By Sola Ogundipe

New hope has appeared on the horizon for reducing the burden of malnourished children in Nigeria and other developing countries. This development came about courtesy of the emergence of a new approach to monitoring the relationship between nutrition and child mortality that shows how changes in the number of mildly underweight children could be used as an early-warning signal of underlying public health threats or changes in child feeding practices that are currently difficult to monitor in other ways, such as disease epidemics.

According to the researchers, low bodyweight, in which nutrition plays a key role, is a well known symptom and also a cause of ill-health and mortality for children in developing countries such as Nigeria.

Traditionally, nutrition experts, healthcare observers and clinicians in general, usually focus on the most severe malnutrition cases, but for public health, it is now appreciated that the extent of mild underweight could be even more meaningful than initially anticipated

The experts who noted that one reason for the development is that there are so few children at the extremes of the nutrition scale and they are difficult to measure. However, mild under-nutrition, which affects a much greater number of children, could be a powerful predictor of population health.

Essentially, Nigeria has the fourth highest number of underweight children in the world (after India, Bangladesh and Pakistan).

An estimated two million Nigerian children suffer from severe and moderate acute malnutrition and most of them are in the northern states. In the country, the proportion of underweight children under five years of age was 35.7 per cent in 1990, reducing to 28.7 per cent between 2001 and 2003 and to 23.1 per cent by 2008 according to the 2008 Nigerian Demographic and Health Survey (NDHS).

According to the Survey, about 19 per cent of the children in the northwest zone were acutely malnourished (13.9 percent on national average). Nigeria aims to meet the Millennium Development Goal of halving the number of malnourished children below five years by 2015.

In the new study, researchers examined 130 Demographic and Health Surveys (DHS) conducted in 53 African (including Nigeria), Asian, and South American countries between 1986 and 2006. Their data cover thousands of children between three months and three years of age, classified by weight according to World Health Organisation (WHO) standards.

The study focused on children who are underweight in terms of their weight-for-height ratio, signaling that they have not recently absorbed enough nutrients to meet their growing needs, and compared the prevalence of severe underweight to the number of children who are only mildly malnourished.

They said tests showed that changes in the number of mild cases were more closely linked to child mortality than changes in the number of extreme cases.

The results showed that, for an individual child, severe underweight is much worse than mild underweight. Mildly undernourished children face only a small increase in their own mortality risk. But when a lot of children fall behind, something dangerous could be happening, perhaps the spread of contagious disease, a worsening of water quality, or food shortages.

If changes in mild undernutrition remain a useful predictor of child mortality, then health authorities around the world could use it as an early-warning signal to guide intervention before much of the damage occurs, they concluded.