Need for action before malnutrition kills another child

A malnourished child at a CMAM centre holding a therapeutic formula

Three-year-old Lami died before she could receive treatment at the nearest malnutrition management centre, about two hours walk from her village in Isa Local Government Area of Sokoto State.

“My dear daughter kept vomiting; anything she took in, came out,” revealed Malama Halima Abdullahi, the distraught mother.

According to medical experts, the little girl with flaking skin, had severe acute malnutrition and  some complications as there was delay in seeking treatment to tackle the malady which they noted is a ‘life –threatening condition’.

They noted convulsion, severe dehydration, intractable vomiting, lower respiratory tract infection, high fever and loss of appetite, among others as some medical complications in severe acute malnutrition.

Concerns have been high over the problem of malnutrition which Dr Yunusa Usman Edzu of the Department of Community Health, Usmanu Danfodiyo University Sokoto (UDUS) explained, “may be in form of under-nutrition  which results from inadequate consumption of balanced diet. This also results in a health condition known as marasmus (lack of adequate food quantity) and kwashiorkor, which is lack of balanced diet.”

He added that malnutrition may also be in form of over-nutrition.

The World Health Organisation (WHO) has said that malnutrition is a contributory factor in about 45 percent of all child deaths.

An estimated 2.5 million children in Nigeria suffer from Severe Acute Malnutrition (SAM), according to UNICEF Nigeria,” 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 malnutrition.”

One consequence of malnutrition is stunted growth. Nigeria, UNICEF says, has the second highest burden of stunted children in the world with a national prevalence rate of 43 percent of children under five – translating to 16.5 million children.

At a high level dialogue organised by the Civil Society and Legislative Advocacy Centre (CISLAC), for political parties in Sokoto State, Dr Yunusa identified lack of adequate quantities of food for the age of the individual, lack of balanced diet, lack of food at the right time, as causes of malnutrition.

The medial expert cautioned against the economic, social and health consequences of malnutrition. “Poor nutrition, means poor mental and physical development since childhood. Poor mental and physical development mean poor health status. Poor health status means poor productivity and poor national development,” he stated.

Assistant Programme Officer, CISLAC, Murtala Muhammed, expressed concern over the current situation of malnutrition in Sokoto State.

Muhammed who gave an overview of a nutrition advocacy project that is focusing on the prevention and treatment of Severe Acute Malnutrition (SAM) in the state, noted that 5.6% of Sokoto State population are suffering from severe acute malnutrition with a stunting rate of 33.8%, 17.2% wasted and a prevalence underweight of 22.9%.

Murtala added that “19 out of 20 children suffering from severe acute malnutrition are without access to treatment. There are 154,108 Severe Acute Malnutrition admissions to date and out of this number, 13,864 did not complete treatment. Out of those admitted 1,975 of them lost their lives.”

He also pointed out that 14 out of 23 local government areas in Sokoto are without Community Based Management of Acute Malnutrition (CMAM) programme.

The nine local government areas are Binji, Gada, Goronyo, Sabon Birni, Wamakko, Sokoto South, Gudu, Ilela and Tangaza.

On challenges in Sokoto State nutrition intervention, he listed non-prioritization of CMAM as an urgent health issue, inadequate budget allocation for CMAM, inadequate allocated budget resulting in low procurement of Ready-to-Use Therapeutic Food (RUTF) and routine drugs by government.

Others include recurring RUTF stock out as a result of poor logistics management and inadequate effective monitoring and supportive supervision.

The advocacy expert underscored the need to act. “What will happen if government does not support the procurement of RUTF? At least 22,995 severely malnourished children are at risk of dying. Now support from development partners is not enough to cover current SAM cases,” he explained.

In order to ensure continued partner commitment, he harped on the need for the state government to take ownership of CMAM activities by contributing up to 80% of the procurement of RUTF needs in the state: 70% in 2019 and 80% in 2020.

“By taking ownership, the state will not only improve the nutritional status of children but will bring more recognition to the government as a leader in child health,” he said.

The current CMAM coverage, Muhammed, emphasized, needs to be scaled up from 19% to cover the remaining 81% of wards remaining in the state.

According to him, the dialogue was to provide platform for stakeholders to make commitment on what role they can play in ensuring the timely release of nutrition funding in the state’s budget as well as, to explore financial and budgetary opportunities and options for states in addressing malnutrition in 2019 and beyond.

Governorship candidates and representatives of different political parties who were present at the forum made various commitments towards tackling malnutrition if elected.

The ruling party in the state, PDP,  said plans were already on by  the  Governor Aminu Tambuwal-led government to produce RUTF locally and enhance efforts towards tackling malnutrition, adding that the administration was also empowering farmers toward ensuring food sufficiency.

The All Progressives Congress (APC) governorship candidate, Alhaji Ahmad Aliyu, said his government would ensure smooth flow of local government councils’ allocations in order to conduct direct programmes on malnutrition.

Aliyu who was represented by Alhaji Aminu Gidado, described health issues as paramount.

The governorship candidate of National Conscience Party (NCP), Alhaji Abba Sidi Idi, said if elected he would allot 16 percent of Internally Generated Revenue to enhancing nutrition of children especially in the rural areas.

The deputy governorship candidate of Social Democratic Party (SDP), Alhaji Sani Suleiman, said the party views issues of malnutrition as vital to human growth and development and that adequate attention would be accorded to it.

Also, Malam Mahdi Shehu of Zenith Labour Party (ZLP) promised the establishment of a department of nutrition at local government level to tackle malnutrition.

In a remark, Solomon Dogo of the International Society of Media in Public Health (ISMPH) expressed worry over the danger Severe Acute Malnutrition poses to the health of children and its negative effects on the nation’s future. He said ISMPH is partnering with the Advocacy Campaign Group to demand accountability from relevant key actors in addressing SAM in Nigeria.

The District Head of Gagi in Sokoto South Local Government Area, Alhaji Sani Umar Jabi, noted the issue of malnutrition as worrisome and urged necessary action by politicians.

Many hope is that all hands would be on deck towards ensuring that children suffering from severe acute malnutrition get the required treatment and are saved.


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