Nutrition remains a powerful driver for socio-economic development of a nation, yet it is one of the sectors that have received little attention by African governments. To improve welfare and economic growth in developing countries, investment in reducing under nutrition is ranked ahead of investments in schooling, health and family planning.
For every dollar invested in reducing chronic under nutrition among children in Africa, there is a return of investment of $16 dollars. Sadly, African countries lose 3% to 16% of their GDP annually to malnutrition[i]. No doubt, nutrition can, and do influence growth, development and productivity of an individual, family, community and a nation. Investment within the first 1000 days, provides greatest opportunity and healthy start of life.
Malnutrition remains a problem of public health importance in Nigeria. Nigeria has the highest number of severely malnourished children in Africa. Over 13 million Nigerian Children are suffering from chronic malnutrition, also called stunting. This makes Nigeria the country with the highest number of stunted children in Africa, and second highest in the world.
There are an estimated 2.5 million children with severe acute malnutrition (SAM) in Nigeria. Children with severe acute malnutrition are nine times likely. The burden of SAM is more severe in the north than in the south with between 60-80% of SAM cases found in Northern Nigeria. Without treatment, over 400,000 of them will die in 2016 alone. Despite the importance of exclusive breastfeeding to child survival, only 17% of children under six months old are exclusively breastfed in Nigeria. Iron deficiency in Nigeria accounts for 20% of the estimated 536,000 maternal deaths. To prevent malnutrition and improve child nutritional status, it is important children are fed with diversified food sources; more than half of Nigeria children do not get minimum dietary diversity necessary for optimal growth.
The Government of Nigeria has made some progress in an attempt to reduce the high malnutrition rates. With the support from UNICEF and other partners, the government has developed a five year National Strategic Plan of Action for Nutrition (2014-2019). The government is also currently providing targeted management of acute malnutrition in the more affected states whiles continuously implementing community nutrition services such as infant and young child feeding, and micronutrient deficiency control measures on limited scale. Despite this commitment in budget and financing nutrition interventions remains very limited and remains heavily external funded. For example, only US$ 10 million out of the US$49 million spent on nutrition in 2013 came from the government.
To avert more deaths resulting from severity of malnutrition, UNICEF has been supporting the government to implement Community-based Management of Acute Malnutrition in Northern Nigeria where the severity is highest. Since 2009 over 1.4 million children had been provided CMAM services and an estimated 263,000 children lives saved. In 2015 alone, over 400,000 children received CMAM services in Nigeria and 77,000 lives save. More children are in need of treatment, as there are an estimated 2.5 million severe malnourished cases requiring treatment in 2016. The major cost of the programme is the Ready-to-use Therapeutic Food (RUTF) for the treatment. It cost UNICEF an estimated US$61 per child reached to procure and distribute the RUTF, trained and monitor programme. This has been made possible, thanks to CIFF, DFID, USAID. To treat more children, and to sustain the live-saving programme, federal and state governments need to contribute in the procurement of the RUTF.
The working to Improve Nutrition in Northern Nigeria (WINNN) programme, which is funded by the UK government, has supported the government to scale up of proven nutrition interventions including in Northern Nigeria and to use multi-sectoral approach in implementing preventive aspect as malnutrition.
Nigeria can reverse the alarming malnutrition rates. Among others:
- Adopt the National Food and Nutrition Policy and the Health Sector National Strategic Plan of Action for Nutrition (2014-2019) at the state level.
- Develop costed plans for the implementation of the National Strategic Plan of Action for Nutrition.
- Ensure nutrition is fully integrated into the Primary Health Care (PHC) per Ward initiative. Especially, taking steps to ensure that Vitamin A, Iron-Folate, Micronutrients Power and Ready-to-use Therapeutic Food (RUTF) are part of the essential supplies of the PHC centers. PHC is not complete without nutrition.
- Create budget lines for nutrition, increase nutrition budgets and releases. As an immediate action, federal and state governments need to release the allocated 2016 nutrition budgets (and/or allocate budget to nutrition if not yet done), and provide adequate budget/funds for nutrition in 2017 during the state and federal level 2017 budget cycle.
- Expand coverage of proven nutrition interventions at the state, LGA and community levels – Community-based Management of Acute Malnutrition; Infant and Young Child Feeding Practices and Micronutrients Deficiency Control.
- Strengthen human resources to effectively implement the Health sector plan of action for nutrition.
- Adopt multi-sectoral approach to tackling the nutrition problem – involve other sectors like water and sanitation; education, agriculture, women and social protection.
- Fully fund, in the 2017 budget, the National Food and Nutrition Policy.
[i] Global Panel on Agriculture and Food Systems for Nutrition, Working Paper, The economics of reducing malnutrition in Sub-Saharan Africa. 2016
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