Combating Severe Acute Malnutrition through Child Nutrition Fund Intervention

By Suzan Edeh

Nasiru is 5 years old, but he looks like a child of 2 years because of a condition known as Severe Acute Malnutrition Compared to other normal children, he has a rapid weight loss which means he no longer has a diet that is diverse or substantial enough to meet his minimal energy requirements.

Meeting with Jamila Mohammed, his 26 year old mother at the Yelwa Domiciliary Primary Health Care Center in the State metropolis said it all. She was seeking a solution to Nasiru’s health condition. Jamila attends regular clinics every Wednesday and Thursday where she receives advice on home care and treatment, including packets of ready-to-use therapeutic food.

According to Jamila, Baby Nasiru is her fourth child, but coping with his condition has affected the family’s finances as a large chunk of the family income is channeled for his treatment.She said that her husband, Mallam Kobi was a peasant farmer and does not earn much while she is a full time housewife, who engages in small scale business.

“I noticed something was wrong in the growth of Nasiru.He falls sick often, always looking weak and cannot play as other children do.When I brought him to this health facility, he was diagnosed of having Malnutrition.We have commenced treatment and he is gradually improving,” She said.

20 year old Habiba Aliyu also shared her experience she has been visiting the health facility with her two year old child who is also recuperating from Malnutrition along with other women who come for their regular clinics, Habiba looked happy as she said that her child, Aisha is recovering fast courtesy of the packets of ready-to-use therapeutic food that she has been taking.

“I started coming to this health facility five months ago and I can gladly tell you that Aisha condition has improved greatly because she no longer falls sick and she is gradually gaining weight as a result of regular consumption of Ready-to-use therapeutic food she is consume”She said.

Just like Baby Nasiru and Aisha, many children in the country, particularly in the Northeast in Nigeria suffer from the problem Severe Acute Malnutrition(SAM) Acute malnutrition occurs when a child experiences a dramatic decrease in energy and nutrients over a short period of time. SAM is caused by a significant imbalance between nutrition intake and individual needs.

A Malnutrition crisis

According to UNICEF, Children with Severe Acute Malnutrition are nine times more likely to die than well-nourished children. It stated that Children with malnutrition have weakened immune systems and are at higher risk of dying from common childhood diseases. Those that survive could face lifelong growth and development challenges. They risk facing a future marked by illness, poor school results, and poverty with ripple effects across generations.

According to health experts, It is estimated that nearly 4.4 million children aged 0 – 59 months are suffering and will likely continue suffering from acute malnutrition in the period of May 2023 – April 2024 in northwest and northeast Nigeria. This includes 1.04 million cases of Severe Acute Malnutrition (SAM) and 3.37 million cases of Moderate Acute Malnutrition (MAM). In addition, 585,000 pregnant or lactating women are acutely malnourished and will likely continue to be malnourished and are in need of treatment.

Bauchi state in the Northeast for instance, recorded four deaths of children under 5 years in the first quarter of 2024 due to the problem of Severe Acute Malnutrition according to the State Nutrition Officer, Abubakar Saleh while giving an overview on the nutrition situation in Bauchi State in 2-day State Committee on Food and Nutrition meeting held at CHOB Guest House, Jos, Plateau State.

He stated that a total of 4,384 children with severe acute malnutrition (SAM) have been admitted for treatment across 14 integrated management of acute malnutrition (IMAM) centers in the state.

UNICEF believes that there is a connection between brain development of a child and physical growth which starts at birth.It stated that maternal, child nutrition and health can determine the child’s ability to grow, and poor nutrition in the first 1,000 days may cause irreversible damage to a child’s growing brain and body.

Hence, the first two years of a child life are crucial to prevent malnutrition in infancy and early childhood Exclusive breastfeeding in the first six months and access affordable and nutritional diets, appropriate feeding, care and stimulation, basic services and a hygienic environment are key to combating malnutrition.

A more effective approach to addressing malnutrition according to UNICEF is prevention rather than the curative approach as it is the surest way of tackling the problem rather than treatment.

According to UNICEF, continuous education on a subject matter can cause behavioral change in people and even government. Hence, the power of media as an avenue in disseminating information to the public cannot be underestimated.

To lead the campaign on why state government must invest in nutrition fund to combat Malnutrition, UNICEF organized a two day Media Dialogue on age-appropriate complementary feeding, organized by UNICEF Bauchi Field Office for Journalists working in Adamawa, Bauchi, Gombe, Taraba and Plateau State Journalists gathered in Gombe state to brainstorm on the way forward to address Malnutrition in children and pregnant women.

The UNICEF Nutrition Specialist, Philomena Irene set the stage rolling by presenting a paper titled “Improving young children’s diet during complementary feeding of between 6 to 23 months”

She said that a normal child’s brain development is 25 percent at birth, but in a malnourished child, brain development is only 5 percent. For a child of 2 years, the brain develops between 50- 75 percent while that of a malnourished child is at 25 percent.For a child of 5 years, the brain development is at 90 percent while that of a malnourished child is at only 40 percent.

According to her, the prevalence of stunting sets in as early as 0-23 months, adding that the case becomes late between 24-59 months.She said that wasting, stunting and micronutrients deficiency threatens the survival, growth and development of young children as well as the societies and economy of the state.

She said that one of the cause of Severe Acute Malnutrition is Child poverty which is children inability to access and consume a minimum of diverse diet in early childhood,

“To meet the minimum dietary diversity for healthy growth and development, children need to consume foods from at least five out of the eighth recommended food groups which include Breast milk, grains, root, Tubers, plantain, beans, nuts and seeds.Others include milk, infant formula, yogurt, cheese, meat, fish, organ meat, eggs, fruits and vegetables” She said

Giving an overview of the nutrition situation of children 6 to 23 months in the BFO states of Bauchi, Adamawa, Taraba, Gombe, Plateau and Taraba.She said that Adamawa state has a population of 4.9 million people and out of the number, only 20,824 children between 6-23 months meet the minimum requirement of acceptable diet.

“Bauchi state has a population of 8.3 million people, out of the number, only 11,965 children meets the minimum requirement of acceptable diet. Gombe state has a population of 3.9 million people, out of which only 11, 982 children meets the minimum requirement of acceptable diet. Plateau has a population of 4.7 people out of which 16,480 children meets the minimum requirement of acceptable diet while Taraba has a population of 3.6 million people, out of which only 31,987 children
the minimum requirement of acceptable diet” she said.

Combating Malnutrition through Child Nutrition Fund

On the 22nd of April 2024, the Bauchi State Governor, Senator Bala Mohammed pledged to pay it’s Counterpart funding for child nutrition aimed at improving nutritional status of children across the State.

Governor Bala Mohammed made the pledge when UNICEF Bauchi Field Office delegation, alongside UNICEF Child Health Ambassador Ms.Kate Henshaw paid him a courtesy visit at the Government House Bauchi.

The governor assured that his administration will continue to support such activities across the state, especially for the welfare and wellbeing of children and women as well as effective and efficient maternal healthcare delivery services in the State.

During the courtesy visit, the Chief of UNICEF Bauchi Field Office, Tushar Rane stated that the collaboration efforts between the European Union and the United Nations Children Funds (EU-UNICEF) was to support the Bauchi state government with funds that will enable it to implement the Maternal, Child Health, Education, and Nutrition (MNCHN) Project in the state for improved family health and foster children’s educational growth.

With this commitment from the Bauchi state government, UNICEF has appealed to other state governments who are yet to key into the Child Nutrition Fund to do so as a new financing mechanism designed to strengthen global and national governance for the early prevention, detection and treatment of Severe Acute Malnutrition.

The Child Nutrition Fund works to support government-led efforts in 23 countries with the highest number of children wasting. The fund also supports the scale-up of five essential actions for the early treatment of child wasting which includes: Weight gain monitoring, nutrition counseling, micronutrient, supplements, deworming, and malaria control for women, particularly during pregnancy.

It also gives support for exclusive and continued breastfeeding in the first two years of life as well as adequate complementary foods, with micronutrient supplements.

The CNF supports food supplements for young children under 5 and for women, particularly those who are pregnant and breastfeeding as well as early detection of child wasting and with ready-to-use therapeutic foods (RUTF).

The UNICEF Nutrition Specialist, Philomena Irene speaking on the importance of the fund stated
UNICEF’s ambition is committed to reaching at least 350 million children and women every year by 2030, adding that to achieve this, the Child Nutrition Fund estimates a financing need of US$3.4 billion per year.

On how CNF works, She said that, “We use three windows to increase the allocation of global and domestic resources to programmes and supplies through Program Window, Match Window and supplier window.”

“The Program Window: Identifies investment needs; Develops robust investment propositions; Track global allocations against needs; Monitors the effectiveness of allocations and Identifies key investment gaps and advocates for a reprioritization of partner contributions.”

“Under the CNF, over $25 million has been allocated to Kenya, Malawi, Pakistan and the Philippines while High-value partnerships have been established, including a $30 million project with Gavi, in Ethiopia” she said.

According to her, the major requirement for any state government to access the CNF is for the Government to provide the minimum fund of 100 Million Naira covering any nutrition programme in the fund. She said that the government can pay for multiple nutrition programmes as it is not a one-time payment.

Presently states like Adamawa, Gombe, Plateau and Bauchi State
have keyed into the CNF interventions. According to UNICEF, investing in key nutrition interventions would yield between 4 to 35 dollars in economic returns.

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