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Reversing Malnutrition Trends in Nigeria

Blessed as the Africa’s wealthiest, the most populous nation with over 200 million people and with this pace Nigeria’s population will be 500 million in 2050. Only India and China is ahead of Nigeria in term of population. In the last five decades high birth rates are the main factor escalating the country’s population. The co-existence of undernutrition among children and overnutrition in women of childbearing age is prevalent in this population especially in northeastern Nigeria.

Malnutrition can be said to be a poor condition of health caused by a lack of food or a lack of the right type of food. Globally, there are 821.6 million people that are considered undernourished or starving.The term malnutrition includes both undernutrition and overnutrition. Undernutrition occurs when an individual cannot maintain normal bodily functions such as growth, recovering from disease, and both learning and physical work. Rural and agricultural communities can be especially susceptible to hunger during certain seasons.

The annual hunger gap occurs when a family’s food supply may run out before the next season’s harvest is available and can result in malnutrition. Meanwhile, the prevalence of people worldwide that are undernourished has decreased over the last decades, from 18.7 percent in 1990-92 to 10.8 percent in 2018.

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Since the 1960s, malnutrition in Nigeria has been a problematic issue and has had a huge impact on the populace. This is because Nigerians are consuming food in poor quality and quantity. Nigeria had acknowledged the role of nutrition as a development issue and had committed to addressing malnutrition.

The Nigerian government has multiple policies and programs to promote, protect, and support optimal nutrition. These include food fortification, biofortification, supplementation, infant and young child feeding policies, and programs to prevent non-communicable diseases.

Social intervention policies of today’s government are wide-ranging and aim to create job opportunities, promote school feeding programs for 5.5 million children, and provide financial support for up to 1 million vulnerable beneficiaries through a conditional cash transfer scheme. Moreover, the linkage between policy and global food and nutrition security (FNS) needs is still weak, and interventions are often underfunded. There remains a strong need for FNS interventions to sharpen the policy process and create an effective coordination mechanism in order to have a more meaningful impact.

How Nigerian Food Value Chain has been hit by COVID-19 Pandemic, Unstable Income

The COVID-19 pandemic both deepens humanitarian needs and complicates the response. The economy of the country has suffered from the drop in global oil prices and from the restrictive measures put in place to curtail the spread of the virus, most intermittent border closures and the need to dedicate resources to respond to the health crisis. The consequent impairment of livelihoods cascades down to loss of income and buying power, with acute effects on the already-vulnerable and food insecure. Operationally, COVID-19 measures to keep humanitarian staff and beneficiaries safe consume time and resources.

Some factors affecting malnutrition and food insecurity in Nigeria are multifaceted and include poor infant and young child feeding practices, which contribute to high rates of illness and poor nutrition among children under 2 years; lack of access to health care, water, and sanitation; armed conflict, particularly in the north. Others are poverty, deficient food production, insufficient food intake, illiteracy and uneven distribution of food, poor food preservation techniques, improper preparation of foods, food restrictions and taboos.

Hidden to the naked eye

Bad or inadequate food can lead to an unbalance of nutrients in the body and this can lead to various diseases which can damage the human body. Malnutrition disrupts the functioning of the human body. It is even more risky for children than in adults because their physical structures are still tender and not that strong and defensive against diseases. United Nations Children’s Fund (UNICEF) noted that Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five. An estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM), but only two out of every 10 children affected is currently reached with treatment. Seven percent of women of childbearing age also suffer from acute undernutrition.

Exclusive breastfeeding rates have not improved tremendously over the past ten years, with only 17 percent of babies being fully breastfed during their first six months of life. Just 18 percent of children aged 6-23 months are fed the minimum sufficient diet. Adeyemi Adeniran, a Nigerian paediatrician, says “Exclusive breastfeeding gives children a better start in life, but not enough mothers practice it.”

“From the point of birth, the baby is being introduced to breastfeeding and that is the cheapest and the best,” he said. “But the advocacy and the awareness about this has been a bit poor. We’re also bringing that on board now to encourage mothers to make sure they breastfeed exclusively for six months.”

Adeyemi Adeniran

Following years of armed warfare in north-eastern Nigeria have resulted in mass displacement, severe food insecurity and undernutrition, and have destroyed livelihoods and further weakened weak health systems. The humanitarian catastrophe in Nigeria’s north-eastern states of Borno, Adamawa and Yobe (the so-called BAY states) is expected to persist unabated in 2021: the ongoing conflict will still severely impact millions of people in 2021, subjecting them to displacement (new or continued), impoverishment and the threat of violence.

The stabilization centre at Biu General Hospital which is supported by the ICRC, has a 65-bed capacity. With children being admitted for up to 21 days, there isn’t nearly enough space to accommodate everyone. COVID-19 spacing guidelines that the hospital is trying to enforce add another layer of challenges. Photo: INTERNATIONAL COMMITTEE OF THE RED CROSS (ICRC)

Approximately 1.92 million people are displaced internally, and 257,000 have sought refuge in bordering Cameroon, Chad and Niger. The majority (54%) of the internally displaced people (IDPs) has found refuge in host communities. Borno State has 81% of the IDPs, of whom slightly more than half (54%) stay in IDP camps. Similarly, about 81,000 newly displaced people arrived in camps and the host communities across the BAY states in 2020. The armed conflict has no clear end in sight. The States in northern Nigeria are the most affected by the two forms of malnutrition – stunting and wasting. High rates of malnutrition pose significant public health and development challenges for Nigeria. Stunting, in addition to an increased risk of death, is also linked to poor cognitive development, a lowered performance in education and low productivity in adulthood – all contributing to economic losses estimated to account for as much as 11 percent of Gross Domestic Product (GDP).

The Global Nutrition Report noted that, Nigeria has made no progress towards achieving the target for stunting, with 36.8% of children under 5 years of age affected, which is higher than the average for the Africa region (29.1%). The country has shown limited progress towards achieving the diet-related non-communicable disease (NCD) targets. The country has shown no progress towards achieving the target for obesity, with an estimated 13.1% of adult (aged 18 years and over) women and 4.6% of adult men living with obesity. Nigeria’s obesity prevalence is lower than the regional average of 18.4% for women and 7.8% for men. At the same time, diabetes is estimated to affect 6.0% of adult women and 6.3% of adult men, the Global Nutrition Report stated.

Stamping down the looming misfortune

The Nigerian government should make smart nutrition commitments and ensure faster, fairer progress towards ending malnutrition in all its forms. Safer health care only goes so far in mitigating widespread poverty. Better access to health care, water and sanitation, food security and appropriate childcare will also diminish stunting in Nigeria. Further attempt should be placed on active nutrition surveillance to determine the frequency and periodically reassess priority constraints. Nutrition training in the areas of healthy eating for weight control, for women and interventions on infant and young child care be undertaken and reinforced. National and international humanitarian actors bring more capacity to bear on northeast Nigeria. There is a need to switch emphasis away from exaggerated advocacy and the politicization of the intervention programmes.

An alternative community-based approach to care and treatment has proven effective in reaching many more children than a limited number of hospital beds allow. Malnourished children can recuperate quickly by eating fortified peanut-based ready-to-use therapeutic food. Mothers and children should also undergo basic health care, treatment for common childhood diseases, and nutrition and feeding advice which can followed at home. Betterment of employment rates and the official minimum wage will boost household income, consequential in more money being spent on appropriate food and research has indicated that empowering vulnerable groups through non-contributory social protection will reduce malnutrition in Nigeria.

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