Securing Greater Funding for Nutrition, Maternal Newborn and Child Healthcare Interventions in Nigeria

Amidst the worsening economic, social and healthcare challenges in the country, children are increasingly being affected and their basic needs for survival are no longer guaranteed. Reports in 2020 showed at least one in three children did not grow well because of malnutrition, and at least two in three are not fed the minimum diet they need to grow, develop and learn to their full potential, writes Onyebuchi Ezigbo

According to the findings of the United Nations, Nigeria has one of the highest maternal and child deaths globally. About 20 per cent of global maternal deaths occur in Nigeria with more of these deaths occurring in rural areas. The report of National Demographic Health Survey (NDHS 2018) quoted by UNICEF said maternal mortality in the country is 556 per 100,000.

Most of these deaths occur either during pregnancy, at childbirth or within two months postpartum. The report also said that there are approximately 40 million children under five years of age in Nigeria, of which one in eight do not survive to their fifth birthday: leading to a mortality rate of 132 per 1000 live births.

Despite the economic growth Nigeria recorded over the last decade, poverty remains persistent with child malnutrition becoming the order of the day in most parts of the country. The situation has also come with widespread inequity and regional disparities which has been further compounded by the COVID-19 pandemic.

The UN said an estimated 40 per cent of Nigerians ( about 83 million people) live below the poverty line (US$1.05 per day). In the same vein, the report showed that the overall poverty incidence in Nigeria stood at 64 per cent in 2016, with almost two-thirds of that total found in rural areas with the north-east of the country exhibiting the highest level (74 per cent).

The impact of this startling economic indices on health and wellbeing of children is enormous. The same report has shown that malnutrition is the underlying cause of many childhood deaths in Nigeria. According to the UN agency, “By 2026, with no change in nutrition, more than half the population of children will die from stunting alone. Malnourished children are more likely to suffer and die from common childhood illnesses such as diarrhea and pneumonia and may be more likely to develop chronic diseases such as heart disease in adulthood.”

Experts say Anemia during pregnancy is associated with maternal and neonatal deaths and is a major cause of low birth weight. They also said babies with low birth weight are five times more likely to die within the first month of life than normal birth weight babies.

Impact on Education

By 2026, it is being projected that if there is no change in stunting, children will lose 33 million equivalent school years of learning from stunting alone.

Regarding it’s impact on economic development malnutrition weakens the affected person and on whole tends to impart negatively on his or her ability to develop and become useful citizen. In order to address the situation in the country, the federal government is collaborating with the UNICEF and state governments to find ways of scaling up funding to promote nutritional health of children, especially in this period of worsening economic difficulties.

MNCHW Week

In this regard, a one-day high level advocacy and accountability meeting was held recently for state commissioners of Health, Budget and Economic Planning and Executive Secretaries of relevant agencies to mark the Maternal, Nutrition, Newborn and Child Health Week (MNCHW). A key objective of the event was to secure the commitment and financial support of commissioners for use in promoting nutritional health of children in the country.

The MNCHW in Nigeria was a week-long campaign introduced at the 53rd Assembly of the National Council for Health meeting in 2010 as a priority and strategic action to accelerate the reduction of child mortality and improvement of maternal health. Vitamin A supplementation is a main indicator to determine performance of the MNCHW. Organisers said MNCHW bridges the gaps in uptake of routine health and nutrition services and presents a good opportunity to drive up coverage of services. It also a huge role in overall improvement of nutrition and health indices if done properly and consistently.

The campaign has been implemented for about 10 years now, but many states still miss at least one or both rounds every year leaving many children and women unprotected with life-saving health and nutrition interventions. There is also need to align MNCHW dates to national dates ensuring six-month interval between rounds of the campaign annually.

As part of efforts to achieve the goal, UNICEF is partnering with the federal government to sensitise commissioners for Health and Economic Planning and Executive Secretaries of State Primary Health Care Boards on the need for enhanced quality and increased coverage of nutritional health interventions in all the states in Nigeria. To this end, the meeting served as an opportunity to formally introduce and present the optimised MNCHW strategy to the commissioners of Health and Economic Planning and Executive Secretaries.

Federal government also said that it will work with UNICEF to ensure that 31,299,942 children between six to 59 months are provided with vitamin A supplement within the next one year. While declaring the event open, Permanent Secretary of the Ministry of Budget and National Planning, Mrs. Olusola Idowu said the advocacy meeting was convened primarily to seek ways enhancing budgetary allocations to efforts at improving nutrition and healthcare of children as well to tackle problems of high maternal mortality rate in the country. She expressed the hope that resolutions reached at the meeting will go a long towards achieving quality and increased coverage of nutrition and maternal heath in the country.

High Level Commitment

Speaking at the meeting, the UNICEF’s Deputy Representative, Rushnan Murtaza who was represented by Chief of Nutrition, Nenat Hedjeboj said children’s lives are more threatened today than before. She federal government and UNICEF have demonstrated a high level of commitment over the years in tackling the problem. However she said that “there is a need to scale quality nutrition interventions, sustain, increased allocation as well as timely release of the funds, annually”.

According to her, increase of investment and commitment for MNCHW and Nutrition interventions is needed to contribute to the prevention and treatment of malnutrition among vulnerable women and children under five years.

Hedjeboj said: “This year, we are committed to reaching 31,299,942 children six to 59 months with Vitamin A supplementation”. The UNICEF scribe who expressed worry at the growing number of children witnessing stunted growth said close to 17 million Nigerian children are undernourished (stunted and or wasted), thus giving Nigeria the highest-burden of stunting in Africa and the second highest in the world.

Hedjeboj added that Vitamin A supplementation reduces all causes of child mortality by up to 24 percent; reduces deaths from diarrhea by 12 percent and reduces the incidence of measles by 50 percent. She added that Vitamin A is also an enabler for the reduction of stunting. Nigeria’s Vitamin A supplementation status is unacceptably low (45 per cent).

“Unfortunately, Nigeria is not on track to meet Sustainable Development Goal (SDG) Targets on undernutrition. And since child nutrition is core to the human capital development of Nigeria, this presents an urgent crisis we need to address.”

She said there is an obvious reduction in donor funding, adding that MNCHW operations are being threatened. In addition, Hedjeboj said that COVID-19 pandemic has worsened the situation. The UNICEF representative further suggested that the best way to respond to reduced donor funding: is for government to take financial ownership of the Intervention programme.

Poor Health, Nutrition Indices

On her part, the Executive Director of Nutrition International, Titiola Abolade said Nigeria has poor health and nutrition indices. She explained that the National Demographic and Health Survey 2018 puts Nigeria’s Maternal mortality ratio at 512 per every 100,000 live births and under five mortality rate at 132 per every 1,000 live births.

According Abolade studies show that 37 per cent of children under five are stunted, while 22 percent are underweight and seven per cent wasted. She further said that almost 58 percent of women of reproductive age are anaemic. She said: “Malnutrition especially in children under the age of five and pregnant women has many adverse consequences for child survival and long-term well-being. Poverty is widespread in Nigeria which has been further increased with the COVID-19 pandemic and the attendant effects of restrictions on livelihoods, access to healthcare and food in households”.

Abolade said government plays critical and vital role at all levels which is vital towards reducing the burden of malnutrition and health issues in Nigeria through quality and increased coverage of maternal and child health and nutrition services. She expressed the hope that the advocacy campaign will secure the commitments of states to prioritise, increase allocation and ensure timely release funds for Nutrition and MNCHW as well as align dates for the conduct of the MNCHW to national dates.