Unsavoury findings in the 2018 National Nutrition and Health Survey

The recently released report on the nutrition and health situation of Nigeria by the National Bureau of Statistics (NBS) does not give any ray of hope that the myriad of problems facing the nation’s health sector are gradually being addressed. The central message in the report is that you cannot continue to do something the same way and get different results. In other worlds, without adequate allocation of funds to the health sector by the federal and state governments, and appropriate compensations for health workers as well as ensuring that the resources allocated to the sector are judiciously used, the narrative will not change.

Public health workers of the federal and state governments have embarked on industrial actions several times to call stakeholders’ attention to the poor state of healthcare facilities in order for governments to improve the working conditions of workers through improved funding and the provision of the state-of-the-art equipment. While frequent strikes may not be the best solutions, the poor funding of the heath sector is one of the major causes of brain drain in Nigeria, denying the citizenry of the our best physicians.

The 2018 National Nutrition and Health Survey (NNHS) was carried out by the NBS with the support of the National Population Commission and the Federal Ministry of Health. Of course, without adequate financial support, the project would not have seen the light of the day, meaning that financial support was provided by the Federal Government of Nigeria, United Nations Children’s Fund (UNICEF), United States Agency for International Development (USAID) and the Department for International Development (DFID).

The 2018 edition is the third in its series as the first two editions were carried out in 2014 and 2015. Through the survey, NBS is able to provide up-to-date information on the situation of nutrition and health, as well as measure key indicators that support the country to progress of Saving One Million Lives (SOML) Program for Result (PforR) initiative plus other goals. The major aim of NNHS was to evaluate the present nutrition status of children aged 0 to 59 months and women that fall within the reproductive age between 15 and 49 years at state, regional and national levels.

A total of 19,471 boys and girls from 24,857 households were sampled for anthropometry and health status. Also, a total of 24,985 women aged 15-59 years were interacted with to determine their nutrition and reproductive health status using validated tool and protocol. The survey adopted a two-stage cluster sampling methodology in selecting 36 clusters from 37 states where each cluster had 20 households each and over 95 percent of the clusters were accessed.

Findings in the NNHS report indicate the level of child and women nutrition with particular attention on the global acute malnutrition (GAM); infant and young child feeding practices; reproductive health, as well as water and sanitation.

“The national global acute malnutrition (GAM) prevalence among children 6-59 months of age based on weight-for-height Z score and/or oedema was 7.0 percent with moderate acute malnutrition (MAM) of 5.5% and severe acute malnutrition (SAM) of 1.5% including 24 (0.1%) oedema cases. The rates indicate that acute malnutrition levels have remained at alert levels of 5-9.9% over the years since 2014. The prevalence of underweight among children aged 0-59 months was 19.9 percent , just at the margin of the 20 percent threshold for serious situation that it has been since 2014, higher than the global estimate of 15 percent but consistent with the rates in the West and Central Africa region (22%)”, the NNHS report states.

In addition, the prevalence of stunting, which means improper growth in children, was found to be at 32 percent, a level it has maintained since 2014. Stunting prevalence was found to be more critical in the north east and west, to be above 40 percent which is WHO critical levels. In the same geopolitical zones, boys aged 0 to 23 months and teenage women aged 15 to 19 years are at a higher risk of malnutrition.

“These results sound a warning to all stakeholders that efforts to invest on nutrition sensitive to geographic location, gender, and age of target population should be maintained to reduce acute and chronic malnutrition levels to below 5 percent and 20 percent respectively as envisaged in the national and international goals. Improving nutrition in the first 1,000 days window and in adolescent girls is critical to improving the nutrition status of the entire population of Nigeria”, the NNHS suggested.

While breastfeeding is a widespread practice in Nigeria, the survey found out that more than 80 percent of the new-borns do not timely receive milk and colostrums within one hour of birth, with about 27 percent of 0 to 5 months old infants are breastfed exclusively implying that over 63 percent of infants within this age group are introduced to complementary foods before the age of six months earlier than the recommendations of WHO/UNICEF. In addition, about 60 percent of the children sampled were not fed to the desired level of meal frequency, predisposing them to unhygienic feeding conditions and increasing their vulnerability to illnesses.

A pharmacist, Babatunde Olayiwola, CEO Minaret Pharmacy Limited in Ibadan attributed the high level of malnutrition to poverty.

“The report simply shows that people are poor. As a result of this they are not able to feed their children very well. Even in pregnancy, if you don’t eat appropriately, it may affect the unborn child and the impact may be there with him for the rest of his life”, Olayiwola said.

The reproductive health status of women aged 15-49 years mirrored the patterns displayed by the aforementioned metrics. According to the survey, the availability of skilled birth assistance is lowest in the North West at 22 percent. In states such as Sokoto, Jigawa, Katsina, Kebbi, as well as Bauchi and Yobe in the North East, over 80 percent of deliveries were not assisted by skilled birth attendants. Deliveries with the support of skilled birth assistants are highest in South East at 88 percent and followed by South West at 85 percent.

Improvement was only recorded in the provision of water and sanitation facilities. Nationwide, 57 percent of the households had access to improved water sources, and improvement over 52 percent recorded in 2015. On the other hand, about 47 percent of the households had access to improved sanitation facilities. South-South, South West and North West witnessed the highest proportions in access to improved water source while the North East and Central the regions with the lowest access to improved water source.

Among the geopolitical regions in the country, South West had the highest response rate of 95.5 percent and it was followed by South-South, 94.7 percent; North West, 94.6 percent; South East, 93.4 percent; North East, 93.1 percent and North Central, 89 percent.

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