Nigeria Zero Hunger/IITA Policy Brief No. 2: Nigeria Zero Hunger Strategic Review – Nutritional Status of Children under the Age of 5 in Ebonyi State, Nigeria

The Federal Republic of Nigeria committed to achieving the “2030 Agenda for Sustainable Development” (also known as Sustainable Development Goals - SDGs). The country prioritized SDG 2, the so-called Zero Hunger goal, requesting all UN member states to “End hunger, achieve food security and improved nutrition, and promote sustainable agriculture” by 2030 [1]. In September 2015, the Nigeria Zero Hunger Strategic Review was established under the leadership of His Excellency, Chief Olusegun Obasanjo, and former President of the Federal Republic of Nigeria. It sought to articulate what Nigeria must do to achieve SDG2 by 2030 through an open and consultative process. The initial activity was to conduct a baseline survey to establish the true situation at the start of the review and enable tracking of the progress. The International Institute of Tropical Agriculture (IITA) was charged with the responsibility to lead baseline surveys in partnership with the Farm & Infrastructure Foundation (FIF) in five states-Benue, Ebonyi, Kebbi, Ogun, and Sokoto. Following a design workshop by stakeholders, field activities for data collection were conducted with full support of governments in the states, the National Bureau of Statistics (NBS), UNICEF and the World Food Programme (WFP). The preliminary findings of the surveys were reviewed and validated by the representatives of the five states and other stakeholders at IITA, Ibadan in 2017. This policy brief summarizes findings for key parameters for Ebonyi that include poverty, hunger, nutrition & health care, and other nutritional outcomes in children under 5 years of age. It ends with policy recommendation to attain the goals of SDG2. The statistical comparisons summarized are between Ebonyi state and the average from all 5 surveyed states.

25.6% of households in Ebonyi state lives below US$1.9 per person per day compared to an average of 28.9% of households in all five states. On hunger, 35.3% of households experience hunger broken down to 18.6% at moderate level and 16.4% as severe compared to an average of 27.7% for the five states (with 17.1% and 10.6% of households in the surveyed states experiencing hunger, moderately and severely respectively). The combined effects of poverty and hunger on households was even more devastating for Ebonyi households where 36.7% are poor and suffering severe hunger (Figure 1) even though when compared to an average of 45.4% of households in other states, the figure is smaller (Figure 2).  

Figure 1: Effect of combining hunger and poverty (% of households) in Ebonyi state, Nigeria.  

Figure 2: Effect of combining hunger and poverty (% of households) in Benue, Ebonyi, Kebbi, Ogun and Sokoto states, Nigeria.

Child nutrition was studied in terms of infant and young child feeding practices and complementary feed offered to infant (during weaning). Breastfeeding practices had similar profiles in Ebonyi state compared to profiles for the rest of Nigeria presented in Food and Nutrition Technical Assistance (FANTA2) in WHO [2] (Figure 3). However, a large majority of mothers and caregivers offered unfortified local cereal of doubtful dietary quality as complementary feed (Figure 4). They were slightly ahead of the overall average in offering infant formulae and/or supplementation of local cereal. The net effect of the lop-sided proportion of unfortified cereal meals compared to fortified meals offered impacted the nutritional status of children. Analyses by age showed that the worst cases of malnutrition occurred during the second year of infancy which also coincides with when complementary feed is given. 

 Figure 3: Child breastfeeding practices in Ebonyi State, Nigeria compared to FANTA2. 

 Figure 4: Proportion of mothers (%) offering various types of complementary feed to their infants in Ebonyi state compared to other surveyed states.

Mothers in Ebonyi state were ahead of the surveyed states in starting and completing child immunization. However, still a high proportion (27%) of infants were not presented to complete immunization as they received only part of series needed for a full programme on immunization. They also had fewer cases of visible signs of oedema, ringworm, recumbency & disability, and diarrhoea compared to the other states surveyed (Figure 5). The prevalence of cough and fever were similar to the overall average. Judging by the performance of Ebonyi the compared to others, children and infants fared better in health care but this is not good enough and needs to be addressed.

 Figure 5: An overview of proportion of child health/care events in Ebonyi state compared to the average of all surveyed states, Nigeria. 

Bringing it all together and analyzing the combined and measurable impacts of poverty, hunger, nutrition and health on the well-being of children and infants, Ebonyi state falls behind both the global average for developing countries and the average for the studied states for Weight-for-Age Z-scores (WAZ) and Height-for-Age Z-scores (HAZ) which measure short-term and longer-term nutritional status of children respectively. For example, while global average for underweight was 8.9% in 2015 [3], figure 6 shows that 12.5% of the children in Ebonyi state were underweight of which 4.6% were severely underweight. Of great concern is the coexistence of underweight and overweight as 5.7% of the children were overweight with 3.9% of them obese. 

 Figure 6: Prevalence of malnutrition (%) among children under 5 in Ebonyi state compared to other surveyed states. 

For stunting, the global average for developing countries in 2015 [3], was 25% compare to 28.5% stunting in Ebonyi state out of which 13.9% were severely stunted. Policy makers in Ebonyi state must be alarmed by these figures and determined to take every possible measure to address them. 

Policy

The policy analysis component of the baseline study investigated the state for the presence or absence of programs, projects, and other initiatives of the public authorities required to create and sustain an enabling policy environment for achieving Zero Hunger targets by 2030. The results are detailed in the main report. However, here is a summary of the key findings: 

Policy articulation 

The extant policy document was produced in 2010, which was due for review since 2015 but this remains inconclusive till date. The main policy thrust of the State involves increasing food production and value addition with particular reference to rice, cassava, and poultry. 

The review of policies revealed the need to produce a concrete policy document for agricultural and food security with popular participation by stakeholders in the articulation of policy documents. There is a lack of philosophical context on which to anchor the contents of the policy documents for food security in the state. Recognizing the role of infrastructure as the backbone in agricultural development; it is recommended a systematic provision of rural infrastructure in the policy documents of the state, consistent with the provision for agriculture or food security in the Constitution. In many instances, no data was available to access the potency of policy instruments in respect of certain targets required for meeting the SDG2, implying that little or nothing is going on in the state relating to these aspects. The need arises for Ebonyi state to conduct a comprehensive review of its food and nutrition security policy, in order to explore opportunities for meeting the Zero Hunger targets and to incorporate the tenets of food as a human right in the new policy, both of which are in consonance with global trends. 

Policy implementation

The Ebonyi State Government has, over the years, been partnering with Federal government institutions such as FMARD, CBN, etc., and some regional, bilateral, and multi-lateral organizations including USAID-Markets, World Bank, IFAD, and UNDP in executing Community and Social Development Projects (CSDP), Rural Access Mobility (RAM), Graduate Enhancement Scheme (GES), Anchor Program, FADAMA, NEWMAP, etc.

In addition to policy articulation, other problems and challenges occur at the stage of implementation. Such constraints are usually shortage of funds and inadequate human and material capacity for effective implementation of policies. To ensure that the goal of Zero Hunger is met in the state, the above challenges could be addressed through the exchange of experiences with other states, improved internal coordination, and better and focused support of the national and international agencies during implementation. It is paramount to explore opportunities for integrating objectives of Zero Hunger into state projects and programs for attaining food security such as those implemented in collaboration with the private sector and in partnership with international agencies such as UNDP, FAO, IFAD, and the World Bank. It was observed that this cooperation or partnership has led to the superior responsibility of the state for agricultural development being subjugated and subordinated to the above national and international agencies. This process undermines the constitutional provision for the states to be in the lead as drivers of the policy processes for agricultural development. The well-entrenched practice does not augur well for the sustainability of policy efforts for meeting the SDG in the long term in these states.

This policy brief shows that Ebonyi State has made some progress in addressing the SDGs. Additional efforts are required if the State wishes to attain the Zero hunger goals. As written, the sustainable development goals require all countries and their citizens to act together to end hunger and all forms of malnutrition by 2030. Setting targets is a good first step, but actions need to follow quickly. Policy action must be designed to reduce malnutrition in all its forms and be adequately funded. Strategies must be evidence based, implemented at scale, and include both broad based and targeted actions aimed at the most nutritionally vulnerable people. The rapidly escalating threats posed by malnutrition represent a planetary challenge on a par with poverty and climate change. An appropriate response at the required scale is top priority for decision makers in Ebonyi state.

1. United Nations (2015) Transforming our world: the 2030 Agenda for Sustainable Development Resolution adopted by the General Assembly on 25 September 2015 (A/RES/70/1).
2. WHO (2010) Indicators for assessing infant and young child feeding practices. Parts 1,2 and 3. Food and Nutrition Technical Assistance.
3. IFPRI (2015) Global Nutrition Report 2015: Actions and Accountability to Advance Nutrition and Sustainable Development. International Food Policy Research Institute, Washington, DC, USA.