Nigeria is experiencing a significant demographic shift as the latest national survey reveals a notable decline in the country’s Total Fertility Rate (TFR). According to the newly launched 2024 Nigeria Demographic and Health Survey (NDHS), the average number of children per woman has dropped from 5.3 in 2018 to 4.8 in 2024.
The Minister of State for Health and Social Welfare, Dr. Iziaq Salako, disclosed these findings on Friday in Abuja at the formal launch of the report, attributing the decline to gradual improvements in reproductive health services.
“Modern contraceptive use among currently married women increased modestly to 15 per cent in 2023 from 12 per cent in 2018, while satisfied demand for family planning rose to 37 per cent,” Salako stated. He emphasized that this decline reflects “gradual gains in access to and use of family planning services nationwide.”
A Mixed Picture on Maternal and Child Health
While the fertility decline marks a pivotal change, the report presents a mixed picture regarding other key health indicators. There have been modest improvements in maternal care coverage. Antenatal coverage currently stands at 63 per cent, skilled birth attendance at 46 per cent, while postnatal coverage within two days after delivery rose from 38 per cent in 2018 to 42 per cent in 2024.
However, Salako noted that these improvements “remained below the levels required to drive rapid social and economic progress.”
A significant achievement was recorded in child survival, with the under-five mortality rate dropping significantly from 132 deaths per 1,000 live births in 2018 to 110 per 1,000 in 2024. This positive trend, however, is shadowed by stagnation in newborn deaths.
Troublingly, the neonatal mortality rate remained nearly stagnant, moving from 39 to 41 per 1,000 live births within the same period. “More efforts are required to reduce neonatal deaths, which account for about 40 to 45 per cent of under-five mortality,” the minister added, highlighting an urgent area for intervention.
Data to Drive Policy and Investment
The minister said the findings highlight urgent gaps requiring coordinated responses, adding that the ministry had already begun translating them into policy reforms. He cited initiatives such as the Maternal and Child Fatality Reduction Initiative and the Nigerian Child Survivor Act (2023–2025) as being “designed to address context-specific challenges through coordinated interventions.”
“This is being done with better health investment targeting, improved coordination, a more efficient planning system, stronger community involvement, and building partnerships,” Salako explained. He further stressed that the utilisation of the 2024 NDHS report to strengthen the health system and drive measurable improvements is “the responsibility of all stakeholders.” The data would also guide sub-national governments to identify geographical areas requiring urgent intervention.
Also speaking at the launch, the Executive Chairman of the National Population Commission (NPC), Hon. Nasir Kwarra, underscored the importance of the survey. He stated that the “NDHS remains a vital instrument for understanding population trends, child and maternal health, nutrition, malaria, HIV, and other development indicators.”
“Since its inception in 1990, the NDHS has been a central pillar in Nigeria’s demographic data architecture,” Kwarra said. “The 2024 edition continues this legacy, providing fresh insights at a time when the need for reliable evidence to guide policy has never been greater.” He added that the success of the exercise demonstrated the power of institutional collaboration and reaffirmed that “data is not merely a technical output but a public good that empowers evidence-based governance.”
Support from Development Partners
The international community has also recognized the value of the report. World Bank Senior Health Specialist, Dr. Ritgak Tilly-Gyado, said the data would support the Bank’s analytical work and policy modelling in key areas such as health, education, and nutrition.
“The NDHS provides critical data points that help us understand what has worked and where further support to the Nigerian government is most needed,” she stated.
The 2024 NDHS, the sixth in the series since 1999, was designed to provide reliable data for monitoring population and health indicators in Nigeria. Its pre-data collection phase ran from August 2022 to November 2023, while fieldwork was conducted across 42,000 households nationwide between December 1, 2023, and May 5, 2024. The report provides a crucial evidence base for shaping Nigeria’s public health strategy for the coming years.
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