The 14th Emir of Kano, Muhammad Sanusi II, has spent most of his time, talking about malnutrition. To him, the federal government is not doing enough to tackle the menace, hence the reason for the constant reminder.
A child that is malnourished in the first 1,000 days of life is already gone; that child can never become a doctor, computer scientist, lawyer, etc, simply because the brains are gone, Sanusi would say, adding, “If we understand the impact of malnutrition on human capital in this country, we will invest more in tackling it now, to safe the future of Nigeria.”
Without doubt, poor nutrition during the early formative years significantly led to morbidity, mortality, delayed mental and motor development, even as several studies have shown that in the long term, it can lead to impairments of intellectual performance, work capacity, reproductive outcomes, and overall health.
This is why the World Health Organisation has tagged malnutrition as one of the most critical global disease burdens in the world accounting for at least nine million deaths per year in children less than five years of age. Nigeria bears a huge part of the burden, having the second highest burden of stunted children in the world and a prevalence rate of 32 per cent of children under five.
Lagos state, one of the fast growing cities in the world, generating N127 billion and N267.23 billion in quarter one and half year respectively in 2021, is not immune to malnutrition as the Nigeria Demographic and Health Survey (NHDS 2018) report showed that 6.4 per cent of the children living in the state are wasted, 17.2 per cent are stunted and 13.3 per cent are underweight.
“From the NDHS report, it is glaring that malnutrition is not only a challenge in the northern part of the country, but everywhere in Nigeria, including Lagos state,” the executive secretary, Civil Society Scaling-Up Nutrition in Nigeria (CS-SUNN) Okoronkwo Sunday told LEADERSHIP Sunday.
Moves to tackle the menace
To tackle malnutrition in Lagos state, Sunday disclosed that CS-SUNN is currently in the state to support the state budget ministry, to develop an Annual Operation Plan (AOP), drawn from the state specific multi-sectoral plan of action for nutrition among other things.
Currently, the Ministry of Environment and Water Resources; Ministry of Economic Planning and Budget; Ministry of Information and Strategy; Ministry of Education; Lagos State Universal Basic Education Board; Lagos State University Teaching Hospital (LASUTH); Ministry of Youth and Social Development; Ministry of Women Affairs and Poverty Alleviation; Ministry of Health; Ministry of Local Government and Community Affairs; Ministry of Agriculture and Lagos State Primary Health Care Board now have budget line for nutrition, the executive secretary revealed.
Having a budget line means a specific amount of money is being allocated to the MDAs to fund the five years strategic plan of action for nutrition, Sunday said, while applauding the state government for this achievement.
“The state government has constantly increased allocation for nutrition intervention programmes since 2014. For instance, in 2014, the budget of Lagos state for nutrition was less than N20 million and most of the nutrition line MDAs didn’t have a budget to fund nutrition intervention programmes, even when they have a big role to play in reducing malnutrition in the state.
“However, in 2022, the budget rose to over N268.5million. Though, budget performance is still at 17 per cent in the third quarter, we are hoping that before the end of the year, the government would have released more funds across all the MDAs.”
As part of efforts to ensure transparency in the disbursement and utilization of the fund in the state, a worker, social development, the federal ministry of Finance, Budget and National Planning, Julius Likuna told LEADERSHIP Sunday that the federal government, with support from CS-SUNN, has developed an appraisal tool to track line MDAs and identify those that are worker, focus on those that are not working, to enable the state address the issue of malnutrition.
“The tool will also help us to easily identify the MDAs that have budget line and those without budget line, the ones that have enough and the ones that do not have so that we can now create time for advocacy to see that they have budget line for nutrition and enough fund to carry out their intervention programmes,” he added.
With support from CS-SUNN, Likuna disclosed that, “We developed the appraisal tools in conjunction with five focal states, where the civil society is working. Presently, the tool is a national tool, to be deployed in all the 36 states including the Federal Capital Territory. We started in Lagos state, which is the pioneer state to domesticate the tool. As soon as we get it right, we will escalate it to other states of the federation.”
Lagos state is indeed moving in the right direction in tackling malnutrition, however, the N268.5 million allocated for nutrition in 2022, is insufficient in tackling the menace in the state, Sunday stated, while calling on the state government and critical stakeholders to put in place what is required to reduce the burden of malnutrition in the state.
The total sum required to fund the nutrition intervention programmes in the state specific multi-sectoral plan of action, is put at over N200 billion, the executive secretary, CS-SUNN disclosed, adding that for each year, it will cost the state N50 to N60 billion to be able to achieve optimal nutrition.
“N60 billion is huge, so also the current burden of malnutrition in the state. For instance, the NHDS 2018 revealed that the state has 2.2 per cent of its children with Severe Acute Malnutrition (SAM), a condition that could lead to death if not treated within one year.
“Lagos has a population of about 28,000,000 and under-five children are 18 per cent of that figure. If you take 18 per cent of 28,000,000, you will have 5,040,000 under-five children in the state. 2.2 per cent of 5,040,000, representing 110,880 children are living with SAM and they have less than a year to either survive or die.
“To treat one SAM patient would require $106, which includes the procurement of Ready-to-use-therapeutic-food, accommodation and other logistics. If you convert that to naira, using $460 per naira, it gives you about N48,760. Multiplying that figure with 110,880 children that are living with SAM, the state would need to budget about N5 billion to save the lives of those children. This is just for one intervention. The state still needs to budget for Vitamin A supplement, Infant and Young Child Feeding (IYCF) and preventive measures like food fortifications,” Sunday explained.
Bridging the financial gap
Nigeria is facing financial crisis and Lagos is also affected, but there are several ways of mobilizing funds to bridge the financial gap in tackling malnutrition in the state, CS-SUNN executive secretary averred.
For instance, the strategic plan of action is a strategy for mobilising resources in Lagos state, Sunday said, adding that, there are industries, companies, and philanthropists who will be willing to contribute to humanitarian projects like fighting malnutrition. All the state government needs to do is to put together a team that will engage these people and get them to contribute towards achieving this huge amount of money, he said.
“What CS-SUNN is pushing for is for the government to have the political will, which is key. We need to come to the point where we all agree that malnutrition is a major challenge and if not tackled, would cost Lagos state both in the immediate and in the future. In the immediate future, we will lose so many children who are potential leaders and in the future, most of the children will be stunted.
“Stunting doesn’t just affect the growth of the child, or the height of the child during their growing period, it also impacts on the brain development and if that child’s brain is not developed, it will reduce the potential of that child to contribute meaningfully to the growth and development of Lagos state.
“My question to the government is what will our tomorrow be like if in Lagos state for example, out of every 10 children, two of them are stunted, and nothing is being done to reduce it? The implication is that it will limit the number of children who have the brain, ability and the healthiness required to contribute meaningfully to the productivity of Lagos State.
“The future of the state is blink, if nothing is done. I believe that investing in nutrition is a worthwhile and wise investment. For instance, if you put in $1, according to World Bank research, you will get back $16. So I urge the Lagos state government to lead the charge because that is part of what they are committed to do in public offices,” Sunday appealed.