Recently, UNICEF, with funding from the Japanese government moved to curb the high incidences of malnutrition in some parts of northern Nigeria. WINIFRED OGBEBO, who went on a fact-finding mission, reports.
A recent report has revealed that over 35,000 children with various degrees of acute malnutrition are being treated at various centres chosen for the Community Management of Acute Malnutrition programme in Jigawa state.
? The programme is jointly sponsored by the state governments and other donor agencies like UNICEF,USAID and Medicines’ San Frontiers.? The UNICEF nutrition specialist, Dr Isiaka Alo, said? many state governments have come out to support? the programme, apart from the Japanese government.? “ DFID just approved 20 million pounds for the period of five years starting from this year starting from Jigawa and Zamfara in two local government areas each.? The EU has been very helpful through their eco funding,” he said.
The programme for the management of acute malnutrition is said to be initiated as part of practical effort towards addressing the high rate of child death in the state.
According to report released by Central Bank in 2007 , Jigawa state has one of the highest rate of maternal and child death in the country and acute malnutrition cases? attributed to illiteracy, cultural practices, poor infrastructure, lack of accessible and good healthcare system as virtually all? the health facilities in the state are in bad shape.
? Alo explained further, “Generally as you know, the north is not fully food secure like the south because of the geographical belt.? Rainfall and the climatic condition of the north, savannah and the rain does not fall as much like in the south so the food production in the south is more, like we have cash crops.? So the revenue that people even generate to access the food they cannot even produce so people have more access to revenue in the south than in the north.”
According to him, “If you look at other parameters associated with malnutrition; how people access health services, care for children, illiteracy level. So those contributory factors are also more in the north. So you see all those factors coming around to affect the level of high malnutrition in Nigeria. Malnutrition is not only an issue of food. There are other factors like literacy level that will make mothers and care givers to be aware of the best feeding practices for a growing child. So if they are not aware, and they don’t access health,? the rate of malnutrition is bound to be high. So there are other indicators like birth attendant, ante natal clinic attendance, and there are more incidences of infections and diseases in the north.? All these contribute to malnutrition, so its not only food.”
At some of the centres visited by LEADERSHIP, it was observed that, hundreds of mothers troop out? daily to the centres with their children who suffered? malnutrition to? benefits from the drugs, milk and nutritious supplementary food distributed.
It was also discovered that some of the children taken to the centres are treated as out- patients while those in critical condition who cannot eat are admitted for two to three weeks in the hospital. Moreover,? children with? malnutrition cases from neighbouring states like Kano,Katsina and Yobe? are taken to the centres.
In an interview with LEADERSHIP, the coordinator, state Nutrition Programme, Hajiya Aisha A Zango, revealed that a meeting for the control of maternal and children health in Nigeria? held at Lafia, Nasarawa State in 2008 brought about the idea of establishing the programme to address the problems of malnutrition in? which Jigawa State share the highest burden.
Zango stated that in 2010, the Community Management of Acute Malnutrition programme was launched at three local government areas of the state and? it has now extended to 35 health facilities in 10 local government areas of the state, comprising Maigatari, Kiyawa, Babura, Kazare, Roni, Yankwashi, Birniwa, Kaugama, Jahun and Gumel.
According to her, children who were taken there with various malnutrition problems are attended by trained health workers, some are treated as out -patients while those in critical condition are admitted for some days, those who cannot eat are fed through “gastro nitrogen tube”.
“Many of the children who were about to die due to acute malnutrition but taken to one of our centres are now doing better, such children after being discharged from the hospital were given eight to 10 weeks to come regularly to see the doctors. We are also monitoring them from admission to the discharging period to assess the level of development”.
Under this programme, she noted that the state is also sensitizing mothers on how to properly feed their children, the type of food and period to be applied as well as supplementary food to the children.
“The problems of malnutrition in Jigawa State is not due to poverty or lack of food but it is due to the lack of knowledge or skills on how to properly breastfeed children and the type of food to? use as most? nutritious food for children is very common and available in all communities across the state”
Zango further noted that the state government through this programme purchased equipment, grains for the production of the supplementary food and over 30 health workers were trained on how to prepare the food given to the patients at the centre. Also, digital cameras and computers were purchased for tracking the patients from admission to discharge for a proper monitoring and record keeping.
The co-coordinator added that from the commencement of the programme in 2010 to date, over 35,000 children were attended to, and every day mothers are taking their children to the centres.
“Going by our assessment, the programme has recorded achievements, as hundreds of lives of our children were saved” Zango said.
Visiting Kazaure General Hospital, one of the centres chosen for the programme, LEADERSHIP found hundreds of women in queue waiting for the health workers to attend to their children; some of the children were new patients while some are old patients.
Hajiya Hauwa Abdurrahman was among the mother queuing with her child Hassan Abdurrahman, who is a new patient at the centre. She told LEADERSHIP that they came from Bacirawa Ungoggo Local Government of Kano State, after she was informed by one of her neighbours who visited the centre and her child eventually recovered from malnutrition he suffered.
She told LEADERSHIP that her child was given drugs, milk, and nutritious supplementary food.? However, she said, “The health workers there have counselled me on the type of food I will be giving to my child, and how to ensure our personal hygiene. The doctor has also given me two weeks to come back”.
Speaking to our? correspondent, Hadiza Mustapha who brought her one year old child Abubakar Mustapha, said it was the first day she was visiingt the Kazaure center but the advice, drugs, and milk she was given restored her hope that her child would survive the malnutrition illness.
“Before coming to this centre, I thought my child was affected by demons, I took him to different traditional medicine doctors but no progress. I thank God today it has been discovered that my child is suffering from malnutrition, and all the type of food I am advised to be giving to my child is available to us, unfortunately we don’t know how to apply it to our children before”.
With grim face, Fadima Auwalu who brought her child Bashir Auwalu from Gada village of Roni Local Government Area, told our source that she had been visiting the centre for more than five weeks. According to her, Bashir was in critical condition before being taken to the centre but since she started admitting the medicine and foods prescribed by the doctors for the child, he has been doing better.
“I am expecting my child to be completely discharged from visiting the centre in the next two weeks, and by the orientation we are given at the centre, I have full knowledge of the type of food and time to be given to my child. However, I am skillful enough to prevent my children from any form of malnutrition”.
Similarly, visiting other centres in Maigatari Local Government and Katika village of Kiyawa Local government, our source met health workers attending patients brought with? cases of malnutrition. Also, most of the mothers met there? expressed? happiness on the programme and the way it is? transforming the lives of their children whose before? were about to lose hope on their survival, as hundreds of their like died in a similar problems.
Our findings equally revealed that though the synergy to address the problems of malnutrition has made an impact, there are hundreds and thousands of children suffering from the problem across Jigawa State who have not yet been not yet reached, especially those living in villages and remotes areas as the programme for management of acute malnutrition is only carried out in 10 out of 27 local government areas of the state.
? The UNICEF nutrition specialist disclosed that there are three interventions basically to address the malaise.
“ The first is curative aspect. The strategy we use is the community management of severe acute malnutrition for children that are severely malnourished that can die anytime. We have to cure them, give them attention so that they don’t die.”
“The second one is promotion and preventive.?? We embark on promotion of optimal feeding practices. What do we do to prevent malnutrition? we have to? look at the? infant and young child feeding practices of the people? What kind of food do they give to their growing child? Do they give water while breast feeding?? After weaning the child at six months, what kind of food in addition to breast feeding? Talking of sanitation; do they wash hands after going to the toilet? Do they have access to adequate potable water? All those things can result in infection outside their environment. If you go to the north now, the way people live and keep their livestock is not sanitary. So we are looking at the living practices of the people and their way of life so that we can prevent malnutrition.”
Concluding,? Alo said the third element is the micronutrient deficiency control. “We want to make sure that the behaviour hunger aspect which is the Vitamin A, Zinc, Iron, and iodine are all in their food and where they are not available in their food, we give supplement as a short term measure. So we have Zinc supplementation for diarrhea management, iron folic supplementation for pregnant mothers.? All those interventions are there for micronutrient deficiency control so that the immunity of the child can be strengthened against infection so that the child can grow up with better physical and mental development.”
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