By Blessing Agbeetan

The fear of losing a child is one of the greatest heartaches of motherhood. For Mary Dosa, a 32-year-old fashion designer and mother of two, this fear almost became a reality when her six-month-old baby, Dominion; began showing signs of malnutrition. After childbirth, Dosa suffered from significant blood loss and was unable to breastfeed. With no other options, she fed her baby a mixture of pap and milk, unaware that these lacked the essential nutrients her baby needed to grow. As a result, her baby’s hands and lips shrank, and his spine became alarmingly visible.

“When he was born, he weighed 3.5 kg. But by the time he was four months old, despite receiving his BCG vaccination, he was still only 3.6kg,” Dosa recounted. “I was worried because there was no improvement, and people started saying all kinds of things,” she added.

Before and After of Dominion, Dosa’s Child

Dosa’s fortune changed when a family friend, who had benefited from the Nutritious Meal Plan Intervention for Vulnerable Mothers and Children (NUMEPLAN) programme, recommended that she take her baby to the Lagos Food Bank Initiative for assistance.

“I enrolled my baby in the NUMEPLAN programme on April 29, 2024. At six months old, he looked like he was only two months old. Thanks to the enlightenment we received, along with the baby formula and other nutritious foods provided, his condition improved significantly. Within two weeks, his weight went from 3.8 kg to 4.6 kg. Now, at nine months old, he weighs over 6 kg. The Lagos Food Bank has been a blessing to my family,” she stated with gratitude.

The Growing Malnutrition Crisis in Lagos

Malnutrition is a persistent challenge in Nigeria, with Lagos being no exception. The economic downturns and inflation currently experienced in the country have worsened the situation, driving up the cost of nutritious food and forcing many families to survive on whatever is available, regardless of its nutritional value. Unfortunately, pregnant women and children under five are particularly vulnerable, as they often face nutrient deficiencies that can lead to long-term health problems. According to the World Health Organisation (WHO), malnutrition contributes to approximately 45% of deaths among children under five in Nigeria.

Providing insights on malnutrition, Dr Olufunmilola Akinola, a Consultant Paediatrician at St Ives Family Hospital, disclosed that it is an imbalance between the nutrients the body requires to function and the nutrients it receives. According to her, “Malnutrition happens when a child doesn’t get enough of the right foods to give the body the essential nutrients needed for growth and development”.

    A Malnourished Child (Source: Lagos Food Bank Initiative)

The 2018 National Demographic Health Survey (NDHS) revealed that 37% of children under five in Nigeria are stunted (too short for their age), while 7% are wasted (too thin for their height). Lagos, being one of the most populous states in Nigeria, mirrors these alarming trends. The National Nutrition and Health Survey (NNHS) indicates that nearly 32% of children under five in Lagos are stunted, further showcasing the prevalence of chronic malnutrition in the state. Data from the Nigerian Federal Ministry of Health shows that a significant percentage of pregnant women in Lagos suffer from anaemia and other nutrient deficiencies, which often lead to adverse outcomes for both mothers and their children.

NUMEPLAN’s Lifesaving Intervention

Since its inception in 2015, the Lagos Food Bank Initiative, a nutrition-focused non-governmental organisation; has been at the forefront of fighting hunger and solving the problems of malnutrition. With a focus on vulnerable populations, the organisation launched the NUMEPLAN (Nutritious Meal Plan Intervention for Vulnerable Mothers and Children) to provide nutritious meals to pregnant women and children under five to ensure that they receive the vital nutrients needed for healthy development. So far, over 1,325 children have benefitted from the programme.

Michael Sunbola, the Executive Director of the Lagos Food Bank Initiative, highlighted the importance of the NUMEPLAN programme in addressing the nutrition gap in Nigeria. “There’s a huge nutrition gap that we have, especially for children within their first 1,000 days and data shows that more than 20% of them are not even getting any help at all. What it means is that when these interventions are not timely, they affect the cognitive development of these children, and it causes irreversible damage to their developmental growth,” Sunbola explained.

He stated further, “Seeing this gap, we designed the NUMEPLAN programme to provide these children with a supply of food for maybe two or three months. Once we provide a constant supply of food with the help of the in-house nutritionists and volunteers, these children come back to life, and we can save them from the claws of malnutrition, which can have a more devastating effect on their cognitive development in the future.”

NUMEPLAN Outreach Programme at the Lagos Food Bank Warehouse in Lagos

In addition to essential food supplies, NUMEPLAN provides nutritional counselling to mothers and caregivers as part of the efforts to address knowledge gaps on how to properly nourish their children. The nutritional counselling sessions are typically held bi-weekly at the Lagos Food Bank warehouse as part of the NUMEPLAN programme and they run for three months.

“We notice a knowledge gap in the sense that a number of these caregivers do not have nutritional knowledge on how to handle these babies. NUMEPLAN fills this gap by giving them the required counselling and knowledge that they need to provide nutritious meals for their children. It’s a maternal, mother and child programme, but mostly for children,” Sunbola noted.

Notably, the NUMEPLAN (Nutritious Meal Plan Intervention for Vulnerable Mothers and Children) does not only provide malnourished children with essential food supplies such as baby formulas and staple foods, but it also extends support to mothers by providing them with food to enhance their own health and ability to care for their children. “We also give the mothers what they will feed on to have enough nutrients to breastfeed and take care of their malnourished children. If there are no underlying conditions, the longest any child can be on our programme should not be more than six or seven months,” Sunbola emphasised.

Sunbola shared a success story about Jimoh, a severely malnourished boy who lost his mother during childbirth and was cared for by his grandmother. Barely surviving on her meagre income, Jimoh’s grandmother could not afford proper nutrition, and as a result; he became emaciated and stigmatised by his community.

“There’s one story that inspires me a whole lot, it’s about a little boy named Jimoh. There was a particular day Jimoh became ill and his grandmother took him to the primary healthcare centre, where she was told about the Lagos Food Bank Initiative. Upon arriving at the Lagos Food Bank, we examined him and provided food packages for him and his grandmother,” Sunbola recounted.

Before and After of Jimoh

He continued, “At the time Jimoh came to us, he was about one year old and he weighed 4kg. By the end of the programme, he had doubled in weight, and his transformation was remarkable. He went from looking weak and malnourished to a healthy, vibrant child.”

Stressing the importance of collaboration in creating a sustainable impact on both maternal and child health, Sunbola disclosed that the Lagos Food Bank Initiative leverages its partnership with the primary healthcare centres, from where healthcare professionals refer malnourished babies and other organisations to identify malnourished children and cater to their immediate needs. “We partner with the primary healthcare centres and they can identify malnourished children. We also partner with some companies that gave us some of their products to give to these babies,” he explained.

Motunrayo Tijani, a 50-year-old divorcee and mother of six, echoed this sentiment. Tijani’s income from hawking pap barely covers the basics, let alone proper nutrition for her children. Her journey with the Lagos Food Bank began when a healthcare centre referred her there after observing that her child looked smaller than her age. At nine months old, Tijani’s child was severely underweight, but today, at nearly two and a half years old, she is thriving.

“It was through the healthcare centre I heard about them. When I got to the Food Bank, they welcomed me warmly and they started treatment for my child. So they gave him food like milk, soybeans, wheat and other foods like semo, plantain, beans, potatoes and fish. I always follow their instructions, and my child responds to treatment. You can see the evidence when you look at her now,” Tijani proudly stated.

Emphasising the need for sustained efforts in combatting malnutrition, Rilwan Oyedele, a public health nutritionist at the Lagos Food Bank Initiative; pointed out that it is important to provide pregnant women and children access to nutritious meals that contain key nutrients like vitamins A, B12, iron, folic acid, and zinc to maintain a healthy living. “Malnutrition on its own is an underlying cause of child mortality. So, if we are to promote child survival; we have to take care of malnutrition because some diseases like diarrhoea and pneumonia that would rather not be fertile to children who are well nourished, can affect the health of malnourished children,” he stated.

Oyedele added, “It is good for the pregnant women and even the children to have access to nutritious meals because it helps them to live a healthy life. What we just need to get an adequate diet is to make sure we consume a variety of fruits and vegetables in the right quantity and quality. Though we have supplements around, we encourage people to get these nutrients from raw or minimally processed foods”.

Highlighting the impact of the NUMEPLAN (Nutritious Meal Plan Intervention for Vulnerable Mothers and Children) on the beneficiaries, Oyedele noted, “The impact of the NUMEPLAN programme is that the child can live a good life, his/her cognitive function will increase, and the mothers or caregivers don’t have to spend most of their time taking care of sick children”.

The key to the success of a programme like NUMEPLAN (Nutritious Meal Plan Intervention for Vulnerable Mothers and Children), lies in meticulous planning, follow-up and transparency. According to Similoluwa Olorunleke, a volunteer nutritionist at the Lagos Food Bank, “For the NUMEPLAN programme, the children are provided with infant formula and there is a sheet that is used to monitor and to ensure that what is written on the list is what the beneficiaries get every day. Additionally, photos are shared online to show that the beneficiaries receive these resources over time”.

Buttressing this, Oyeleke stated, “After we discharge them, we don’t just leave them like that. We follow up and call them so that they don’t suffer relapse”.

Challenges

Despite its successes, the Lagos Food Bank Initiative faces challenges, including limited funding. Sunbola admitted that the NUMEPLAN (Nutritious Meal Plan Intervention for Vulnerable Mothers and Children) programme often relies on funds from its other programmes like the Temporary Food Assistance Programme, to continue its work. “There are quite many challenges, but funding is number one. There are times that we now have to use funding from our other programmes to support NUMEPLAN. We are faced with a lot of problems but where you have limited resources, there is little that you can do especially since we don’t have the support of the government,” he said.

Another challenge is the risk of relapse among recovering children. Common illnesses like diarrhoea often cause children to lose weight again, requiring extended care and resources. “Sometimes we make some progress on these babies and they come out of that state where they get discharged and then something happens maybe they fall sick and then they relapse again and we start over again,” Sunbola lamented.

Undoubtedly, there is a lack of adequate awareness about the prevalence of malnutrition in Lagos. Many people still assume that malnutrition is only present in the northern part of the country due to how the area is largely populated. “There is a problem of malnutrition in Lagos. It is not as rosy as people think it is”, Sunbola stated.

For Oyedele, the lack of economic access to food is a major challenge when it comes to combating malnutrition. “Even with nutritional counselling and the little support we provide, families still need to purchase food outside. But when they can’t afford it, what are they going to do?” he queried.

Way Forward

The consequences of malnutrition are severe unless urgently addressed. According to Dr Akinola, malnutrition can significantly impair the cognitive development of a child and result in poor academic performance. “A malnourished child may not perform well at school, suffer neurological problems, appear shorter than expected for their age, unusually thin or bloated; and may also have a weakened immune system. Nutritional deficiencies can impact various systems in the body, including taste, sight, and smell, and may even lead to anxiety, mood changes, and other psychiatric symptoms.”

Therefore, in tackling the issue of malnutrition head-on, interventions like that of the Lagos Food Bank Initiative should be supported and replicated by other organisations. “I think more words should be put out there. Interventions like this should be replicated”, Sunbola advised.

Speaking on the importance of consuming adequate nutrients to combat malnutrition, Oyedele emphasised, “This intervention should start when a woman is pregnant. We should consume a variety of foods in our everyday life”.

Healthcare providers must collaborate with families to prevent and address malnutrition by educating parents and establishing regular checkups for children under five. “During clinic visits, healthcare providers should monitor the weight and height of these children and plot the measurements on age and sex-appropriate growth charts to ensure they are developing properly,” Dr Akinola emphasised. Additionally, parents should endeavour to feed their children essential nutrients that the body needs to prevent malnutrition.

The government’s role in addressing malnutrition cannot be overemphasised. The current economic realities in the country have made it difficult for families to afford nutritious meals. Therefore, it has become imperative for the government at all levels to live up to its responsibilities by providing jobs and startup capital for the citizens to cater to their survival needs.

While the Lagos Food Bank Initiative continues to make strides, more funding is needed to expand its reach and sustain its life-saving programmes. “The more donations we receive, the more food we can provide to those in need,” Oyedele emphasised.

The NUMEPLAN programme demonstrates the profound impact that timely interventions can have in transforming the lives of vulnerable families. With sustained support, it can continue to serve as a lifeline for thousands more.

This solution journalism report was produced by Blessing Agbeetan for Women Radio 91.7, in partnership with Nigeria Health Watch through the Solutions Journalism Network.