How malnutrition threatens future of children in Northeast Nigeria

Malnutrition is one of the world’s major public health and development concerns. In Nigeria, the situation is dire. Currently, UNICEF says 5 in 10 children under five years old suffer from the effects of being malnourished.

This has an overarching impact on the lives, future and productivity of Nigerian children. DOOSUUR IWAMBE in this report examines how malnutrition threatens the future of children in Northeast Nigeria.

29-year-old Ibrahim Fatima (Not real name), was displaced from her ancestral home in Mafa local government area of Borno State by the Boko Haram insurgents in 2016.

Since then, Ibrahim, her husband and 3 children have been taking shelter at the makeshift huts of the Muna Garage Internally Displaced Persons (IDPs)camp, an out-skirt of Maiduguri.

With weak feet and frail body, Ibrahim warmly clutched her eight -month-old baby Amina to her chest as the malnourished baby continually let out resounding cries.
Sitting with her frail-looking 8-months old baby under the scorching sun at the entrance of Muna Primary Healthcare (PHC) Clinic A, Fatima told this reporter through the help of an interpreter that she left her hut as early as 5: 30am to get a good number that will guarantee her access to the facility.

Looking distraught and helpless, she said even though she was feeling terribly sick, the heath workers informed her they can only attend to her child adding that she was waiting for her number to be called before she could go in.

She said, ‘’I have not been feeling well for some time now. My baby too is not feeling fine as you can see for yourself.

I woke up as early as 5: 30am to come here and queue so that the health workers will attend to me but unfortunately, they informed me that they can only attend to my child.

‘’We were displaced from our home in 2016 by Boko Haram and since then, we have been living here in this camp. At the initial stage when we got here, the government and other non-governmental organizations used to bring food stuff for us but in the last three years, we have been taking care of ourselves.

My husband usually goes out every day to do some menial jobs and we feed from whatever proceeds he makes for the day’’.

Like Fatima who is unable to feed her baby at Muna IDP camp, Atikah Danasabe is equally finding it difficult to also feed her nine-month-old baby, Bashir.

Sitting under the shade of a neem tree at the camp, Danasabe who was also displaced from her ancestral home four years ago narrated her ordeal saying, she is sad about the poor health of her 4-year-old son Bashir, also occasioned by undernourishment.

Danasabe disclosed that her husband was killed when the insurgents invaded their community leaving her with four children to care for. She said that she had lost her husband, properties, home and was on the verge of losing her child to Severe acute malnutrition (SAM) before the United Nations Children’s Fund (UNICEF) with support from the Department for International Development (DFID), discovered her and immediately placed him on the Ready -To -Use Therapeutic Food, RUTF, specially made for the treatment of SAM.

She said, ‘’It all started after our home was attacked by the Boko Haram insurgents leading to the death of my husband. I was moved to the IDPs with my children where we have to rely on gifts from donors. Because I had nothing to feed my children, my son was affected by malnutrition.

At age 4, he has no energy either to stand or walk. ’When I took my child to the clinic, it was discovered that he was suffering from SAM.

The health officials at the clinic after screening him for malnutrition immediately commenced the administration of RUTF on him. He is improving and eating better now,” she said in Hausa language.

Children suffering from SAM like Ibrahim and Bashir are nine times more likely to die from related complications than healthy children are.

He is one of the estimated 450 000 children who are malnourished in the North-eastern region of Nigeria and require varying degrees of therapeutic interventions.

It was estimated in August 2021, that 1,148,906 children under the age of five will be acutely malnourished in Borno, Adamawa and Yobe states, out of which 605,000 will be severely acutely malnourished.

They will suffer from the most severe form of malnutrition that leads to death without adequate treatment.

In his opening remarks during a three-day media dialogue on ‘child malnutrition reporting’ in Borno State, officer in charge, chief of field office, of the United Nations children’s Fund in Maiduguri, Samuel Sesay said, malnutrition is currently the biggest threat to child survival and development in the north-eastern part of the country.

He said, the outbreak of COVID-19 pandemic, conflict and multiple displacement were peculiar contributors to the growing number of children affected by under-nutrition in the region.

“In North-East Nigeria, however, conflict, multiple displacement, destruction of source of livelihood for households, destruction of basic infrastructure and services, climate change and the COVID-19 pandemic are peculiar contributors to the growing number of children affected by undernutrition.

“Household food insecurity, poor infant and young child feeding, care practices, as well as poor feeding environment, hygiene and health services have been identified as the underlying causes of under nutrition in children”.

Sesay who disclosed that malnutrition is the underlying cause of nearly half of all deaths in children under the age of five across the globe said, it is unacceptable that children continue to bear the burden of conflict, climate change and COVID-19.

He stressed the need for government at all levels as well as policy makers to prioritise malnutrition saying, good nutrition helps in nation building.

Long – and short-term effects of malnutrition on a child

The worst damages of malnutrition happen during pregnancy and early childhood – from conception to two years, the first 1000 days. Undernourished children have weaker immune systems and are thus more susceptible to infections and illnesses.

Long-term nonsufficient nutrient intake and frequent infections can cause stunting, whose effects in terms of delayed motor and cognitive development are largely irreversible.

A maternal and child health expert, Mrs Abimbola Kanayo disclosed that malnutrition imposes unacceptably high costs direct and indirect on the nation.

She said that it stretches the economy of a nation and has important economic consequences at the individual, household and community level.

At the individual level, she said, children who are supposed to sustain whatever legacy that was left behind are malnourished and could hardly defend themselves, academically and otherwise.

‘’Malnutrition has a long-term devastating effect on children because, in most cases, it strikes them at their developmental age.

It shortens the lifespan of children and destroys, totally, their cognitive abilities. In addition to that, it makes them less useful and prone to ailments even after they have recovered from SAM.

‘’Any child that suffers malnutrition hardly enjoys academic excellence or records impressive performance in any intellectually competitive environment. They don’t develop well, physically and mentally.

They are 11 times more likely to die compared to their normal peers. They have high risk of diabetes, obesity and several other ailments at adult age.

‘’As it stands, malnutrition is a serious threat to the future of northeast Nigeria because the children who are supposed to sustain whatever legacy that was left behind are malnourished and could hardly defend themselves, academically and otherwise’’.

Economic consequences of malnutrition on Nigeria

Experts say that multiple forms of malnutrition reduce nearly 8 per cent of the nation’s economic growth owing to reduced schooling, cognitive impairments, compromised adult labour productivity, and increased healthcare costs.

They said that malnutrition keeps people from reaching their full potential. Malnourished children underperform in school, limiting their future job opportunities.

Malnourished adults are less able to work, contribute to local economies, and provide care for their families.

This perpetuates a cycle of poverty and economic stagnation

The health experts further revealed that mortality and morbidity associated with malnutrition represent a direct loss in human capital and productivity for the economy.

For a microeconomic level, they explained that it is calculated that 1 percent loss in adult height as a result of childhood stunting equals to a 1.4 percent loss in productivity of the individual.

They listed other indirect losses for the country’s economy are caused by poor cognitive function and reduced school attainment that originate in early childhood undernutrition.

On the education gap, they said that a consequently lower skill-level of the workforce substantially delays the development of countries affected by malnutrition.

‘’Undernutrition in early childhood also makes an individual more prone to non-communicable diseases later in life, including diabetes and heart disease, significantly increasing health costs in resource constrained health systems.

‘’In total, the economic cost of malnutrition is estimated to range from 2 to 3 percent of Gross Domestic Product, to as much as 16 percent in most affected countries.

The effects of malnutrition are long-term and trap generations of individuals and communities in the vicious circle of poverty’’, explained Pharmacists Osayamen Olaye, Abuja based food and nutrition expert.

Why more action is needed to end malnutrition in Nigeria

Even though malnutrition is the underlying cause for a third of child mortality in the world, it is yet to receive the nature of high-profile campaigning and investment necessary to address it effectively.

Therefore, unless our governments, at all levels, take immediate steps to address hunger and malnutrition, especially in children and pregnant women, our poor indices on maternal and child mortality can only further worsen.

Political commitment is necessary to ensure advocacy on the adverse implications of malnutrition and how to avoid its devastating consequences. Partnership with civil society and academic institutions with focus on food and nutrition is also an imperative.

However, such political commitment is best demonstrated by a tangible increase in resource allocation, with the relevant ministries and agencies committing to establish a road map and coordinated mechanisms for implementing activities for up-scaling nutrition in the public sphere.

This road map should consist of clear roles and responsibilities for the various stakeholders, as well as implementable strategies, with milestones for mainstreaming nutrition into agriculture, fortifying basic foods with essential minerals or vitamins, mobilizing communities for action on growing more beneficial foods, and highlighting the perils of malnutrition.

For effective health and social protection, mothers must be encouraged to adopt exclusive breastfeeding habits for their babies in the initial six months of their lives.
Thereafter, complementary feeding can be introduced for 24 months, then the consumption of various nutrients such as Vitamin A, iodised salt and zinc, among others.

Nigerians, as we have always argued, deserve a life free from hunger, in a country so blessed with arable land and natural resources. Unfortunately, both poverty and hunger continue to saturate our country’s landscape.

Hunger is both a cause and consequence of poverty, as people on low incomes tend to have worse diets, while people who lack adequate nutrition struggle harder to extricate themselves from poverty.

We must begin to address the crushing indices and causes of malnutrition that have continued to deprive over half of our children (and mothers) of a healthy and productive life span.