28042019 - No delaying minimum wage, go ahead and pay, FG tells MDAs, states, others

PAGE 32 — SUNDAY VANGUARD, APRIL 28, 2019
Nigeria’s ‘severely wasted
children’: The inside story
By Chioma Obinna
It is no news that Nigeria ranks high among
countries with unenviable statistics on child
malnutrition. She has the second highest
stunted children in the world with estimated 17
million due to malnutrition and, according to
the United Nations Children’s Fund, UNICEF,
25 million of the children under the age of five
are wasting. Most of the children are from the
North-East and suffering due to insurgency.
Today, it is also not news that Nigerians are
hungry but the danger is the fact that they are
only interested in having a full belly without
minding the quality of the food. Meanwhile,
nutrition indicators show that the current
situation in the country is dangerous for children
who are the future leaders.
According to UNICEF, malnutrition is a
condition that results from eating a diet lacking
in nutrients. The damage resulting from
malnutrition to physical and cognitive
development during the first two years of a child’s
life is largely irreversible. Sunday Vanguard writes
that Nigeria may be breeding a malnourished
generation in future.
Recovering but with a blemish
As ten-month-old Halimat Ahmed rests on her
mother’s shoulder, her sunken eyes are enough
to attract sympathy even from the hard-hearted.
Her lips were filled with drool, arms as tiny as a
broomstick. She keeps sulking. A closer look at
the baby shows a clear difference from old Halimat
when she was six months old. Her frame doesn’t
fit the frame of a10-month-old baby.
Like every other mother, Halima’s mother is
worried that she might lose her. Halimat is the
only surviving child of her parents after
insurgency hit her community. Halimat is
struggling to survive Severe Acute Malnutrition,
SAM, an extreme form of malnutrition that
makes its victims weak, skeletal and requires
urgent treatment. Thanks to a UNICEFnutrition
supported program in IDP camps where
she was urgently treated to stop the devastating
effect of SAM, Halimat was treated with Ready
to Use Therapeutic Food, RUTF, which helps
malnourished children regain lost nutrients. The
girl has recovered. But did she recover without
blemish? Will she grow like other children? These
and more are the questions surrounding victims
of malnutrition. She is one of the Nigerian
children born in a small community in Borno
State where insurgency has escalated
malnutrition and brought about high food
insecurity, as well as sub-optimal infant and
young children feeding practices.
The nation is facing SAM that has claimed
thousands of children. Findings show that one
in 10 of severely wasted children worldwide lives
in Nigeria.
Halimat is among the 35 million children aged
five and below in the North-East affected by SAM
due to insurgency. Recent figures from the United
Nations Children’s Fund, UNICEF, revealed that
Global Acute Malnutrition, GAM, in the region
has crossed the threshold for “serious”.
According to the World Health Organisation,
WHO, classification for “serious” is for levels of
combined moderate and acute malnutrition
exceeding 10 in 100 children.
Worse still, the levels of malnutrition in three
states in the North-East - Central Borno,
Municipal Maiduguri, Jere; and South, Central
and North of Yobe - have crossed the threshold.
However, Halimat and other victims of
malnutrition will suffer long term effects of
malnutrition, especially in adulthood.
According to UNICEF, although death is the
worst outcome of malnutrition’s ugly grasp, it is
not the only outcome as children who survive
can face an unending list of devastating side
effects that last a lifetime.
Studies show that most of the victims are
prevented from achieving success in school and
pursuing meaningful work in
adulthood.
Like Halimat, children
affected by malnutrition battle
with challenges such as
increased vulnerability to
diseases, developmental delays,
stunted growth and even
blindness. Such children,
according to experts, will not be
able to contribute to the
development of the country or
achieve their dreams.
According to UNICEF
Nutrition Specialist, Akure
Field Office, Mrs Ada Ezeogu,
during an interaction on child
nutrition, an estimated 17
million or 43.6 per cent of
children in Nigeria under the
age of five have their bodies and
minds limited by stunting.
Ezeogu described stunting as
a manifestation of the severe,
irreversible physical and
cognitive damage caused by
chronic malnutrition early in a
child which is one of the most
significant barriers to human
development.
Impact
Studies show that beyond the age of 2-3, the
effects of chronic malnutrition are irreversible. This
means that to break the intergenerational
transmission of poverty and malnutrition,
children at risk must be reached during their first
two years of life.
Children who do not reach their optimum
height or consistently experience bouts of weight
loss during childhood are affected in the long term
in numerous ways.
They do not reach their optimum size as adults
Children who do
not reach their
optimum height
or consistently
experience
bouts of weight
loss during
childhood are
affected in the
long term in
numerous ways
and may have less physical capacity for work,
their brains are affected resulting in lower IQs
and they are at greater risk of infection which
kills many children during their early years.
Child malnutrition also impacts on educational
attainment. The degree of cognitive
impairments is directly related to the severity of
stunting and Iron Deficiency Anaemia. Studies
show that stunted children in the first two years
of life have lower cognitive test scores, delayed
enrolment, higher absenteeism and more class
repetition compared with non-stunted children.
It also impacts on economic productivity. The
mental impairment caused by iodine deficiency
is permanent and directly linked to productivity
loss. The loss from stunting is calculated as 1.38
per cent reduced productivity for every 1 per cent
decrease in height while 1percent reduced
productivity is estimated for every 1percent drop
in iron status, according to Haddad and Bouis,
1990.
Lip service
Adults who were
undernourished as children are
at risk of developing diseases
such as obesity, diabetes and
cardiovascular issues.
Regardless, Nigeria is said to
be paying lip service to issues
of child nutrition. Some
states are yet to provide a
budget line for nutrition.
Malnutrition, according to
experts, is caused by a
combination of complicated
factors including poverty,
political instability; climate
change, feeding practices,
disease, contaminated water,
poor sanitation among others.
Nigeria is battling with these
causes.
Extremely poor
According to the World
Poverty Clock, no fewer than
91.6 million Nigerians are
extremely poor and living on
less than one dollar per day.
Prices of foodstuff are
unpredictable and many
parents are jobless and lack the
purchasing power to buy healthy, nutritious foods.
According to the latest National Nutrition and
Health Survey, NNHS, 2018, acute malnutrition
remains at alert levels while chronic malnutrition,
as characterised by stunting, remains the biggest
burden at serious or high levels according to
WHO/UNICEF classification.
The 2018 NNHS shows that acute malnutrition
levels have remained at 19.9 per cent, 3.5 per
cent higher than the global estimate of 15 per
cent.
The country’s Exclusive Breastfeeding, EBF,
rate is also low, no thanks to the inability of
mothers to breastfeed their children exclusively
for the first six months of life.
Currently, 3 in 4 babies are not exclusively
breastfed, a practice, according to scientists,
reduces the number of child deaths from
malnutrition.
The 2018 NNHS also shows that breastfeeding
remains widespread among the Nigerian
population.
Child feeding indicators are poor and suboptimal.
The survey reveals that more than 80
per cent of newborns do not timely receive milk
and colostrums within one hour of birth; only 27
per cent of 0-5 months old infants are breastfed
exclusively, and so majority are introduced to
complementary foods before the age of six months
earlier than the time WHO/UNICEF’s
recommended that mothers exclusively breastfeed
their children, and in the process predisposing
the children to unhygienic feeding conditions and
vulnerability to illnesses and malnutrition.
Nearly 60 per cent of the children (6-24 months)
assessed were not fed to the recommended
minimum meal frequency for their age and
breastfeeding status; 65 per cent do not meet the
minimum dietary diversity and only 17 per cent
of children aged 6-23 months receive the
minimum acceptable diet while less than 50 per
cent are fed on iron-containing foods.
The 2018 NNHS further reveals that the
national GAM prevalence among children 6-59
months of age based on weight-for-height was
7.0 per cent with MAM of 5.5 per cent and SAM
of 1.5 per cent. The rates indicate that acute
malnutrition levels have remained at alert levels
of 5-9.9 per cent over the years since 2014. The
prevalence of underweight among children aged
0-59 months was 19.9 per cent, just at the margin
of the 20 per cent threshold for “serious” situation
that it has been since 2014, higher than the global
estimate of 15 per cent but consistent with the
rates in the West and Central Africa region.
The prevalence of stunting was 32.0 per cent
and has remained the largest burden of
malnutrition with stagnated rates of above 30
per cent since 2014, and with many states in the
North-West and North-East recording prevalence
above 40 per cent- the WHO critical levels.
Addressing malnutrition
The survey recommends that improving
nutrition in the first1, 000 days window and in
adolescent girls was critical to improving the
nutrition status of the entire population of
Nigeria.
According to the President of Nutrition Society
of Nigeria, Dr Bartholomew Brai, nutrition is a
fundamental right.
Without good nutrition, Brai says the mind and
body cannot function well, hence, appropriate
investments on good nutrition can help reduce
the global burden of diseases and impaired quality
of life.
At a workshop on ‘Advancing Nutrition, Health
and Wellness through the Media’, organised by
Nestlé Nigeria and the Lagos Business School,
he said proper investment on nutrition can help
to improve our health, prevent certain diseases,
maintain a desirable weight, and maintain
Nigerian’s energy and vitality.
To him, good nutrition leads to higher earnings
and mental acuity, which, in turn, supports
macroeconomic and societal growth.
Critical health watchers believe that there is
need to intensify efforts to reduce stunting
through proper nutrition, especially now that
Nigeria was at a critical stage of malnutrition
and proper nutrition is germane to human growth
and a well-nurtured generation will contribute
meaningfully to the development of the society.