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 Malnourished Children...

Overcoming Nigeria’s Malnutrition Crisis: A Coordinated Approach By Barrister Chinedu Moghalu

Nigeria is currently facing a significant malnutrition crisis that affects millions of children across the country. According to the National Demographic and Health Survey (NDHS), approximately 37% of children under five in Northern Nigeria are stunted, reflecting chronic malnutrition, while 7% suffer from wasting, an indicator of acute malnutrition. Recent UNICEF reports indicate that about 2 million children suffer from severe acute malnutrition (SAM), with 40% of these cases concentrated in six states. Additionally, over 6 million children are moderately malnourished, and many women, especially those who are pregnant and lactating, suffer from micronutrient deficiencies. The projection that 26.5 million Nigerians will be food insecure in 2024 underscores the urgency of our response.

Underlying Causes and Challenges

The malnutrition crisis in Nigeria is driven by governance inefficiencies, widespread poverty, insecurity, and climate change, which disrupt food production and distribution. Rapid population growth and high dependency ratios strain resources, making it challenging to ensure adequate nutrition for all. Compounding this are poor feeding practices and cultural misconceptions about nutrition further exacerbate the problem; and gender inequality which limits women’s access to education, employment, and resources, impacting their ability to provide adequate nutrition. Other issues include poor access to healthcare due to inadequate infrastructure and products; inadequate social protection systems; and insecurity, especially in the North, which displaces communities and leads to food insecurity.

Government Commitment and Policy Interventions

Pursuant to President Tinubu’s Renewed Hope Agenda, which aims to foster a prosperous and healthy Nigeria, and aligned with the Nigeria Health Sector Renewal Initiative (NHSRII), the government has been tackling this issue head-on. This commitment aims to improve the quality of healthcare, ensure food security, and promote social well-being and economic stability. Recent meetings on solving malnutrition in Nigeria, held on June 6, June 14, and July 2 with clear action paths underscored this unwavering commitment to addressing the crisis.

“The malnutrition crisis we face is a symptom of deeper, systemic issues that have developed over decades,” said Hon. CMHSW Muhammad Ali Pate. “We are committed to not just addressing the symptoms but tackling the root causes to create a healthier future for all Nigerians.”

And the response in the health sector has been robust. The government has mobilized 1.3 million doses of multiple micronutrient supplements for pregnant women, expected to arrive by mid-July. To strengthen the primary healthcare system, more than N12 billion has been approved for primary healthcare centers across the country. These funds, part of the Basic Health Care Provision Fund (BHCPF), will help ensure that centers are equipped to handle malnutrition cases effectively. The government is also working with state governments through the National Primary Health Care Development Agency (NPHCDA) to allocate resources for revitalizing primary healthcare, focusing on states like Kebbi, Katsina, and Niger that have yet to receive their allocations. Coordination with State Primary Health Care Development Boards (SPHCDB) will be essential to this effort.

Equitable Distribution of Resources

A key principle of the approach is the equitable distribution of available resources across the entire country, not just the most affected areas. This ensures that all children, regardless of their location, have access to the necessary nutrition support. Equitable distribution will prevent the exacerbation of regional disparities and ensure a comprehensive national response to malnutrition.

Comprehensive and Coordinated Approaches: SWAp

Addressing malnutrition requires a comprehensive “whole-of-government” and “whole-of-society” approach involving all sectors of government and society leveraging the Sector-Wide Approach (SWAp) as approved by Mr. President last December. This includes coordinated efforts across health, education, agriculture, social protection, and environmental protection sectors. The pivotal role of the Presidency, particularly through the Office of the Vice President, in championing and coordinating these efforts at the highest level of government, cannot be overstated. Already, the Compact signed among all government and non-government stakeholders is gaining strong traction for consolidated delivery of the NHSRII pillars.

At a recent dialogue titled “Malnutrition Surge in Northern Nigeria: Addressing a Looming Humanitarian Crisis,” co-hosted by the Hon. CMHSW and the Athena Centre for Policy and Leadership, the necessity of coordinated action at the state level was emphasized. Key commitments from the dialogue included data integration, state-level actions, and local capacity building to strengthen intervention programs and ensure sustainability.

The role of agencies such as UNICEF, Médecins Sans Frontières (MSF), the World Bank, the World Food Programme (WFP), the International Rescue Committee (IRC), and the Bill & Melinda Gates Foundation (BMGF), among others, has been critical and immensely helpful in the fight against malnutrition. Their support and expertise align with the path being taken to address the crises in a holistic and more sustainable manner. The potential to immediately unlock $30 million from the World Bank’s Accelerating Nutrition Results in Nigeria (ANRIN) project, with a potential 1:1 match from the Child Nutrition Fund, represents a significant step forward in scaling up the response.

Given Nigeria’s multicultural heritage and rich religious diversity, faith organizations and traditional institutions can play a pivotal role in promoting nutrition and healthy practices within communities. Ongoing collaboration with traditional and faith leaders from across the nation has highlighted successful case studies where faith leaders have significantly impacted enhancing human capital through nutrition.

Equally, community-based approaches and local ownership of nutrition programs, including by community leaders, are being embraced. Women’s groups and other stakeholders are involved in designing and implementing interventions to strengthen efforts. Again, this is in line with the NHSRII Compact, which emphasizes collaborative efforts with state health commissioners and community leaders towards fully harnessing Nigeria’s rich tradition of coming to one another’s aid in times of need. According to Minister Pate, “enhanced coordination and a strong bias for action are crucial to success.”

Global Benchmarks and Commitments

Nigeria’s aspiration to achieve global nutrition benchmarks, such as those outlined in the Sustainable Development Goals (SDGs), further reiterates the commitment to addressing malnutrition. The dedication to building an improved quality healthcare system and promoting investments in reproductive, maternal, child, and adolescent health and nutrition through the NHSRII remains unwavering. The commitment to Universal Health Coverage (UHC) reflects a national resolve to ensure that every Nigerian has access to essential health services without financial hardship.

Data from few African countries show that Nigeria is on the right track. Countries like Rwanda and Ethiopia are known to have made significant strides in reducing malnutrition through comprehensive national nutrition programs and strong government leadership. For example, Rwanda’s stunting rate among children under five has decreased from 51% in 2005 to 38% in 2020, thanks to integrated health and nutrition interventions. Similarly, Ethiopia’s stunting rate declined from 58% in 2000 to 37% in 2019 due to the implementation of effective policies and community-based nutrition programs. These examples demonstrate that with the right policies and committed implementation, such as being pursued under the Administration, substantial progress can be made.

The Gender Imperative

A deliberate gender mainstreaming approach is critical to addressing malnutrition given the patriarchal nature of Nigerian societies. Women and girls are often disproportionately affected by malnutrition due to socio-economic factors, cultural practices, and limited access to education and healthcare. Policies must ensure that women, particularly those who are pregnant and lactating, receive adequate nutrition and healthcare services. For longer-term impact and success, empowering women through education and economic opportunities can have a profound impact on reducing malnutrition and improving overall health outcomes.

Policy Recommendations for Strengthening Implementation

To strengthen efforts, the following steps are recommended:

Enhance the implementation and monitoring of existing policies, ensuring they are adequately funded and effectively executed.

Develop state-specific nutrition action plans to address regional disparities.

Integrate nutrition interventions within primary healthcare services to improve coverage and impact.

Increase investment in community-based nutrition programs to ensure local ownership and sustainability.

Promote public-private partnerships to leverage additional resources and expertise in combating malnutrition.

Conclusion and Way Forward

The urgency of addressing malnutrition in Nigeria cannot be overstated. An estimated $912 million annually is required to comprehensively scale up nutrition-specific interventions. Timely implementation and effective tracking are essential to ensure that resources reach those in need and achieve the desired impact. This demands the concerted effort of all stakeholders, including private sector actors and foundations such as the Dangote Foundation, to achieving significant progress in reducing malnutrition. Commitment to actionable steps and continuous collaboration can save lives, reduce suffering, and improve health outcomes across the country.

Coordinated efforts, strategic leadership, and unwavering commitment have the potential to transform the nutritional landscape of Nigeria and ensure that every child and family has the opportunity to thrive. As Hon. CMHSW Muhammad Ali Pate pledged, “The fight against malnutrition is one we are determined to win. With coordinated efforts, strong leadership, and unwavering commitment, we will ensure a healthier future for our children and our nation. We are not just addressing the crisis at hand but building a sustainable framework that will protect future generations from malnutrition.”

Barrister Chinedu Moghalu

Senior Special Adviser to the Hon CMHSW on Strategic Communication, Stakeholder Engagement, and Advocacy