Malnutrition amidst COVID-19: Thousands of children severely affected in Sokoto and Zamfara States

UNICEF, with support from the European Union and in collaboration with the State Primary Health Care Development Agencies of Sokoto and Zamfara, has set up Severe Acute Malnutrition treatment sites in 20 wards

Franka Osakwe
MUAC tape
UNICEF Nigeria
30 April 2020

In a time of health crisis, like we are seeing with the COVID-19 pandemic today, nutrition is even more important than ever, as it helps to build immunity to all kinds of diseases.

The displacement of many women and children as a result of attacks on villages by bandits in Sokoto and Zamfara States has led to a situation of severe hunger and malnutrition. The impact of the COVID-19 restrictions and border closure appear to have worsened the situation, increasing the number of malnourished children.

Presently, Sokoto State has the highest prevalence of malnutrition in Nigeria, with 7.9 per cent of children aged six and 59 months severely malnourished (NDHS, 2018). 


A mother’s plight

One year after bandits drove Zuwaira Lawal and her family away from their village, Kamitau, in Goronyo Local Government Area of Sokoto State, she is still struggling to save her three-year-old malnourished baby from dying. 

Twenty-year-old Zumaira recalled how her husband and 24 other villagers were instantly massacred that day, by the bandits.

“It was terrible! I only managed to escape with my three children, without any property. The bandits stole our land and cows.”

Aside bandit attacks, the restrictions and border closure as a result of the COVID-19 pandemic, has contributed to food scarcity, and increased price of staple food. 

“Now things are even worse. People run away from you as though you have the virus. Price of food is very high now,” she said. 

When her last child, Hassan, fell ill six months ago, and was vomiting and stooling, she tried all she could to save him. 

“I gave him herbs and drugs, but he only got worse. Then he stopped eating completely,” she recalled. “I heard about the free malnutrition treatment programme taking place at the Sabon-Gari Dole Primary Health Care Centre, and made a last attempt to save my baby. Someone told me about the UNICEF programme at Sabon-Gari Dole, so I brought my baby for treatment.”

Two weeks later, Hassan started gaining weight and is on a path to recovery. Hassan is one of the many children currently receiving free treatment for acute malnutrition at Sabon-Gari Dole Primary Health Care Centre, Goronyo Local Government in Sokoto State. 

According to reports from the health care centre, about 150 children has been treated successfully from October 2019 up till now at the Out-patient Treatment Centre (OTC) in Goronyo. 


Setting up more malnutrition treatment sites

UNICEF, with support from the European Civil Protection and Humanitarian Aid Operation (ECHO) and in collaboration with the State Primary Health Care Development Agencies of Sokoto and Zamfara, has set up Severe Acute Malnutrition treatment sites in 20 wards - 7 in Sokoto and 13 in Zamfara.

These wards are in seven LGAs: three in Sokoto (Rabah, Goronyo and Sabin Bini), and four in Zamfara (Shinkafi, Maradun, Zurmi and Birmingham Magaji). All the 20 wards have a high number of IDPs and malnourished children, currently benefitting from the intervention. 

The Community Management of Acute Malnutrition (CMAM) officer-in-charge in Sabon-Gari Dole Primary Health Care Centre, Bashar Saidu, explained how Hassan and other children get saved everyday at the centre. 

“When the baby comes here, we first measure his/her Mid-Upper Arm Circumference (MUAC). If it’s below 11.4 cm, and the child weighs four kilogram and above, and has no medical condition, then the child will be admitted for the programme. We refer those with medical condition to the In-patients Care Centre (IPC), where they will receive food and treatment. After treatment at the IPC, the child is sent back to the Out Patient Treatment Centre (OTC). 

“When they come each week, we check their MUAC and weight to see if these are increasing. If there is no progress after two consecutive visits, we refer them to the IPC. But we expect progress within one week.”

At the centre, Zumaira, and other caregivers - about 50 women with their malnourished children - were seated at the OTC, waiting their turn for the clinical assessment and the weekly RUTF ration. 

UNICEF Nutrition Head in Sokoto, Walton Beckley, explained that as at the time of this report, about 4,565 and 5,755 children with acute malnutrition had been admitted for treatment in Sokoto and Zamfara so far. He said about 3, 963 and 5, 057 children with acute malnutrition had been successfully treated in Sokoto and Zamfara States respectively. 

“About 3,716 and 4,706 in Sokoto and Zamfara States received iron and folic acid supplements,” he said. “In Sokoto, about 5,688 pregnant women and caregivers of children less than two years have received advice on how to take care of their children and feed them to prevent malnutrition. And in Zamfara State, about 8, 219 women had received same advice.”


The impact of COVID-19 on the CMAM program:

According to Mr. Beckley, the COVID–19 pandemic has impacted the program. “We are now seeing an increase in the number of malnourished children coming for treatment. This is likely due to the fact that some families have lost their livelihoods and now find it difficult to provide for their families.

“The lockdown and restriction of movement has negatively affected many businesses. People have been made unemployed or without access to their normal livelihoods. Even after this short time, the number of acutely malnourished children are already increasing. It is expected that this trend will continue and even worsen as the pandemic continues,” he said.

The work on curbing malnutrition is more important now than ever – and more at risk now than ever.  Frontline workers – including those from UNICEF, are committed to continuing to do this lifesaving work with children, but of course they are taking risks, and working against a timeline that no one can predict – when will it be when these communities get hit by COVID-19 themselves?


Story based on a longer feature in The Guardian on 19 April 2020.