Children in poor countries face 40% death rate from birth defects – UI don

A Professor of Surgery at the University of Ibadan, Taiwo Lawal, has warned that mortality among children born with certain gastrointestinal birth defects reaches 40 per cent in low-income countries, calling for improved early detection and access to specialised surgical care.

Lawal made the call while delivering the University of Ibadan’s 629th inaugural lecture, where he urged the Federal Government to establish a comprehensive national newborn screening programme to reduce preventable deaths and disabilities among Nigerian children.

The lecture, titled “Creating Passageways in Dark Alleys: The Bumps, the Spurs and the Speed Breakers”, examined the challenges facing children with congenital abnormalities and measures to improve their survival and quality of life.

Citing an international study involving 3,849 patients across 74 countries, Lawal said mortality among children treated for gastrointestinal birth defects was about six per cent in high-income countries, 20 per cent in middle-income countries and 40 per cent in low-income countries.

He identified sepsis on admission, severe illness before surgery, failure to use surgical safety checklists and inadequate access to life-saving support, including mechanical ventilation and intravenous treatment, as factors linked to poor outcomes.

Lawal said the findings highlighted the need to strengthen neonatal resuscitation, improve referral systems and ensure access to safe, quality surgical care, particularly in countries with limited resources.

He called for every newborn in Nigeria to undergo a thorough examination by a paediatrician or, where one was unavailable, a suitably trained healthcare professional.

According to him, inadequate screening, low public awareness and delays in seeking medical care continue to complicate the treatment of birth defects, many of which can be managed more effectively when detected early.

Citing research at the University College Hospital (UCH), Ibadan, Lawal said a five-year review identified 1,479 birth defects, but only 11 were detected before birth, indicating limited uptake of prenatal screening.

He said subsequent efforts to improve detection through prenatal ultrasound screening had helped identify abnormalities and enabled affected families to receive specialist counselling and follow-up care.

The professor also expressed concern about limited awareness of birth defects among expectant mothers and the potential for preventing some of the conditions.

He cited a study involving 714 mothers in which only about one-quarter knew about birth defects, while just 10 per cent were aware that folic acid could help prevent certain congenital abnormalities.

Another study, he said, found that only 2.1 per cent of women had taken folic acid around the time of conception during their most recent pregnancies.

Lawal said the findings highlighted the need for stronger public health education, earlier antenatal booking and appropriate folic acid supplementation before conception and during early pregnancy, under medical guidance.

He also advocated the establishment of regional centres of excellence in paediatric colorectal surgery to provide specialised, multidisciplinary care for children with abnormalities affecting the anus, rectum and intestines.

He noted that shortages of essential equipment, specialist personnel and critical care resources remained major challenges for paediatric surgical services in low- and middle-income countries.

Lawal called for increased investment in neonatal ventilation, perioperative care, surgical equipment and specialist training, stressing that improving outcomes required coordinated efforts among surgeons, paediatricians, anaesthetists, nurses and other healthcare professionals.

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On preventing postoperative infections, he cited an international clinical trial involving 13,301 patients, which found that changing surgical gloves and instruments before wound closure reduced surgical site infections by approximately 15 per cent in the intervention group compared with the control group.

He said adopting evidence-based infection prevention measures could reduce complications, shorten hospital stays and ease the financial burden on patients and their families.

Lawal maintained that reducing preventable deaths among children with congenital abnormalities required more than surgical expertise, highlighting the importance of early detection, informed parents, accessible specialist services and sustained investment in the health system.