Poor diets retard children’s growth and their development, including their cognitive development. Photo: REUTERS
Although the federal government has expressed its commitment to meeting the Millennium Development Goals, especially as relates to health, some experts say investment in quick gains projects such as improved nutrition would be cheap but eventually productive for the nation.
In 2000, for instance, the World Health Organisation (WHO) ranked Nigeria’s health system 187th out of its 191 member states, particularly due to problems such as hunger and malnutrition, which have become increasingly severe over the years.
Jane Miller, the country representative of UK’s Department for International Development (DFID), explains the rationale behind Nigeria’s poor ranking rather succinctly.
“Malnutrition, malaria and communicable diseases such as measles, diarrhoea and pneumonia significantly contribute to maternal and child mortality and morbidity,” Miller says, adding that “one million Nigerian children under the age of five die each year.”
Malnutrition has been a serious concern to the WHO, which insists that it is by far the major factor behind child mortality, with underweight births and inter-uterine growth restrictions causing 2.2 million child deaths every year.
The global health agency says mothers’ neglect of infants’ breast-feeding also causes about 1.4 million deaths, while describing malnutrition as the most serious single threat to public health across the world.
Linus Awute, the permanent secretary of the Federal Ministry of Health, concedes that Nigeria is one of the countries that are mostly affected by deaths of children under the age of five years due to factors such as malnutrition.
He stresses that over two-thirds of malnutrition-related deaths of children usually occur within the first year of their existence, adding that the children’s undernourishment is associated with inappropriate feeding practices.
“Appropriate feeding of infants and young children remains a key factor in promoting health and child survival. However, many mothers have yet to imbibe the required child-feeding attitudes and practices, in spite of many public sensitisation campaigns,” he says.
Going from the general to the specifics, the WHO says malnutrition is also responsible for about 14 percent of infants born with low birth weights in Nigeria and more than 75 percent of children, under the age of five, who are anaemic.
Mr Awute, on his part, stresses that babies who undergo exclusive breast-feeding do well in their first six months of life, adding, however, that such babies subsequently need adequate and appropriate complementary feeding for them not to become malnourished.
He also said malnutrition usually crops up because of deficiencies of macro- and micro-nutrients in the babies’ food, adding that these deficiencies induce ”protein-energy malnutrition, iron-deficiency anaemia, iodine-deficiency disorders and Vitamin A-deficiency.”
Lawan Tahir, a paediatrician, also called on new parents to ensure that infants are given healthy, balanced diets after stopping their breast-feeding.
“To reduce child mortality, mothers should feed their children with balanced diets after they have been weaned,” he says.
Killer of young ones
Mr Tahir, a senior registrar at the National Hospital, Abuja, who said two out of every three child deaths are related to malnutrition, adding that a malnourished child is prone to numerous diseases because of the child’s poor immune system which cannot resist infections.
After breast-feeding, the next thing most mothers do is introducing the babies to cereals, as the infants feed on mainly carbohydrate diets.
“Nevertheless, what the child needs at that point is actually not carbohydrates alone but proteins, fats and oils, as well as micro-nutrients to enable him or her to have a balanced nutrition,” he said. “Unfortunately, most children are not given well-balanced diets, probably due to their parents’ poverty or ignorance.”
Mr Tahir adds that poor diets retard children’s growth and their development, including their cognitive development. The paediatrician explains that malnutrition is a health condition which signifies poor nutrition, as well as an imbalance between the intake of nutrients and what the body actually requires.
Experts say rising cases of malnutrition in Nigeria can be attributed to the lack of food security in the country, poor feeding habits, waning exclusive breast-feeding of newborn babies and poor quality complementary feeding of infants after the age of six months.
Another paediatrician, Azeez Ibrahim says micro-nutrients deficiency is a direct cause of child mortality.
“Micro-nutrients such as iron, iodine, and Vitamin A are necessary for the healthy development of children, while their absence in diets can cause serious disorders,” he said He, however, said malnutrition is not a health problem of children alone, adding that “many adolescents are also having malnutrition problems and these affect their learning processes and productivity.”
Mr Ibrahim, nonetheless, insists that some cases of malnutrition in adolescents are due to increased intake of carbonated drinks (soft drinks), as such drinks only provide “empty calories” that are insufficient to meet the body’s requirements for proper growth.
“Malnutrition in a female adolescent is worse because as the young ladies prepare for marriage, they need a balanced diet for them to attain their potential as women,” he says.
All together on safety
As part of efforts to foster improved nutrition in Nigeria, the Global Alliance for Improved Nutrition (GAIN) is working with the federal government via the National Fortification Alliance (NFA). The NFA comprises government regulatory agencies such as National Agency for Food, Drug Administration and Control (NAFDAC) and the Standards Organisation of Nigeria (SON).
Hauwa Keri, NAFDAC’s director of Establishment Inspection, says the aim of the government policy on fortified foods is to get more nutritious staple foods like wheat and maize flour, vegetable oil and sugar into the markets and homes of vulnerable families whose diets lack the essential micro-nutrients.
“The goal of the effort, which began in March 2007, is to change the lives of the citizens by giving them a chance to eat more balanced diets every day,” she says.
Ms Keri stresses that the Federal Government has been leading a national campaign to add essential micro-nutrients to food products such as wheat and maize flour, refined sugar and vegetable oils since 2002.
Besides, Ms Keri said, a pilot programme is underway to fortify table salt with iron so as to provide the needed micronutrients for the people, adding that table salt is already being fortified with iodine.
“The project is at a pilot stage in three zones and it aims at ascertaining whether fortifying salt with iodine and iron will be acceptable,” she says. “It is also at a research and study stage; the outcome of the investigations will determine whether to adopt the iron fortification scheme or not.”
Larry Umunah, the country representative of GAIN, says Nigeria has been identified as one of the countries that are determined to tackle the menace of malnutrition frontally.
He, however, stresses the need to ensure that mothers and children have proper nutrients so as to curb the rising menace of maternal and child mortality in the country.
Umunah said if Nigeria is able to effectively tackle the issue of malnutrition among mothers and children, the country will definitely be in a better position to achieve the health targets of the UN Millennium Development Goals (MDGs).
“Ensuring that mothers and children have proper nutrients is of paramount importance. If Nigerian mothers and children are able to have improved nutrients, the country will move toward achieving the MDGs,” he said.
Dr Orhii, the director general of NAFDAC, however, stresses the need for regulatory agencies to enforce the full compliance of food industries with the extant regulation regarding the fortification of their products.
Mr Orhii bemoans the inability of the vast majority of the rural people to have access to fortified foods, adding that the prevalence of ”hidden hunger” among the rural populace has been a source of public health concern.
The NAFDAC director says that fortified foods contain all the essential vitamins that prevent diseases, adding that lack of iodine in salt, for instance, can make a child dull.
“Iodine deficiency can also interfere with the reproductive system of girls in future,” he said. “We insist on the fortification of foods with essential vitamins to prevent diseases which usually affect vulnerable groups like pregnant women and children below the age of five.”
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