Malnutrition Puts Nigeria’s children At Multiple Risks, By Rafiu Ajakaye

Nigeria has won a few battles on the health front.  One is the war against Ebola. It recently marked a year without a new polio case. But this is definitely no time for victory dance. At least a thousand children die of malnutrition in Nigeria everyday, a figure roughly 55% of the under-five deaths in the country, according to official data from the country’s bureau of statistics, ministry of health and the UNICEF.

Described as a situation where a child has deficiencies in key vitamins and nutrients required for healthy growth, malnutrition leads not only to stunted growth and deaths but also has huge implications for national economic growth. With low intelligent quotient, malnourished children mostly perform woefully in school, are prone to diseases and likely grow up becoming economic burden.

Drawing attention to what experts call ‘Nigeria’s silent crisis’, the UNICEF recently held in northwestern Kano city a media dialogue on child malnutrition and community management of acute malnutrition (CMAM) where experts took turns to lay bare the causes of malnutrition, scary figures of malnourished children across Nigeria and offer solutions which include increased government funding to tackle existing cases as well as scale up the advocacy to arrest the trend.

According to figures from Nigeria Demographic and Health Survey 2013, 11 million Nigerian children suffer stunting,  a key indicator of childhood malnutrition.  This figure, cutting across social strata and regions, is the second highest in the world after India.

Maryam Abdullahi, coordinator of Yanhawaki CMAM centre in Kano, one of the several centres operated in at least 11 states in the north by the UNICEF in collaboration with some state governments, said they admit “at least 400 new cases” of malnutrition in one week. At the centre, the children are given Ready to Use Therapeutic Food (RUTF) to regain what they could of lost nutrients.

Dr Arjan de WAGT, UNICEF Chief Nutritionist, said apart from malnutrition accounting for nearly half a million deaths of under-five in Nigeria annually,  at least two-thirds of the National GDP is also lost since “productivity losses to individuals are estimated at more than 10% of their life time earnings.”

He said nutrition affects all stages of the life cycle, hence the need to get it right.

UNICEF Nutrition Specialist Dr Bamidele Omotola says the agency has admitted at least one million children into the CMAM programme since 2009 when UNICEF launched the intervention, gulping roughly $61million for the RUTF alone. Added to other costs, at least $274 is needed to treat a malnourished child, he said.

But how did Nigeria get here?

Malnutrition results from people not consuming the right amounts and types of food and essential nutrients, experts say. The 2013 survey shows that only 17% of Nigeria’s 27m underfives get exclusive breastfeeding in their first six months of life,  the only sure bet to avoid children malnutrition.

Nearly four out of five Nigerian children do not meet the World Health Oganisation’s recommendation for exclusive breastfeeding during the first six months of life and two in every five Nigerian children are stunted, according to official figure.

At a joint news briefing on Monday,  the Nigerian government and UNICEF announced they have reached more than a million Nigerian children with a highly successful and cost-effective treatment for acutely malnourished children, saving over 200,000 lives in the past six years.

“Beyond every other things, we must ensure that what led us into this is stopped and we ensure that that our children have access to the quality type of care (such as exclusive breastfeeding for the first six months), food and services that are required,” Dr Omotola said, explaining the way out of the crisis.

He blamed poor infrastructure, education, belief system and sociocultural practices for the alarming figure. In most cases, he said, mothers do not give exclusive breastfeeding to their infants within 30 minutes of delivery up to six months of life.

Dr Omotola added that breast milk substitutes,  as are resorted to by some mothers, “do not have what we refer to as anti-infective property that is contained in the immune cells which the mother can pass to a child.”

Dr Chris Isokpunwu, Head of Nutrition for the Federal Ministry of Health and one of the experts at the dialogue, urged governments at all levels to scale up funding for nutrition and commit to the implementation of ‘the strategic plan of action for nutrition.’

“We have a five-year plan and over five years it is going to cost about $900m but we still have a huge gap between what is required in terms of funding and what is on the ground across board,” he added.

“We need to vigorously campaign for exclusive breastfeeding in the first six months and breastfeeding continued up to when the child is two years old, along with adequate complementary feeding. We need to also emphasise maternal nutrition especially during pregnancy to feed right in order to produce well nourished children.”

Investment on nutrition may be considered huge by policymakers. But leaving the crisis unattended is more expensive because, as the experts observed, “even when stunted children survive,  there are several long term impacts such as reduced educational achievement and economic productivity,  and perpetuation of an intergenerational cycle of poverty and ill health.”