NAME: TEMITOPE ABAYOMI FADIYA
PROGRAM: MPH
EMAIL:[email protected]
COURSE: INTRODUCTION TO PUBLIC HEALTH NUTRITION
DATE: 20TH OCT., 2004
NUTRITION HEALTH ISSUES IN THE UNDER-5 CHILDERN IN NIGERIA
We live in societies which are constantly evolving and more so, at this period in the history of mankind when all hands are on deck to making sure that we all live in a world that is relatively free of those negative elements which I have termed the infectious agents. A world that is so much endowed as ours where nature has endowed us with so much abundance in terms of natural resources and the ever green products of the field for the benefit of man kind where each person could enjoy such free gifts of nature!
As the population of the world grows exponentially, the situation is now more precarious than ever. “The estimated population of the world taken to be 6.1 billion as at year 2000 and growing at a rate of 76 million people per year”(1). This leads, invariably, to increase in the number of people living per square mile and will be appreciated that most of this growth is taking place in the developing world, Nigeria for instance. Thus, with this increases we have a situation on hand in which the nutrition concerns of the population becomes an issue to worry about.
In Nigeria for instance with a population of over 120 million inhabitants and about 43.4% of the population between the ages of 0-14years (2) and specifically the estimated numbers of the concern age group for this discussion, that is, the under-5 is about 20552 thousands of the entire population as at year 2002, (3) which shows that this age group represent a vital link in the Nigeria context. However, it is sad to note that the health issues and condition affecting this age group are serious and precarious to the extent that international attention has been drawn to the health concern of this age group!
The question remains why the under-5? The issues of health boarding this age group are vital as this is one of the formative stages in life which invariably affect the sequence of life. An issue such as this cannot really be over emphasized because nutritional concerns at this early stage of life is so paramount to growth, development, and the acquisitions of the basis of intellectual growth in the later parts of life.
Nutrition and health at this age group are inextricably linked to each other that one affects the other. This is true to the fact that nutrition is vital to life and as the common saying: “you become what you eat” this is a statement that has proved itself over time!
A statement which, I would say, has found itself into the philosophy and mission statements of international organization like the UNICEF whose over goal is to promote and protect the right of children. And the right of a child includes access to adequate, safe and affordable nutrition that is vital to the joy and the realization of the full potential of that child.
The director general of the world health organization made an unequivocal assertion: “proper nutrition and health are human right”. I believe this is a litmus test for the world if the health of young children is really a matter of right or not! This is also a for thought and for serious political action in the Nigerian situation where the nutritional concern of the under-5 are a public health issue in view of the high morbidity and mortality associated with the problems of malnutrition in this age group. Malnutrition in the case of the Nigeria situation is of the opposite end of the spectrum, that is, under nutrition while in the western world the issue is more of over-nutrition!
A critical look at this menace of under-nutrition of the under-5 in a nation known as the sixth largest producer of Oil in the world is an issue that calls for a joint action to arrest the ugly situation if the future of the entire country is to be preserved!
Nutrition and human right goes hand-in-hand, the right of a child to adequate nutrition is paramount. The reason is not far fetch since nutrition is a cornerstone that affects and define the health statues of children, particularly the under-5!
So, what is this health issue that affects the under-5 in the Nigeria situation that has generated so much international concern? This is the issue of under nutrition! A country that is blessed with such verse land where agriculture could flourish but still experiencing the problem of under nutrition of a certain age group of her children population.
What must have really gone wrong? Before attempting to answer this nagging question, it is of import to point out that malnutrition as an entity is liked with poverty and these constitute a vicious circle that presently ravaging the living standard and health of the under-5 children in the Nigerian situation, it is compromising their hope for a sound tomorrow that is free of disease where they could develop their full potential. In a nut shell malnutrition is truncating their destiny! Thus, the need to reawaken our sensibility to this issue and strive for the survival of our young!
It is worth mentioning that “malnutrition has been the responsible, directly or indirectly, for 60% of the 10.9 million deaths annually among children under five. Well over two-thirds of these deaths, which are often associated with inappropriate feeding practices, occur during the first year of life.”(4)
One of the factors that could explain the problem of malnutrition in the under-5 in Nigeria is the fact there is inappropriate feeding practices or perhaps the mothers of these children do not have adequate information on the correct feeding practices of their children, thus it is invariably difficult to achieve an optimal health outcome.
This is a problem that must be addressed if the society would see an improvement in the health statues of these children. In appropriate feeding practices have its untoward consequences at the same time in that Nigeria is one of the countries in the sub-Saharan Africa where the mortality rate of the under-5 is still as high as 183 per 1000 while this mortality rate rank the top 15 (3), this is a very sad situation in view of the global effort of the international organization at reducing in general childhood morbidity and mortality!
183 out of every 1000 under-5 die of malnutrition related state yearly in Nigeria is alarming. Although efforts are being made at reducing this menace had yielded some results but only marginally! For instance, the annual rate at reduction of the mortality rate of the under-5 for 1990-2002 is only 0.3% (3)
So, there is a fundamental problem with the ways these children are fed. For instance, the concept of exclusive breastfeeding of these children is still to be embraced by the mothers
Despite the fact that this practice is natural act but it is learnt. The gains of exclusive breastfeeding cannot be overemphasizes considering the fact that it is first social contact the child has with the mother and the bond thereafter cannot really be quantified. The breast milk confers the child with natural antibodies which help to boost the immunity of the child and thus able to fight with infectious agents in the immediate environment and also the child is able to cope with life. Of course some many reasons or what I could call a taboo about breast feeding among the so-called mother day sophisticated ladies regard their physique when they engage in exclusive breastfeeding.
Exclusive breastfeeding is paramount to wellbeing of these children since it ultimately ensures optimal health for them. The phenomenon of inappropriate feeding practice is only worsened by the introduction of complementary feeds but already the underlying problem stem from poor breast feeding practices. The consequences are grave, for instance, the long term impact includes poor school performance, reduced productivity, and impaired intellectual and social development.
All these constitute the cascade of problems that further compound the daunting issue of malnutrition!
The question of poverty is another cogwheel in the pathway of optimal health for the under-5 in the Nigerian situation. As it is known “poverty is a major cause and consequence of ill-health worldwide. Poverty, hunger and malnutrition stalk one to another in a vicious circle, compromising health and wrecking havoc on the socio-economic development of whole countries, entire continents. Nearly 30% of humanity, especially those in developing countries – infants, children, adolescents, adults, and older persons – bear this triple burden. This is a travesty of justice, an abrogation of the most basic human rights.”(4)
Of course, the issue of poverty itself is linked to the question of the GDP per capital income of the populace. In Nigeria, for example, the GDP per capital annual growth rate is estimated 0.4 for the period between1960-90 and -0.3 for 2002, (3), which means that there is a decline in the per capital income in the Nigerian society.
A negative GDP per capital annual growth rate, which is the “value” of goods and service in a country, a picture of the quality of life, is worrisome and calls for a lot of concern!
If this continues it would be difficult for the nation to realize its health care objectives!
In line with is the burden of increasing fertility rate, which thus increase the number of children, particularly the under-5 who must be fed adequately. Total fertility rate for the year 2002 was put at 5.5! This is still compared with the nation’s annual GDP growth rate!
So, these economic indices are strong evidences behind the daunting problem of malnutrition of the under-5 in the Nigerian society!
True to the fact that UNICEF´S goal is to promote the rights of children and women through the various capacity building initiatives, thus, in inference this shows that “the health and nutritional status of the mothers and children are intimately linked. Improved infant and young child feeding begins with ensuring the health and nutritional status of women, in their own right, throughout all stages of life and continues with women as providers for their children and families.” (4)
The adult literacy rate for female in Nigeria as at year 2000 is estimated at 56% compared to the male of 72% (3). The gap is still much and this also explains the level of enlightenment of the female population in the Nigeria situation! Of course, the consequences are grave – ignorance is one! I strongly believe, education in which ever form, is linked to health and wellbeing!
Also worth mentioning is the issue of “rapid social and economic change which only intensifies the difficulties that family face in proper feeding and caring for their children.
Expanding urbanization results in more families that depend on informal or intermittent employment with uncertain incomes and few or no maternal benefits. Both self-employed and nominally employed women face heavy workloads, usually with no maternity protection. Meanwhile, traditional family and community support structures are being eroded, resources devoted to supporting health- and, especially, nutrition-related, services is lacking, and the number of food-insecure rural and urban household is on the rise” (4).
“The HIV pandemic and the risk of mother-to-child transmission of HIV through breastfeeding pose unique challenges to the promotion of breastfeeding, even among unaffected families. Complex emergencies, which are often characterized by population displacement, food insecurity and armed conflict, are increasing in number and intensity, further compromising the care and feeding of infants and young children the world over. Refugees and internally displaced persons alone currently number more than 40 million, including 5.5 million under-five children” (4).
These are the issues militating again the health and wellbeing of the under-5 in the Nigerian society. I know there is a way out but it calls for a joint and concerted effort on the part of individual, families, communities, governments, the international organizations and all stake holders in the health care of the children of the world.
Firstly, there is the need for increased willingness on the part of individual families, the concerned mothers to see to it that their children fare well in life by making sure that the basic value of the African woman towards her child is fulfilled, this is the issue of exclusive breast feeding. Malnutrition has its origin in inadequate or disrupted breastfeeding!
Secondly, there has to be a program at the grass root geared towards encouraging all concern parents, particularly the mothers to improve on their feeding practices. These ones should have access to the objectives and complete information about appropriate feeding practices.
Mothers should have access to skilled support to help initiate and sustain appropriate feeding practices. They should equally be encouraged to continue breastfeeding after their maternity leave or after returning to paid employment.
Employers of labor should also assist nursing mothers to breastfeed by ensuring that maternity entitlements are paid to them, including breastfeeding breaks or other work arrangements to facilitate breastfeeding.
Thirdly, Mass media should also embark on an extensive campaign designed towards encouraging the concerned groups to be aware of the gains of exclusive breastfeeding and of information needed for appropriate feeding practices!
Above all, there is the need for strong political will on the part of the government of Nigeria to making sure that information which is adequate is disseminated to the grass roots about the skills and gains of breastfeeding and appropriate feeding practices. This is important because it is not just sufficient to ratify international conventions without implementation!
Equally important is the fact the government must be transparent in terms of her policies and, this, create and enabling environment where children could grow to their fullest potential and be able to realize their dreams. This is of course possible through the provision of social welfare schemes that will facilitate the realization of the set objectives!
To cap it all, “health and sustainable human development are equity issues,”
We must ensure that our values and our vision are anchored in human right law – only then can they become reality for all people.”
“Nutrition is a crucial, universally recognized component of the child’s right to the enjoyment of the highest attainable standard of health as stated in the convention on the Rights of the Child. Children have the right to adequate nutrition and access to safe and nutritious food, and both are essential for fulfilling their right to the highest attainable standard of health. Women, in turn, have the right to proper nutrition, to decide how to feed their children, and to full information and appropriate conditions that will enable them to carry out their decisions. These rights are not yet realized in many environments”. (4)
REFERENCE
- Global strategy for infant and young child feeding.
Geneva, World Health Assembly, May 2002
www.who.int/nut/publications.htm#gs_inf
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