Increased attention required to combat child malnutrition

Nigeria has improved in its child nutrition indices, but BusinessDay findings reveal a lot more still needs to be done particularly as it pertains to children under the age of five.

According to the United Nations Children Fund (UNICEF), malnutrition is the underlying cause of morbidity and mortality of a large proportion of children under-5 in Nigeria. It accounts for more than 50 per cent of deaths of children in this age bracket.

UNICEF has also reported that there are over 2.5 million children suffering from acute malnutrition in Nigeria.

There however seems to be reduction in child malnutrition, a development which has been described as good news in the National nutrition and health survey report for 2015 which nonetheless remarks that the battle is far from won.

Oluremi Keshiro, a professor of Human Nutrition while attributing poor nutrition of children to the rising cost of food, a report which has been previously covered by BusinessDay, noted this affects what parents will be able to give their children to eat.

Keshiro also described the cooking methods adopted by many Nigerians as a factor which contributes to poor nutrition. According to her, “some of the cooking methods handed down to us by our parents such as parboiling of vegetables and even adding potash which destroy a high amount of nutrients, especially ascorbic acid which is very important for children.”

Keshiro condemns taboos in some parts of the country where children are discouraged from eating eggs, a phenomenon she describes as “selfish taboo”. According to her “as small as an egg is, it contains all the nutrients that our body needs (and can easily absorb).” She also condemned the taboo preventing pregnant women from eating snails, one predicated on the uninformed assumption that children from such women “will salivate excessively.”

“We have a lot of taboos that surround our foods, particularly cooking foods that are good for our children. These taboos abound across different ethnic groups and place embargo on foods that are highly nutritious for children. This must stop.” She added.

A 2015 appraisal report by the Nigerian Bureau of Statistics (NBS), which shows that although Nigeria is still one of the five large low-middle income countries where more than half of children under age 5 are either stunted or wasted, however also noted that the trends in meeting the global World Health Assembly Resolution (WHAR) targets are positive and Nigeria is obtaining “some progress”.

The survey results as the NBS report asserts seem consistent with the Global Nutrition Report 2015 findings, as the overall Global Acute Malnutrition (GAM), and Severe Acute Malnutrition (SAM) prevalence for under-five children is reported at 7.2 and 1.8 percent respectively, whereas the same indicators were reported at 8.7 and 2.2 percent in 2014. In addition, none of the states surveyed in 2015 reported GAM and SAM above critical WHO cut off points.

Stunting is still the largest burden, thus indicating a long term nutritional problem in the country, and the indicator is quite stable (33 percent), confirming an overall prevalence positively below Sub-Saharan regional level (37 percent). In terms of overweight, national prevalence has not changed since last year (1.6 percent) and the prevalence is below the 7 percent threshold in all the 37 domains. The prevalence of under 5 children who are not stunted or wasted is 63 percent. These results are particularly encouraging, also considering that the 2014 survey was conducted between February and May – hence before the expected hunger gap – while the 2015 survey has been conducted during the lean season – July and September – which corresponds with the rainy season and greatest hunger needs, especially in the Northern area of the country.

The findings to some extent corroborate the Global Hunger Index (GHI) earlier this year, which noted that despite the progress made in Nigeria and other countries, the level of hunger in the world remains unacceptably high, with 795 million people still going hungry, more than one in four children affected by stunting, and 9 percent of children affected by wasting.

Data for Nigeria showed the highest percentage of nutrition concerns was stunted growth in children under the age of 5. From 1998 – 1992, there was prevalence of stunting in 50.5% of children under the age of 5, 43.8% from 1993 – 1997, 39.7% from 1998 – 2002, 42.9%; 2003 – 2007, and 36.4% from 2010 – 2014. In addition, under-five mortality rate has also been on a decline from 21.3% in 1990 to 11.7% in 2013.

The main challenge as observed from the data published is stunted growth in children under the age of 5. New analysis on the part of Global Nutrition report shows that in Nigeria and a few other countries, the percentage of children under age 5 who are not stunted or wasted ranges between 43 and 48 percent. Children growing up healthy are in a minority.

Oladejo Adepoju, a doctor of human nutrition at the University of Ibadan explains there are windows of opportunities to prevent stunting in children, these according to him “start from day zero of life, which means it starts from pregnancy. The woman must be in good nutritional status. She should have adequate diets containing all the essential nutrients for growth and development in the right proportion.”

The submissions from nutritionists interviewed by BusinessDay indicate healthy growth and development of children starts from maternal feeding during gestation, as children born unhealthy are already at a disadvantage and at risk of growth anomalies.  As children grow, supplementary feeding should contain essential minerals and vitamins.

 

 CALEB OJEWALE