How women in Maiduguri community are curbing malnutrition

By Tobias Lengnan Dapam

In Borno, Adamawa and Yobe (BAY) states, the challenges of malnutrition is threatening the existence of children. In fact, the United Nations Children’s Fund ( UNICEF), said approximately 2.8 million children under five and pregnant and lactating women (PLWs) are in need of preventative nutrition services.

UNICEF Chief of Borno Field Office, Dr. Tushar Rane, said

if they are not provided with quality preventative services, approximately 1.7 million boys, girls, women, and adolescents across in the BAY states are likely to be affected by acute malnutrition in 2024, including 206,779 pregnant and lactating women are expected to suffer acute malnutrition.

“According to the 2023 lean season Nutrition and Food Security Surveillance (NFSS) Round 13 conducted across the BAY states, the prevalence of global acute malnutrition (GAM) among children under 5 years in Borno is 10.2%, 8.0% in Yobe and 4.0% in Adamawa. This also means that an estimated 511,807 children under five suffer from Sever Acute Malnutrition annually, requiring urgent interventions to save their lives.”

But in Layin Jere, a small community in Jere Local Government Area of Borno state, there are community efforts curbing the menace and giving hope to women and children.

The effort led by Mrs. Usaina Abba Ibrahim, the leader of the women support group in the community has significantly transformed the lives of young mothers and their children.

The woman who was trained by UNICEF to champion the advocacy in her community, said the campaign has become part of her daily activities.

Usaina, said at the beginning of the campaign, she moved from house to house to educate women on how to address malnutrition by ensuring exclusive breastfeeding and (Tom brown); combination of local foods that are rich in nutrients for children.

“We are also educating mothers on the need for hygiene and the use of ash in place of soap. This method is necessary considering the level of poverty in our community.”

Speaking about her challenges, she said the journey was discouraging, as people shut their doors at her and called her names.

“It was not an easy experience to convince women and their husbands to embrace our advocacies considering our believes and the high level of poverty and illiteracy in this part of the country.

“Also, because of lack of awareness, some of them thought exclusive breastfeed was a strange teaching and that children cannot survive without water. But when I told them that the breast milk have 70% water, few of them gave it a trial while others kept their distance.

“But despite all the challenges, I kept on moving further and persuading them on the need to embrace our advocacy and kick out malnutrition from our community. After so much persistence, few women started coming and the circle kept increasing. Now, I am happy that we have two women groups; Alherì and Godiya.

“These two groups have women that are committed and are also seeing results of what we are doing. I am teaching the women how to take care of the baby from the pregnancy stage to when they are two years old.

“When others started seeing the babies that were exclusively breastfed, they started joining us to share the success story. These women we have are also educating others on the need for exclusive breastfeeding and the food that is good for nursing mothers and the babies.

“ I also teach them how to use the Mid-Upper Arm Circumference (MUAC) tape to identify malnutrition in their children.”

Also speaking, 30 years old Aisha Muhammed, a nursing mother, said this is the second time she is exclusively breastfeed her children. She said out of six of them, the fifth and the sixth, upturned out healthy because of exclusive breastfeed.

“When I saw the result of exclusive breastfeed in my fifth baby, I decided to continue because the difference is clear. It is even more interesting that I can squeeze my breast milk and keep at home for the baby whenever I am not around.

“ The use of Tom brown has also been helpful. I am happy to be part of this initiative. The women leaders has been very helpful and the evidences are there for all so see.”

On whether she gets support from her husband, Aisha said the husband found it strange when she first told him; “but when he saw the changes in our fifth child, he said I should continue. In fact, he always tells his mother that water should not be giving to a child who is breastfeed.”

Another woman who’s baby is four months old, said the advocacy is transforming the lives of women in the community.

She said her first child is enjoying exclusive breastfeed and looking healthy than other babies around them because of the orientation she has received from the lead woman.

She said the training has exposed her to understand how to properly take care of her children and assists other parents in

the community.

While explaining what the women are learning, a nutrition supervisor working with UNICEF, Chanda Grace, said the women are in group of 15 in different communities.

She said they learn about the importance of exclusive breastfeeding for the first six months and how to prepare nutritious complementary foods for older children.

Despite all these, she said some communities are hostile towards them. “ There were instances where some people stoned us and chased us out of their community.

“But we are happy that the leadership of Bulama Mustapha, the women have overcome these challenges. Infacts, the women are considered champions in some places.”

Speaking on the importance of the campaign, Bulama Mustpha, a community leader in the community said there is a lot positive changed in the community since the campaign began in the community.

Mustapha, who is helping to ensure compliance said feedback from parents is a confirmation that the health of children in the community has improved tremendously. “Even children who fall sick easily before now have not complained in a long while. More parents are becoming aware and are educating each other to ensure that we succeed as a community”.

On her part, Officer-in-Charge, UNICEF Nutrition Manager, Mrs Priscilla Bayo, said the women support group has achieve results in Borno Adamawa and Yobe states.

“They are not only saving lives but also empowering themselves and their communities. Their courage and determination are a testament to the resilience of the human spirit. As they continue their fight against malnutrition, they are inspiring others to join their cause and create a healthier future for their children”

She said there are over 4000 women support group in the BAY states and over 1000 in Borno state.

She added that there is a multi stakeholders collaboration in addressing malnutrition in those states.

She said UNICEF is working with government and other partners to curb malnutrition in those states.

She said UNICEF has a counseling centre to address various stages of malnutrition.

“We have a place that takes care of infants and children depending on their conditions. If a child is severely malnourished, we take that child to the stability center at the facility. We also apply the Ready to Use therapeutic Food (RUTF) to children from 6 to 59 months.”

Speaking on the collaborative efforts of UNICEF, Rane said the organisation is the lead partner for the Nutrition Sector.

He added that there are 46 partners (14 international non- governmental organizations (INGOS) and 32 national non-governmental organizations (NNGOs)), as well as 2 observers (MSF and ICRC), supporting nutrition activities in the states alongside other UN agencies.

“Nutrition programmes are integrated within government health facilities where there are 765 outpatient treatment programme (OTP) sites in the BAY states providing treatment for children with SAM without medical complications, and 50 Stabilization Centers (SCs) treating SAM with medical complications. Only 63% of the 714 wards in the BAY states provide nutrition services.

“With support from UNICEF and donors such as the United Kingdom Government (UKAid) and the German Ministry for Economic Cooperation and Development (BMZ),

among other donors Government across the BAY states are currently supporting 4,383 child nutrition mobilisers (CNMS) supporting malnutrition screening at the

community levels. The CNMs are an important link in the nutrition system. They reinforce nutrition best practices in the communities and, from house to house, they build the capacity of mothers to screen their children.

“With the collaborative efforts of government and all partners,

over460,000 children were treated for acute malnutrition across Borno, Adamawa and Yobe states, during 2023. That is 37 per cent increase over the coverage for same period in 2022.”

He said besides supporting CNMs and the provision of nutrition supplies to 765 OTPs and 50 SCs across northeast Nigeria, UNICEF has been supporting the government to pilot a few holistic programmes to address child malnutrition.

“Across the BAY states, UNICEF and the Borno State Primary Health Care Board are adopting a proactive screening approach to identify children with SAM. Across northeast Nigeria, the family approach to malnutrition screening has led to the empowerment of more than

100,000 caregivers to screen and identify children with acute

malnutrition. Mothers play a crucial role and contribute to promoting the health of their children to ensure proper growth and development.

“The aim of the family screening approach is to shorten the

identification, referral and treatment gap and also train caregivers to provide household screening for their children, using the Mid-Upper Arm Circumference (MUAC) tape.

UNICEF is excited that this approach is already yielding results. In Banki, a community in Borno State, more than I in 4 children (30%) receiving acute malnutrition treatment are identified through the

family screening approach. The family approach is a game changer leading to prompt and early identification of children with acute malnutrition than in previous years.

“Similarly, UNICEF has initiated the Child Nutrition Fund (CNF) with the Government across the northeast and signed Memoranda of Understanding (MoU) with them for this purpose. The CNF is an alternative financing mechanism to address child malnutrition.

“The MoU will tackle the problem of malnutrition among children less than 5 years old as well as pregnant and lactating women through the provision of Ready-to-Use Therapeutic Food (RUTF). The main beneficiaries will be children 0 – 59 months as well as pregnant and lactating/breastfeeding women. The Borno State Government has

committed the sum of $100,000 counterpart funding to match UNICEF’s contribution in the same sum to the purse.”