Preventing the scourge of malnutrition in Kaduna State

Stakeholders in health sector observe that reported cases of malnutrition among children and women in the country have become a public health concern in recent times.

For instance, Dr Idris Isokpunwu, Head of Nutrition, Federal Ministry of Health recently rated Nigeria the second largest contributor to the less than five years and maternal mortality rate in the world.

In Kaduna State specifically, a survey across the state shows that malnutrition accounts for 50 per cent death among children less than five years; a development which made health expert to declare the state epidemic for malnutrition.

The Nutrition Officer in the state’s Ministry of Health, Mrs Janet Gwani said that 912, 822, representing 57 per cent children in the state are stunted; meaning six out of every 10 children less than five years in the state are stunted due to chronic malnutrition.

Gwani also said that more than 750, 000, representing 42 per cent of children less than five years old, had severe acute malnutrition and were 10 times more likely to die, stating that infant mortality rate stood at 103 out of 1,000 live births.

Mrs Theresa Pamma, United Nations Children’s Fund (UNICEF) Water Sanitation and Hygiene Specialist in the state, described inadequate water, sanitation and hygiene as a significant contributor to malnutrition and stunting.

According to her, 50 percent of malnutrition cases is associated with repeated diarrhoea or worm infections.

She said that stakeholders should focus more attention on issues relating to sanitation, health and water situation in both urban and local communities in the state.

Similarly, UNICEF’s Nutrition Specialist in the state, Dr Florence Oni, attributed the development to inadequate breastfeeding, complementary feeding, care and ignorance, among others.

“The problem was caused by inadequate food intake, lack of dietary diversity and infectious diseases, inadequate child and maternal care, poor access to health services and unhealthy environment accompanied by poverty,’’ she said.

According to her, many parents do not know what to do when their child becomes malnourished and they do not take the child to the hospital until the child is about to die.

“In Kajuru Local Government Area for example, a mother told us that she was asked to throw away her malnourished child on the grounds that the child was not a human being.

“The child was almost two years but looked smaller than three months old baby.

“This woman grows soya beans and groundnuts that could be used in preparing complementary food that would have saved the life of the child, but she does not know.

“Women plant groundnuts, soya bean, vegetables, named them, but they sell; they don’t give the children,’’ she observed.

Oni, however, said that the state government was already doing something about the situation, adding that much needed to be done if the epidemic would be address.

“So far, the state government has released about N37 million to treat just about 3,060 children, and UNICEF had equally supported the government with the same amount to treat additional 3,060 children.

“When you add up, it will give you just 6,120 children that are being treated. This is a very insignificant figure when compared with the high number of malnourished children in the state,’’ she said.

She, however, said that Dangote Foundation has pledged to treat about 20,000 children suffering from acute malnutrition, promising that the implementation will begin in September.

“With these interventions, the state will be able to address about 30 percent of the affected children, but there is the need for more investment by the state to effectively arrest the challenge,’’ she added.

She said that UNICEF in collaboration with the state government had rolled out Community Management of Acute Malnutrition (CMAM) early this year as part of efforts to address the problem.

“CMAM is an approach which involves early detection of severe acute malnutrition in the community and provides treatment for those without medical complications with ready to use therapeutic foods or other nutrient dense foods at home,’’ she noted.

She also said that 507 children from six months to 59 months old with severe acute malnutrition were admitted into CMAM between March and May.

She added that so far, 138 children had been treated and discharged, while two defaulted and five died.

She also said that 60 health workers and 160 community volunteers had been trained and had acquired necessary skills and capacity for the management of severe acute malnutrition.

She said that Community Infant and Young Child Feeding was recently inaugurated in the state to promote optimal breastfeeding and complementary feeding and to educate mothers on proper feeding of children.

“So far, 11,572 pregnant and lactating mothers in Kajuru and Zaria local government areas were trained between January and May on appropriate infant and young child feeding,’’ she said.

According to her, the state government has released N80 million for two rounds of Maternal Neonatal Child Health Week across the state.

She said that during the week, 2,585,092 children from six months to 59 months old received vitamin A supplement, while 1,809,784 children from 12 months to 59 months were de-wormed.

“Also, 502,569 pregnant women received a supply of iron supplement for the prevention of micro nutrient deficiencies.

“With this figure, we have met the set milestones of 75, 45 and 45 per cent, respectively, for the three key nutrition intervention of vitamin A, de-worming and iron folate this year,’’ she added.

Shedding more light on the efforts of the Federal Government to prevent malnutrition, Isokpunwu, Head of Nutrition, Federal Ministry of Health said the total cost required to implement the national strategic plan of action for nutrition in the country was estimated at N182.4 billion.

He added that the investment would avert 890,000 stunting in five years and save 123,000 lives each year.

He also said that the intervention would cost the Kaduna State Government N74.62 billion which in the long run would avert 81,886 stunting in five years and save about 5,363 children in the state.

Irrespective of this, the Chief Field Officer, UNICEF Kaduna, Mr Uptal Moitra, said the timely release of fund for nutrition interventions remained urgent and critical towards addressing malnutrition in the state.

Moitra emphasised the need for the state government to increase investment to effectively address the epidemic in the state.

He equally sought the support of local councils’ chairmen in the state to tackle the problem of acute malnutrition.

“The state government has made a commitment; UNICEF has made a commitment, we need the local government to equally make a commitment to cover the operational cost to ensure successful implementation of malnutrition interventions.

“Malnutrition has remained a major child killer disease in the country and the number of children dying of malnutrition in Kaduna state is unacceptable.

“We are deploying our expertise as part of our continued support to the government of Kaduna State, but we equally need your support for the effective implementation of these projects in your respective local government areas to ensure that no more children die of malnutrition,’’ he said.

All in all, stakeholders stress the need for integrated nutrition specific and nutrition sensitive intervention approach in tackling the epidemic.

They call for more focus on community management of acute malnutrition and promotion of optimal breastfeeding and complementary feeding, among other measures.