Nigeria’s preterm babies face struggle for survival as medical costs soar

Shakira Abubakar, a resident of Ogijo, a border town between Lagos and Ogun states, was thrilled when she found out she was pregnant. However, her joy was nearly shattered when she unexpectedly went into labor at 27 weeks and gave birth to a premature baby boy.

“I was at the salon plaiting my hair during a visit to my mother at Yaba when I felt a sharp pain in my stomach,” Shakira said on Monday, December 3. “I was rushed to the hospital, where I was told it was a contraction. I was shocked, scared, and burst into tears, but my mother kept encouraging me and praying for me.”

Her son was born weighing just 1.2 kilograms and was referred from a private hospital to the Lagos University Teaching Hospital (LUTH) for urgent care. “The birth of my child has brought me pain and sorrow because we find it difficult to meet the expenses to keep him alive,” Shakira added.

Shakira’s experience is far from unique, as globally, 13.4 million babies are born prematurely each year, with sub-Saharan Africa shouldering a disproportionate share of the burden. Premature births bring with them not only uncertainty and emotional distress for parents but also staggering medical costs, as babies born too early often require months of specialized care in neonatal intensive care units (NICUs).

The World Health Organization (WHO) reports that complications from prematurity are now the leading cause of child mortality in low-income countries. Unfortunately, Nigeria ranks third globally for preterm births, with approximately 774,100 premature babies born annually. The country also faces a high perinatal mortality rate.

Challenges of Preterm Births

Natasha Williams, a Nigerian-American, experienced the heartbreaking challenges of preterm birth after several failed IVF procedures led to the birth of her triplets. One of the babies tragically died from infection shortly after birth, despite spending over N15 million on medical expenses at one of Nigeria’s leading private hospitals.

“It was traumatic, but I was determined to see my daughters live,” Williams recalled. “I left Nigeria shortly after their discharge and moved to the U.S., where my kids are thriving.”

Sarah Ango, secretary of the Nigerian Society of Neonatal Medicine (NISONM), also highlighted the grim realities of preterm birth in Nigeria, where many babies struggle to survive due to a lack of timely and quality care. “The mortality rate in preterm babies is higher than in full-term babies,” Ango said. “It’s heartbreaking for parents to go through these experiences and still not go home with their babies.”

The Economic Burden

Professor Chinyere Ezeaka, head of the Neonatology-Perinatology Unit at LUTH, explained that the quality of care a preterm baby receives often depends on the family’s financial situation. “There are expected expenditures that new mothers prepare for, but it is hard to prepare for the costs associated with a preterm baby,” Ezeaka said. “The medical costs have gone beyond the reach of many families.”

The cost of treating a preterm baby can be astronomical. For example, a single vial of surfactant, which helps preterm babies with respiratory issues, costs around N135,000 in Nigeria. Many babies may require multiple doses, and a week in the NICU can easily run into the hundreds of thousands of Naira, even in government facilities. In private hospitals, the costs can exceed N2 million, which is unaffordable for many families.

Many parents are so overwhelmed by the costs that some abandon their preterm babies at hospitals. Ezeaka revealed that doctors often have to appeal to social welfare officers or philanthropists to help cover the costs of care for these abandoned babies.

“We see more parents abandoning their preterm babies because they can’t afford the care,” Ezeaka said. “How can these children get quality care when their parents can’t even afford the basics?”

The Need for Government Action

Experts like Ezeaka are calling for a comprehensive approach to ensure that preterm babies in Nigeria receive the care they need. She emphasized that the Nigerian government must provide robust health insurance coverage targeted specifically at preterm babies. “In high-income countries, the medical expenses for these babies are covered by health insurance,” she said. “In Nigeria, families are left to bear the full cost.”

The shortage of essential medical equipment in many Nigerian hospitals is another major obstacle. WHO guidelines recommend that 80% of healthcare facilities offering childbirth services should have equipment like CPAP machines to assist preterm babies with breathing. Unfortunately, less than 10% of health facilities in Nigeria are equipped with such life-saving devices.

Toward Better Care

Ezeaka and other experts advocate for cost-effective interventions to save the lives of preterm babies. One such intervention is kangaroo mother care, where the baby is placed on the mother’s chest for skin-to-skin contact. This method, particularly beneficial in resource-limited settings, can help regulate the baby’s temperature, prevent infections, and improve survival rates.

Neonatal experts also recommend strengthening antenatal care and training healthcare workers, especially in primary and secondary care settings, to identify high-risk pregnancies early and ensure proper referrals.

The Nigerian government must prioritize improving the care of preterm babies if it is to meet the Sustainable Development Goal 3, which calls for ensuring healthy lives and promoting well-being for all at all ages.

As Shakira Abubakar’s journey with her premature baby continues, the challenges of securing proper care reflect a harsh reality faced by many parents in Nigeria. The government, health organizations, and communities must act swiftly to ensure that preterm babies are given the best chance at life, regardless of their family’s financial situation.