A New Approach to Addressing Nigeria’s Malnutrition Challenge

For decades, the Nigerian government has undertaken several agricultural reforms and nutrition strategies aimed at boosting food production and decreasing malnutrition. This work has been fruitful, with Nigeria’s food production index increasing over the last forty years.

Despite this, Nigeria still struggles with high rates of malnutrition throughout many regions of the country, posing a public health and development challenge for many of the nation’s most vulnerable citizens. The enormity of the challenge is reflected in the country’s childhood nutrition statistics–37 percent of Nigerian children under age 5 are stunted, 23 percent are underweight, and seven percent are wasted (Nigeria Demographic and Health Survey 2018). This prevalence of malnutrition among children is higher in rural areas than the urban areas, causing further societal inequalities along geographic lines. Further, malnutrition has significant adverse effects on childhood development, while exposing pregnant women to disease susceptibility, poor fetal growth, and a higher risk of pregnancy complications.

Due to the multidisciplinary nature of nutrition, combating malnutrition in all its forms at both national and subnational levels requires a holistic approach that is multisectoral. Multisectoral collaboration for food and nutrition can pull together all stakeholders in relevant issue areas to ensure a better understanding of the situation, come up with solutions, and take broader actions against malnutrition in the country. That is the rationale behind the adoption of the National Multisectoral Plan of Action for Food and Nutrition (NMPFAN), which aims to guide intervention efforts targeting malnutrition for the period 2021 to 2025. The five-year plan is designed to eliminate all forms of malnutrition as a public health problem in Nigeria, as well as contribute to the achievement of the Sustainable Development Goals target by 2030. To achieve optimal results, the plan aims to scale up priority high-impact-nutrition-sensitive interventions and programmes across all sectors with a special focus on the most vulnerable Nigerians especially women and children. The plan proposes prioritized interventions mainly in states where the incidence of stunting and severe stunting exceeds 40 percent and 20 percent respectively.

NMPFAN Objectives and Priority Areas

The broad objectives of the multisectoral plan of action are to improve food security at the national, community, and household levels and to reduce the proportion of people who suffer hunger and malnutrition by 50 percent by 2025. To achieve these objectives the plan identified six priority areas which include food and nutrition security; enhancing caregiving capacity; enhancing provision of quality health services; improving capacity to address food and nutrition insecurity problems; raising awareness and understanding of the problem of malnutrition and resource allocation for food and nutrition security at all levels.

• Food and nutrition security: The plan focuses on achieving food and nutrition security through investment in agriculture to increase food production, availability, accessibility, and affordability to all Nigerians. In addition, policymakers identified the development and strengthening of school-based strategies such as the National Home-Grown School Feeding Programme (NHGSFP) by the government as one of the most effective measures to improve the management of food security crisis and malnutrition among children.
• Enhancing caregiving capacity: The plan seeks to address the entire scope of the malnutrition problem in the country through focus on infants, young children, and mothers. It aims to specifically implement programmes to ensure optimal nutrition in the first 1000 days of life — a period between a woman’s pregnancy and her child’s second year.
• Enhancing provision of quality health services: The plan seeks to enhance the provision of quality health services through managing nutrition-related diseases. It proposes specific interventions targeted at preventing micronutrient deficiencies as well as protecting the consumer through improved food quality and safety.
• Improving capacity to address food and nutrition insecurity problems: This involves the provision of enabling environment such as a conducive macro-economic environment to improve capacity to address food insecurity problems. For example, the government and policymakers will need to consider nutrition-sensitive social protection programmes to cushion the effect of rising food inflation on vulnerable groups.
• Raising awareness and understanding of the problem of malnutrition: The plan includes activities to promote positive behaviour change, healthy lifestyles, and dietary habits among Nigerians through advocacy, communication, and social mobilization.
• Resource allocation for food and nutrition security at all levels: The NMPFAN identifies and addresses the issue of resource mobilization which is one of Nigeria’s nutrition policy implementation problems. It provides activities to ensure budget allocation, timely release, and utilization.

In addition, the plan provides an implementation coordination structure from national to local government. The Federal Ministry of Finance, Budget, and National Planning is responsible for the coordination and implementation of the policy and to provide the national focal point for food and nutrition policy programme planning. On the other hand, State committees on food and nutrition and Local government committee on food and nutrition will coordinate all food and nutrition programmes at State and Local government levels respectively. The plan also proposes the creation of a ward committee on food and nutrition for extensive impact at the ward level.

Limitations

With less than two years of policy implementation and the first evaluation of progress set for next year, it is difficult to assess the NMPFAN’s performance. However, comparing the plan with previous nutrition policies in Nigeria, the NMPFAN cuts across various sectors and adopts a  monitoring and evaluation system with a robust food and nutrition information collection and management system to provide information on extent of progress being made towards achieving zero hunger. It also establishes a budget line for food and nutrition in relevant MDAs at all levels of government —judging by this and its population of potential beneficiaries, the policy is commendable, and the potential is enormous.

However, the plan has some limitations. One of them is that while the plan recognizes public-private sector collaboration and outlines the roles of both sectors in scaling up nutrition interventions, it failed to provide a framework for communication between the government and the private sector, civil society organisations and development partners. In addition, the multisectoral plan also failed to recognise the significant role digital technology solutions and strategies led by the Ministry of Communications and Digital Economy and National Information Technology Development Agency (NITDA) could play in addressing the country’s food and nutrition insecurity problems. For example, deploying digital technologies into the agricultural sector in areas such as irrigation, food production and processing and leveraging on NITDA’s smart agriculture policies will further increase the availability and affordability of food year-round. However, the availability of digital agriculture solutions does not guarantee adoption for food production —one way to facilitate uptake would have been to strengthen the collaboration between the Ministry of Agriculture and the Ministry of Communications and Digital Economy with the nutrition plan.

Furthermore, the nation’s economic uncertainty and political changes in proposed years of programme implementation could significantly influence the progress of the plan in achieving its target of halving the proportion of people who suffer hunger and malnutrition by 2025. For example, economic factors like high inflation can lead to reduced food access due to increases in the prices of food (including ready-to-use therapeutic food). A recession can also result in funding cuts for nutrition programmes. The upcoming political change could result in discontinuity of the nutrition programme implementation by the succeeding government administrations.

In conclusion, to make considerable progress on NMPFAN implementation by 2025, it is necessary to strengthen coordination and collaboration among all stakeholders for sustainable programme funding. There is a need to promote advocacy to key stakeholders to increase the commitment to nutrition funding; strengthen intersectoral capacity for collaboration; and institute periodic monitoring of NMPFAN’s impact on nutrition indicators in collaboration with partners, civil society organisations, and the private sector at all levels.

This article was written by Malcolm Durosaye.