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At a glance: Niger

In facing nutrition crisis, the Niger benefits from lessons learned

By Bob Coen

MADAROUNFA, Maradi region, Niger, 10 September 2012 - Ouma Abdul sits on a cot at the Madarounfa Pediatric Intensive Feeding Centre comforting her underweight 18-month-old daughter Nafiza. Despite the promise of a good harvest, hospitals and health centres across the country are filled to capacity with young children suffering from severe acute malnutrition (SAM).

“Last year’s harvest was so poor and insufficient, there’s just no food left now,” says the 34-year-old mother of seven. The Niger, like the whole Sahel region, is facing a serious food and nutrition crisis.

Thanks to lessons learned through the devastating nutrition crisis of 2005, the Niger's approach to malnutrition can now be seen as a model for the rest of the region.  Watch in RealPlayer


Painful reminder of 2005

For Ms. Abdul and others, this year’s crisis is a painful reminder of the devastating crisis of 2005. That year, two of her children were rushed to the main hospital in the regional capital, Maradi, suffering from SAM. Only one survived.

“Back in 2005, it was this exact same time of the year when there was just no food left,” she recalls. “We had used up all our food reserves, and this season’s crop was not ready to harvest – so there was just nothing to eat for the adults, as well as the children.”

In 2005, not accustomed to dealing with malnutrition, hospitals and health centres were overwhelmed by the sheer number of cases. Thousands of young children died from the effects of malnutrition and associated complications.

“I can say it was catastrophic,” remembers head nurse at the Madarounfa health centre Sa’a Amadou as she checks in on Nafiza and monitors the other children. “The work was difficult to bear back then. It was something we were not used to at all, as we had just been recruited that year. It wasn’t easy for us.”

© UNICEF Niger/2012/Coen
Nafiza, 18 months, receives therapeutic milk at Madarounfa Pediatric Intensive Feeding Centre, Madarounfa, Niger. She was suffering from severe acute malnutrition when admitted. Lessons learned by the Ministry of Public Health, UNICEF and partners have helped such health centres cope with the influx of children affected by malnutrition.

But the 2005 crisis would prove to be an important learning experience for authorities on how to deal with a nutrition crisis, and would become a turning point in how malnutrition is treated. Thanks to the coordinated efforts of the Niger’s Ministry of Public Health, UNICEF and NGO partners, the Niger’s approach to malnutrition can now be seen as a model for the rest of the region.

Lessons learned

After studying the response to the 2005 crisis and analysing the challenges faced by health professionals, in 2009, UNICEF, together with the Niger’s Ministry of Public Health and NGO partners, put in place an action plan that integrated nutrition into the country’s existing health centres.

Today, as the Niger grapples with its third food emergency since 2005, there are more than 850 health centres across the country equipped to treat SAM. Resources have been mobilized to provide better equipment, supplies and training of health personnel. Monitoring and evaluation of cases have also improved vastly – both at centres such as Madarounfa and at small rural health posts, where community health workers have been trained to spot early signs of malnutrition.

Another component of the support has been the education of mothers, which begins once their children are out of danger and continues until they are released. Sitting under the shade of a large mango tree in the Madarounfa health centre complex, groups of mothers attend lively education sessions on healthy nutrition and learn how to prevent their children from becoming malnourished.

© UNICEF Niger/2012/Coen
Nafiza's mother Ouma Abdul comforts her at the Madarounfa Pediatric Intensive Feeding Centre. Once Nafiza's condition has stabilized, Ms. Abdul attends education sessions on nutrition. "I am going to put into practice everything I have been taught," she says.

The death rate resulting from malnutrition has dropped to 1.5 per cent – and 85 per cent of children admitted for SAM now recover.

Good prognosis

After two weeks of treatment, Nafiza is almost well enough to return home and is receiving the last of her treatments. Ms. Abdul says, “I am so thankful with the treatment I’ve received because I arrived here with a dying child who couldn’t sit up, couldn’t eat and couldn’t even move. And now here she is, eating on her own and even crying because she’s still hungry. I’m so happy because I’ll be returning to my village with a living, healthy baby.”

She has attended the education sessions and has plans for the future: “If I had received this knowledge before, I would not find myself here on this hospital cot today. I am going to put into practice everything I have been taught to prevent my child falling into this situation ever again.”

Ms. Amadou has grown confident about the centre’s ability to confront malnutrition. “We have experience now compared to 2005, when we were brand new and had no notion of how to deal with it,” she says. “If I can say so, whatever the situation, and one hopes that it will not be more catastrophic than 2005, but whatever the situation, we are prepared to face it.”



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