Advances in Pediatric Research
Open Access
ISSN: 2385-4529
ISSN: 2385-4529
Robert Ndamobissi*, Edward Eungu Kutondo, Annabel Judith Hodge, Nemat Hajeebhoy, Morey Mitchell, Hannan Ring, Anna Warren and Ariyo Oluwaseun
Nigeria is the largest country in Africa in terms of its population and economy, and has innovative policies, strategies and investments to improve child survival and development. Despite these efforts, approximately 12 million Nigerian children aged under 5 years are stunted and 3 million are suffering from wasting. In response to this child malnutrition crisis, United Nations International Children's Emergency Fund (UNICEF) partnered with the government of Nigeria and public-private partners to develop and implement the Nigeria-UNICEF country programme of cooperation (2018-2022), with nutrition as part of the child survival component.
The impact assessment within the pilot states has been performed using the primary data collected across seven states using an holistic questionnaire (51) developed for this purpose covering a sample of 5,600 households. We also supplement the analysis with findings from our nationwide historical impact evaluation using secondary data. Key objectives of the evaluation were to determine the programme’s merit based on expected results and impact; and the effectiveness of multisectoral interventions for addressing child malnutrition.
Quantitative findings of the multi variate statistical analysis of the HH primary data collection reveals that the pilot multi sectors community based nutrition programme implemented in selected states, has contributed to decrease the prevalence of stunting in children under five years. There are many factors that may simultaneously contribute to this finding, such as caregiver attitudes and knowledge, WASH and housing conditions and broader socioeconomic empowerment. Committee for Programme and Coordination (CPC) programme activities improved children’s anthropometric measurements by reducing stunting and underweight cases. The CPC programme impact evaluation yielded a statistically significant 3 percentage-point reduction in both stunting (z<-2) and severe stunting (z<-3) and a 3 percentage-point reduction in underweight children (z<-2). These impacts translate to small, standardized impacts of 0.06 (likelihood of stunting) to 0.07 (likelihood of underweight) standard deviation impact. However, we did not find any impacts on the overall length-for-height z-score or for the overall weight-for-height z-score. This contrast suggests that the CPC Programme was most effective at improving anthropometric outcomes for the most stunted and underweight children.
But we can conclude that the programme impacts were concentrated amongst children who otherwise would have been stunted since better nourished children-that is, those with z-scores greater than (-2)-did not see a corresponding boost. We did not find any impacts on child wasting or body mass index. We also saw that only 4% of the children in the treatment group received treatment for undernutrition, even though stunting prevalence exceeded 30% and underweight prevalence exceeded 20%.
However, the prevalence of wasting has increased during the period due to the negative impact of Coronavirus Disease of 2019 (COVID-19) on household food insecurity, poverty and increased inflation, as well as physical insecurity in the north of the country. Delivering a multisectoral programme to support nutrition proved challenging and many stakeholders have concerns about the government’s capacity to sustain the progress that has been achieved.
Published Date: 2024-09-10; Received Date: 2024-08-09