Written by Ijeoma UKAZU

Nutritional deficit: The challenge before the Nigerian child

A new report of a commission convened by the World Health Organisation, WHO, United Nations Children's Fund, UNICEF, and medical journal, The Lancet, notes that out of 180 countries, Nigeria is ranked 174 on child survival, health, nutrition and education.




The new global index consists of 180 countries, compared performance on child flourishing, including measures of child survival and well-being such as health, education, and nutrition.

From the report, Nigeria is seen at the bottom place with countries such as Afghanistan, 171; Sierra Leone, 172; South Sudan, 173; and Guinea, 175.

Others are, Mali, 176; Niger, 177; Somalia, 178; Chad, 179; and Central African Republic, 180.

The commission, however presents the case for placing children, aged 0–18 years, at the center of the SDGs: at the heart of the concept of sustainability and our shared human endeavour.

This landmark report involving over 40 child and adolescent health experts from around the world, shows that no single country is adequately protecting children’s health, their environment and futures.

This further indicates that the future of children globally is uncertain, hence could stand as a barrier to fulfilling their full potential.

These findings have established the fact that, government at all levels need to take issues relating to children seriously.

Titled, "A Future for the World’s Children?, revealed that the health and future of every child and adolescent worldwide is under immediate threat from ecological degradation, climate change and exploitative marketing practices that push heavily processed fast food, sugary drinks, alcohol and tobacco at children.

"Despite improvements in child and adolescent health over the past 20 years, progress has stalled, and is set to reverse," said former Prime Minister of New Zealand and Co-Chair of the Commission, Helen Clark.

Clark further said that, "it has been estimated that around 250 million children under five years old in low and middle income countries are at risk of not reaching their development potential, based on proxy measures of stunting and poverty. But of even greater concern, every child worldwide now faces existential threats from climate change and commercial pressures."

Clark said, countries need to overhaul their approach to child and adolescent health, to ensure that we not only look after our children today but protect the world they will inherit in the future."

According to UNICEF Executive Director, Henrietta Fore, from the climate crisis to obesity and harmful commercial marketing, children around the world are having to contend with threats that were unimaginable just a few generations ago.

"It is time for a rethink on child health, one which places children at the top of every government’s development agenda and puts their well-being above all considerations.”

Fore added that the report shows that the world’s decision makers are, too often, failing today’s children and youth: failing to protect their health, failing to protect their rights, and failing to protect their planet.

In his comment, Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, said "this must be a wakeup call for countries to invest in child health and development, ensure their voices are heard, protect their rights, and build a future that is fit for children."

As climate and commercial threats intensify, WHO, UNICEF and Lancet commission presses for radical rethink on child health.

The report also pointed that, while the poorest countries need to do more to support their children’s ability to live healthy lives, excessive carbon emissions disproportionately from wealthier countries threaten the future of all children.

It said, if global warming exceeds 4°C by the year 2100 in line with current projections, this would lead to devastating health consequences for children, due to rising ocean levels, heat waves, proliferation of diseases like malaria and dengue, and malnutrition.

Similarly in another report by UNICEF, in Nigeria, malnutrition is the underlying cause of more than half of 2,300 under five deaths daily.

While micronutrient deficiencies have been identified also as a significant problem that have persisted overtime in the country which health watchers say has severe consequences on the Nigerian child if not tackled.

Despite the federal and state governments efforts to stem the tide, the scourge lingers, however, nutrition stakeholders has suggested solutions to combat these challenges.

Micronutrients such as vitamin A, zinc, Iron, folic acid and iodine are required in small amount for proper growth and development, their deficiency in the body comes with great consequences.

The lack of these nutrients have continue to contribute to morbidity and mortality amongst children by impairing immunity, impeding cognitive development and growth

The recent Nigeria Demographic and Health Survey, NDHS 2018 data shows that 68 percent of children six to 59 months of age and 58 percent of women of reproductive age in Nigeria are anemic, with at least a third of the anemia attributing to iron deficiency. The report also revealed that the prevalence of anemia among children age 12 to 17 months is 81 percent

For zinc deficiency, a report by the National Nutrition and Health Survey, NNHS 2015, shows that the national prevalence is estimated at 20 percent. Based on this evidence, WHO and UNICEF recommend zinc with Oral Rehydration Solution, ORS in the treatment for diarrhoea.

With these alarming statistics, the NNHS 2018 report showed that only 40.8 percent of children age six to 59 months received vitamin A and only 40.4 percent of children age 12 to 59 month were dewormed.

Worried by these trend, the Civil Society Scaling Up Nutrition, CS-SUNN organised a one -day workshop for stakeholders to dialogue and proffer lasting solution to these challenge.

Speaking at the event, the Executive Secretary, CS-SUNN, Mrs Beatrice Eluaka, said that Micronutrient Deficiencies, which is caused by lack of essential vitamins and minerals, have been identified as a public health problem.

Eluaka said, "lack of vitamin A, zinc, iron and iodine in our diets can cause morbidity and mortality among children by impairing immunity, impeding cognitive development and growth as well as reducing physical capacity and work performance in adulthood."

She pointed out that the deficiencies in the aforementioned micronutrients are also the leading causes of anemia in women, birth defects, increased vulnerability to infections, blindness and poor development in children.'

In order to tackle this issue of micronutrient deficiencies, Eluaka said that the provision of micronutrient powder like iron, folic acid, vitamin A supplement for pregnant women and children at the Primary Healthcare Centres, PHCs, level cannot be over-emphasised.

Calling on the state government, she said there need to scale up not only the provision and distribution of these supplement to withdrawn areas, but across health facilities during the maternal, new-born, child health week.

The CS-SUNN Executive Secretary urged state governments yet to approve their State Specific Strategic Plan for nutrition to do so and to commence implementation and ensure releases with specific funds allotted to interventions around micronutrient powder, bio-fortification, iron folate supplementation and vitamin A.

On awareness, Eluaka said there is the need for massive sensitisation, education and awareness creation to provoke behavioural changes that would promote adequate infant and young child feeding practices in the country, stressing that early initiation of exclusive breastfeeding for the first six months of life and adequate complementary feeding, thereafter, is very crucial for baby survival.

Also speaking, the Deputy Director and Head, Micronutrient Deficiencies Control, Federal Ministry of Health, Mr John Uruakpa, identified essential minerals and vitamins needed for the proper growth and development as vitamin A, Iodine, iron, zinc and folate.

Uruakpa said that the federal government had over the years made several efforts toward controlling micronutrient deficiency in the country, adding that the government’s strategies in response to micronutrient included food fortification, deworming, bio-fortification, dietary diversification and supplementation.

He said the government has highlighted Water, Sanitation and Hygiene, WASH interventions as key for preventing and controlling diseases and parasitic infections that can induce iron deficiency.

He pointed that efforts are consistently ongoing in Nigeria to improve the availability, access to basic water and sanitation infrastructure that will support optimal WASH practices.

He said government cannot do it alone when it comes to tackling the issue of malnutrition, adding that more investment is required from partners and the private sector to address the scourge.

"There is need to develop and implement policies and programmes that favour procurement and availability of MNDC commodities such as vitamin A, iron folate, and micronutrient powders,  used in the prevention of micronutrient deficiencies."

The Chief Agriculture Officer, Federal Ministry of Agriculture and Rural Development, FMARD, Adam Okpoju, said despite globalisation, the underlying causes of micronutrient deficiencies are household food insecurity, inadequate care and feeding practices as well as poor WASH practices.

He pointed lack of access to nutritious foods, lack of cash income and limited livelihood opportunities, sub-optimal Infant and Young Child Feeding, IYCF, poor knowledge on diet diversity and nutritious diets, poor knowledge and beliefs on IYCF, poor nutrition education, unsafe water supply, inadequate sanitation practices and poor knowledge and hygiene practices have marred the efforts of the government in tackling micronutrient deficiencies in Nigeria.







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