Nigeria has the second highest number of stunted children (pdf) in the world, and rates of stunting, a measure of chronic undernutrition, exceed 50 per cent in some northern states. Rates of acute malnutrition, where a child is dangerously thin, are often above the international threshold for an emergency situation.
Given the high number of undernourished children in Nigeria, achieving improved nutrition in Nigeria is essential to achieve ambitious global nutrition targets including the World Health Assembly global nutrition targets for 2025. However, improving nutrition requires strong political commitment, as well as strong evidence for what works, and what does not, tailored for the context of northern Nigeria.
Sharing lessons with policymakers, civil society and the media
Earlier this month, the Operational Research and Impact Evaluation project (ORIE), in partnership with the Working to Improve Nutrition in Northern Nigeria (WINNN) programme, Department for International Development, and the Government of Nigeria, organised an event to share research findings from ORIE’s evaluation of and operations research with WINNN over the last two years.
Key stakeholders present included representatives from Federal and State Governments, development partners, civil society, academia and the media. Messages from the event were picked up by a number media outlets via a press release and briefing. Coverage included a video report by The Daily Trust. The event followed an ORIE and WINNN engagement event held in April 2014.
During the event, ORIE shared some of the key findings from operations research studies of barriers to women practicing exclusive breastfeeding and how these can be overcome; why women are not attending antenatal care clinics and how attendance can be increased; and how to improve messages around improving children’s diet when complementary foods are introduced. An economic evaluation, seeking to understand the cost of delivering a comprehensive nutrition programme, as well as a study looking at health facilities providing Community Management of Acute Malnutrition (CMAM) services, were also presented. Finally, analysis from an annual gender synthesis, which seeks to understand the gender implications of all of these studies, was presented.
Key issues highlighted during the debate
- Political will is critical, especially at the highest levels in state and federal government. Participants highlighted the importance of gaining support from the powerful state governors who control major priority and resource decisions.
- Increased budget, and critically disbursement, for nutrition is essential to achieve sustainable reductions in malnutrition. In many states, budget has been allocated, but often not disbursed, or disbursed late. Ensuring sustainability of the nutrition interventions currently funded by DFID through WINNN means that the Government must commit adequate and reliable funding for nutrition at local, state and federal levels. Developing a strong evidence base is necessary.
- Equally important is disseminating the findings to all those involved in policy and programme decision. Building the capacity of Nigerian researchers, especially in the North, will allow the evidence base to continue to grow. One action which many of the participants committed to was taking the findings back to their states and organisations, and using them to increase awareness and inform resource decisions and priority setting.
- Nutrition messages, mobilisation and advocacy, need to be targeted, as highlighted by ORIE. Improving nutrition is not only the responsibility of mothers, but rather the whole family, community, local government officials, and through to state and national government. Messages need to be developed and targeted with different family and societal members in mind. The research found that older female relatives play a significant role in influencing infant feeding. Their views are respected, meaning messages around the importance of exclusive breastfeeding need to reach these women.
- Gender roles and relations impact nutrition. Gender is not just about women, but also getting men involved in supporting their wives, daughters, and other female relatives to use health services and to support them with infant and young child feeding and care. The whole family, and community, must take responsibility for ensuring improved child nutrition.
At the end of the meeting, participants made specific commitments to actions they would take within the next six months, translating the evidence shared into better policies, programmes and, hopefully, improved nutrition outcomes in Northern Nigeria.