*Seeks increased commitment to end malnutrition
By Chioma Obinna
AN estimated 500,000 Nigerian children aged five years and below are at risk of dying from malnutrition by the end of this year except funds are urgently released to tackle the debilitating condition, UNICEF has alerted.
These at-risk children are among the 2.5 million children suffering from Severe Acute Malnutrition, SAM, a condition associated with insufficient nutrients needed for a child’s development.
With government silent on specific allocation of funds to tackle malnutrition in the 2017 Federal budget, UNICEF officials and stakeholders at a recent national media dialogue in Yola, Adamawa State, affirmed that the only way Nigeria can end child malnutrition in the short term is to source the required sum of $144 million to treat at least two million underfed children in the country.
They argued that to avert more deaths from severe acute malnutrition, Federal government must as a matter of urgency invest more in intervention services, particularly the Community-based Management of Acute Malnutrition (CMAM).
Available statistical estimates show that no less than half a million Nigerian children aged five and below die yearly as a result of malnutrition, hence, investing in nutrition will yield valuable returns. At the media dialogue with the theme: “Investing in Child Malnutrition For the Future, “UNICEF Nutrition Specialist, Mrs. Philomena Irene, observed that although there are pockets of malnutrition all over the country, the cases are more in the North, particularly in the North East apparently due to insurgency.
Irene said inaction at any level could cost every investment of $1 a loss of $16. “If government does not spend the $1 needed to prevent malnutrition now, $16 would be spent on numerous diseases that malnutrition causes in the future.”
Irene said improving nutrition during the critical 1,000-day window from a woman’s pregnancy to her child’s 2nd birthday has potential to save lives; help millions of children develop fully, as well as deliver greater economic prosperity.
She cited the low rate of exclusive breastfeeding in the country, stressing the need for policies that would promote breastfeeding culture in the country.
According to UNICEF, $107 million is needed for treatment of malnourished children in Nigeria, but just $21.5 million has been realised leaving a shortfall of $85.5 million. “Only $5 is needed to prevent malnutrition in a child while a total of $71 is needed to treat each malnourished child,” she noted.
Justifying the urgent need to tackle pervasive problem of malnutrition, particularly in the North East, Irene explained that half of the pre-existing health facilities have been damaged. The situation of the burden of malnutrition in states like Borno, according to statistics from the Global Acute Malnutrition, GAM, a total of 244,268 children suffer from Severe Acute Malnutrition, 241,584 have Moderate Acute Malnutrition, MAM, while 183,352 breast feeding women are malnourished.
Urgent intervention: Irene stressed that without urgent intervention, 19 per cent of these children may be lost. Currently, UNICEF statistics show that the total number of children affected by malnutrition in the South East in 2016 was 34, 889, while 6, 700 deaths were recorded.
In the South South, 86, 304 children were affected, out of which 16, 700 died, while the South West had 84, 417 cases and 16, 300 deaths; North West had 1,594, 462 cases and 308, 000 deaths; North Central 43,635 cases with 8,400 deaths; and North East 695,998 cases and 134, 000 deaths.
To avert more deaths from SAM, Irene maintained that all the 36 States of the Federation must play their part by contributing to the SAM intervention services, such as the Community-based Management of Acute Malnutrition, CMAM. There is also need to expand the Centres to all political wards with a view to bringing it to the door steps of the rural poor.
To reach the targets to reduce stunting among children and anaemia in women, increase exclusive breastfeeding rates, and mitigate the impact of wasting, the UNICEF Nutrition Specialist called for full commitment from all States of the Federation to the campaign against child malnutrition in the country.”
“Only four states, Kaduna, Gombe, Bauchi and Sokoto have contributed to the fund in 2016 towards the purchase of Ready-To-Use-Therapeutic Food (RUTF), the major intervention for severe acute malnutrition.
Kaduna’s contribution: Studies show that Kaduna contributed the largest sum of N300 million with Sokoto, Gombe and Bauchi contributing N50 million, N17 million and N10 million respectively.
Jigawa State has approved N150 million for the purchase, but the money is yet to be released.
At the Nassarawa Health Centre, Yola North Local Government Area of Adamawa State, hundreds of mothers thronging the premises daily in search of treatment for their babies suffering from various degrees of malnutrition.
The initiative, under the Community Management of Acute Malnutrition, CMAM, is designed to bring succour to millions affected by the pervasive problem of malnutrition, particularly in the North East. Aisha Abdullahi, 40, was there with her 11-month-old baby, Mohammadu, who suffers from SAM. Aisha was ill all through her pregnancy and the baby was born premature. She was a regular visitor to the Centre to collect the Ready- To- Use Therapeutic Food, RUTF. “When I stopped exclusive breastfeeding, I started giving him pap and kunu but suddenly he began losing weight after a bout of diarrhoea.”
Six-month-old Fatimah Umoru is also battling SAM. Fatimah’s mother Hafsat did not breastfeed her exclusively because she was not producing enough milk. Instead, she fed her with a combination of breast milk, kunu and soya milk. This ill advised mode of feeding led to her being malnurished.
Ten-month-old Hauwa was also taken to the Centre following bouts of diarrhoea. Her mother, Hajara, who was there for the first time, said her baby was okay at birth but started losing weight at four months. I went to the General Hospital and she was given some drugs but she was referred here.
Predicament: These children’s predicament is typical of the situation of millions of Nigerian children today. Studies show that no social class in Nigeria is spared the burden of malnutrition as reports show that 18 percent of malnourished children are from homes of the rich.
All of them combined are among the 2.5 million children with SAM and possibly part of the 500,000 of those at risk of death by end of this year if nothing is done.
Reports of increasing rates of malnutrition have been making the rounds nationwide and experts are worried that if adequate investments are not made in time, the country may end up with a generation of malnourished children that have potential to grow into malnourished adults.
Worse still, malnutrition is associated with Non Communicable Diseases such as diabetes and obesity among others. A World Bank report shows that every year, malnutrition claims the lives of three million children aged below five with billions of dollars lost to productivity and health care costs.
A Nutrition Focal Person, Yola, North Local Government, Adamawa State, Nacha Bitrus attached to the Nassarawa, Health Centre, Yola North Local Government Area of Adamawa State, said 15 -20 new cases are seen weekly. Bitrus however, lamented that some of the cases of malnutrition they treated relapsed due to the inability of the mothers to continue with the right food at home.
Lesson for mothers: “We teach them what to do, how to feed the children but to be able to remain in a good state of health, poverty must be addressed. Government should begin to think of how to alleviate poverty. When parents are empowered they will be able to take care of their children.
Bitrus said just one death had been recorded this year because the child that died had medical issues and acute malnutrition and the mother failed to bring her on time. She however, noted that despite the RUTF nicknamed “miracle food” many mothers still default or abscond.
As a way out, there is a Young Child Infant Feeding Programme which comprises a group of women who go into the villages to fish out these babies. “When these babies are brought to the Centre with the help of this group, we screen them and treat those malnourished with RUTF for at least eight weeksafter which they are discharged.”
To tackle ignorance, the Centre also initiated health talk for mothers on the types of food to feed their children after they have been discharged to avoid relapse.
In her presentation, at the workshop entitled “Addressing Child Malnutrition in Nigeria: Challenges, Efforts and the Way Forward” on behalf of Nutrition Specialist UNICEF, Abuja, Zach Fushieni, explained that many parents seem not to be aware of what to eat, how to prepare it and the quantity to be taken.