Nigeria Zero Hunger/IITA Policy Brief No. 4: Nigeria Zero Hunger Strategic Review – Nutritional Status of Children under the Age of 5 in Sokoto State, Nigeria

The United Nations’ “2030 Agenda for Sustainable Development” (also known as Sustainable Development Goals - SDGs) has 17 goals [1], to which the Federal Republic of Nigeria committed to achieving. Out of the 17 goals, Nigeria prioritized SDG 2, the so-called Zero Hunger goal, calling on member states to “End hunger, achieve food security and improved nutrition, and promote sustainable agriculture”. Under the leadership of His Excellency, Chief Olusegun Obasanjo, former President of the Federal Republic of Nigeria, the Nigeria Zero Hunger Strategic Review (aka “The Review”) was established which sought to articulate what Nigeria must do to achieve SDG2 by 2030 through an open and consultative process. The Review decided, as a first step, to conduct a baseline survey to establish the true situation at the start of its strategic intervention to 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. This selection enabled spread across four of Nigeria’s six major agroecological zones to also provide insights along the country’s gradients of agricultural intensification and market access. 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 Sokoto state focusing on the issues of poverty, hunger, nutrition & health care, and other nutritional outcomes in children under 5 years of age. The results also present comparisons between Sokoto state and the average from all five surveyed states. It ends with policy recommendation to attain the goals of SDG2.

44.0% of households in Sokoto state live below US$1.9 per person per day compared to an average of 28.9% of households in all five states. On hunger, 29.8% of households experience hunger broken to 18.6% at moderate level and 11.2% as severe compared to an average of 27.7% (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 Sokoto households where 73.0% are poor and suffering severe hunger (Figure 1) compared to an average of 45.4% of households in other states (Figure 2). 

 Figure 1: Effect of combining hunger and poverty (% of households) in Sokoto 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 and no cause for concern in Kebbi 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 lagged behind 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 Sokoto State, Nigeria compared to FANTA2. 

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

Sokoto state, compared to other states, was found to be behind for mothers or caregivers starting immunization (61.7% compared to 65.3%) and completing immunization (52.0% compared to 61.2%) for their infants and children. This inaction of not presenting their children and infants for immunization exposed about 50% of the children to preventable diseases in the study year. There were also comparatively poor results on number of surveyed children who had diarrhoea within 2 weeks of the interview or were recumbent during the interview. However, there were less cases of visible signs of oedema, disability, cough and fever compared to the other states surveyed (Figure 5). This is not good enough and needs to be addressed. 

 Figure 5: An overview of proportion of child health/care events in Sokoto 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, Sokoto 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 24.0% of the children in Sokoto state were underweight of which 6.3% were severely underweight. Of great concern is the coexistence of underweight and overweight as 5.6% of the children were overweight with 5.3% of them obese. 

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

For stunting, the global average for developing countries in 2015 [3], was 25% compare to 31.0% stunting in Sokoto state out of which 15.0% were severely stunted. Policy makers in Sokoto 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 key policy articulation initiatives in Sokoto comprised: An economy-wide policy document exists as Master Plan; The Sokoto State Agricultural Policy (2007-2020) commissioned for 2007-2015 but remains inconclusive and suspended till date; A Food and Nutrition Policy document is operational in the State at the instance of the State Ministry of Health. The policy gaps were: Policy articulation irregular (Policy document cited is out-dated); Extant policy documents not articulated within the Zero Hunger principle of food as a human right; Policies, Programmes and other initiatives available for meeting the Zero Hunger targets include the Ramadan Free Feeding Programme; School feeding programme. 

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 these States relating to these aspects. The need arises for Sokoto 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

As in the case of the other states, Sokoto State works in partnership with Federal Government and development partners namely: FGN (FADAMA III, Growth Enhancement Scheme, CBN Anchor Borrowers’ Programme (ABP) on wheat, onions and rice value chain developments); with IFAD (Assisted Climate Change Program); USAID (Markets II, World Bank–assisted projects; EU-German ADP on onions seeding) etc. A good deal of ‘stop-go’ nature of agricultural policy was also observed. 

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.

The results for Sokoto state show that under nutrition is rampaging and lead to the conclusion that the state has a long way to go to reach the Zero Hunger targets. Attaining the sustainable development goals requires all countries and their citizens to act together to end hunger and all forms of malnutrition by 2030. Therefore, the state requires to redouble its efforts. Targets have been set, but actions need to follow quickly. Policy action must be designed to reduce malnutrition in all its forms and be adequately funded. The most nutritionally vulnerable people, must be targeted with strategies which must be evidence based, implemented at scale, and include both broad based and targeted actions. A planetary challenge on a par with poverty and climate change is represented here by the rapidly escalating threats posed by malnutrition. An appropriate response at the required scale is top priority for decision makers in Sokoto 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.