In a country where the coronavirus pandemic has created an impossible dilemma for the nutrition sector, gross under-funding of key programs is severely impacting already strained health services, especially in Nigeria’s rural communities.
Recognising the importance of key nutritional programmes and allowing them continue should be considered a priority as much attention is channelled to stalling the spread of COVID-19, health experts say.
The pilot programme of the Community-based Management of Acute Malnutrition (CMAM) was introduced in Nigeria in 2009 by Unicef, the UN children’s agency, in 12 northern states where the scourge has remained endemic.
Under CMAM, malnourished children, who are six months to five years, are given Ready-to-Use Therapeutic Food (RUTF) for about two months.
The RUTF is a peanut-based paste, which contains milk powder, sugar and multiple micronutrients.
More than two million children with severe acute malnutrition have been rehabilitated since this programme began, according to Unicef.
But for the programme to continue, states and the federal government need to make a counterpart financial obligation.
For the first time since Unicef began the programme, the federal government provided N1.2 billion in the 2017 budget to purchase RUTF.
According to the government, the allocation will be for “co-funding to Unicef for the procurement of ready-to-use therapeutic food to be distributed to six geopolitical zones, including the establishment of CMAM sites.”
Acute funding cuts
But since then, the government has continuously trimmed the allocation.
In the 2020 budget, about N800 million initially earmarked for it was later removed, a situation that has put the programme under severe threat.
Health experts have repeatedly warned of a disastrous increase in malnutrition both in the immediate and long term due to government’s failure to allot a dime in the 2020 budget for the programme.
Nigeria has the second-highest number of stunted children in the world with two million children battling with Severe Acute Malnutrition (SAM).
“We call on government to return the N800 million RUTF allocation removed from the 2020 budget of the federation as Nigeria runs the risk of increased burden of malnutrition if government allows the emergency situation of COVID-19 to stop them from funding and implementing nutrition programmes and interventions in the country,” Beatrice Eluaka, the Executive Secretary of Civil Society Scaling-up Nutrition in Nigeria (CS-SUNN), said.
She spoke during the virtual nutrition conference in August, convened by the wife of President Muhammadu Buhari, Aisha, through her pet project, Aisha Buhari Foundation, in collaboration with the International Society of Media in Public Health (ISMPH).
Nutrition advocates at the event said the removal of the fund has led to zero allocation for nutrition and would hamper the war against malnutrition, saying the country has over the years depended largely on donors for nutrition funding.
The theme of the event was: “Harnessing Innovation Financing Options for Nutrition — unravelling the bottleneck”.
Currently, an estimated 2.5 million Nigerian children under five have severe acute malnutrition. To survive, they need urgent treatment.
About 420,000 deaths are recorded from SAM annually, according to UNICEF.
Nigeria still has the highest burden of stunting in Africa and is still the second-highest in the world next to India.
The country’s current nationwide childhood under-nutrition indicator stands at 37 per cent stunting, 7 per cent wasting and 23 per cent underweight, according to Nigeria Health and Demographic Survey (NDHS, 2018).
Unicef puts the cost of treating a malnourished child under the CMAM at N50, 000. To cover all the affected children in the country, it would cost about N95 billion.
CMAM has been largely financed by the British charity, the Children’s Investment Fund Foundation (CIFF) with counterpart funding from the federal government and states that are benefitting from the programme.
Even when there were budgets for RUTF, some states suffer from RUTF stock-outs due to several factors including poor counter-part funding.
Mrs Eluaka explained that only two out of every 10 children currently suffering from SAM are reached for treatment and with the Covid-19 pandemic, cases of malnutrition have risen in the country.
Ebere Agu, a nutritionist said zero allocation for RUTF only makes the situation an “impossible dilemma” for several communities battling SAM.
Grants from foreign donors are shrinking as much attention is been channelled to tackling COVID-19 coupled with the global economic downturn from the pandemic.
The misinformation that came with the pandemic also makes the situation more complicated.
A PREMIUM TIMES report in August revealed how breastfeeding programs, which are regarded as an alternative in tackling SAM is being impeded by a wave of rumours, mixed messages and deliberate misinformation that came with COVID-19.
“One can imagine what the situation will be now without an RUTF budget,” Mrs Agu told PREMIUM TIMES on Friday.
“The coronavirus has already caused disruptions in delivery at the 200 CMAM sites across the country with several restrictions and safety protocols in place to curb the spread of the contagion,” she said.
“With acute underfunding added to the mix of factors, there could be a dilemma in the near future.”
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