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Dr Benjamin Odeka MB DCH MA(healthcare law) FRCP(Lon) FRCPCH(UK)MD/CEO Lady Helen Child health Foundation Consultant In Healthcare Governance , Quality, Paediatrics & Gastroenterology Performance Assessor General Medical council UK Professional & Clinical Advisor Care Quality Commission UK Former Medical Director Women & Children’s services Peninne Acute NHS Trust UK

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Definitions

• Malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilization. The double burden of malnutrition consists of both under nutrition and overweight and obesity, as well as diet-related non-communicable diseases (WHO)
• Under nutrition manifests in four broad forms: wasting, stunting, underweight, and micronutrient deficiencies.
• Wasting is defined as low weight-for-height. It often indicates recent and severe weight loss, although it can also persist for a long time. It usually occurs when a person has not had food of adequate quality and quantity and/or they have had frequent or prolonged illnesses
• Stunting is defined as low height-for-age. It is the result of chronic or recurrent under-nutrition, usually associated with poverty, poor maternal health and nutrition, frequent illness and/or inappropriate feeding and care in early life. Stunting prevents children from reaching their physical and cognitive potential

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WHO’s Africa Nutrition Report

• In 2017, more than one third of stunted children under the age of five lived in Africa. The prevalence of stunting in children under the age of five varies by region. Sub-Saharan Africa shows a higher prevalence (33.9%) in comparison with North Africa
• A newly released nutrition report by the World Health Organization (WHO) Regional Office for Africa has revealed that under-nutrition is still persistent in the region and the number of stunted children has increased.
• The Report points out that while the prevalence of stunting decreased between 2000 and 2016, the absolute numbers of stunted children are in fact increasing: from 50.4 million in 2000 to 58.5 million in 2016.
• Joint UNICEF, WHO and World Bank 2016 estimates show that the number of overweight children in Africa increased by more than 50 percent between 2000 and 2015. The Report found that 24 countries have rates between 3 and 10%; above this range are Algeria (12.4%), Botswana (11.2%), Comoros (10.9%), Seychelles (10.2%), and South Africa (10.9%). 

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Nigeria: Nutrition Profile

• In Nigeria, 37 percent of children under five years are stunted. The prevalence of stunting increases with age, peaking at 47 percent among children 24–35 months (USAID 2021)
• The national stunting prevalence has improved since 2008 (41%), and wasting has also improved from 14% in 2008 to 7% in 2018 among children under five years (USAID 2021)
• 22% of children are underweight. However, regional variation have very high stunting, wasting, and underweight rates in some states that have not improved (NPC and ICF International 2019)
• More children in rural areas are stunted (45%) than those in urban areas (27%), and the pattern is similar for severe stunting (22% in rural areas and 10% in urban areas). The prevalence of early initiation of breastfeeding increased from 33% in 2013 to 42% in 2018, while children who received a pre-lacteal feed decreased from 59 % in 2013 to 49% in 2019. 29% of children under six months old are exclusively breastfed; though this number decreases by age (39% among children zero–one month, to 29% among those aged two–three months, and 18 % among those aged four–five months) NPC and ICF International 2019.

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Factors Associated with Food �Insecurity & Malnutrition in Nigeria

• The factors associated with food insecurity and malnutrition in Nigeria are multifaceted and include inadequate year-round diets; poor infant and young child feeding practices; high rates of illness; lack of access to health care; water, sanitation, and hygiene; armed conflict, particularly in the north; irregular rainfall; high unemployment; and poverty (Nigeria Federal Ministry of Health, Family Health Department 2019).
• Although chronic and seasonal food insecurity occurs throughout the country, and is exacerbated by volatile and rising food prices, the impact of conflict and other shocks has resulted in acute levels of food insecurity in the northeast (FEWS NET 2020). An estimated 1.5 million people in the states of Borno, Yobe, and Adamawa received emergency food assistance or cash transfers in the first half of 2020 but, because humanitarian food assistance delivery to the northeast remains restricted, the number who need assistance is likely much greater (FEWS NET 2020).
• Diet-related non-communicable diseases are also on the rise in Nigeria due to globalization; urbanization; lifestyle transition; socio-cultural factors; obesogenic diets; and poor maternal, fetal, and infant nutrition (Nigeria Federal Ministry of Health, Family Health Department 2019).

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THANK YOU