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Stunted leadership and stunted brain: how poor families miss out on child nutrition programmes

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By Abiose Adelaja Adams

Despite the rains, nursing mothers trooped to various primary health centres in Lagos last week to observe activities of the Maternal Child and Newborn week.

Amongst other lifesaving programmes, the state’s officials also focused on growth monitoring and promotion, screening for malnutrition and appropriate counseling/management/referral of the children; as well as distribution of Information Education and Communication (IEC) materials to the mothers to improve their capacity to raise healthy kids.

Although the service was free, many poor and illiterate nursing mothers were missing. One of them is 35 year-old Nkechi, a professional vegetable farmer.

When visited at her home in Oko-Ito, off Gberigbe in Ikorodu, outskirts of Lagos, she was met in her hut-like parlour, drinking garri with her five children. Asked why she didn’t take her youngest child, a one year-old, to the hospital, she calmly said she was busy at her farm.
Taking a cursory look at the children shows visible signs of malnourishment. These include expanding head, yellowing hair on dark-complexioned children, apparent loss of muscle mass, bloated belly, evident ribs lines around the chest and thin legs. The first child, who is 12-years-old, looked like a seven year old; while the second, who is 11, appeared like an eight year old. The fourth child looked like a three year-old, whereas she is five.

Kids from poor homes often fall through the cracks

“For the morning meal, they ate garri before they go school,” she said (in pidgin English) when asked what their breakfast was. “We have cassava farm, what you have is what you give ya child.”

The slender, dark complexion woman who appeared to be expecting another child, was quite smug in her replies.
The condition of the children confirms the Nigeria Demographic Health Survey (NDHS) 2008, which shows that 41 per cent of Nigerian children under five are stunted and 23 per cent are severely stunted. Stunting is apparent, even among children less than 6 months of age (21 percent).

Child experts describe stunting as what happens to a child’s brain and body when they don’t get the right kind of food or nutrients in their first 1,000 days of life. It is irreversible. Scientists have found that stunted children may never regain the height lost, and most children will never gain the corresponding body weight.
When asked what the family’s dinner will be, Nkechi said it would also be garri because she could not afford foods such as beans, fish, milk, fruits or other micronutrients-rich meals. Though she sells vegetable, her ignorance and poverty would not allow her to spare some for her family.

“Where is the profit, if I eat and all of us eat the vegetables at home? There is no gain. But garri will fill their stomach,” she explained.
The Coordinator of Maternal and Child program at the Ijede Health center, Ikorodu, Nurse O. Okoh, was resigned about the situation. “We see a lot of cases of malnutrition here, but we address it immediately with nutrition. We inform the mothers on the kinds of nutritious foods to give their children and how to cook it. We even demonstrate it here for them to see, as you can see we are doing now. But if a woman like that (Nkechi) does not come, there is nothing we can do really.”
According to Dr. Chris Isokpunwu, Head of Nutrition, Federal Ministry of Health, micro nutrient deficiency which contributes to stunting is the major cause of slow cognitive development.

“If we don’t give them food that will enrich their brains, they will be susceptible to diseases and also develop cognitive problems,” he said.
As of 2012, an estimated 162 million children under five years were stunted. Meanwhile, reports have it that more than 90 per cent of the world’s stunted children live in Africa and Asia.
A professor of Child and Adolescent Psychiatry at the University College Hospital, Ibadan, Olayinka Omigbodun says: “Common nutritional deficiencies such as iron and iodine have detrimental effects on the developing brain and consequently on  mental health. In her research, she finds that stunted children earn 20 per cent less than their peers in adulthood and the cost to the nation is estimated at 13 billion dollars annually.

“Children are the leaders of tomorrow and if their brains suffer through nutritional deficiencies at the developmental stage, the type of leadership they will be able to provide will be problematic,” she adds.
Dr. Isopkunwu explains that stunting can be prevented if parents give their children food that contains micro nutrient of public health importance such as: Iodine, Zinc, Vitamin A, Folic Acid, Iron, which the Lagos State government is trying to achieve through the programme.
However, the programme, laudable as it is, might not truly achieve its goal if it does not find a way to involve non-educated vegetable farmer such as Nkechi.