Department of Agricultural, Food, and Resource Economics Feed the Future Innovation Lab for Food Security Policy

Todd Benson, Mulubrhan Amare, Motunrayo Oyeyemi, and Olusegun Fadare, 2017. Study of the Determinants of Chronic Malnutrition in Northern Nigeria: Qualitative Evidence from Kebbi and Bauchi States. Feed the Future Innovation Lab for Food Security Policy Research Paper 82. East Lansing: Michigan State University.

ABSTRACT
The burden in northern Nigeria of chronic malnutrition, particularly undernutrition, is among the heaviest globally. Close to half of all under-fives in the Northeast and Northwest geopolitical zones were estimated to be stunted in their growth for their age in 2013, compared to 22 percent in the rest of Nigeria. To inform discussions on future programming to address drivers of undernutrition, a rapid scoping study of chronic malnutrition in northern Nigeria was conducted. This report presents findings drawn from interviews with key informants and focus group discussions in Kebbi and Bauchi states and in Abuja conducted in April and May 2017.

Drawing on the UNICEF conceptual framework of the determinants of child nutritional status, we observed:
• Food security – Sufficient food is available in northern Nigeria. However, due to poverty, many households are unable to reliably access the quantity and types of food they require.
• Water, sanitation, and access to public health services and health facilities – There is low use of the public health and medical services provided in northern Nigeria. Clinics are often understaffed, and the dominance of male staff poses a cultural barrier to use by women.
• Nutritional caring practices – Poor care is the dominant determinant of the high levels of chronic undernutrition observed in northern Nigeria. However, given the limited education most mothers of young children have received, ensuring that they have the knowledge to effective provide proper nutritional care to their young children is a significant challenge.
• Gender – Poor nutritional care is an outcome, in part, of the relative social and economic disempowerment of women in carrying out their nutritional care roles and in obtaining information on proper care. Women do not have control over sufficient resources or have access to sufficient knowledge so that both they and their children can live reliably healthy and well-nourished lives.

The recommendations for future nutrition programs drawn from this study include:
• Strengthen flows of information and carry out social mobilization to promote use of optimal nutritional care practices. Such efforts will require a ‘whole community’ approach, rather than only targeting the principal care-givers of young children, their mothers.
• Increased training in northern Nigeria on public health nutrition at all levels, from primary school through to post-graduate. Health personnel particularly need a deeper understanding of what needs to be done to improve child and maternal nutrition in their communities.
• Research on several important knowledge gaps related to nutrition in northern Nigeria.
• Step up political mobilization efforts at state and LGA levels to address chronic undernutrition – particularly efforts