By Chikezie Omeje
The hope of saving many Nigerian children suffering from hunger and malnourishment next year may have been dashed with no provision made for that purpose in the proposed capital expenditure of N51 billion for the entire health sector in the 2017 budget.
The budget oversight would be particularly felt in childhood malnutrition and vaccines where evidence has shown that increased funding will reduce the record number of children under the age of five who die each day in Nigeria from 2,300 by at least 40%.
According to United Nations Children’s Fund, UNICEF, World Health Organization, WHO, and Federal Ministry Health, FMH, more than a half of these 2,300 daily deaths among under – five children are related to malnutrition causes.
The government has tried to underplay the hunger and food crisis that have attended the insurgency in the north east, with president Muhammadu buhari declaring early in December that reports of humanitarian crisis were exaggerated.
The United Nations had announced in a statement that about 5.1 million faced food shortages due to the insurgency in North east Nigeria and the inability of people to go to their farms.
“A projected 5.1 million people will face serious food shortages as the conflict and risk of unexploded improvised devices prevented farmers planting for the third year in a row, causing a major food crisis,” the U.N. Deputy Humanitarian Coordinator, Peter Lundberg, said in a statement Friday.
UNICEF too had warned that over 400 children in the conflict affected areas risked acute malaria and that “more than half of the children could die within 12 months unless urgent measures were taken by the concerned authorities.”
But in a statement released by his senior special assistant on media, Garba shehu, the President dismissed the fears of a food and nutrition crisis as unfounded, indicating that the government does not understand the magnitude of the problem or was failing to face it.
“We are concerned about the blatant attempts to whip up a non-existent fear of mass starvation by some aid agencies, a type of hype that does not provide a solution to the situation on the ground but more to do with calculations for operations financing locally and abroad,” the President said in the statement.
But the federal legislature has been more responsive to these reports. Early this month, the Senate demanded that N95 billion must be budgeted for nutrition to treat children under the age of five who are severely malnourished in the country.
Speaking at a dialogue on nutrition in Abuja, the Chairman, Senate Committee on Health, Olanrewaju Tejuoso, said the N95 billion will be used to treat 1.9 children at an estimated cost of N50, 000 per child.
Overall 2.5 million under-five children are severely malnourished across the country but UNICEF has pledged to support the treatment of 600,000 children in 2017 with Ready to Use Therapeutic Food, RUTF, while the Nigerian government is expected to cater for the remaining1.9 million children.
In an interview with icirnigeria.org reporter six days after President Muhammadu Buhari presented the 2017 budget before a joint session of National Assembly in Abuja, Tejuoso said that though the committee had not received the details of the health budget, effort would be made to allocate adequate funds for nutrition.
He said the legislators would discuss with members of the executive to prioritise nutrition and reallocate funds to carter for the malnourished children.
The senator said that “even without the budget, the government has provided some intervention funds for nutrition in the North East because it is an emergency. If it is an emergency, funds must come from somewhere instead of observing children dying.
“What we are saying now is let us make adequate provision for nutrition but we must understand that you cannot spend the money you do not have. We will look at what we have on the ground and then do what is possible”.
It is not yet known the exact amount that has been budgeted for nutrition in 2017 but the Head of Nutrition in the FMH, Chris Isokpunwu has observed that “nearly a half of the amount demanded by the legislators for nutrition alone was budgeted for the whole health systems.”
“Ministries are given envelopes within which they work. So, the Ministry of Finance says health, this is your envelope, you can’t exceed this envelope. You also have to allocate resources within that envelope that you’ve been given, Isokpunwu explained.
“But we also must realise that in health, nutrition is not the only priority. There are lots of competing priorities. I will not say because I am the head of nutrition, all the money must go for nutrition,” he stressed.
In 2016, the paltry sum of N2.4 million which was budgeted for nutrition has not even been released.
Defending the role of National Assembly in approving only N2.4 million in 2016 for nutrition in view of alarming malnutrition crisis in the country, the Vice- Chairman, Senate Committee on Health, Mathew Urhoghide, said that the amount was “proposed by the ministry and that was what we passed.”
Despite Federal Government’s inability to fund nutrition, over one million children with severe acute malnutrition have been treated in the country through donor funding within the past six years.
UNICEF said over 200,000 child deaths have been averted since Community-based Management of Acute Malnutrition, CMAM, began in Northern Nigeria.
CMAN, which began in Gombe State in 2009, has been introduced in 10 other states in the North West and North East where malnutrition is very high.
The states are Adamawa, Bauchi, Borno, Jigawa, Kano, Katsina, Kebbi, Sokoto, Yobe, and Zamfara.
Without government’s intervention, CMAN cannot reach all the children in need because of limited donor funding. According to UNICEF, two out of every three children still do not receive the treatment they need in the eleven states where CMAN operates.
“What’s stopping us from scaling up?” UNICEF Chief of Nutrition, Arjan de Wagt said. “When the resources are there, it is very easy to scale to a million children. That’s not rocket science”.
Nigeria signed up to the Scaling-up Nutrition, SUN, movement in 2011 and signed the global Nutrition for Growth Compact in 2013. In doing so, the country committed to tackling its high rates of child malnutrition. In spite of these commitments, Nigeria has failed to allocate funds to scale up nutrition.
On September 8, 2015, Nigeria also adopted the National Strategic Plan of Action on Nutrition (NSPAN 2014 – 2019). The policy is expected to reduce stunting by 20%, wasting by 15% and increase exclusive breastfeeding by 50% in 2019.
“How can a policy be developed for 2014 to 2019, it is 2016 and there is no funding for it,” Dr.Philippa Momah, the Coordinator of Civil Society for Scaling-up Nutrition in Nigeria (CS-SUNN) said.
At a Town Hall Meeting on Nutrition in Abuja, Momah said, “We find it very disheartening that duty bearers and policy makers finalised the 2016 annual budget for the federation and at state levels within the new zero-based budgeting framework, yet nutrition was not seen as priority issue in a country where over 11 million under-five children are stunted. “
Stunting occurs when children are too short for their age and it is the commonest indicator of under-nutrition in Nigeria. Others are wasting and underweight.
Over 11 million children are stunted in the country and Nigeria also accounts for one-tenth of the global burden of severe acute under-five malnutrition.
About 32% of under-five children in Nigeria are stunted with northern Nigeria bearing the largest burden.
Malnutrition is considered as a social injustice. Experts say stunted children have poor physical growth and brain development, which prevent them from reaching their full potential in life.
The 1,000 days, beginning from conception to a child’s two years of age, is the most critical stage in a child’s mental development and medical experts have concluded that any damage to the brain during this period as a result of malnutrition is irreversible.