Galvanising legislative support to halt child malnutrition in Northern Nigeria

The United Nations Children Fund (UNICEF) has identified malnutrition as a direct or underlying cause of 45 per cent of all deaths of under-five children in Nigeria. This is aside the country being the second highest burden of stunted children in the world, with a national prevalence rate of 32 per cent of children under five.
 
It is estimated that two million children in Nigeria suffer from severe acute malnutrition (SAM), but only two out of every 10 affected children have access to treatment. Also, seven per cent of women of childbearing age suffer from acute malnutrition. Exclusive breastfeeding rates have not improved significantly over the past decade, with only 17 per cent of babies exclusively breastfed during their first six months of life, while just 18 per cent of children aged six to 23 months are fed with the minimum acceptable diet.
 

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 per cent of Gross Domestic Product (GDP).
 
So, there is need for concerted effort to halt the trend to avoid the short and long-term implications. Surprisingly, despite the negative data on nutrition in Nigeria, the budgetary allocation to tackle this essential aspect at the state and federal levels is dwindling.
 
Worried by government’s seeming nonchalant attitude to check the trend, the Civil Society Legislative Advocacy Centre (CISLAC), organised a Legislative Summit on the Prevention and Treatment of Severe Acute Malnutrition (SAM) for Speakers, Chairs of Committees on Health and Appropriation, Clerks of Bauchi, Gombe, Jigawa, Kano, and Kastina State Houses of Assembly, including State Nutrition Officers and Civil Society Organisations in these states, with the hope of overcoming the funding challenges posed by the COVID-19 Pandemic.
 
In his address, the Executive Director, CISLAC, Auwal Ibrahim Musa Rafsanjani said the summit became imperative, as available data and reports indicated that malnutrition remains high in Northern Nigeria.

He noted that inadequate budgetary allocation to nutrition and delay in or non-release of nutrition appropriated funds by state governments are not complementing donor efforts in checking malnutrition in the region. Malnutrition, he insisted, doesn’t only impact negatively on socio-economic development, but sustainable development cannot also be achieved in the country, especially at the sub-national levels, without prioritised attention to nutrition investments at all levels. He, therefore, underscored the need to involve all stakeholders, particularly the House Leaderships and relevant Committee Chairs and their MDAs.

“We find it worrisome that during the review exercise of the 2020 federal government budget as a response to COVID-19 impact, the N800m that was initially allocated for the procurement of Ready-To-Use-Therapeutic-Food (RUTF) was expunged. We also note, with serious concern, that the N146m allocated for the treatment of severe acute malnourished children in the proposed 2021 appropriation bill currently with the National Assembly to be grossly inadequate to cater for the millions of children requiring treatment from Severe Acute Malnutrition in the country,” he said.

Discussions at the programme helped participants to understand their state nutrition status, to guide them in making commitments on how they can ensure that Severe Acute Malnutrition (SAM) prevention and treatment is properly focused and prioritised as a human rights issue through appropriate legislative interventions.
 
In their presentations, the nutrition officers explained how their respective states are trying to get rid of the ugly trend. They also identified some of the challenges. For instance, Gombe State government has adopted different strategies in addressing problem of malnutrition in the state, by implementing various interventions and basic nutrition packages for women and children to access the services.

And to strengthen and ensure continuity of nutrition activities in Gombe, government approved N75m for procurement of Ready to Use Therapeutic Foods (RUTF) in 2020; N25m was released to UNICEF and 1,159 cartoons of RUTF were procured and distributed to the implementing LGAs. The state committee on food and nutrition (SCFN) and LGAs committee on food and nutrition (LCFN) were functional, with developed nutrition cost plan of action and nutrition policy signed and approved. 

An update on Kano nutrition status in the last quarter also showed distribution of deworming tablets for adolescents Nutrition Programme between the ages of 10 and 19 years across the 44 LGAs; organisation of a four-day Annual Operational Plan for Health sectors and MDAs for 2021 supported by UNICEF; and Virtual meeting with Nigerian Governors Forum (NGF) at the Abuja Secretariat on strengthening State Committee on Food and Nutrition.

In Katsina, the nutrition situation is characterised by double burden of malnutrition with about one third of the children under five years stunted (more than half in the northwest).  In Bauchi only UNICEF is supporting CMAM, MNP and IYCF, no any other IP/NGO is taking part.

While sensitisation programmes on radio and television are ongoing, the major problems identified are inadequate information to caregivers on the differences between Polio vaccine and Vitamin A and inadequate knowledge on complementary foods.

CISLAC and its team believe that problems identified are already solved. So, what is essential is starting critical deliberation on existing developmental challenge. It is hoped that a result-oriented deliberation will be applied in support of legislative and policy processes towards sustainable prevention and treatment of SAM in Nigeria.

Speakers of the SHoA agreed to do more towards improving budgetary allocations on nutrition.

Recommendations and action points for implementation reached at the summit included the need to tackle the dreaded impacts of malnutrition reflected in monumental economic and productivity losses, irreparable potential loss, increased susceptibility to communicable diseases and other infections.

Speakers from Bauchi, Gombe, Jigawa, Kano, and Kastina also underscored the need for increased empathy, acknowledgement, regional consciousness and ownership of the SAM issue by leaders at all levels of government, as this would help achieve improved budgeting and release of funds for SAM in the states.

Also emphasised was collaborative efforts, synergy and communication amongst MDAs and sectors with nutrition component in their mandate to ensure collective and effective interventions. This is in addition to stressing the need for deliberate and more effective implementation of State Action Plans, mainstreaming of oversight of MDAs, and budget performance to check lapses in programme implementation and performance and prioritisation of local production of RUTF, among others.