Population: 155 million Total TB cases notified (2009): 94114 Treatment Success Rate for new smear-positive TB cases (2008): 78%
Country Director: Tushar Kanti Ray E-mail: RayT @ kncvtbc.nl Address: KNCV / TB CARE I Fourth Floor / Block B 564/565 Independance Avenue Central Business District Abuja Nigeria Telephone: +234-80-37010976 Lead Partner: KNCV Tuberculosis Foundation
Nigeria is a federation of 36 states and the Federal Capital Territory (FCT) with 774 administrative units referred to as Local Government Areas. The country has an estimated population of 154, 729,000 (WHO, 2009). The autonomous status of states puts a constraint on the control of the Federal Government over states and local governments in terms of resource allocation for various sectors, including health and education. More than half of Nigerians (54.4%) live in poverty in spite of the huge revenues accruing from oil and gas. The country is composed of more than 250 ethnic groups with Yoruba, Igbo and Hausa being the most influential. Nigeria practices federalism and is composed of 36 states and a federal capital territory in Abuja. The health system in Nigeria is structured along three levels, namely primary, secondary and tertiary corresponding to the level of government that provides oversight and is responsible for health care services, the federal, state and local government. The public and private sectors are partners in the delivery of health care throughout the country. Nigeria fares very poorly in all development indices. The situation of MCH in Nigeria is among the worst in Africa and has not improved substantially – and in some areas of the country, has worsened – over the past decade. Under 5 Mortality Rate is estimated to be 201 deaths/1,000 lives births, Maternal Mortality Rate 1,100 deaths/100,000 live births, and total fertility to be 5.7 births per woman.
Nigeria ranks fourth among the 22 high-burden TB countries in the world. WHO estimates that 460,000 new cases of all forms of TB occurred in the country in 2009. The TB burden is compounded by high prevalence of HIV in the country which stands at about 4.6% in the general adult population. The prevalence of HIV among TB patients increased from 2.2% in 1991 to 19.1% in 2001 and is currently estimated to be 27% in 2009 which indicates that the TB situation will continue to be HIV-driven. Although HIV prevalence is much lower in Nigeria than in other African countries; an estimated 3.6 million people are currently living with HIV. The emergence of MDR-TB also poses a threat, which if not effectively addressed may wipe the achievements of previous efforts in controlling TB. Nigeria established its National TB and Leprosy Control Program (NTBLCP) in 1989. The NTBLCP operates along the three levels of government: National, State and Local Government Areas, with coordinating offices at each level. Health facilities at the peripheral level are the operational units of DOTS services. As of 2009 there were 3,455 health facilities providing free TB and DOTS services in Nigeria. Nigeria adopted the DOTS strategy in 1994. At the beginning of 2002, only 21 of the 36 states were implementing DOTS, but with assistance from partners such as TBCTA and others, the country successfully extended DOTS services to all 36 states by the end of 2004. Nigeria ranks fourth among the 22 high-burden countries for TB in the world. WHO estimates that 374,000 new cases of all forms of TB occurred in Nigeria in 2004 and that incidence is increasing. Based on these estimates, the case detection rate is still low, as of the end of 2005 only 26 percent of estimated smear-positive cases were actually notified under the DOTS program in the country.
Management & Leadership Training for HIV Managers
HIV/AIDS is also a serious concern in Nigeria. The rate of HIV incidence is about 4.1 percent in the general adult population (2010 National HIV Sentinel Survey report). It is estimated that about 3.3 million people are living with HIV/AIDS and about 220,000 deaths occur due to HIV/AIDS (2009 estimates). Some one million adults have both HIV and TB infection, comprising 50,000 TB cases every year dually infected with HIV and needing both anti-TB and antiretroviral treatment.