Malnutrition is a significant public health concern affecting nearly 1 in 5 children particularly those under the age of five. It undermines their health, growth, and development, perpetuating poverty and inequality.
A UNICEF report states that an estimated 2 million Nigerian children suffer from Severe Acute Malnutrition (SAM), and according to the World Health Organization (WHO), Nigeria has one of the highest rates of malnutrition in the world.
Types of Malnutrition
Malnutrition manifests in the following forms:
1. Undernutrition: Underfeeding which can cause:
Stunting: Short stature in relation to a child’s age. It affects 149 million children, hindering growth and development.
Wasting: Low weight in relation to a child’s height. It is a life-threatening condition resulting from poor nutrient intake and recurrent illnesses, weakening children’s immunity.
Underweight: Low weight in relation to a child’s age.
2. Overnutrition: Overfeeding which can cause:
Overweight: Excess weight for a child’s height. It affects an estimated 43 million children under 5, a 54% increase from 1990.
Obesity: Severe and excess weight for a child’s height.
3. Micronutrient Malnutrition: This can be in form of:
Deficiencies: Lack of essential vitamins and minerals (e.g. iron, vitamin A, zinc), or
Excesses: Excessive intake of vitamins and minerals.
4. Specific Nutrition-Related Disorders: Nutritional disorders include:
Kwashiorkor: Severe protein deficiency.
Marasmus: Severe calorie deficiency.
Anaemia: Iron deficiency leading to low red blood cell count.
Rickets: Vitamin D deficiency causing bone deformities.
Scurvy: Vitamin C deficiency causing connective tissue damage.
Additionally, malnutrition can be classified based on its causes:
1. Acute Malnutrition: Results from sudden onset of inadequate nutrition (e.g. famine, conflict).
2. Chronic Malnutrition: Results from long-term inadequate nutrition (e.g. poverty, food insecurity).
3. Secondary Malnutrition: Results from underlying medical conditions (e.g. HIV/AIDS, tuberculosis).
Causes of Malnutrition in Children
1. Poverty and food insecurity: Poverty and food insecurity are major causes of malnutrition in children. In Nigeria for example, 87 million people live in poverty (National Bureau of Statistics, 2020), and 40% of Nigerians are food insecure (Food and Agriculture Organization), leading to reduced access to food.
2. Lack of access to healthcare and nutrition services: Healthcare and nutrition landscape faces significant challenges, contributing to high malnutrition rates. These challenges include inadequate healthcare infrastructure, shortage of healthcare professionals, limited access to healthcare services, poor quality of care, limited education, counseling, and support on nutrition, and insufficient breastfeeding promotion.
3. Inadequate breastfeeding practices: Breastfeeding is crucial for infant nutrition, yet inadequate practices contribute to malnutrition in children. Children are inadequately breastfed as a result of lack of breastfeeding knowledge and education, cultural and societal barriers (e.g. stigma, misconceptions), insufficient healthcare support and counseling, maternal employment and lifestyle constraints, and aggressive marketing of breastmilk substitutes.
4. Poor dietary diversity and quality: Dietary diversity and quality play critical roles in ensuring optimal nutrition for children. In Nigeria, poor dietary practices contribute significantly to malnutrition. 70% of children under 5 do not meet minimum dietary diversity standards and only 12% of children aged 6-23 months receive a balanced diet (Nigeria Demographic and Health Survey, 2018).
5. Infections and diseases (e.g. malaria, diarrhoea): Infections and diseases can aggravate malnutrition in children creating a vicious cycle of infection and undernutrition.
6. Conflict and displacement: These are devastating causes of malnutrition worldwide. Nigeria is ravaged by conflicts and displacements such as Boko Haram insurgency, farmer-herder conflicts, ethnic and communal clashes, Niger Delta militancy, and IDP (Internally Displaced Persons) camps. These have resulted to limited access to nutritious food, loss of income, assets, and infrastructure, poor sanitation, water, and healthcare, anxiety, depression, and stress, and orphaned or unaccompanied children.
50% of children under 5 in conflict-affected areas suffer from acute malnutrition (UNICEF, 2022).
7. Climate change and environmental degradation: Climate change and environmental degradation threatens the survival, growth, and development of children.
Climate change causes an increase in temperature which leads to change in agricultural productivity and food availability, rainfall variability which affects crop yields and livestock productivity, droughts and floods which disrupts food systems and livelihoods, and water scarcity which limits access to clean water and sanitation.
Environmental degradation like deforestation leads to loss of biodiversity and ecosystem services. Soil degradation reduces agricultural productivity. Air and water pollution increase disease burden, and poor waste management practices contaminate food and water sources.
8. Limited access to clean water and sanitation: This can lead to illnesses and undernutrition in children. Access to clean water and sanitation reveal a concerning picture – As of 2020, only 74% of the global population uses safely managed drinking water sources, leaving one-in-four people without access to clean drinking water. This issue disproportionately affects countries with low incomes, particularly in Sub-Saharan Africa, where less than one-third of the population has access to safe water. According to WHO/UNICEF (2020) report, 47% of Nigerians lack access to improved water sources, and 71% of Nigerians lack access to improved sanitation facilities.
54% of the global population use safely managed sanitation facilities, and nearly half of the world’s population lack access to basic handwashing facilities. The World Health Organization and UNICEF Joint Monitoring Programme reports that 6% of the global population practices open defaecation due to lack of access to sanitation facilities.
Impacts of Malnutrition on Children
Malnutrition results to the following in children:
1. Stunted growth and development
2. Weakened immune systems
3. Increased risk of illnesses and infections
4. Delayed recovery from illnesses
5. Cognitive impairment and reduced educational performance
6. Increased mortality rates (under-5 mortality rate: 132/1000 live births)
Solutions to Malnutrition in Children
The solution to malnutrition is the collective effort of the government, international organizations, communities, health care providers, private sector, and individuals.
Short-Term Solutions
1. Emergency food aid and supplementation: This helps to address acute malnutrition in children particularly in crisis settings. This can be in form of therapeutic milk (F-75 and F-100), ready-to-use therapeutic foods, Supplementary plumpy nuts, emergency food rations, and cash-based transfers.
2. Therapeutic feeding programs: These are evidence-based interventions providing specialised nutrition care to treat acute malnutrition in children. Key components include: Nutritional assessment and classification, Therapeutic milk (F-75 and F-100) or Ready-to-Use Therapeutic Foods (RUTFs), Medical care and monitoring, Hygiene and sanitation promotion, and Community mobilization and education.
3. Vaccination and disease prevention: These are crucial strategies to address malnutrition in children, reduce morbidity and mortality. Key vaccinations include Measles, Rotavirus, Diarrhoea diseases (e.g cholera), Respiratory infections (e.g pneumonia), and Malaria. These help to enhance the immune system, prevent malnutrition exacerbation, and reduce morbidity and mortality.
4. Improved access to healthcare services
5. Cash transfer programs for vulnerable families
Long-Term Solutions
1. Sustainable agriculture and food security initiatives: Sustainable agricultural and food security initiatives ensure access to nutritious foods (like Moppet) and promote healthy eating habits.
Key initiatives include:
Home Gardens: Promoting household food production and diversity.
School Gardens: Integrating agriculture and nutrition education.
Community Supported Agriculture (CSA): Connecting farmers to consumers.
Sustainable Livestock Farming: Improving access to protein-rich foods.
Irrigation and Water Harvesting: Enhancing crop yields and resilience.
2. Nutrition education and counseling
3. Support for breastfeeding and optimal infant feeding practices
4. Improved access to clean water, sanitation, and hygiene (WASH)
5. Economic empowerment programs for women and caregivers
6. Policy formulation, funding, and coordination: Governments should establish policy reforms and increase funding for nutrition programs. International organizations, NGOs and CSOs should provide funding, implement programs, engage with the community and advocate for better nutrition. Private sector should also help in funding, innovation, and carry out social responsibilities to end malnutrition and hunger.
7. Strengthened healthcare systems and community-based services: Strengthening the health care systems and grassroot services help to curb malnutrition. Key strategies to achieve this include:
Integrated Nutrition Services: Combining nutrition counseling, screening, and treatment.
Community Health Workers (CHWs): Training and deploying CHWs for doorstep services.
Health Facility Strengthening: Upgrading infrastructure, equipment, and staffing.
Telehealth and Mobile Health (mHealth): Leveraging technology for remote consultations.
Social and Behaviour Change Communication (SBCC): Promoting healthy practices through community engagement.
To conclude, the United Nations aims to achieve universal access to clean water and sanitation by 2030 as part of the Sustainable Development Goals. While progress has been made, the current rate of progress is insufficient to meet this target, with an estimated 13 percentage point increase needed every five years to achieve universal access.
Despite efforts from all concerned, the world is still far from achieving a malnutrition-free future, with insufficient progress toward the World Health Assembly targets set for 2025.
To address this issue, organizations like UNICEF focus on nutrition in early childhood, adolescents, and women, as well as early detection and treatment of malnutrition.
Our goal at Moppet Foods is to provide nutrient-rich and balanced foods to boost nutrition from an early age. This way, we can help to end hunger and malnutrition in children.