Despite its achievements in physical infrastructure, Gombe state government has a poor nutrition record among other states in the country. Writes AUWAL AHMAD.
Malnutrition described as one of the major factors affecting the society particularly in northern Nigeria was found to be more critical in the North- west and North-east according to NDHS 2018. Nigeria has the second-highest burden of stunted children in the world with a national prevalence rate of 32 per cent of children under five.
National estimate
An estimated two million children in Nigeria suffer from severe acute malnutrition (SAM), but only two out of every 10 children affected are currently reached with treatment. Seven per cent of women of child-bearing age also suffer from acute malnutrition.
In six states of the North-east, there is 42.8 percent of stunting children, 1.5 severe acute malnutrition (SAM) and underweight 25.5 percent.
The Gombe example
In Gombe state, 44.6 per cent of children are stunted, 1.3 per cent severe acute malnutrition and 26.9 percent underweight.
Profound global problems like hunger are largely driven by poverty and inequality. Given the high poverty rate in Nigeria and the North-east States, the poor are most disadvantaged when it comes to access to food and nutrition with most vulnerable groups, children and mothers being the most affected.Report has it that no fewer than 342 children died from malnutrition in Gombe State between 2017 and August 2020 while on treatment at Community Management for Acute Malnutrition (CMAM) Centres in the state.
In 2020 alone, between January and August, 50 malnourished children died and many experts have seen this figure as a microscopic representation of actual reality especially in hard-to- reach villages without government presence like school or clinic.
Blueprint Investigation has shown that in 2017 in Gombe, 15, 972 malnourished children were admitted. Out of that number,13,069 were treated and discharged while 150 lost their lives and 710 children defaulted and were not able to continue with the treatment for reasons best known to their parents.
Also in 2018, no fewer than 13,594 children were admitted in the state out of which 11,250 were treated and discharged while 673 defaulted and 99 lost their lives during the treatment. Meanwhile, in 2019 about 7,637 children were admitted, 4500 were cured while 694 defaulted and 43 lost their lives. From January to August 2020, 14, 175 malnourished children across the 23 Community Management of Acute Malnutrition (CMAM) centres in the state namely Gombe, Dukku, Nafada, Akko, Kwami and Kaltungo local government areas were admitted and out of that number, 9, 189 were treated and discharged while 1195 children defaulted and were not able to continue with the treatment for reasons best known to their parents. However, 50 children died while on treatment which was attributed to Covid-19 pandemic.
The pandemic highlighted the need for stronger measures to be taken on malnutrition treatment in Nigeria and Gombe in particular. COVID-19 pandemic, like most emergencies, leaves families with children in an extremely vulnerable position.
Pandemic availability and increased access to health care workers, including midwives and nurses, to deliver skilled counselling on breastfeeding to mothers and families are essential. And efforts must be made to increase investment in maternal, infant and child nutrition interventions at the community level and to implement policies that support maternity leave for six months in the public sector and an enabling environment for breastfeeding in the private sector.
Advocacy for paid paternity leave must also continue to ensure full participation of both parents in the early moments of the child.Investigation also revealed that the state is among the eight in the country that secured loans from the World Bank to address malnutrition.
Efforts made so far
Further investigation reveals that the state government has been implementing the state National Plan of Action on Food and Nutrition Policy to strengthen health and community systems in order to fully integrate nutrition into all aspects of primary health care system which would focus on Community Management of Acute Malnutrition, Infant and Young Child Feeding intervention in the state.
Some stakeholders speak
The state coordinator of Civil Society CS-SUNN, Comfort Mokolo, appealed to the state government to scale up Community-Based Management of Acute Malnutrition (CMAM) sites across the 11 LGA’s of the state.According to her, the remaining five sites should be considered for effective distribution of ready-to-use therapeutic food and treatment of severe, acute malnutrition.
“Out of 11 local government areas in the state, six local government areas have Community Management of Acute Malnutrition (CMAM) sites and five local government areas yet to be established.
Malam Alhassan Yaya Abdullahi, the executive director SAIF Advocacy Foundation and Nutrition Champion in Gombe state commended Governor Muhammadu Inuwa Yahaya for approving 75 million Naira for the purchase of RUTF and it is on record that out of the approved money, 25 million has so far been released. He further called for effective release of budgetary allocations.
“There were many items deducted during implementation where the House of Assembly would use its power most especially during oversight functions. We are appealing to the House of Assembly to add more funds to cover for the entire thematic areas, which is a major challenge health is facing.
The speaker Gombe state House of Assembly, Ibrahim Abubakar, during an under spot assessment to Pantami CMAM site, said what was observed is a stark reality of the situation of malnutrition in the state.
“The governor has made the health sector his priority and as such has taken good time and resources to invest into the health sector from the confession by parents that the RUTF that they have been giving their children was improving their health.”
The speaker however lamented the increasing number of children suffering from Severe Acute Malnutrition (SAM) in the state even as he pledged that the state assembly would collaborate with the executive arm of government and support moves aimed at improving the health sector of the state.
He also announced that plans were underway to scale-up the Community-based Management of Acute Malnutrition (CMAM) services to the whole state.
However, he assured that the house is working in collaboration with the state Food and Nutrition Committee toward improving funding for nutrition in the state health budget while also explaining that what he and other lawmakers observed during the assessment visit to CMAM site in PHCC Pantami is a stark reality on the situation of malnutrition, which has made it necessary for actors to stand against SAM in the state.
He added that, “The governor has made the health sector his priority and as such has taken good time and resources to invest in the health sector by providing the Ready to Use Therapeutic Food (RUTF) for distribution to children and as we have heard from the confessions of the parents, it has helped to improve the health of their children. “However, we are going to make sure that the government does more for these children who are our future leaders.”
Aishatu Umar is a registered nurse-midwife. While speaking with Blueprint, she said there is a need for parents to be sensitised and encouraged to embrace complementary feeding and exclusive breastfeeding.
“So that as the children are transiting from RUTF to the locally available food, there would be an impact,” Aishatu said. This is coming just as the state commissioner for health assured that the government would leave no stone unturned in addressing health issues in the state.
Mrs Ronas Amusa, the state’s nutrition officer told Blueprint that the African Development Bank, through Gombe State Rural Water and Sanitation Agency, had provided grinding machines in the 11 local government areas (LGAs)of the state to be used in the production of complementary food.
According to Amusa, complementary food is for children who have been screened and found moderately malnourished at the facilities.She explained that the nutrition office would collaborate with the state’s Ministry of Science and Technology in providing the raw materials for production of the food.
She disclosed that through the Accelerating Nutrition Result In Nigeria (ANRIN), the project had also been providing vitamin A supplements such as Fesolate and Folic acid to pregnant women and adolescents mothers.Amusa, however, expressed regrets that out of the 11 LGAs in the state, only six had Nutrition Service Centres; therefore, urged the state government to scale up the service to the remaining five LGAs for effective service delivery.
