Nigeria, India, China Top Child Developmental Disabilities List

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By  Ndubuisi Francis in Abuja

Nigeria, India, and China are the top three leading contributors to the global prevalence of developmental disabilities in children, a new report has revealed.

A research sponsored by the Bill and Melinda Gates Foundation, and just published in the prestigious Lancet Global Health journal revealed that over 53 million children under the age of five worldwide had developmental disabilities in 2016.

The research was conducted by the Global Research on Developmental Disabilities Collaborators (GRDDC) by experts in child disability from different world regions, supported by the Institute of Health Metrics and Evaluation, United States of America.

Developmental disabilities are a group of life-long health conditions that affect the ability of a child to develop, grow and function optimally.

They include conditions such as hearing loss, vision loss, cerebral palsy, epilepsy and autism spectrum disorder. Others are; attention-deficit/hyperactivity disorder, learning disorders, intellectual disability and Down’s syndrome.

According to the report, the top three leading contributors to the global prevalence of developmental disabilities were India, China and Nigeria.

The report further discovered that whereas under-five mortality in sub-Saharan Africa declined by 20.8 per cent from 3.4 million in 1990 to 2.7 million in 2016, the number of children with epilepsy, intellectual disability, hearing and visual impairments, autism spectrum disorder and attention-deficit/hyperactivity disorder alone rose by 71.3 per cent from 8.6 million in 1990 to 14.7 million in 2016.

In Nigeria alone, the number of children with developmental disabilities rose by two thirds (66.7 per cent) from 1.5 million in 1990 to 2.5 million in 2016.

This figure is considered grossly under-estimated as it excludes children with birth defects and other developmental disabilities such as learning and communication disorders.

Moreover, children with cerebral palsy without intellectual disability and those with developmental disabilities that cannot be associated with specific medical causes are also excluded.

Reacting to the report, a world-renowned expert in global health and leader of GRDDC, Dr. Bolajoko Olusanya said that the data was troubling when viewed within the context of the challenges typically encountered by children with disabilities and their families in a developing country like Nigeria. These children, she observed, often require more help daily to communicate, play, learn, understand or use information than others.

“They require a great deal of support to be as independent and successful compared to children without disabilities. Failure to provide necessary assistance to these children in the first five years of life especially when the brain is most amenable to stimulation has a great deal of adverse consequences on their educational and vocational attainment, “she noted.

Perhaps of greater concern, she pointed out, citing a follow-up article on developmental disabilities in Africa, also published in the Lancet Child and Adolescent Health journal, is the seemingly dire future that awaits such children in many communities.

This is largely due to unfavourable cultural beliefs, discrimination and family stigma which place the children at higher risks of neglect, as well as maltreatment, violence, family disintegration, exclusion from formal education and full economic participation and even premature death compared to children without disabilities, she stated.

Olusanya observed that the direct impact on family is diverse, including but not limited to frequent frictions among family members, threat to family cohesion, high risk of divorce or parental separation, and unavoidable intrusion by third parties.

“It is not uncommon for disability to be attributed to an ‘evil force’, supernatural causes, or linked to some superstitious beliefs. On such occasions, often out of ignorance or frustration with available (or lack of) services, some mothers resort to either ‘spiritual healing or appeasement’ or traditional medicine that entails unorthodox and potentially harmful therapies.

“A child that is accepted is more likely to be hidden from public view or sent away to live with the extended family members in villages because of the stigma and the stress of parenting. The very thought of these challenges frequently compels some families to consider disability as worse than death, and view infanticide (killing a child in the first year of life) as an escape route to freedom,” Olusanya, who is the  Executive Director, Centre for Healthy Start Initiative, said.

The overriding message from this research, the expert added, is that an increasing number of the beneficiaries of the globally sponsored child survival programmes in Nigeria and the rest of Africa since 1990 have developmental disabilities and that something needed to be done about it.

She proferred a number of measures that could be applied to manage children with such conditions.

“Merely keeping these children alive is just not enough. The Sustainable Development Goals (SDGs) require policies and intervention to ensure that every child survivor thrives, and that no child is left behind. SDG 4.2.1. specifically mandates all countries to identify and monitor the proportion of children under-five years who are at risk of not attaining their developmental potential.

“The findings from this research should therefore challenge the relevant authorities, especially in the health and educational sectors to consider a three-pronged strategy namely: interventions to curtail the incidence of avoidable disabilities, community-based programmes for the early detection of children with disabilities from birth, and provision of support services for children with disabilities and their families.

“The needs of these children and their families must be explicitly recognised in the maternal and child health policy for the country. As a first step, an inter-ministerial technical team should be established to address this issue in greater detail in consultation with relevant stakeholders including developmental partners like the UNICEF, WHO and the World Bank.

“ This will facilitate a more effective platform for coordinating the activities of the diverse service providers within and outside the public sector for improved and qualitative outreach,” she said.