By: Monday Danladi, Bauchi
Bauchi State is facing a severe malnutrition crisis, with a dramatic increase in cases, particularly among children U-5, thereby raising an urgent need for multi-sectoral solutions to address the issue, including improved nutrition education and healthcare access.
Here’s a more detailed look at the situation of rising malnutrition: Bauchi State has witnessed a surge in malnutrition cases, with Doctors Without Borders (MSF) reporting a 120% increase in severe malnutrition admissions between January and June 2024 compared to the same period in the previous year.
The MSF’s response indicated that MSF facilities in Bauchi are already overstretched in capacity, highlighting the severity of the situation. They are treating an overwhelming number of malnutrition cases and are working to expand their response to deliver critical care to children and families.
Factors contributing to malnutrition include inflation, lack of exclusive breastfeeding, and limited access to healthcare in the facilities across the state, qualified medical staff, medications, and ready-to-use therapeutic foods.
In order to check the alarming situation, there has been a Government and Partner Initiatives.The Bauchi State government, in collaboration with partners like United Nations Children’s Fund (UNICEF) and Catalyzing Strengthened Policy Action for Healthy Diets and Resilience (CASCADE), is taking steps to address the issue, including reintroducing nutrition corners and gardens in primary healthcare centers (PHCs) across the state.
The Bauchi Field Office of United Nations Children’s Fund (UNICEF), for 5 days, engaged the State House of Assembly and Executive Chairpersons of the 20 LGAs in the state on the way to overcome the situation with particular focus on funding (budgetry allocation and prompt release).
Be that as it may, an important approach is the multi-sectoral approach which is crucial to addressing malnutrition, involving collaboration between government agencies, healthcare providers, and other stakeholders.
The key should be focus on early detection and prevention as initiatives like “parent MUAC” activities, which train parents to measure children’s mid-upper arm circumference (MUAC) at home, aim to detect malnutrition early and prevent severe cases.
Also, addressing underlying issues as the Bauchi State House of Assembly has launched an investigation into the spending of funds allocated for child nutrition, highlighting concerns about the lack of progress in improving child nutrition despite allocated funds.
The specific initiatives include the establishment of Nutrition Corners and Gardens in PHCs across the state as the state government, with support from CASCADE and the Development Exchange Centre (DEC), has reintroduced nutrition corners and gardens in PHCs to address the growing issue of malnutrition.
Another is Maternal Nutrition Programmes which the Bauchi State has launched a research project to identify new ways to accelerate maternal health and strengthen maternal nutrition programmes just as it has earmarked the sum of N100 million to combat malnutrition in children under 5.
The Bauchi State Multi-Sectoral Plan of Action for Food and Nutrition (2024–2028) was launched with support from CASCADE Nigeria.
For two days, UNICEF engaged Members of the Bauchi State House of Assembly and Chairpersons of the 20 LGAs in the state on how to navigate the situation with particular focus on financing (budgetry allocation and prompt release of the allocation).
Despite collective efforts, challenges remain, including limited access to healthcare, lack of qualified medical staff, and inadequate provision of medications and ready-to-use therapeutic foods.
One major problem is the inability of the state government to release matching funding to access the Children Nutrition Fund (CNF) managed by the United Nations Children’s Fund (UNICEF) which is meant to be used to procure the foods and other commodities needed to fight malnutrition.
For the past 2 years, the government has being dragging its feet in releasing the fund despite being one of the focal states of the operation of UNICEF in the Bauchi Field Office.
A visit to PHCs in Miri, Kofar Ran and Domiciliary in Yelwa revealed that there are children who are suffering for malnutrition and need immediate attention, yet, the needed and required nutritional commodities are not readily available a situation that has become worrisome to the mothers.
The Executive Chairman of Bauchi State Primary Healthcare Development Board, Dr Rilwanu Mohammed in his reaction to the development, stated that, “It is not that we refused to do something about it nor the Governor refused to approve the matching fund. We are in the process of preparing the memo, very soon, it will be presented to the Governor for approval.”
He added that, “UNICEF has sent a letter to the effect to us and we are working on it. They told us that if we give N100m they will give N200m, it will be joined together to procure the required food nutrients. We will give the N100m and they will give N200m, that is the contents of the letter, we still have it.”
The EC added that,”Other States in the Bauchi Field Office of UNICEF, Adamawa, Gombe, Plateau and Taraba have paid except our own. It was me that has not written the memo, not that the Governor refused to pay. Now, I am writing, I have proposed a bill which I am going to send to the Governor as soon as he comes back for approval.”
According to him,”For now, there is no cause for alarm, we are doing our work normally, we are planning for the MNCHW, everything is in place, the Committee sat last Monday with the Deputy Governor as the Chairman of the Multisectoral approach to Nutrition, we have decided what to do, that is just one of the issues, there are many others.”
Rilwanu Mohammed added that,”There is the issue of Vitamin A supplementation, deworming of children and others which we are going to tackle. Now we have 54 CMA centers, they were 33 before, we added 19, we are going to start work in these places. We are receiving 100,000 cartons of RUTF from Abuja but we are to do a training before the distribution.”
On the issue of MMS, he said that,”There are about 316,000 tins of MMS which we are going to utilize during the MNCHW, to be distributed to all pregnant women to prevent ameania in pregnancy. Everything is on cause, we will not sit and Wath our children die, we are fully prepared to act. We have a budget line which will be attached to the memo for the approval of the N100m, we cannot write to the Governor without making reference to the budget line, it will not work, we have N150m in the budget, we are removing N100m from it, the Local Government Funds. We are almost there, we have started the work
Reacting to the development, the Chief of Field Office (CFO) Bauchi Field Office of United Nations Children’s Fund (UNICEF) Dr Nuzhat Rafique stated that, “I think for the children in Bauchi State, this is one of the most important issues, having nutrition supplies and nutrition programmes for them.”
She stressed that, “As you know, Bauchi is one of the states that indicators are very very bad. I will say that malnutrition is very high. Malnutrition in itself is an indication of multiple problems. When a child gets malnourished, it means that there are so many problems in that area relating to sanitation, relating to health system, relating to poverty, no adequate food availability and also the cultural and social practices, how mothers are feeding the children, how they are using the local food and all that.”
She added that,”You know Bauchi is a very different state, I will say, because in one LGA you will see that there is a very good thousand day project supported by the UNICEF and communities are really taking it up. On the other hand, there are very far away LGAs that there is nothing and the children are, huge a number of children you will find them very severely malnourished, moderately malnourished, malnourished who can be saved but because of multiple reasons, they are not able to do that and were not able to help them because basically it’s the responsibility of the state government.”
“State government in that meeting, you may recall that all LGA Chairpersons signed a communique that they will contribute towards the Child Nutrition Fund (CNF). You know child nutrition fund is a beautiful scheme that is managed by the UNICEF, but the Donors are the UK Government, Bill Gates and Child Investment Foundation Fund. So these are the partners who joined hands together and make this child nutrition fund. Some states, Gombe for instance gave N160 million, then we matched that grant to child nutrition fund and with more than N300 million we brought the RUTF for them and many of the children are recovering RUTF across primary healthcare centers in the state,” She explained.
Nuzhat Rafique stated that,”Similarly, in Adamawa, they have already provided N100 million that we matched and brought Small Quantity .. supplies (SQLS) for them. And now, this year they have already committed N300 million and we are already in the process of matching that grant and bringing the supply for them. So these are the examples from the neighboring states but unfortunately, Bauchi has not contributed anything yet.”
She added that,”And as you people saw in the last year expenditure report of Bauchi which were reported as RUTF procurement but we did not see any RUTF in the health facility. So we are very hopeful and we are still very hopeful, given the commitment of the state government, His Excellency, the Governor and the Commissioner of Budget, Economic Planning and Multilateral Coordination who was there and Commissioner of Health, they are all committed and dedicated people which we met and discussed this nutrition issue.”
According to her,”They feel for the people, the state government also feel for the children and I had experience where directly, His Excellency announced monies, farhers for good health for example and he made it available that day and I am praying that we get this child nutrition fund matching grant. Also from Bauchi state government as we have gotten from Gombe and Adamawa but still, there is no valid commitment seen, there has been communique, all LGAs (ALGON) committed, the Commissioners who were available at the meeting also committed but these commitments have been promised for the last two years since the CNF started honestly speaking, but we have not received anything to match the grant and procure the supplies for the children of Bauchi.
“You can see that severely acute malnutrition if you see at the public health is at alarming level, out of ten children , three are severely acute malnourished. Given the circumstances of 13 LGAs where there is zero dose children. Zero dose children means that you have never reached them with any immunization. So what will be the immunity status of these children?,” She enthused.
Then the risk of polio in Nigeria, also the increasing risk of malnutrition due to poverty, increasing poverty, you can see that the economy is not stable, it’s also a threat. So, all these things put the children at the very high risk. We already have six out of every ten as moderately malnourished. So you can see that moderately malnourished means that they can go into severe acute malnutrition any time and it becomes so difficult to retrieve them.
So, at moderate nutrition which is more than 50 percent children suffering in Bauchi. If you are not able to bring them back into normal status they will go and then severed ones will die, so they are pushing children towards death literally by not contributing towards the child nutrition fund because this is extremely sensitive and extremely critical for the children of Bauchi state to have this nutrition supplies and nutrition programmes and I want to use this opportunity to beg honestly , the state government of Bauchi to do something for these children and provide like, for example in 2024 N2.1 billion was allocated for RUTF , can you imagine if that N2.1 billion was given for the matching grant it could have been used to provide RUTF and it could have treated ten thousand children in Bauchi out of around 34,000 children who need the support.
If they had given us that money for child nutrition fund this N4.2 billion could have saved the lives of 20,000 children who are at risk, we could have dedicated that amount of RUTF in the number of children saved. But that N2.1 billion we don’t know where it spent.
Speaking on the five year launch of nutrition plan, She stressed that, “UNICEF has been a big technical partner in this, developing this plan, it is led by the Federal Government and trickled down the States and Bauchi, I congratulate them for launching the plan and it is very important for the children of Bauchi. Already, UNICEF is supporting Eight LGAs in Bauchi state where we have nutrition, sanitation, health, birthrate registration, all these elements are put together in an integrated manner and we are trying to support technically, financially to some extent , bringing in other partners , going to communities, leveraging their personal contribution in terms of social mobilization , communication for better behaviors, infant and child feeding behaviors, child immunization , childbirth registration and sanitation.”
She added that,”On Nutrition, we always stand by the state government to support them technically and whereever possible, with finances because financial element now as you know that USAID fund they have been cut off for most of the agencies, for most of the countries and UNICEF has been affected by that, but still UNICEF will do its best to leverage resources from all sides but the most important thing is that we will continue to provide technical support to the budget and finance to social policy to child health and nutrition departments, MDAs to bring in the innovations, interventions that can help in saving these children in a cost effective manner and we request the state of Bauchi to allocate resources and as we all hear from all sources that money is been allocated to LGAs directly by the federal government.”
“We will support them at the LGAs level and we will provide them with figure for their LGAs and for their, you know situation in their LGAs and where it needs to be allocated, where they need the funds to be allocated to protect the social sector. The implementation of this multi-sectorial nutrition plan is very much in line with what we are doing in Toro local government area for example, and in other seven LGAs where this same model is been implemented. So, we will provide all the technical support to scale them up in all the LGAs of Bauchi, She added.
On the number of malnurished children, Nuzhat Rafique assured that, “We will provide you with the exact figure, but it is around 54,000 children that are in need of treatment but I am sure these figures are changing from different sources, so we have one final source that we will provide you with for the referencing but you know RUTF is not on cheap supply, it is expensive but when it comes to life of a child you can see that it is cost effective.”
According to her, “To prevent the children going into that severe acute malnutrition by treating them at moderate level, or earliest picking up, so UNICEF is trying to help communities. You know the people of Bauchi , every mother to learn how to monitor her child, we have mama2mama group, we have fathers4good health , these people help in mobilizing communities and mothers understand, there are facilitators, social mobilizers, volunteers, community mobilizers who teaches the mothers on how to monitor their children and all over the world that is the best and sustainable way to prevent children malnutrition.”
She added that,”On one side, they provide good food, exclusive breastfeeding, perfect weaning and diversity of food using local food materials, not expensive or unaffordable food, whatever is locally available, it depends on how to use it in a best manner.”
Nuzhat Rafique stated that,”Bauchi has so much natural resources. Nowadays you see fruits everywhere , mango, banana, but how people are using them to diversify children’s diet matters, I don’t see that here, the practice of using local food , you are rich in grains, millet, wheat, yam, potatoes , they are all good sources for children and lactating mothers, we need to bring them to the level where they can use them properly to feed their children so they can not go into malnutrition in the first place. It’s the state government responsibility to really help the communities to get them back to normal.”
Speaking on the Dandore and Miya Barkate villages initiative in Toro LGA, She said that,”UNICEF can request that the state government takes the initiative up, we can advocate for that, we can provide technical support and help in establishing the mechanisms that can help in scaling up the initiative but the finances needs to be allocated by the state government. We have demonstrated a model of success, we have demonstrated this can work for every child in Bauchi, this is the responsibility of the state government.”
According to her, “In every country where UNICEF works, it is not working on behalf of the government , UNICEF is supporting the government technically. I am here after working in Eleven countries, I am bringing my wealth of experience to support health department, nutrition department, budgeting and financing department, in all the other countries that is how people are doing it, that is what we are doing, my Nutrition Specialist has worked in many places, in many areas of Nigeria and she knows how within the local culture people can do this. So, together we made a team of experts, technical experts who can help the state and local government that we can scale it up, but they have to put it in their focus, their money, their attention, and hold on their accountability. It’s the state government accountability to reach every child and UNICEF can help with technical support to actualize that.”
She stressed that, “All other States have done it, we have three focal states, even Plateau state which is not one of the focal states have done it, we are not doing any proper funding in Plateau like we are doing in Bauchi. When we asked all the five states in Bauchi UNICEF Field office, three are focal states , Bauchi, Gombe and Adamawa. When we requested, Gombe and Adamawa immediately started and responded and they have supplies with the matching grant in their facilities . Then we extended this invitation to states which we are not financially supporting, we are only technically supporting , Taraba and Plateau states, Plateau had excellent response, they have already received SQLNS and I handed over in Adamawa, in Taraba I went and they promised that this year they are going to put in N300 million and I am sure they will do it because of the way they are committed , only Bauchi remains.”
On how UNICEF will curb diversion of RUTF She stated that,”You know UNICEF’s role is to support in the process throughout that the supplies are done, the money is received , CNF is given the matching grant , procurement is done and brought into the country then to the state level and then handed over to the state governments. Health and nutrition departments are responsible for distributing them to the health facilities , selected primary healthcare centres. During that, we support technically , we see that where they need to go and we sit with the health department, they prepare the distribution plan and we see that these are the right facilities that the supplies are going and it’s their responsibility to distribute them and UNICEF will definitely along with health team from the state government monitor it. We will go to the health facilities, as you know, I am even the person who went to some facilities recently and even to the house and I saw whether the children were getting what they need to get or not.”
“So, UNICEF is monitoring with them to see that every facility where children with malnutrition are coming for treatment they should have that, and we will make sure in sha Allah, I am fully confident that the director of health in Bauchi and the commissioner of health would help us in doing the right process of distribution and would also advocate that this is the right time to get the money so before the children die we should reach them with these supplies.
