By Shittu Ahmed Obassa
By virtue of the role nutrition plays in the survival, growth, development and sustenance of children below the age of five, the experts say nutrition has become a developmental issue both for the individuals and the nation at large. To them, no normal child grows into a healthy, strong and happy adult, without the intake of dietary diversifications including exclusive breast feeding for six months ,complementary feeding for 24 months and the consumption of various nutrients such as vitamin ‘A’, iodised salt, and zinc supplementation. All of these, in the opinion of the experts, must be given as a matter of right to a child in the first 1,000 days of its life including the period of his conception.
“Within 1,000 days of a child, from pregnancy to 24 months after delivery, it has been identified as an opportunity to make the child whatever it should be in life,” says the Assistant Director, Micronutrient Deficiency Control / Nutrition at the Federal Ministry of Health, Mr Uruakpa John at a two-day Zonal Review Meeting of State Committees on Food and Nutrition held in Ilorin. He contended that when the nation emphasizes preventive approach, much less fund is being expended on the curative measures including building of health facilities, purchase of drugs and sundry equipment. According to him,, 58 per cent of the basic needs of a child during the process of growth and development will be captured well
enough provided that the Key House Hold Practices are strictly adhered to by the caregiver.
John seems to drive the issue of nutrition among his family members with absolute conviction and passion as all his children hardly fall sick to a critical extent that they would require medical attention to get cured of any ailment because their immunity has been boosted considerably.“It has been realized that the only way to reduce mortality and morbidity among our children and women of child-bearing age is by adhering to nutrition which is the preventive approach,” he added. He urges the revitalization of Nutrition Education at all social strata in the country with all the seriousness it deserves. For, an adage says “Prevention is better and cheaper than cure.”
The Chief of Nutrition in the Country Office of the United Nations Children’s Fund (UNICEF), Dr Davis Bamidele Omotola also contends that no responsible parent would want to see his or her child die from an avoidable cause and that it is always the wish of parents to do all within their power to keep their children alive. But, he believes that the Global Acute Malnutrition in the Sahelian region of Nigeria, stretching from Sokoto to Borno requires international community offering donations to stem the problem that has pervaded the states sharing borders with Niger Republic such as Katsina, Kebbi, Sokoto and Zamfara.
In Kastina State alone , he noted that more than 45, 000 children suffering from severe acute malnutrition received treatment at the designated stabilisation centres, while 141,043 of such children got rehabilitated in 11 states of the federation in 2011. According to him, Nigeria does currently not have the Ministry of Development to bring to the front burner the issues of malnutrition.
“The issue of nutrition is a developmental issue. But, where is the Miinistry of Development?” he asked rhetorically. Omotola said the situation of Severe Acute Malnutrition (SAM) among Nigerian children could be likened to the gory video clips on Somalia, Ethiopia, and India in spite of the enormous resources available in Nigeria.
A medical practitioner from the Department of Community Health, Ahmadu Bello Teaching Hospital, Zaria, Dr Ibrahim Jimoh said, “In Nigeria, of all childhood killer diseases, malnutrition has accounted for more than 50 per cent of under five mortality.”
He believes that support given to the various State Committees on Food and Nutrition (SCFN) by International agencies like UNICEF as well as the state governments will go a long way in reducing the current level of malnutrition to the barest minimum and meeting goal four of the Millennium Development Goals(MDGs) will cease from being a mirage.
Health analysts note that growing healthy is a function of good nutrition and that it means that “We are what we consistently eat.” John contends that mortality and morbidity rate among children under five and women of child-bearing age could be reduced by the preventive approach.
On his part, a senior lecturer in the Department of Biochemistry, Ahmadu Bello University, Dr Abdullahi Balarabe says nutritional activities in the Northern part of Nigeria should be stepped up significantly with all the stakeholders renewing their commitment of to success of the project. ”There should be an effective mechanism in place for sensitization and high level advocacy. Training and re-training of health workers must be made a primary issue. Monitoring, evaluation as well as surveillance should be under taken for the purpose of efficiency and effectiveness of the intervention programmes.” Balarabe expressed his support for every measure that will be taken towards eradicating malnutrition in especially endemic communities.
“The upscaling of nutritional activities is a very good step taken towards eradication of malnutrition in Northern Nigeria considering that the Nortern Nigeria has the highest incidence of malnutrition compared to the Southern part(FCNS,2001).” The university don said further,”There is a profound level of commitment on the side of UNICEF to ensure that malnutrition is eradicated, if not reduced to the barest minimum. This is proven by the support given to the Department of Epidemiology and Community Health, University of Ilorin, the organisers of the zonal meeting of 181 stakeholders from the “C” Field Office of UNICEF headquartered in Kaduna.
In the same vein, Uruakpa notes that the ‘C’ Field Office of UNICEF is taking the right step in the right direction as it is firing on all cylinders, but added that the Nutrition Officers and other members of the Committees on Food and Nutrition at federal, state and local government levels must wake from their slumber. “Our lackadaisical attitude must change if we will be at par with other nations that have nutritional matters topmost on their national agenda.”
In taking a hard look at the procedure of the just concluded zonal meeting, Balarabe expressed dismay at the various reports presented by the states on their nutritional activities in 2011.“I have observed from the presentations made by the various planning officers and
the nutrition officers that there is a gap in the area of monitoring, evaluation and surveillance required to strengthen the efficiency of some nutritional programmes in the North West.
“Level of preparedness by some state representatives at the zonal meeting is questionable, considering the fact that the data being presented are either incomplete or inconclusive, given the timeline they are expected to obtain the relevant data.
“This attitude creates a cog in the wheel of progress and success of nutritional programmes because effective work plan can only be developed if efficient data are made available so that it will make the stakeholders and partners know where they are and where they are going.
Jimoh seems to subscribe to the views of Balarabe on the attitude of the representatives from the states toward a critical issue such as SAM in their respective domains.
He said,”…during the presentation of each state’s report on its activities, it seems there is a lot to be done if the intervention programme like Community based Management of Acute Malnutrition(CMAM) is to make a meaningful impact in our communities. This is because some state governments are not doing enough as reflected in their respective reports. For instance a state government gave the state Committee on Food and Nutrition a meager N 500,000 out of the total of N 2.5 million budgeted for its activities.
“I want those states that are giving enough support to their SCFNs through reasonable budgetary allocations and approvals to put in place an effective monitoring system so that they can get value for their money.” The government s of Niger, Kebbi and Zamfara received varying degrees of commendation by the participants and facilitators alike, after their reports had been presented.
Although Niger is not identified as a CMAM state the data gathered from the state complied with the specified guidelines of the organizers. But, unlike Kebbi and Zamfara that already have budgetary allocations as subheads in the annual budgets of their state governments, Niger attaches other programmes to SCFN’s activities. Anytime the SCFN has an activity to carry out the needed fund is said to be obtained from the appropriate subhead under the Ministry of Health’s budgetary allocation.
The State Nutrition Officer of Niger, Hajiya Amina Isah offers some explanations. “In our state, every one of us is committed and we work as a team. When everybody knows he or she has a role to play you find that we are up and doing. With the little resources available to us, we have been able to achieve a lot.”
Given the giant strides made by Kebbi State, it will attract special fund from the relevant donor agencies as from October, 2012. In 2011, the Kebbi government spent as much as N 130 million on the rehabilitation of 20,000 malnourished children at their stabilization centres and this action has endeared Kebbi to some international agencies now signifying interest in the plight of the children suffering from SAM.
The Nutrition Specialist at the ‘C’ Field Office of UNICEF, Dr (Mrs) Florence Ebun Oni gave the assurance in order to encourage other states to brace to the challenges of malnutrition at a time when as much as 5,000 malnourished children receive treatment in a single state. “It is the child that raises up its two hands that the mother lifts up,” she said.
