Nigeria refuses to bring out money to treat malnourished children
Chikezie Omeje, September 01, 2016
It has been estimated that over 300 thousand children, who are under the age of five, will die of malnutrition this year alone in Nigeria if they are not given the treatment they need.
Despite this knowledge, Federal Government budgeted N1, 099,404 only on nutrition this year and additional N729, 136 on infant and young child feeding.
To prevent these malnourished children from dying, they need to be treated or given highly nutritious Ready to Use Therapeutic Food (RUTF).
According to the United Nations Children’s Fund (UNICEF), it costs just about $160 for each child to be treated. That is $76 for RUTF and $84 for other expenses.
UNICEF estimates that 1.6 million under-five children suffer severe acute malnutrition in Nigeria.
According to the Head of Nutrition in the Federal Ministry of Health, Dr. Chris Isokpunwu, each day, Nigeria loses about 2,300 under-five children and malnutrition accounts for a half of these deaths. This makes Nigeria the second largest contributor of under-five mortality in the world after India.
Meanwhile, the overall budget on health is N250 billion, representing only four per cent of the total budget and falling short of the Abuja Declaration where African leaders agreed in the year 2000 to commit at least 15% of their national budgets to health.
A breakdown of the health budget shows that 89% is recurrent while only 11% is for capital expenditure.
As much as N3.8 billion will be spent on Aso Rock Clinic. This hospital caters for the top government officials, ranging from the president to the ministers, as well as other top government functionaries and their family members.
As Nigeria depends mainly on donors to rehabilitate its malnourished children, the Federal Government budgeted over N220 million for Hajj vaccines. This money will be spent on vaccines for those going for a religious pilgrimage in Saudi Arabia.
Concerns have also been raised on why the budget for National Primary Health Care Development Agency (NPHCDA) will be diverted to build N10.5 million dialysis centre at the General Hospital, Agenebode, N35 Million for installation of medical, dental, and ophthalmological equipment at Ugheli General Hospital, N14 million procurement of radiology equipment (x-rays) and N250 million for the completion of 250 bed hospital in Okene, Kogi State.
Despite Federal Government’s inability to fund nutrition, over one million children with severe acute malnutrition have been treated in the country through donor funding within the past six years.
UNICEF said over 200 thousand child deaths have been averted since Community-based Management of Acute Malnutrition (CMAM) began in Northern Nigeria. CMAN which began in Gombe State in 2009 has been introduced in 10 other states in the North West and North East where malnutrition is very high. The states are Adamawa, Bauchi, Borno, Jigawa, Kano,Katsina, Kebbi, Sokoto, Yobe, and Zamfara.
Without government’s intervention, CMAN cannot reach all the children in need because of limited donor funding. According to UNICEF, two out of every three children still do not receive the treatment they need in the eleven states where CMAN operates.
UNICEF Country Representative, Jean Gough has called for a scale up of CMAN because “it is a proven high-impact intervention that is saving lives and helping Nigerian children reach their full potential through a good start in life.”
She added that “We need greater investment in Nigeria’s future by investing in good nutrition”.
On September 8, 2015, Nigeria adopted the National Strategic Plan of Action on Nutrition (NSPAN 2014 - 2019). The policy is expected to reduce stunting by 20%, wasting by 15% and increase exclusive breastfeeding by 50% in 2019.
“How can a policy be developed for 2014 to 2019, it is 2016 and there is no funding for it,” Dr.Philippa Momah, the Coordinator of Civil Society for Scaling-up Nutrition in Nigeria (CS-SUNN) asked.
At a Town Hall Meeting on Nutrition in Abuja, Momah said, “We find it very disheartening that duty bearers and policy makers finalised the 2016 annual budget for the federation and at state levels within the new zero-based budgeting framework, yet nutrition was not seen as priority issue in a country where over 11 million under-five children are stunted. “
Nigeria signed up to the Scaling-up Nutrition (SUN) movement in 2011 and signed the global Nutrition for Growth Compact in 2013. In doing so, Nigeria committed to tackling its high rates of child malnutrition.
These data are based on the National Demographic and Health Survey (NDHS 2008 and 2013) and the National Nutrition Health Survey (NNHS 2015).
Stunting is the commonest indicator of undernutrition. Others are wasting and underweight. Over 11 million children are stunted in the country and Nigeria also accounts for one-tenth of the global burden of severe acute under-five malnutrition. About 32% of under-five children in Nigeria are stunted with northern Nigeria bearing the largest burden. More than a half of the children in the North West are stunted.
Nigeria has not made any significant reduction of childhood malnutrition since 2008. Rather, it has increased in the North West. Only the South East and South West have recorded a steady decrease in stunting while it has increased slightly in the North East, North Central, and South-South between 2013 and 2015.
“We have become deaf to these numbers,” UNICEF’s Head of Nutrition in Nigeria, Dr. Arjan de Wagt said. “We have accepted these numbers. We don’t find it strange. Unless it is your child, then it is no more a number”.
Stunting occurs when children are too short for their age.
“Stunting is a result of chronic hunger,” Momah said.
Malnutrition is a social injustice. Experts say stunted children have poor physical growth and brain development which prevent them from reaching their full potential in life.
Quoting Lancet Journal of January 2008, Isokpunwu said the 1000 days (Window of Opportunity) from conception to two years is the most critical stage in a child’s mental development, noting that any damage to the brain during this window of opportunity as a result of malnutrition is irreversible.
Isokpunwu identified poverty, failure of governance, gender inequality as the basic causes of malnutrition while inadequate food intake, lack of dietary diversification and infectious diseases are the immediate causes of malnutrition.
He added that food insecurity, inadequate child and maternal care, poor access to healthcare and unhealthy environment have contributed to the level of malnutrition-induced deaths in the country.