By Usman Aliyu
Malnutrition is an issue that no country can afford to overlook. Literally, malnutrition connotes ‘bad nutrition’ and aptly describes the imbalance between the body’s supply and demands of nutrition.
Nutritionists describe it as an abnormal physiological condition caused by inadequate, unbalanced, or excessive consumption of macronutrients, micronutrients, or both.
From 2019 statistics of the United Nations Children’s Fund (UNICEF), malnutrition is a direct or underlying cause for 45 per cent of all deaths of under-five children in the world. The data rate Nigeria as the second country in the world with the highest burden of stunted growth among children, an impaired development evidently caused by malnutrition.
The studies noted that the national prevalence rate of stunted growth in Nigeria is 32 per cent of children under the age of five. The findings further revealed 2 million as the estimated number of children in Nigeria that suffer from severe acute malnutrition (SAM), while only two out of every 10 children affected are currently reached with treatment.
Similarly, seven per cent of women of childbearing age, according to the UNICEF, report, suffer from acute malnutrition in Nigeria.
Nutritionists identify the four broad sub-forms of malnutrition as wasting, stunting, underweight, and deficiencies in vitamins and minerals and these conditions make children, in particular, more vulnerable to disease and death.
It is because of this ugly situation that some public hospitals in Kwara devised a means to help in the fight against incidence of malnutrition.
Civil Service Hospital, Ilorin is one of such hospitals that have adopted food demonstration for nursing mothers as a way to check cases of malnourished children in the society.
Since poverty is said to increase the chances of malnutrition in a family, the hospital teaches mothers how to improvise with locally available ingredients to form balanced diets for their infants.
Mrs Margret Olayinka, is a Community Health Officer and the Head of Department (HOD), Immunisation Unit of the hospital, a section that spearheads the food demonstrating activities for nursing mothers during visits to immunise their children.
Olayinka explained that the decision to engage in the activities was taken following the discovery of cases of malnourished children among infants who came for immunisation some years back.
“There is something we call growth monitoring that we carry out for a child from birth until he or she is fully immunised.
“From growth monitoring like checking weight and arm circumference, we discovered children that are underweight for their age.
“When we interviewed their mothers especially of children of six months and above on what they feed their children with, some would say breast milk while others could not give satisfactory answers.
“From this, we decided to introduce what we call fortified pap to them. Fortified pap is a semi-solid food they can give to the children once they reach the age of six months in order to guide against malnutrition,” she said.
The senior health officer adjudged that the effort had been very fruitful as no case of malnourished child was reported since the introduction of the demonstration.
“This is because what we taught them to be doing is characterised by a form balanced diet. All the nutrients that a child needs are found in the foods we asked them to make.
“Besides, the fortified pap we always talked about is cheap and economical, even for the mother and the family at large to consume.
“It is made from guinea corn, soya beans, crayfish, and fish. Even fish and crayfish may not be really necessary for whoever that does not like their aroma.
“The most important ingredient is soya beans because it is highly proteinous. So adding it to the pap makes it more nutritious for babies. It helps them to develop well”, said Olayinka.
She also said mothers were trained on how to introduce and make family foods like beans, amala, semo, ewedu and moimoi for babies in a different way from for the adult’s.
“We teach them how they can peel the back cover of beans, cook it and make it very soft and give to the children.
“We teach them how to make moimoi for children; how to prepare solid foods like amala, semo as well as how to make ewedu with crayfish or mashed fish.
“All these ingredients will make babies derive the necessary nutrients they need. We also teach them how to match fruits together like doing smoothies for babies for vitamin acquisition”.
Testifying on the benefits of the food demonstration sessions in the fight against malnutrition, Mrs Bola Mohammed, a nursing mother and resident of Ilorin related how she used fortified pap learnt at one of the training sessions to save her malnourished daughter.
“Since we were told that our breast milk would no longer be much useful after six months without complements, we need food supplements.
“We were taught ways to prepare supplements with natural and locally available ingredients if we do not want to use those package baby foods.
“My little girl, she was malnourished and suffered weight loss. When I brought her here, I was asked to buy ingredients like guinea corn or millet, soya beans and add groundnut or dry fish if I like and grind them together to make fortified pap.
“As soon as I fed her with it, I began to see changes. This food is cost effective because right in our household we consume pap.
“So when we prepare pap, we can use it for our breakfast. So it will save us the labour of cooking another thing to eat in the morning”, she said.
Mohammed commended community health workers in the hospital engaged in the demonstration, saying it was really helping the society in many ways.
Corroborating the stance, Mrs Abisola Olayemi said the fortified pap and tom-brown she learnt through food demonstration had proven effective in nourishing her children and improving their growth.
Olalemi, who demonstrated how fortified pap and tom-brown were made, laid emphasis on the need to carry out the preparation under a very hygienic environment to avoid contamination.
She said the foods were devoid of any preservative that could be harmful to children.
Notwithstanding this, Olayinka, the sectional head of the unit, identified lack of money as the major challenge that always threatened the continuation of food demonstration.
“As we all know, money is the alpha to everything. We buy all the ingredients we use – guinea corn, soya beans, crayfish and fish among others, even the cooking gas.
“Our major challenge is financing the demonstration from time to time. With inflation, price of everything has soared.
“Nobody is giving the money, we leverage relationships to finance the food demonstration”, she said.
She, however, assured that the unit would continue to improvise to ensure that the programme does not stop.
She explained that immunisation is free, hence it would be difficult to levy nursing mothers, but says that the unit would source for resources within its means.
Another challenge for the programme is the Covid-19 pandemic. The Kwara senior health officer said the outbreak of the pandemic changed the routine at the hospital.
“Covid-19 has stopped us from meeting people in groups. We used to carry out the demonstration in groups of 20 mothers; it was a kind of group discussion.
“But Covid-19 has forced us to stop this gathering. We do attend to our patients now one after the other. We don’t even want them to wait. At a point, we stopped the demonstration.
“As a result of this development, some new mothers have not been able to witness the demonstration or benefit from this training”, she added.
The unit head, nevertheless, said arrangements had been concluded to resume the demonstration in line with the new normal.
“We have concluded arrangements to resume the food demonstration services, but with strict adherence to COVID-19 protocols.
“We will have to reduce the number of participants per training session. This place used to be crowded, but that cannot happen again”, said the senior community health worker.
She called on private hospitals in the state to introduce the programme, saying its benefits for mothers and infants were important to their well-being.
In her reaction to the efforts of public hospitals in Kwara, Mrs Chinwe Ezeife, the Nutrition Specialist at the Kaduna Field Office of the UNICEF, commended the health workers for their proactiveness in the fight against malnutrition.
“It is my biggest joy is that they are integrating nutrition services as part of their routine. The food demonstration services will give the practical skills to pregnant and nursing women on how to prepare complementary foods, which they have to introduce to children of six months and above.
“The counselling on maternal nutrition will build their skills and enhance their capabilities for optimal infants and young child feeding practices,” she said.
Ezeife, thereafter, called on policy makers in Nigeria to see nutrition as a human capital development.
According to her, policy makers must know that nutrition is not just a health intervention of well importance but a human capital development issue that requires head-on attention.
“In fact, this is in line with the SDGs of which nutrition is very important,” she said.