Malnutrition remains a pressing public health concern in Nigeria, with alarming statistics highlighting the severity of the problem. According to the 2018 Nigeria Demographic and Health Survey (NDHS), about 37% of children under the age of five are stunted, 23% are underweight, 7% are wasted , and a staggering 68% suffer from some kind of anaemia. The consequences are dire, malnutrition is responsible for about half of all deaths among children under five . This crisis also has severe economic implications, with malnutrition estimated to account for up to 16% loss in GDP, higher healthcare costs, reduced productivity, and hindered economic growth.
These poor indices are very concerning and indicate that Nigeria is not on track to meet the 2025 Global Nutrition targets, or even the national nutrition targets. The main driver of,
Despite concerted efforts, Nigeria's poor food and nutrition indices and outcomes can be somewhat attributed to fragmented coordination and insufficient multisectoral collaboration. This has hampered progress for years across both nutrition-specific and nutrition-sensitive programmes. Nutrition-specific programmes directly address the immediate causes of malnutrition, such as inadequate dietary intake or disease, through interventions such as breastfeeding promotion, and treatment of acute malnutrition.
On the other hand, nutrition-sensitive programmes tackle the underlying factors of malnutrition, such as food security, healthcare access, and sanitation, by integrating nutrition goals into broader sectors like agriculture, education, and social protection to improve overall health and well-being.
Considering this challenge, Nigeria Health Watch convened a nutrition policy dialogue titled, "Addressing Coordination Bottlenecks for Improved Nutrition Outcomes." The dialogue brought together nutrition experts and multisector stakeholders, to examine the challenges, opportunities, and strategies for overcoming nutrition coordination bottlenecks in Nigeria, with the goal of improving nutrition outcomes.
Efforts to address malnutrition so far
The dialogue brought to light the commendable efforts that have been made by the government in the past to strengthen nutrition coordination and governance, and address Nigeria's poor food and nutrition outcomes.
Some of these efforts include the revision of the National Food and Nutrition Policy and establishing a national nutrition budget line in 2016. Nigeria also joined the Scaling up Nutrition (SUN) Movement, launched the National Multisectoral Plan of Action for Food and Nutrition (NMPFAN) in 2021 and designated the Ministry of Budget and Economic Planning as the core agency for coordinating the implementation of nutrition policies and programmes in the country.
The NMPFAN document, spanning 2021-2025, outlines a clear strategy to combat malnutrition. It defines the roles and responsibilities of various Ministries, Departments, and Agencies (MDAs), as well as other stakeholders, to ensure a collaborative effort. This five-year plan also advocates for a joint funding approach, known as "basket funding", to pool resources and tackle malnutrition from multiple angles.
During the 144th National Economic Council Meeting, the Federal Government has continued to demonstrate political will and commitment by prioritising nutrition interventions in the 2025 budget, establishing Food and Nutrition Security (FNS) Task Forces and endorsing the Nutrition 774 initiative to combat malnutrition.
However, despite these policies and national guidelines to improve nutrition outcomes, malnutrition rates remain high, underscoring the need for enhanced collaboration and effective implementation.
Nutrition coordination bottlenecks
Discussions at the dialogue further highlighted that several bottlenecks exist, underscoring the challenges that weaken effective multisectoral coordination in Nigeria's nutrition response. These issues contribute to fragmented efforts and diminished progress, include:
1. Some implementing partners without registering with Ministry of Budget and Economic Planning , proceed directly to the states or communities to implement activities after they have registered with the Corporate Affairs Commission (CAC).
2. Misalignment of mandates and priorities, for instance, sub-national level governments do not prioritise national level nutrition priorities.
3. The absence of dedicated nutrition agencies or stand-alone nutrition departments with dedicated budget lines for nutrition, within several Ministries, Departments and Agencies (MDAs) at national and sub-national levels.
4. Inadequate budgetary allocation and release of funds for nutrition interventions in some MDAs, especially at sub-national levels.
5. National policies and action plans are not being implemented at sub-national level due to inadequate funding.
6. Inadequate personnel and human resources across sectors and levels to effectively implement nutrition interventions
7. Weak monitoring and evaluation systems including weak data systems.
8. Lack of communication or non-disclosure of information -especially with regards to finances, plans and achievements -- by development partners and occasionally by MDAs.
Recommendations from stakeholders
Strengthening multisectoral coordination for nutrition requires the active involvement of stakeholders, at both national and sub-national levels. Significant progress is achievable if all stakeholders collaborate to implement these actionable recommendations outlined during the dialogue:
Advocate for laws that mandate investments in nutrition: Nigeria must go beyond just adopting policies and advocate for laws that mandate investments in food and nutrition at both the national and state levels.
Create a stand-alone agency for nutrition, directorates or departments of nutrition within each MDA: This is key to fostering coordination and driving sustainable progress in addressing Nigeria's food and nutrition crises and improving outcomes.
Create designated budget lines for nutrition within each nutrition directorate: Sustainable funding is essential for implementing and scaling nutrition interventions in Nigeria, ensuring resource optimisation, long-term impact and ultimately improving food and nutrition outcomes.
Align mandates and domesticate national policies and plans at sub-national level: Effective coordination rests on the foundation of a shared vision and collaboration between the government and multi-sector stakeholders.
Strengthen technical capacity for nutrition across sectors and levels: This ensures that professionals across sectors and government levels have the requisite knowledge, skills and expertise needed to design, implement, and effectively monitor nutrition-specific and nutrition-sensitive interventions.
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Prioritise and integrate interventions and implement at scale: Prioritising interventions is the best way to maximise limited funding and human resources. By leveraging existing multisectoral platforms at national and sub-national levels, we can deploy a targeted response focused on preventive services, and treatment when necessary and implement interventions at scale.
Strengthen monitoring and evaluation systems and accountability mechanisms: This enables data-driven decision-making, ensures efficient resource allocation, and holds stakeholders accountable for delivering impactful nutrition interventions.
Nigeria has developed policies, strategies, and frameworks to tackle malnutrition, however effective collaboration across various sectors remains a critical missing piece. With just one year left to meet the 2025 Global and National Nutrition targets, and six years to achieve SDG 2, urgent action is required to strengthen coordination efforts. This calls for fostering a shared understanding of malnutrition's devastating impact on both individuals and national development, aligning goals, and collaborating to improve food and nutrition outcomes.
There are signs of progress. In a positive step towards enhancing nutrition interventions, the Federal Capital Territory (FCT) is set to establish a dedicated nutrition department. This development will strengthen nutrition interventions and improve budget allocations for nutrition. Hopefully, other states will follow suit. Combined with the sector-wide approach championed by the Ministry of Health and Social Welfare, these collective efforts should bring about meaningful improvements in Nigeria's nutrition outcomes.
Read the full event report here.
