NIGERIA is one of six countries that account for half of all child
deaths worldwide, with one million children under-five dying every year
and malnutrition contributes to nearly half of these deaths.
A new document jointly developed by the United Nation Children Fund
(UNICEF) and the Federal Ministry of Health (FMoH) titled “Malnutrition:
Nigeria’s Silent Crisis,” noted: “Malnutrition is called a silent
crisis because it can be happening around us, and we do not always know
it is there. Although we have all seen photos of malnourished children
who look sick and very thin, they only represent a small portion of
children who are suffering from malnutrition.
“There are many children who do not look that way and yet they are
also malnourished because they are not receiving the nutrients they need
to grow and develop to their full potential. For these children,
malnutrition over a period of time (especially in the 1000 day window of
opportunity between conception and a child’s second birthday), silently
causes poor brain and body development, weakens the immune system, and
worsens the impact of common illnesses such as diarrhoea. Malnutrition
contributes to the deaths of about a half-million Nigerian children each
year.”
Head, Nutrition, FMoH, Dr. Chris. Osa Isokpunwu, told journalist at a
recent training workshop on nutrition organized by UNICEF, in Kano,
that: “Every single day, Nigeria loses about 2,300 under-five year olds
and 145 women of childbearing age. This makes the country the second
largest contributor to the under–five and maternal mortality rate in the
world.”
Isopkunwu said malnutrition is a pathological condition brought about
by inadequacy of one or more of the nutrients essential for survival,
growth, development, reproduction and capacity to learn and function in
the society.
According to a Fact Sheet on nutrition by the World Health
Organisation (WHO) and UNICEF, child nutrition in Nigeria has improved
in recent years, but around 11 million children under the age of five
are stunted and there are regional and social disparities, with
particularly high levels of stunting in the north-east and north-west
and among the poorest quintile.
According to the 2013 Nigeria Demographic and Health Survey (NDHS),
conflict in the north-east has further aggravated the nutrition
situation. Fields have been destroyed, farmers are afraid to return to
their land, and hundreds of thousands of people have fled.
Stunting is what happens to a child’s brain and body when they d not
get the right kind of food or nutrients in their first 1,000 days of
life. It is irreversible.
According to the WHO and UNICEF document, Nigeria has made progress
in micronutrient deficiency control, but about half the children aged
six to 59 months do not receive vitamin A supplementation. Vitamin A
deficiency can mean a child will be growing up with lower immunity,
which can trigger frequent health problems and poor growth.
WHO and UNICEF recommend that babies should be exclusively breastfed
during the first six months of life. In Nigeria, the rate of exclusive
breastfeeding is just 15 per cent.
President, Nutrition Society of Nigeria (NSN), Prof Ngozi Nnam,
malnutrition is a condition that occurs when people consistently do not
consume or absorb the right amounts and types of food and essential
nutrients. Globally, it contributes to nearly half of all child deaths —
that is more than three million children each year.
Nnam said the main indicator of childhood malnutrition is stunting —
when children are too short for their age. “Stunted children have poor
physical growth and brain development, preventing them from thriving and
living up to their full potential. With over 11 million stunted
children, Nigeria is facing a crisis of malnutrition and ranks second
behind India among all countries with the highest number of stunted
children,” she said.
Is there a window of time to prevent malnutrition? Isokpunwu said:
“Yes! The 1,000 day period- from the start of a woman’s pregnancy until
her child’s second birthday- represents a critical window of
opportunity. Adequate nutrition during this period can avert
malnutrition, ensuring that children have the best possible opportunity
to grow, learn, and rise out of poverty. When nutrition is not optimized
during the 1,000 day window, the effects are often irreversible.”
What are the benefits of addressing malnutrition? The nutritionist
said adequate nutrition during the 1,000 day window produces a lifetime
of benefits for individuals, families, and nations. He said
well-nourished children will have improved brain and physical
development; they will develop good motor skills, have stronger immune
systems to fight off infection and disease, and have sharper mental
abilities.
Isokpunwu said healthier children will be better able to focus and
learn, and will thus have improved school performance and complete more
years in school.
He further explained: “Improvements in school performance and
completion will lead to increased job opportunities and personal income,
adding at least 10 percent to lifetime earnings and helping families
step out of the cycle of poverty.
“Well-nourished, well-educated children will grow into a more
productive labor force as adults. Improvements in nutrition could lead
to a boost in Gross Domestic Product (GDP) growth by as much as 11
percent annually.
Also, investments in nutrition produce returns up to 25 times greater
than the initial investment—for every N100, 000 spent, we generate N2.5
million in economic returns.
Which strategies work to improve malnutrition? The nutritionist said
the following four proven strategies can protect mothers and children
from malnutrition:
• Mothers should put babies to the breast in the first half-hour
after birth and breastfeed them exclusively for the first six months
without any other foods or liquids — not even one drop of water!
• After the first six months of life, mothers should start giving
their children sufficient quantities of a variety of healthy foods such
as fruits, vege- tables, eggs, and meat, along with continued
breastfeeding for up to 2 years or beyond.
• Mothers and children should be ensured access to essential vitamins, minerals, and nutrients.
Meanwhile, The Lancet, one of the world’s most highly respected
medical journals, in January 2008, demonstrated the availability of 13
proven nutrition interventions that could address the problems of
malnutrition and save millions of lives.
The set of interventions focused on the “window of opportunity” from
minus nine to 24 months (that is from pregnancy to two years old) for
high impact in reducing death and disease and avoiding irreversible
harm.
These include: appropriate policies and guidelines in place infant
and young child feeding; micronutrient deficiency control; and community
management of acute malnutrition.
Nnam said: “While we are grappling with the challenge of under
nutrition, the incidence of obesity and related manifestations of
over-nutrition are beginning to emerge at relatively significant
levels.”
The NSN President noted that nutrition is the bedrock of development
and that for an individual to develop well that individual needs to be
in the state of good nutritional status.
The nutritionist further explained: “And it’s only people that eat
well, and combine their food well, and they are in the state of good
nutritional status can reach their desire potentials in life, and will
be able to make significant contribution to the development of the
nation.
“Poverty rate is not the major cause of malnutrition in Nigeria
because, most of these people we say are “poor”, around their
environments, they have fruits that could really make them be in good
nutritional status. The problem is not poverty, the problem is that they
lack nutrition knowledge.”
She added: “Also let’s take fats and oil for instance: adding
vegetable oil or fortified margarine improves the taste of our meals,
gives us the feeling of satisfaction. I must also encourage Nigerians to
ensure they consume foods that are fortified with essential
micronutrients such as fortified margarine, iodized salt, fortified
flours and others.
“It is important we clarify the dynamics of food intake and healthy
weights. When we eat properly in ways that meet our daily energy and
nutrient needs we maintain healthy weights? This means our food intake
matches our daily nutrient needs considering our physiological
requirements and physical activity levels.”
What is currently being done at national and state levels to address
malnutrition? Isokpunwu said: “Nigeria is taking important steps to
address nutrition. For one, we have joined the SUN movement, which
stands for Scaling Up Nutrition. This is an exciting new global effort
aimed at bringing country and global leaders together to fight against
malnutrition. Nigeria is one of the newest countries to become a SUN
member, and we are joining more than 45 countries and over 100
international organizations and donors to rally around a common agenda
and solutions, with the goal of mobilizing broad commitment and
resources to advance our nutrition agenda.”
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