B. N. ALI (MRS.)NUTRITION DIVISION

FMOHABUJA

PRESENTATION OUTLINE• Introduction - Nutrition Situation in Nigeria

- Key Nutritional Problems- Causal Analysis and Consequences- Government Interventions- Recommendations- Conclusion

INTRODUCTIONAdequate nutrition in the first two years of life is the

“critical window” for achieving survival, optimal growth & development into adolescence and adulthood.

Malnutrition results in a weaker immune system and a higher risk of severe infectious diseases, including diarrhoea and pneumonia.

Access to sufficient amounts of safe and nutritious food is key to sustaining life and promoting good health.

Maternal reproductive status is built at early years of girl child which subsequently determines pregnancy outcomes.

Difficult situations-emergencies, low birth weight, persistent diarrhoea, HIV&AIDS and diet-related disease conditions adversely affect feeding patterns in early childhood.

INTRODUCTION Contd.The nutrition situation in Nigeria has over the years

assumed public health importance with malnutrition accounting for more than 50% of under-five deaths.

Addressing increasing public health problems of diet-related non communicable diseases is a challenge.

Key nutritional problems as follows:- Poor Infant feeding practices- Energy and Protein deficiencies- Vitamin A deficiency (VAD)- Iron deficiency Anaemia (IDA)- Iodine Deficiency Disorders (IDD)

NUTRITIONAL INDICES 1990-2013

1990

1999

2003

2008

2013

Stunting 43% 46% 42% 41% 37%Wasting 9% 12% 11% 14% 18%Underweight 36% 27% 24% 23% 29%EBF 2% 22% 17% 13% 17%

The key problems ContdDiet related non communicable diseases

(DRNCD) such as obesity, diabetes mellitus, and cardiovascular diseases are increasing in public health importance in Nigeria.

About 5 million Nigerians may die of non communicable diseases by the year 2015, and diabetes alone is projected to cause about 52% of the mortality by 2015.

At present, about 8 million Nigerians suffer from hypertension and 4 million have diabetes.

Causes of malnutritionInsufficient food intake, repeated infectious

diseases and/or a combination of both. It can degenerate to increased risk to illness and death as well as a lowered cognitive development.

Multifaceted challenges to malnutrition ranging from Basic causes-poverty, Ignorance to food values and

proper food selections due to governance and institutional weaknesses due to fragmented and inadequate funding across sectors,

Underlining causes-food insecurity, inadequate care and access to health services

Immediate causes-inadequate food intake and diseases

GOVERNMENT INTERVENTIONSAppropriate Policies and Guidelines in Place

Infant and Young Child feeding Programme

Micronutrient Deficiency Control

Community Management of Acute MalnutritionCapacity Building Awareness creationAdvocacy and Resource Mobilization

Policies & Guidelines in place:National Policy on Food & NutritionInfant and Young Child Feeding Guidelines,

Policy and Strategic Plan of Action Micronutrient Deficiencies Control Guidelines Food-based Dietary Guidelines for NigeriansGuidelines on Nutritional Care and support for

PLWHANational Operational guidelines on CMAMDomestication of the BMS CodeNational Strategic Plan of Action for Nutrition

(2014 - 2019)

STRATEGIESPromotion of essential nutrition intervention as part of

health services & programmes particularly at PHC levelPromotion of nutrition education & services to rural

and urban communities (through eg. home/school/community gardens for food dietary diversification)

Sustained & regular media campaigns for nutrition advocacy and public education

Control of micronutrient deficiencies through food fortification by large and medium scale food industries

Vitamin/mineral supplementation to mitigate nutrition risks as short-term measure

Promotion of educational, health and nutrition interventions through the Home Grown School Feeding and Health Programme, physical exercise

•Infant and Young Child Feeding: •Early initiation of BF, •exclusive breastfeeding for 6months;• continued BF for children 6 – 24 months; •complementary feeding from 6 months; •Infant Feeding counseling for PMTCT

•Growth Monitoring and Promotion•Vitamin A Supplementation and treatment for measles; •Deworming for children ≥12 months & pregnant women•Prevention and management of child malnutrition (facility- and community-based)•Vitamin A Supplementation in post partum period•Prevention & treatment of iron deficiency anaemia

Nutrition Interventions/actions in IMNCH Strategy

CHALLENGESPoor health behavioural practices

Ignorance

Poverty

Insufficient nutrition education.

RECOMMENDATIONSBreastfeed newborn infants exclusively for the first 6 months

of life, give adequate complementary foods from 6 months while continuing breastfeeding up to 2 years

At every meal, give variety of foods to ensure adequate meal

Increase consumption of fruits, vegetables, grains and legumes eg beans and soya beans.

Eat more of foods close to nature and reduce consumption of refined foods that may predispose one to cancer.

Increase consumption of poultry and fishUse more fats from vegetable sources

RECOMMENDATIONS CONTDDecrease consumption of foods high in animal fat

Decrease consumption of sugar and food high in sugar & additives content

Decrease consumption of salt and foods high in salt content

Drink water as much as possible daily (2.5 to 3L)

Improvement of nutritional status & reduction of disease burden will enhance protection of human capital,

CONCLUSIONNutrition problem is not a subject to be studied; it

is a problem to be solved.

We know so much about malnutrition (undernutrition and overnutrition) and yet we do very little about it.

We can do a lot by effecting changes in our meals (by making wise food selections) as well as our lifestyles, reducing morbidity and mortality rates due to malnutrition.

TIME TO ACT IS NOW