Malnutrition is a condition that occurs owing to deficiency in the access and intake of people to consume or absorb the right amount and type of foods with essential nutrients consistently. This has contributed to the deaths of more than three million children globally each year. HALIMA OGIRI writes on this silent health crises taking place in Nigeria which many may not be aware of.
Malnutrition among Nigeria's children constitute a serious problem in Nigeria, as it contributes to the death of about half a million children each year. The percentage of children in the country who are wasted, or too thin for their height has steadily increased over the last decade, as about 70 percent of children between ages 6 to 23 months are not receiving the minimum acceptable diet.
The main indicator of childhood malnutrition is stunting, a situation that makes children become too short for their age. Stunted children have poor physical growth and brain development, thereby preventing them from thriving and living up to their full potential. With over 11 million stunted children, Nigeria is facing a crisis of malnutrition and ranks second behind India among all countries with the highest number of stunted children. An estimated 37 percent of Nigeria's children are believed to be stunted. This figure is higher than Senegal, where the proportion of stunted children is 27 per cent. Nigeria has about 22 million children under 5, but only 3 percent are stunted. Another important nutrition indicator is exclusive breastfeeding. In Ghana, 63 percent of infants under 6 months are exclusively breasted, while in Nigeria, only 17 percent are exclusively breastfed.
Miracle Essien, is a one-year-six-months old baby diagnosed with Severe Acute Malnutrition (SAM), and receiving treatment at one of the Community-based Management of Acute Malnutrition (CMAM) centres in Calabar, Cross River State, set up by the government in partnership with the United Nations Children Fund (UNICEF). Miracle and few other children at the community-based management of acute malnutrition Centre, Calabar, only represent a small portion of the children suffering from malnutrition in Nigeria and other parts of the world.
A recent survey by UNICEF reveals that at least 500,000 Nigeria children die yearly from malnutrition, while about 1.7 million children are severely malnourished. Disaggregation by geo-political zones shows that acute malnutrition is highest in the North-east at 12 percent and North-west at 10 percent and lowest in South-east and North-central at 5 percent each.
Speaking at a two-day workshop on child malnutrition tagged “Stop Child Malnutrition in Nigeria,” in Calabar, the Chief of Nutrition, UNICEF, Arjan de Wagt, who spoke on the Nutritional situation in Nigeria, said most children die of malnutrition during their first 1,000 days on earth, describing the period as "window period," adding that 55 percent of child mortality is associated with malnutrition.
According to Wagt; "The 1,000 day period is the start of a woman's pregnancy until her child's second birthday. The first 1,000 days of a child are so important that they determine not only the child’s growth but also the child's entire health status throughout his or her life, up to old age. "When nutrition is optimised during the 1,000 window period, the effects are often irreversible.
"The cause of malnutrition is lack of exclusive breast feeding of the child in the first six months of his birth. Breast milk is made strictly for the babies and they must not be denied of it. Exclusive breastfeeding has the potential to save more children's lives than any other preventive intervention. An estimated 13 percent of child deaths could be averted if 90 percent of mothers exclusively breastfeed their infants for six months of life.
"If the same proportion of mothers provide adequate and timely complementary feeding for their infants from 6 to 24 months, a further 6 percent of child deaths could be prevented," he noted.
Though, UNICEF announced that through its numerous interventions, about 200,000 lives of malnourished children have been saved in the past six years, this development has stressed the need for more financial assistance from donor agencies to increase the number of those it could save from the dangerous effect of malnutrition to one million per annum. One of the interventions is the introduction of the Community-based Management of Acute Malnutrition (CMAM), which was piloted in Gombe and Kebbi States in 2009 and has now been introduced in 11 northern states in Nigeria where malnutrition poses the greatest threat.
According to the Chief of Nutrition, UNICEF, CMAM treats acutely malnourished children from six months to five years old on an out-patient basis. More than 830,000 children have been cured in the programme with the cure rate rising steadily – currently standing at 85 per cent. Of the remaining children, about two per cent do not respond to treatment and are referred to hospitals; the current mortality rate is just one per cent, while the other children have defaulted from the programme.
CMAM as a programme is carried out based on weekly appointments over approximately period of eight weeks at primary health care centres. It includes education of parents and care givers on nutrition, the importance of continuing breastfeeding and the role of hand washing and hygiene. The nutrition status of the children is assessed during the CMAM sessions and children are given a health screening and if necessary, they are treated for other illnesses. They are also given highly nutritious Ready-to-Use Therapeutic Food (RUTF), during the sessions and mothers and caregivers are provided with supplies of RUTF to feed the child at home.
Speaking at a presentation of the new data on child malnutrition and the effectiveness of CMAM recently in Abuja, the Permanent Secretary, Federal Ministry of Health in Nigeria, Linus Awute, said the Government of Nigeria is committed to reaching more children with CMAM.
“We cannot accept that Nigerian children continue to die of malnutrition and that our potential future leaders should be diminished by its effects. Nigeria is taking important steps to address nutrition. We have joined the Scaling Up Nutrition (SUN) movement.
“This is an exciting new global effort aimed at bringing country and global leaders together to fight against malnutrition. Nigeria is one of the newest countries to become a SUN member, and we are joining more than 45 countries and over 100 international organisations and donors to rally around a common agenda and solutions with the goal of mobilising broad commitment and resources to advance our nutrition agenda," he hinted.
In line with the programme aimed at minimising the risk rate of malnutrition, UNICEF and the Government of Nigeria are scaling up the CMAM response and UNICEF is advocating for increased investment in CMAM from both the Government of Nigeria and external donors.
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