Mobilizing and Strengthening Civil Society Organizations To Scale Up Nutrition in Nigeria
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Transcript of Mobilizing and Strengthening Civil Society Organizations To Scale Up Nutrition in Nigeria
Mobilizing and strengthening Civil
Society Organizations to scale up nutrition in
Nigeria: A Call for Action
by Dr. Philippa Momah
Network CoordinatorCivil Society Scaling Up Nutrition in
Nigeria (CS-SUNN)
…….Working together to attain a country where every citizen has food and nutrition is secured
Presentation outline…
• Introduction• The Crisis of Under-nutrition in
Nigeria• Stopping Child under-nutrition• Mobilizing Civil Society
Organizations to scale up Nutrition in Nigeria
• A call to action to PAPHNON
…….Working together to attain a country where every citizen has food and nutrition is secured
Introduction ..(1) • Food is an important resource to human
development and survival.• Food security exists when all people, at all times,
have physical and economic access to sufficient safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.
• Health implications of food insecurity include malnutrition, impaired mental development, diminished learning ability, increased prevalence of chronic diseases, morbidity and mortality.
• An adequate diet consists of all classes of food in the right proportion e.g. staple foods, legumes, animal source foods, fruits, vegetables, fats and oils .
…….Working together to attain a country where every citizen has food and nutrition is secured
Introduction ..(2) • Nutrition is the process involved in taking in,
absorbing and utilizing nutrients for tissue growth, repairs and maintenance of body systems.
• Adequate nutrition is essential throughout the lifespan especially within the first 1000 days of life that begins with conception, through the mother’s pregnancy and up till the child is aged two years.
• Good nutritional practices such as exclusive breast feeding, complementary feeding, family dietary diversification and improved hygiene practices contribute towards the protection of the first 1000 days.
• The effects of poor nutrition during the 1,000 day window period are often irreversible. It can result in brain damage, poor growth and development problems .
…….Working together to attain a country where every citizen has food and nutrition is secured
Introduction ..(3) • Malnutrition is a condition that occurs when people
consistently do not consume or absorb the right amounts and types of food and essential nutrients.
• Malnutrition among Nigeria’s children is a serious problem : each year about 1 million Nigerian children die before their 5th birthday and malnutrition contributes to nearly HALF of these deaths.
• Dimensions of malnutrition in children:– Under-nutrition : Stunting, Wasting, and Micronutrient
deficiencies (Hidden Hunger);– Over-nutrition : Overweight / Obesity
• Nigeria has the highest burden of stunting in Africa, with over 11 million children less than 5 years old, stunted ( NDHS 2013).
…….Working together to attain a country where every citizen has food and nutrition is secured
The Crisis of Under-nutrition in Nigeria…
Trends in Childhood under-nutrition(NDHS 2013): Stunting (short for their age):• Stunting reflects failure to receive adequate nutrition
over a long period of time (i.e. chronically malnourished)
Trends: The proportion of children who are stunted declined from 41 % in 2008 to 37 % in 2013.
Wasting (thin or acutely malnourished). • Wasting describes current nutritional status and
represents the failure to receive adequate nutrition in the period immediately preceding the survey.
Trends : Wasting has increased from 14% (2008) to 18% (2013), indicating recent nutritional deficiency among children in the country.
…….Working together to attain a country where every citizen has food and nutrition is secured
The Crisis of Under-nutrition in Nigeria…Trends 2003 – 2013 (NDHS)
2003 2008 2013
Stunting 42% 41% 37%Wasting 11% 14% 18%Underweight
24% 23% 29%
EBF 17% 13% 17%
…….Working together to attain a country where every citizen has food and nutrition is secured
The Crisis of Under-nutrition in Nigeria…Zonal Distribution (NDHS 2013):
NAT./ZONES STUNTING % WASTING %
NATIONAL 37 18
North Central 29 12
North East 42 20
North West 55 27
South South 18 11
South West 22 10
South East 16 12
…….Working together to attain a country where every citizen has food and nutrition is secured
The Crisis of Under-nutrition in Nigeria: Trends in 10 states & FCT
S/No States
Height- for -age (stunted) in %
weight-for-height (wasted) in %
weight-for-age (under-weight) in %
1Anambra 18.4 17.3 14.12Akwa-Ibom 22.4 10.5 15.13FCT 20.6 13.8 12.64Kwara 27.1 6.5 13.85Adamawa 34.3 14.5 23.16Gombe 47.5 14.2 327Kebbi 60.6 18.1 398Sokoto 51.6 19.3 37.79Enugu 11.7 8.9 7.1
10Delta 14.9 17 15.411Lagos 17 11.3 12.9
Trends of GAM, Stunting, Underweight and MUAC<125mm by age in months , Nigeria 2014
Trends in under-nutrition in Nigeria by age – 1000 days
The Crisis of Under-nutrition in Nigeria…the Drivers of the burden..A. Immediate causes: • Inadequate dietary intake: NDHS 2013 states
that only 17% of babies (0 – 6 months) were exclusively breast fed & only 10% of children aged 6 – 23 months were fed appropriately.
• Infectious diseases e.g. diarrhea, malaria.B. Underlying causes: Food insecurity, poor
child and maternal care; poor access to health services; unhealthy environment; Emergencies.
C. Basic causes: Poverty; Population ; failure in governance; gender inequality.
…….Working together to attain a country where every citizen has food and nutrition is secured
Table 1: Drivers of Malnutrition: Magnitude of the problem in Nigeria
Cause Indicator National
Sources Im
med
iate C
ause
s Inadequate
dietary intake Exclusive Breastfeeding of children until 6 months of age (%)
17 NDHS 2013
Prevalence of Diarrhoea
Percentage of children under age 5 who had diarrhoea in the two weeks preceding the survey
10.2 NDHS 2013
Prevalence of Malaria
Percentage of children under age 5 with a fever during the two weeks preceding the survey
12.5 NDHS 2013
Unde
rlyin
g Cau
ses
Food Security Households in poorest wealth quintiles with poor or borderline food consumption (%)
29 IFPRI 2013
Global Hunger Index Score Rank (2013) 15 GHI 2013 Health & Sanitation
Women 15-49 years with problems accessing health care (%)
53.3 NDHS 2013
Household access to an improved water source (%) 60.6 NDHS 2013
Household access to improved sanitation (%) 30.1 NDHS 2013
Care and Feeding Practices
Exclusive Breastfeeding of children until 6 months of age (%)
17 NDHS 2013
Timely initiation of breastfeeding percent (within the first hour)
33.2 NDHS 2013
Compliance to recommended infant and young child feeding practices
10% NDHS 2013
Education Females that completed primary school or higher (%) 62.2 NDHS 2013
Basic
Caus
es Population Total Fertility Rate (%) 5.5 NDHS 2013
Gender Women’s intra-household decision-making power (%) 31.3 NDHS 2013
Poverty Population living under the national poverty line (%) 54.7 UNDP 2013
normal wasted stunted
If not addressed, malnutrition is
transmitted from generation to generation.
However, the implementation of key Nutrition interventions
by Government and Non-state Actors at all
levels will enable Nigeria break this
vicious cycle and stop the Crisis!!...
…….Working together to attain a country where every citizen has food and nutrition is secured
Stopping Child under nutrition(1)Government’s Role: • Nigeria joined the Scaling Up Nutrition (SUN)
Initiative in November, 2011. SUN is a global movement which is led by governments and comprises of civil societies, business, donors and UN organizations in a world-wide effort to reduce hunger and malnutrition.
• Developed the National Strategic Action Plan for Nutrition ( NSPAN, 2014- 2019) , for implementation at all levels.
Goal of the NSPAN: Improve the nutritional status of Nigerians, with a particular focus on vulnerable groups especially women of reproductive age and children under five years of age.
…….Working together to attain a country where every citizen has food and nutrition is secured
NSPAN Targets….
• To reduce the number of under-five children who are stunted by 20% by 2018
• To reduce low birth weight by 15% by 2018• To ensure no increase in childhood overweight by
2018• To reduce and maintain childhood wasting to less
than 10% by 2018• To reduce anaemia in women of reproductive age
by 50% by 2018• To increase exclusive breastfeeding rates in the
first six months to at least 50% by 2018
…….Working together to attain a country where every citizen has food and nutrition is secured
Estimated unit costsCost of key nutrition interventions –
World Bank 2014 – Basis for: MOH national strategic plan of action for nutrition 2014-2019
Intervention Cost per child (units vary)
Promotion of Breastfeeding, appropriate complementary feeding, handwashing
US$ 5 per participant / year
Vitamin A supplements US$ 0.44 per child through MNCHW
Micronutrient powders US$ 3.60 (6-24 months)Deworming US$ 0.44 per child through
MNCHWIron-folic acid supplements for pregnant women
US$ 1,79 per pregnancy MNCHWUS$ 2.00 per pregnancy Community
Iron fortification of staple foods US$ 0.20 per person / year
Salt iodisation US$ 0.05 per person / year
Stopping Child under-nutrition..(2)
1. Exclusive Breast Feeding: support early initiation of breastfeeding within 30 minutes after birth and exclusive breastfeeding for the first six months of life of the baby:– An estimated 13% of child deaths could be averted if
90% of mothers exclusively breastfed their infants for first 6 months;
2. Complementary feeding: Give children the right quantity and variety of foods from 6 months of age with continued breastfeeds until 2 years;– If 90% mothers provided adequate and timely
complementary feeding for 6 to 24 months olds, additional 6% of child deaths could be prevented.
• …….Working together to attain a country where every citizen has food and nutrition is secured
Stopping Child Under nutrition…(3)
3. Nutrition education:
• Provide parents & caregivers with information and support on EBF, care & feeding practices for young children.
• Babies must be fed very frequently and on demand because of the small stomach size. Key:- 1 oz = 30 ml; 1 cup = 240 ml
Stopping Child under-nutrition..(4)4. Food Security:Ensure mothers and their children have access to essential vitamins, minerals, and nutrients.
…….Working together to attain a country where every citizen has food and nutrition is secured
The Government has taken major steps, so what are the roles of Non- state Actors?...
…….Working together to attain a country where every citizen has food and nutrition is secured
Mobilizing Civil Societies to scale up Nutrition in Nigeria….(1)
• Civil Society Scaling Up Nutrition in Nigeria (CS-SUNN )is a non-governmental, non-profit making coalition, made up of organizations with a shared vision to transform Nigeria into a country where every citizen has food and nutrition is secured.
• CS-SUNN was launched on August 7, 2014. • Membership is multi- sectoral including
human rights, agriculture, health, community development, education, water, sanitation, planning and financing.
…….Working together to attain a country where every citizen has food and nutrition is secured
Mobilizing Civil Societies to scale up Nutrition in Nigeria….
(2)CS-SUNN objectives are to:• Engage state and non-state actors for nutrition action;• Mobilize and strengthen CSOs in Nigeria to scale-up
nutrition through advocacy and public awareness;• Support existing policy, legal and budgetary frameworks
to be more accountable to meet the nutritional needs of Nigerians , with focus on maternal and child nutrition;
• Enhance experience sharing and learning between and within organizations , nationally and globally.
CS-SUNN has mobilized CSOs in 10 states and Federal Capital Territory (FCT) to establish Volunteer Local Working Groups for nutrition advocacy.
…….Working together to attain a country where every citizen has food and nutrition is secured
Mobilizing Civil Societies to scale up Nutrition in Nigeria….(3)Key roles:• Create awareness on the crisis of malnutrition;• Advocate for the domestication of the National
Strategic Plan of Action for Nutrition (NSPAN, 2014 -2019) with focus on maternal and child nutrition at the state & LGAs;
• Organize the communities to identify their nutrition priorities / “asks” to be presented to the relevant decision makers;
• Mobilize stakeholders, interest groups and citizens to participate in budget work;
• Advocate for a culture of accountability.
…….Working together to attain a country where every citizen has food and nutrition is secured
Mobilizing Civil Societies to scale up Nutrition in Nigeria….(4)Key roles:• Mobilize communities to participate in Community
maternal nutrition and IYCF services implementation.
• Monitor nutrition services delivery ; share reports and circulate relevant information to stakeholders including community groups and the media;
• Organize public dialogue meetings for the members of the community to interact with local leaders, discuss key issues that affect them, and to demand action from the decision makers;
• Use data for advocacy: e.g. Maternal, Newborn & Child Health Week (MNCHW) data provides evidence to equity gaps, coverage and accountability for services provision.…….Working together to attain a country where every citizen has food and nutrition is secured
Mobilizing Civil Societies to scale up Nutrition in Nigeria….(5)
CS-SUNN ASKs to Government..• Domesticate the National Strategic Plan of
Action for Nutrition (NSPAN, 2014 -2019) with focus on maternal and child nutrition;
• Allocate Budget with timely release of funds to implement nutrition interventions that target Adolescents, mothers and young children;
• Extend maternity leave to 6 months for working mothers, to protect Exclusive Breast Feeding;
• Provide maternal nutrition and IYCF services, through Health Facilities and Community based structures.
…….Working together to attain a country where every citizen has food and nutrition is secured
1. Utilize extensive network to :• Promote Exclusive Breast Feeding;• Advocate for the provision of
Community maternal nutrition and IYCF services;
• Provide sustained community nutrition education.
2. Partner with CS-SUNN, so that together we can make a difference and contribute to stopping child under-nutrition in Nigeria .
CS-SUNN Call to Action to PAPHNON:
…….Working together to attain a country where every citizen has food and nutrition is secured
.
THANK YOU…
…….Working together to attain a country where every citizen has food and nutrition is secured
Acknowledgements..
• CS-SUNN Coalition Members• SUN MPTF Team• UNICEF Nigeria Country Office Nutrition
Team
…….Working together to attain a country where every citizen has food and nutrition is secured