Malnutrition: Stakeholders’ demand for emergency action in Benue

Even though Benue state is said to be the Food Basket of the Nation, a number of children are suffering from malnutrition as JOHN SHIAONDO reports.

Benue State though with the nomenclature of ‘Food Basket of the Nation’ is said to have high malnutrition rate of especially children between ages 0-5 years being stunted.

Available data indicate that in Benue, almost one out of two (43%) children are denied the vital benefits of exclusive breastfeeding within the first six months of life, a situation that has affected the nutritional requirement of the children adversely. Reports also indicate that children who are between 6- 23 months are exposed to poor and inappropriate diet.

Malnutrition, according to stakeholders working for scaling up nutrition, has remained a public health concern in Nigeria and is a significant cause of death, with stunting, in particular, linked to adverse outcomes such as poor brain and cognitive development, a loss of 2-3 years of schooling, poor school performance and diminished productivity in adulthood.

Reports available from the United Nations International Children Emergency Fund, (UNICEF) says that 100 children die every hour in Nigeria with malnutrition as underlying factor. This means 2,400 deaths a day and 876,000 deaths a year. It also means that no fewer than 801,600 children died between January 1 and November 30, 2023.

This makes malnutrition a silent killer more than any disease, insurgency and warfare.

It is unfortunate that Benue which is regarded as the ‘Food Basket of Nigeria’ is rated among states with high cases of malnutrition in the country.

The Nigeria Demographic and Health Survey (NDHS 2021) revealed that Benue alone has a stunting rate of 21 percent (representing 283,727 children under five years of age), underweight prevalence of 13.6 percent  and almost 1 out of 2 (43 percent) children are denied the vital benefits of exclusive breastfeeding within the first six months of life.

In addition, the Multiple Indicator Cluster Survey (MICS) 2021 puts minimum acceptable diet rate at 19%, early initiation at 47.4% and exclusive breastfeeding rate at 56.8%.

The government, in collaboration with key stakeholders in order to tackle the menace of malnutrition, had developed the National Strategic Plan of Action for Nutrition (NSPAN) which sets out costed, nutrition-specific and nutrition-sensitive interventions with measurable targets to be achieved between 2014 and 2019.

The NSPAN has been domesticated in Benue since 2021 to provide a multi-sectoral approach to tackling the problem of malnutrition among women and children.

Unfortunately, this strategic plan is yet to be approved by the state government.

The non-approval and implementation of the state NMSPAN has posed a persistent barrier, hindering the adoption of a multisectoral approach by various nutrition line MDAs in advancing food and nutrition security in the state.

While a multi-sectoral approach with a central coordination is necessary to deal with the complex nature of malnutrition, the absence of dedicated nutrition departments in the state has exacerbated the issue.

This gap experts said has resulted in a dispersion of leadership and responsibility for nutrition policy, planning, programming, advocacy and monitoring, among various sectors.

Notably, the absence of explicit budget line items for specific nutrition programmes in Benue’s 2022 budget further compounds the problem, contributing to suboptimal budgetary allocations, releases and utilisation for nutrition initiatives.

It is unfortunate to also note that though the current government of Hycinth Alia made allocation of a whooping 15% to health sector out of the total budget, no specific provision is made for nutrition.

These challenges collectively have contributed to the deepening of the challenge of effectively tackling of malnutrition in the state.

While presenting a paper at the media parley organised by Civil Society Scaling Up Nutrition in Nigeria CS-SUNN, the Benue State Nutritional Officer (SNO) Shar Faustina M. disclosed that the state need at least ₦9,918 billion to implement the 22 specific and nutrition-sensitive interventions within four years.

She noted that out of the total, an average annual public investment cost is estimated at ₦2,479,550,847.00.

She said the costed plan is expected to be used as an advocacy tool for improved nutrition financing in Benue and it incorporates monitoring and evaluation, accountability and learning component for easy tracking of progress and impact evaluation.

According to her, the fund, if approved, would also give the state the leverage to contribute towards the achievement of the Sustainable Development Goals target by 2030.

She said the State Strategic Plan of Action on Food and Nutrition was developed in line with the Benue State Policy on Food and Nutrition, using a multi-stakeholder participation approach including the relevant MDAs, development partners, academia, civil society organisations and private sector. The plan is to run for a period of four years (2022 -2025).

“The BNSPFAN prioritise the nutritionally vulnerable groups particularly among people in Internal Displaced Camps, pregnant women, lactating mothers and children under five,” she added.

Statistics to buttress facts

It could be noted that the

implementation of the plan of action  involves multi-sectoral actions by the various MDAs across the sectors (State Primary Health Care Board, State Ministry of Health, State Planning Commission, Ministries of Agriculture, Education, Information, Women Affairs etc) at different levels (state, LGA and ward) involving multiple partners (UN agencies, bilateral organisations, foundations and INGOs) and other stakeholders using existing delivery platforms, community structures and systems, while the Benue State Planning Commission is  tasked to coordinate the implementation and mobilisation of resources.

Some of the result areas of the programme was to

achieve food and nutrition security through investment in agriculture, enhancing caregiving capacity and enhancing provision of quality health services.

Others include improving capacity to address food and nutrition insecurity problems, raising awareness and understanding of the problem of malnutrition and resource allocation for food and nutrition security at all levels.

Using the NNHS (2018) and MICS (2017) as baseline and targets, the BNS Strategic Plan of Action on Food and Nutrition was aimed at reducing, hunger and malnutrition from 50% to 25% by 2025, childhood wasting from 20% to 5% by 2025, child stunting from 22% to 10%, anaemia among pregnant women from 46.1% to 20% and prevalence of diet-related non-communicable diseases from 25%  to 10%.

The plan was also expected to increase exclusive breastfeeding from 85% to 99%, intake of appropriate complementary feeding from 65% to 95%, coverages of vitamin A supplementation from 40% to 80%, zinc from 90% to 99%, deworming from 50% to 99%, and access to potable water from 50% to  90%, by 2025.

However, the plan since it was domesticated in the state has not been implemented, with little or no hope on when it will be given attention.

Need for urgent attention

The chief UNICEF Field Office, Enugu, Mrs Juliet Chiluwe during a coordination meeting of all partners, stakeholders and ministries, departments and agencies (MDAs) on the implementation of food and nutrition programme in Makurdi recently pointed out that the situation in the state called for urgent attention.

Represented by the UNICEF nutrition specialist, Ngozi Onuora, Mrs Chiluwe described the situation as unfortunate saying, “Malnutrition has become a silent emergency and this silent emergency receives far too little attention.”

A medical doctor with the Benue State University Teaching Hospital (BSUTH) Dr Priscilla Utoo said though the state government had a plan on nutrition, there is need to go back to the drawing board, since the plan which was supposed to be a four year one with implementation from 2021 to 2025 is no long feasible.

Concerns

According to Dr Utoo, the indices used for the plan can no longer be feasible and adoptable in the current situation considering that what obtained at the time the plan was made was different and there are lot of changes now.

“The plan is no longer achievable and must be reviewed. The ₦9,918 billion which was budgeted at that time to implement the 22 specific and nutrition-sensitive interventions within four years may no longer be realistic considering the changes in Nigeria’s economy today.

“Also at the time the plan was made, the Early Breast Feeding (EBF) was 65% but has now dropped drastically to 56.8%. these indices are not the same with what obtains today; so the plan must be reworked to conform with the current situation.

“Another thing is if the plan is fully prepared, it must be approved and the money released as at when due.

“Benue is the food basket but the current rate of malnutrition is very high and that is not good for our state,” she stated. 

More concerns

Also Aji Racheal Robinson, national co-chairman Steering Committee, Civil Society Scaling Up Nutrition in Nigeria (CS-SUNN) in a statement at a media parley in Makurdi, expressed worry that though Benue domesticated the National Strategic Plan of Action for Nutrition (NSPAN) since 2021 to provide a multi-sectoral approach to tackling the problem of malnutrition among women and children, unfortunately, the strategic plan was yet to be approved by the state government.

She said the non-approval of the state NMSPAN has posed a persistent barrier, hindering the adoption of a multisectoral approach by various nutrition line MDAs in advancing food and nutrition security in the state.

She therefore called on the state government to allocate and release promptly adequate funds for the implementation of nutrition interventions designed to reduce malnutrition in the state and extend maternity leave for nursing mothers from the current three to six months with pay.

She also urged the state government to approve and fund the Benue Strategic Plan of Action for Nutrition, establish nutrition departments in all line ministries, department and agencies and scale-up staple food fortification initiatives for availability of affordable nutritious foods in the state.

State coordinator of  civil society scaling up nutrition Mrs Racheal Ityonzughul in an interview urged the media to step up reportage of nutrition issues to spur policy makers and concerned stakeholders to take the right steps towards curbing malnutrition in the state.

She also urged  organisations to unite with CS-SUNN in advocating for the implementation of maternal and child nutrition interventions while calling for a collective commitment to consistently promote comprehensive community health education initiatives focused on nutrition.

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