Sustainable Development Goals (SDGs).
They established the fact that the key to a better future for children in any country lies in quality education. Schools must look beyond the confines of the classroom and adopt a blended approach that supports children and adolescents to face-to- face settings in community centres, to turn the tide and enable a better future for children.
The group suggested other pratical recommendations which include the boosting of digital skills which are crucial in the 21st century for learners to be able to navigate an increase in digital world. They also noted that school meal programmes must be provided to access a healthy nutrition for children.
In 2015 ,UNICEF noted that countries all over the world agreed on SDGs , on the future of children, yet years later, only few countries have recorded much progress towards achieving them. The commision presents the case for placing children aged 0-18 years at the centre of SDGs.
They maintained that governments must harness coalitions across sectors to overcome ecological and commercial pressures to ensure children receive their rights and entitlements now and liveable planet in years to come.
They stated that many children go hungry or are in conditions of absolute poverty. Also, millions of children grow up scared of war, kidnapping or insecurity, and are excluded from receiving the most basic health, educational and developmental services.
Here in Nigeria, the federal government in order to boost children development signed into law the Child Rights Act. The Child Rights Act was enacted to domesticate the Convention on the Rights of the Child. The children’s Rights Act of 2003 expands the human rights bestowed to citizens in Nigeria’s 1999 Constitution to children. So far, since it’s enactment, some states had replicated the Act. Rivers State is one of the states that the Act has been enacted.
On January 3, 2010, the Rivers State Child Rights Act 2009 was signed into law in recongnition of children, restore their confidence and self esteem as well as improve their status. Basically, the law provides for care and protection.
The Nigerian government has also set aside a day, May 27 every year to celebrate Nigerian children aimed at drawing attention to their needs,to uphold with particular attention to the rights of special protection and care afforded to minors,including their rights as human identity as well as the basic needs for food, state-paid education and health care.
However, inspite of efforts of Nigerian government, children are asking government for good security and health care system among others.
Speaking with The Tide in different interviews with pupils namely-Elenwa Diamond Victor-Army Children School, PH; Olojede Ferami-Graceville Christian School, Jos, Plateau State and Ezue Precious-Graceville Christian School, Jos, Plateau State.
Also,students namely-Balafama Precious Tamunobebie-Ibiyeomie-Community Secondary School, Kalio-Ama,R/S;Oberenibia Lolia-Community Secondary School, Kalio -Ama,R/S.; Wisdom God’swork-Community Secondary School, Kalio-Ama,R/S and Beulah Amagala-Potters Touch High School, Bayelsa State.
As future leaders of tomorrow, they intend to lead by presenting themselves as worthy examples and models, obey instructions and laws of the land. Maintain well trained military personnel for security of lives and properties. Ensure free and basic educational system for all children and the masses. Improve the value of the naira. Eradicate corruption especially during elections. Unite the different tribes and religions in the country for peaceful co-existence. Ensure that Nigerians patronise made-in-Nigeria goods. Ensure fixing electricity problems. Employ youth and ensure that childrens rights are not violated. Build better schools that are affordable to the poor. Be a voice for the less-privileged and fight for their justice.
As children presently, they want to be in a peaceful country where everyone is treated fairly. Citizens are given opportunities to explore talents. A country that can rank with other developed countries. Good roads and schools for all children. Everyone should be treated equally whether rich or poor. Good and eligible leaders who can care about the feelings of the people and can also pilot the affairs of the country.
Finally, in the spirit of the celebration, they advised other children to always obey their elders, concentrate on their studies because they are the future leaders of the country and not to be distracted by negative lifestyles. Be contented, hold on to their dreams and fulfil their passion in life.
By: Ibinabo Ogolo
‘Why Child’s Rights Act Still Doesn’t Apply Throughout Nigeria’
Nigeria adopted the Child’s Rights Act in 2003, giving legal consent to both the United Nations Convention on the Rights of the Child and the African Charter on the Rights and Welfare of the child. The country’s constitution states that for an international law to take effect, Nigeria’s legislature must create a national version.
But as Nigeria operates a federal system of government, the law does not automatically become applicable in all of its 36 states. In terms of the constitution, children’s issues are the preserve of the constituent states. Each state legislature must make the national law applicable within its territory. And only 25 of the 36 states in Nigeria have localised the Child’s Rights Act.
Currently, 11 states, all in northern Nigeria, have yet to domesticate the Child’s Rights Act. There are no records of discussions or debates about the Act in these state legislatures. It has been argued that other laws, including the constitution, are able to protect children. But children in those states are still subject to practices like early marriage, female genital mutilation and begging.
Why The Law Has Not Been Adopted Fully:
Apart from the federal structure of Nigeria’s government, there are other reasons the Child’s Rights Act has not been adopted by all states. Chief of them is religion, coupled with ethnic and cultural diversity. The dominant religions in Nigeria are Christianity and Islam, with a significant population being adherents of traditional African religions.
It may be simplistic to describe Nigeria as comprising “a Muslim North” and “a Christian South”. There are significant numbers of Christians in the north and Muslims in the south. But Islam does dominate in the north, in comparison to the south.
And the Supreme Council for Shariah in Nigeria, along with some legislators from the north, characterised the Child’s Rights Act as anti-culture, anti-tradition and anti-religion. Some of the contentious issues include the definition of the child (a person below 18 years) as it pertains to child marriage, particularly for girls.
Child marriage is a prevalent practice in parts of the north. Children about the age of 10 or 12 years get betrothed or married off. While the Child’s Rights Act prohibits child betrothal and child marriage, there are other operational laws that make exceptions.
The basis for this is that in Islam, puberty is a determining factor in a (girl) child’s readiness for marriage. Fixing 18 years as the minimum age does not fit the doctrine.
Other religious concerns against the acceptance of the Child’s Rights Act include children’s right to freedom of religion, differences in the inheritance rights of male and female children, and the Shariah’s prohibition of adoption, in favour of kafalah, which distinguishes between biological and non-biological children.
By ratifying the Child’s Rights Convention and African Children’s Charter, the Nigerian government has the overall responsibility for ensuring these are implemented in a uniform and coherent manner. The government also took on the responsibility of discouraging religious, cultural, customary or traditional practices that are inconsistent with the Charter.
Yet, at the most basic level, the government is failing to live up to this obligation. Children, a most vulnerable group on account of physical and mental immaturity, bear the brunt of this inaction. They are being denied the full protection of the law. And the consequences for many children, besides child marriage and its health and other consequences, include negative impacts on their education and overall development.
With regard to education for example, the socio-cultural Almajiri system remains prevalent in the north. The practice allows children, usually from poor homes, to be sent to “Islamic boarding schools” for religious education. Many, however, end up on the streets as child beggars, seeking alms and menial jobs for daily survival.
Successive governments have failed to incorporate it as part of the formal school system, leaving children exposed to harmful practices and abuses prohibited by the Convention on the Rights of the Child, the African Children’s Charter and the Child’s Rights Act. In Nigeria, recruitment of these child beggars by terrorist organisations such as Boko Haram is a real threat or option.
Children Need Uniform Protection
The Child’s Rights Act and the African Children’s Charter define a child as a person below 18 years. But various laws in Nigeria define children differently and for various purposes. The government needs to take the lead in harmonising the various definitions in conformity with these international and regional laws.
A constitutional amendment would ensure unification across the nation. It should leave no loopholes for contradictory laws, particularly at the state and local levels or based on religion or customs. But a constitutional amendment is a Herculean task, hampered by some of the obstacles facing the Child’s Rights Act. It should consider the multi-cultural and multi-religious nature of Nigerian society but focus on the best interest of all children.
While the constitution does not expressly declare Nigeria to be a secular state, a harmonious approach to law making that does not vilify religion is in the best interests of the child. Religious and traditional leaders are “gatekeepers” who cannot be jettisoned. Negotiations with them should not devalue their religion, but get them to become drivers of change for the benefit of children.
The importance of public education campaigns about the issues cannot be over emphasised. The voices of children must also be amplified. Increasingly, examples from the world over show that the power to cause real change begins with the populace. In other words, political will can be secured via a bottom-up rather than top-down approach.
States that have domesticated the Child’s Rights Act also have a role to play in challenging the remaining 11 states to do the same. They can do this by showing concrete evidence of the change in the lives of children in those states.
There is no strong case to be made for domestication if it has not translated into fulfilled rights for children. For example, female genital mutilation, a prohibited harmful traditional practice, is still common in parts of southern Nigeria.
Ultimately, where children are concerned, all actions must be in their best interests. The first step in that regard is applying the Child’s Rights Act across the country.
By: Usang Maria Assim
Assim is of the University of Western Cape.
Three Years Of COVID -19: What Hope For Children?
As 2022 progresses, the third year of the global pandemic, the harm done to children by COVID-19 crises is increasingly evident. There is a record rise in child poverty. Also, setbacks to progress on routine vaccinations and disruption to education which has been greatest among poorest children and job losses have been greatly borne by women and youth.
COVID-19 has been a uniquely dis-equalising crisis. It is a universal crisis and for some children, the impact may be lifelong.
Children and young people are not the face of this pandemic, but they risk being its biggest victims.
The economic crisis generated by COVID-19 threatens to hit children and families the hardest.
According to analysis by Florish Data Visualisation, even before the pandemic struck, 591 million children, that is almost one in three children in the mostly low and middle income countries were considered poor by national definitions.
The vast majority of them lived in Sub-Sahara Africa and South Asia.
As families lost their sources of income and home environments turned upside down due to the devastating effects of COVID 19, children and young people found themselves more vulnerable to poverty and deprivation of their basic needs.
Available data on the impact of unemployment and the loss of parents, income due to COVID-19 pandemic are not disaggregated by age and do not reflect the realities faced by children around the world.
According to reports, impact of COVID-19 on the welfare of households with children from data collected in 35 countries including Nigeria states that households with three or more children were most likely to have lost income with more than three quarters experiencing a reduction in earnings. The report also states that income losses have left adults in one in four households with children going without food for a day or more.
Adults in nearly half of households with children reported skipping a meal due to lack of money.
“The modest progress made in reducing child poverty in recent years risks being reversed in all parts of the world. Families have expressed loss at a staggering scale. Last year,2021, inflation reached its highest level in years, more than two thirds of households with children brought in less money. Families could not afford food or essential health care services. They could not afford housing. It was a dire picture and the poorest households were pushed even deeper in poverty”, said Sanjay Wijesekera, UNICEF Director of Programme Group.
Meanwhile, Nigeria was particularly vulnerable to the economic impacts of COVID-19 due to the absence of a functioning social security system capable of providing support to households that lost jobs and income during the crisis.
The United Nations High Commissioner for Human Rights, Michelle Bachelet noted in 2021 that although the pandemic has brought into sharp focus the importance of the right to social security, over 70 percent people worldwide had no or only partial social security coverage.
Nigeria‘s Constitution does not provide a legal right to social security. Nigerian laws create no entitlements to unemployment or child benefits.
However, United Nations Children’s Fund (UNICEF) and the World Bank have urged a rapid expansion of social protection systems for children and their families support may include the delivery of cash transfers and the universalisation of child benefits which are critical investments that can help lift families out of economic distress and help them prepare for future shocks. Since the start of the pandemic, more than 200 countries or territories have introduced thousands of social protection measures and the World Bank has supported countries with approximately $125 billion.
By: Ibinabo Ogolo
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