INVESTIGATION: How COVID-19 impedes fight against child malnutrition in Nigeria

By Hassan Zaggi

Like other sectors of our national life, the COVID-19 pandemic has had a huge negative impact on the fight against Severe Acute Malnutrition (SAM) in Nigeria, The AUTHORITY investigation has revealed.

Checks across the Community Management of Acute Malnutrition (CMAM) centres in some parts of the country, revealed that most centres were almost totally locked down due to the COVID-19 pandemic.

Also, a cross section of experts interviewed by our Correspondent, expressed fears that the number of children suffering from SAM might have increased in Nigeria due to the pandemic.

According to experts, prior to the COVID-19 pandemic, SAM has remained a life-threatening condition affecting over 2.6 million Nigerian children under the age of 5 years.

This number, the experts argued, might have doubled due to the pandemic.

More worrisome, experts said, children with SAM are nine times more likely to die than well-nourished children; more likely to be sick and have reduced cognitive ability.

Regrettably, however, findings by our Correspondent at one of the CMAM centres in Kwali Area Council in the Federal Capital Territory (FCT), revealed that SAM related services are almost grounded due to the COVID-19 pandemic.

Even though our Correspondent did not meet the officer in charge during the visit, a staff of the clinic who pleaded anonymity, revealed that since the COVID-19 pandemic started, less patients visited the facility.

The source revealed that during the peak of the COVID-19 lock down, SAM related services were not offered because the parents of the children were afraid of the COVID.

“You know the COVID-19 affected everything. Even normal patients were not even coming to the clinic let alone those with the issues of malnutrition. Everybody was afraid and the restriction of movement also put everything at a stand-still.

“Even though I am not involved in treating people, but I noticed that what they usually give children who are suffering from malnutrition (Ready to Use Therapeutic Foods –RUTF) got finished. Even now that people are beginning to come to the clinic, I don’t always see patients coming out with that thing they usually to give them. The health personnel always just see them and give them some small drugs and tell them to go.”

Responding to a question on whether he is aware of any plan by the clinic managers to get more RUTF, the source said: “I don’t know. All I know is that during the COVID-19 period, not many children were treated of malnutrition in this place.”

When asked by our Correspondent to direct him to the house of one of the patients that is suffering from SAM, the source said: “I don’t know their houses because they come from remote areas for treatment here.”

Speaking to our Correspondent on phone, a nutritionist based in Kaduna, Halima Umar, said that due to the COVID-19 pandemic, Nigerians should expect an increase in the number of children suffering from SAM.

According to her, prior to the COVID-19 pandemic, poverty in Nigeria was already high and that the lockdown and the near stand-still in economic activities during the first 4 months of the pandemic escalated the poverty level of Nigerians, hence, also increased the severity of malnutrition in the country.

“Why are you asking me whether the COVID-19 pandemic has affected the fight against malnutrition? Are you not in this country? Are you not aware of the high level of poverty in the country even prior to the pandemic and how it has increased now?

“Let us be sincere to ourselves, whether we like it or not, the number of severely acute malnourished children have increased. Let them conduct a survey and see for themselves. Most parents don’t have source of income now, how do you expect them to feed their families well.

“If you go to the remote areas, especially in Kaduna here, you will understand what I am saying. The government should be up and doing because deaths related to SAM will rise.”

Corroborating the effect of COVID-19 on the fight against SAM, an Abuja-based expert, Lovelyn Agbor- Gabriel, expressed fears that the efforts of the federal government might suffer set back because, according to her, there might be an escalation in the number of children suffering from SAM due to the COVID-19 pandemic.

She reiterated that even though the government had tried in fighting child malnutrition, it, however, needs to do more to ensure that Nigerian children do not die as a result of SAM related illnesses.

“The COVID-19 has affected the fight against child malnutrition in two areas.

“You remember due to the COVID-19, budgets at both the federal and state levels have been reviewed due to the current economic situation.

“This review affected the budget plan for malnutrition negatively.

“Already, before now, you find out that the budget line allocated for the treatment of child malnutrition is not even enough and there has been agitation for it to be increased because of the enormity of the situation, but now, because of the COVID-19 impact on the economic outlook of the country, they have even reduced it.

“This means that the little progress we made some years ago was taken back, particularly in the area of purchasing of RUTF to treat children that are severely acutely malnourished. This situation is the same even at the state level because they have reviewed their budgets downward.

“Generally there is a slash. Even where there is no slash, the release of the budget is another problem still because of the economic situation.

“Because of the COVID-19, governments are not paying attention to malnutrition, they don’t even see the urgency in it, the pandemic has taken the attention of governments at all levels.

“The other way the fight against COVID-19 has impacted on malnutrition is that families are further impoverished.

“During the lockdown when no economic activities were happening, all the families that depended on daily income have nothing to write home about and these are mostly the category of people that have severely malnourished children.

“So, because family income dropped down to almost zero in most cases, their livelihood is further depreciated and we have more children coming into the malnourished line,” she said.

On whether the number of severely acute malnourished children have increased, she said: Yes, its okay to say that. This is because if you go to a place where there is a stock out, even children that were already treated because they have not finished their cycle of treatment and there is stock out of the RUTF, they may relapse.

“And then, with the economic situation, people are not eating properly, you find out that new cases will be arising.

“So, it is not out of place to say that.

“However, it is not that the government has not tried. Before the pandemic, the budget line at the federal level for the prevention and treatment of severely acute malnourished children doubled the one of 2019.

“So, if not for the pandemic, people have been pushing for the release, at least, whatever they released, it would have helped.

“But then, the economic situation has further tightened down the hands of the government.

“However, the government has tried, but the pandemic has affected its effort. They need to do more.

Lovelyn Agbor- Gabriel, however, expressed optimism that the country can recover from the effect of COVID-19 pandemic if the governments at all levels muscle the political will.

“We can recover only if the government is ready to deal with these issues. It all boils down on availability of funds. We need funds for awareness creation at all levels. People should know the way to take care of their children in order to avoid their children falling within the malnutrition line. And for those who are already severely acute malnourished, they need RUTF.

“But by and large, it is not like it is not doable to reverse the situation. It just required a stronger level of political will and commitment of more funds.

“ I say commitment of more funds, it is not verbal commitment, having it in the budget and actually releasing it.

“This is because in the past, you find out that it has been captured in the budget, however, it has not been released. Even if you talk about the release, there is no cash backing and in most cases too, you find out that there is diversion.

“Until all these issues are taken care of, we cant move ahead. The truth is that we can actually do it as a nation. That requires political will if we want to do the right thing.”

She further called on the private sector to consider producing RUTF in-country to make the product readily available and at a reduced cost.

At the level of individuals, she called for more awareness creation so that people can know more about where to get help when in need of it.

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