Yecenu Sasetu: The SAM Epidemic

MADAROUNFA, NIGERIA - JUNE 14: Yahya Abdumalik, a 14-month-old severely malnourished child held by his mother, Zayha Arouna, at a clinic in Madarounfa, a village in Niger near the Nigerian border on June 14, 2012. According to UNICEF, nearly a quarter of a million children under 5 suffering from severe acute malnutrition received life saving treatment in West Africa's sahel region during the first four months of this year. At least 1.1 million children will need similar assistance over the course of this year. (Photo by Sudarsan Raghavan /The Washington Post via Getty Images)

At a period in my life, I started to hear “you are getting fat” and all I wanted to do was shed that weight. I checked Google on how to lose weight and I got some suggestions, one of which was intermittent fasting.

A diet Coach also recommended starting with a 24hour fast to ‘cleanse’ the system. So, I decided to do the 24hr fast, and all I was allowed to take was water throughout the day till the next day. I started my fast and as the day progressed, I experienced dizziness, headaches, anger, and at a certain point, my vision became blurry. I held on and kept taking water. By evening, I was so dizzy that all I could do was lie down and by the next morning, I couldn’t even get up from the bed.

Now shift your imagination to a child that has to live without food for several hours, days, weeks and when food does come, it is in limited portions or totally devoid of nutrients.

There is a pandemic right now and no it is not COVID 19 pandemic, it is nutrition pandemic. I say pandemic because the situation is not just local but global. Therefore, let’s look into the current nutrition situation in Nigeria with a focus on Severe Acute Malnutrition (SAM) in children.

The World Health Organisation says malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. In simpler terms, malnutrition happens when the body does not have enough nutrients.

Severe Acute Malnutrition (SAM) in children is when they lack growth nutrients that are required to build new tissues. These nutrients help them to regain their weight after illness, repair damaged tissues and also help build up their immune system. And this begins at infancy with breastfeeding.

Data from UNICEF   showed that an estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM). The Global Nutrition Report 2020 has revealed that Nigeria experiences a malnutrition burden among its under-five population.

Vice President, Yemi Osinbajo, at the virtual conference on nutrition said “Perhaps it bears repeating that with malnutrition, we are confronted with a terrible scourge. One capable of defeating the present aspirations of millions of young Nigerians for healthy and productive lives. But worse, one that can jeopardise the physical and mental abilities of future generations since children are its most vulnerable victims.”

Children with SAM are nine times more likely to die than well-nourished children. They are more likely to be sick, have reduced cognitive ability and more than 10% of household earnings lost due to poor productivity, and increased health costs” said Dr Emmanuel Sokpo, Country Director, Network for Health Equity and Development, NHED.

Indeed, there is nutrition pandemic and according to WHO Regional Director for Africa, Dr Matshidiso Moeti, “Hunger and malnutrition heighten vulnerability to diseases, the consequences of which could be far-reaching if not properly addressed.”

The SAM Pandemic in Nigeria

Yes, malnutrition is indeed a global problem, but we in Nigeria have quite a few unique factors that worsen the prevalence of malnutrition.

The first is poverty; with poverty comes affordability and accessibility to a balanced diet. A poor family may not necessarily bother about the nutrients of the meal as they will be more concerned that there is a meal. The story has even worsened today by the effect of the economic downturn resulting from the COVID-19 pandemic. People are losing their jobs, the Nigeria government has raised tariffs, and therefore, inflation is the order of the day.

Second is the displacement of large populations especially children as a result of the insurgency and community clashes. The persistence of these underlying issues increases the overall physical and material resources that will be required to deal with malnutrition.

According to UNICEF, Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five. An estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM), but only two out of every 10 children affected are currently reached with treatment.

The Way Out

A very effective treatment for severe acute malnutrition is Ready to Use Therapeutic Food (RUTF). Children were provided with this RUTF at Community Management of Acute Malnutrition (CMAM) sites. It costs N21, 350 to cure a child with SAM for an 8 week treatment with RUTF compared with 6months treatment with other forms of treatment. It costs N36,750 to cure a child in an emergency state with SAM. This treatment was majorly funded by donors who are currently dwindling and to worsen the situation, the N800m allocation for RUTF was removed from the 2020 budget.

With the paucity of funds, SAM Advocacy partners are now seeking innovative ways to finance nutrition and bring an end to malnutrition in Nigeria.

In her submission, Executive Secretary of the Civil Society Scaling-Up Nutrition in Nigeria (CSSUNN), Beatrice Eluaka said “Innovative Financing is an approach to funding enterprises, interventions, and value chains that create positive social or environmental impact. It uses available financial tools (philanthropic and commercial) to catalyze and scale solutions, and when existing tools do not work, it creates new ones. Innovative financing often relies on partnerships to pool resources from a range of public and private sources to solve problems faster, more effectively, and at a larger scale than would be possible alone.”

A cost effective way to prevent malnutrition is to breastfeed but how can a hungry mother breastfeed her child? UNICEF revealed that 7% of women of childbearing age also suffer from acute malnutrition.  Exclusive breastfeeding rates have not improved significantly over the past decade, with only 17% of babies being exclusively breastfed during their first six months of life. Just 18% of children aged 6-23 months are fed the minimum acceptable diet.

In April 2016, the United Nations General Assembly adopted a resolution proclaiming the UN Decade of Action on Nutrition from 2016 to 2025. The Decade aims to catalyse policy commitments that result in measurable action to address all forms of malnutrition. The aim is to ensure all people have access to healthier and more sustainable diets to eradicate all forms of malnutrition worldwide.

What then can be done innovatively to provide resources for the battle against malnutrition?

Professor Adebayo Fayoyin, Visiting Professor of Mass Communication, Caleb University, Lagos suggested a few strategies:

  • Prioritize pro-poor investments and interventions: focus on investments that will give accurate result,
  • Appropriate budgetary allocation and release of funds: let budgeting have allocations for malnutrition interventions and accountability ensured.
  • Domestic funding – private sector etc: partnerships and donations from the private sector.
  • Donor funding – dwindling: get more funding from international organisations targeting nutrition
  • Crowdsourcing: Goodwill from organisations and even individuals
  • Equity-based investments and budgeting: ensure that budgeting and investments are made for the appropriate needs.


This Outbreak story was supported by the Pulitzer Center and Code for Africa through the West Africa Data Literacy Programme.


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