Ending acute malnutrition requires everyone's commitment

In Niger, children with severe acute malnutrition need urgent life-saving treatment to survive, particularly during emergencies.

By Araia Tamayo
UNICEF Niger / Araia Tamayo
UNICEF Niger / Araia Tamayo
11 May 2020

“I thought I would lose my daughter. When I saw how healthcare workers took care of us, I was hopeful. After three days of treatment Aicha started to eat and play,” says Khadjetou, one of the mothers whose children suffer from severe acute malnutrition in Maradi, Niger.

Malnutrition is a major threat to children’s health and development in Niger. More than 4 out of 10 children under 5 are stunted, robbing them of their full potential. Since 2014, Dr Souleyman Kadri has been working as a vocational pediatrician in the in-patient facility for severely wasted children with medical complications (CRENI in French) in Maradi. He accompanied us during our visit and told us of the challenges they face in the treatment of acute malnutrition.


That was the case of Aicha, Khadjetou's daughter. “Aicha had rubella and she was very tired. She stopped eating and was suffering from malnutrition. After some days with the symptoms we were referred to the CRENI for urgent treatment.”

Concerning figures in three regions across Niger

A UNICEF-supported national nutrition survey based on the SMART (Standard Monitoring and Assessment of Relief and Transition) methodology conducted in August-September 2019, showed that Global Acute Malnutrition (GAM) rate of 10.7% and Severe Acute Malnutrition (SAM) rate of 2.7% were above the WHO critical thresholds in Niger. The Maradi, Tahoua and Zinder regions show a particularly concerning situation with a SAM prevalence above or near 3%.

Dr Kadri acknowledges the efforts of healthcare workers in the CRENI, “We are a team of committed doctors, nurses, nutritionists assistants, hygienists and a cook. The professionalism and sacrifice of the team is unquestionable. During peak periods of diseases, such as malaria, our staff is overstretched due to the increased number of patients in the facility’’ he says.

UNICEF Niger / Araia Tamayo
UNICEF Niger / Araia Tamayo

The mothers and patients are also immensely grateful to the healthcare workers. “Aicha was very sick when we arrived to the CRENI. Her feet were swollen. She didn’t eat. She didn’t laugh. As soon as I looked at her she cried. And I cried too,” remembered Khadjetou with tears in her eyes. “But when I saw how the healthcare workers looked after us and the other patients, I was hopeful. They were with us morning, noon and evening. After three days she started to recover. She smiled again” Khadjetou explained.



UNICEF Niger / Araia Tamayo
UNICEF Niger / Araia Tamayo

“When a child who suffers from moderate or severe acute malnutrition and has medical complications, we send them to the CRENI. These complications often include severe malaria, gastroenteritis, pneumonia, tuberculosis and HIV and can be deadly”

explains Dr Kadri.

Malnutrition challenges child survival in Niger

This is everyday life at the CRENI. Dr Kadri noted, “We receive a lot of mothers who bring in children on the verge of death and who fully recover after we provide the appropriate care. You cannot imagine the happiness of a mother who arrives to the hospital thinking that her child will die and then after a few days their child starts opening their eyes, eating, smiling, and even playing.”

In Niger, the lean season (the period between harvests) from June to August coincides with peaks of malaria and malnutrition, cholera epidemics and floods. “During off-peak periods, our cure rate is around 90-98%, but during peak periods it decreases to 85-90% because of the pressure imposed by the surge in admissions,” reports Dr. Kadri.

UNICEF Niger / Araia Tamayo
UNICEF Niger / Araia Tamayo

Severe acute malnutrition can increase dramatically during emergencies.

The COVID-19 pandemic is having worrying impacts on household incomes, food supply chains, health services and schools. The current situation aggravates the difficulties many families already face in terms of access to affordable, healthy diets. And the restrictions on movement and closing of borders affects poor and vulnerable households in rural and urban areas across Niger.

This year UNICEF alerts about a substantial increase in the amount children treated of SAM before and after COVID-19 due to the repercussions of the pandemic. The analysis is based on the current trends regarding food insecurity and other aggravating factors due to the crisis.

UNICEF is focusing its response to the pandemic on countries with existing humanitarian crises like Niger – working both to prevent transmission and mitigate the collateral impacts on children, women and vulnerable populations, especially around access to health, nutrition, water and sanitation, education and protection.

With the support of ECHO, DFID, US AID, Lux. Dev. Spain, Czech Republic, and Canada, UNICEF provides technical and financial support to the Government of Niger to maintain effective programs to prevent Severe Acute Malnutrition (SAM). In addition to the support for SAM treatment, UNICEF continues to strengthen community capacities to improve childcare practices and screening processes.