The Minister of Health, Osagie Ohanire, launched the Revised National Health Promotion Policy in November 2019, along with its ancillary policy documents that detail the Nigerian government’s approach to improving health outcomes. This approach targets the reduction of adverse health outcomes through behavioural and lifestyle changes. Whilst this is a welcome development, it does little to address the persistent challenge of malnutrition in Nigeria, a significant obstacle to the promotion of preventive health care.
The prevalence of various forms of malnutrition in Nigeria is high. This is measured in its various forms – stunting, wasting and other vitamin and mineral deficiencies. An estimated 361,000 Nigerian children die annually from malnutrition and other related diseases; the country loses about 2,300 children below 5 years of age and 145 women of childbearing age, daily. A key factor contributing to this crisis is poverty. Approximately half of Nigeria’s population, an estimated 105 million Nigerians, live below the poverty line on less than US$2 a day. As a result, many households do not have access to the varied selection of nutritious foods, which ordinarily constitute a balanced diet; they rely mostly on grain and tuber foods that are often lacking in essential nutrients.
The Federal and State governments are implementing several nutrition programmes especially in areas disrupted by insecurity, e.g. North East Nigeria, which currently has the highest regional burden of malnutrition. They collaborate with various civil society and non-governmental organisations to deliver these services effectively. Many of these types of direct intervention programmes are targeted at providing emergency care in situations that demand urgency.
For the vast majority of Nigerians outside of conflict zones, nutrition is directly impacted by the quality of foods they are able to access and consume. Quality, specifically around micronutrients, was the key factor that led the Nigerian government to introduce mandatory regulations necessitating the fortification of a selection of staple foods – wheat flour, semolina flour, maize flour, sugar, and edible oils – in 2002. These laws effectively compel Nigerian processors of these products to become accountable, along with the relevant regulators, for key elements of the nutrition requirements of Nigerians. The law extends that responsibility by mandating that these products meet national micronutrient fortification standards.
For a variety of reasons, regulatory compliance levels have varied with each staple food carrier, generally tending to be significantly below the legal requirements (except for iodised salt, which is widely available). And yet, fortification of staple foods is regarded as a proven method for tackling malnutrition at scale because of their high demand, and the wide reach food processors have through their distribution channels. There are limited market or demand-driven incentives for compliance as well as limited repercussions for non-compliance. According to a research conducted by TechnoServe on the edible oils sector, 60-70% of all the vegetable oils consumed in Nigeria are either smuggled or are domestically produced unbranded oils which tend not to meet the quality and fortification measures stipulated by law.
Malnutrition hinders Nigeria’s development and leads to annual economic losses amounting to US$1.5 billion in GDP. Public-private partnerships are being highlighted by international organizations like the United Nations as a crucial aspect of development and a pathway to achieving the Sustainable Development Goals. Development partners have recognised the need to work in collaboration with governments of developing nations towards augmenting the modest success of regulatory efforts. TechnoServe, a globally active international development organisation, manages the Strengthening African Processors of Fortified Food (SAPFF) programme, sponsored by the Bill & Melinda Gates Foundation, in Nigeria, Kenya and Tanzania. Working with the mandate of food industry leaders in Nigeria, TechnoServe has developed and implemented the Micronutrient Fortification Index (MFI), an industry-owned and led tool that supports best practice in processing and self-testing for compliance with national fortification standards. The MFI was piloted successfully in 2019. Since then, the tool has been adopted by over 70% of the flour market with participation from Honeywell Flour Mills, OLAM, and Flour Mills of Nigeria, as well as PZ Wilmar in the edible oils sector, to mention a few.
The MFI tool supports food processors’ corporate benchmarks and responsibility to provide high quality and nutrient fortified products. The MFI has recently been adapted to target the participation of small and medium sized enterprises, especially within the fragmented edible oils sector, which is dominated by many smaller ventures across the country. Speaking recently at a themed workshop for the edible oils sector, an executive of PZ Wilmar Limited noted that the tool enables a 360-degree review of key company systems – personnel, processes, partnerships, procurement and governance – helping to identify areas of improvement and providing a third-party testing mechanism, which validates the initial self-assessment.
It is expected that with wider and consistent MFI participation, food processing companies will aspire to higher index placement, recognizing their key role in the strategic development and growth of their markets, as well as their duty to serve the wellbeing of the community. The benefits of this would be immense; for consumers, it would mean increased access to a variety of nutritious foods. For the government, it would potentially enable more effective deployment of monitoring & enforcement resources and improvement in health indicators associated with hidden hunger. For food processors it should lead to a significantly lower risk of regulatory failure, increased overall efficiency in making quality food products accessible to increasingly knowledgeable consumers, and making a worthy contribution to the elimination of malnutrition in Nigeria.
Umunna is regional director for West Africa, Technoserve.