Listen to this articleLAGOS, NIGERIA: Mrs. Faith Awodele, seated among other mothers at Dr. Ibijoke Sanwo-Olu primary health centre in Somolu, was concerned about her 10-month-old daughter’s lack of appetite and incessant crying which had persisted for 3 weeks. She had tried everything to make her daughter eat but nothing worked.
She visited Ibijoke’s health centre for the routine immunization of her daughter in July 2022 but when Nurse Joy saw her, she exclaimed at her daughter’s weight and immediately referred her to a group of doctors’ right outside the premises of the health centre.
“I was not the only one there, many other mothers were seated and waiting for their turn but when they weighed my baby, they immediately focused their attention on me. They tested my baby and my baby was on the red mark,” Mrs. Awodele said.
Mrs. Awodele’s daughter was tested with the mid upper arm circumference (MUAC), an equipment used to identify children between six months to five years suffering from malnutrition and are at risk of dying. MUAC has three colours which act as indicators. Green signifies the child is healthy, yellow symbolizes moderate malnutrition and red indicates severe malnutrition.
After Mrs. Awodele’s daughter had received treatment which entails essential nutritional supplements, for boosting the immune system, she was given extra medication to administer to her daughter at home by adding it to her meal.
When she got home, Mrs. Awodele mixed the homemade guinea corn pap she fed her daughter with one of the seeds from the Multiple Micronutrient Supplement (MMS) and for the first time in three weeks, her daughter finished drinking the pap with ease.
Overjoyed at the progress, she rushed to the primary healthcare centre the next day to follow up with the doctors on how to maintain her daughter’s health, that was when she noticed who these doctors were and what their mission was.
The ReachOut project
“They came to me and told me that they wanted to administer some vitamins to the children in our district for free. When I asked if it was the government that sent them, they said they were here on their own accord. They explained the importance of the vitamins they wanted to administer to the children to me and when I saw that they were medical professionals, I summoned other chiefs and our women and we collectively told them to go ahead,” Alhaji Rahmoni of Ilasamaja district in Oshodi, Lagos State told The SolutionsPaper.
It was permissions like this that allowed the doctors under the ReachOut Project to assist Mrs. Awodele and others. Operated by The Neo Child Initiative (TNCI), the ReachOut project provides free nutritional counselling and screening to women and children in underserved areas in Lagos state.
Felicity Ufedo Chukwurah, another mother in Somolu received free Ready to Use Therapeutic Foods (RUTF) from the ReachOut team after her son measured yellow on the MUAC scale, indicating moderate malnutrition.
“The doctors taught us the different kinds of milk and other kinds of foods a baby should take at each stage and where to get them. Malnutrition can be very dangerous and I would advise any mother to take their babies to the hospital as soon as they notice the baby is not eating well,” Felicity added.
While an estimated two million children in Nigeria suffer from severe acute malnutrition and only two out of every 10 children affected is currently reached with treatment, data from the 2022 Lagos State Reproductive and Child Health Survey show that over one-third of children under five years old in the state were stunted due to inadequate nutrition.
Since 2015, data from TNCI reveal that the ReachOut project has supported an estimated 20,000 beneficiaries including children and mothers across 10 communities in Lagos with nutritional screening and malnutrition counselling services.
How it works and what could work better
The ReachOut project adopts an underserved community in Lagos state once a year and organizes comprehensive nutritional screening and counselling for residents. In addition to providing medical check-ups and vitamins to boost the immune system of the children, the project prioritizes enlightening the community on the use of their own environmental gift of nature such as the vegetables around them and the right combination of food to maintain nutritional feeding.
To adopt any community, the first step is to identify an underserved community. To ascertain the nutritional condition of a community, the ReachOut Project collaborates with the community leaders and the primary healthcare centres through which they get valid medical history of the community, which aids their needs assessment.
According to Chief Francis Adetayo Ogunbanjo, a medical doctor and the Akin Ilu of Iwaya-Yaba, the physical signs of malnutrition is unmistakably evident, especially among children, “their heads often appear disproportionately large compared to their small, fragile legs, making it seem as though their bodies could collapse under the weight. These children also tend to be lethargic,” he stated.
When cases of malnutrition are identified through MUAC screening, the severe ones are treated as an emergency and subsequently connected to the nearest health centre for more robust follow-up.
In less severe cases, essential nutritional supplements such as vitamin A, folic acid, deworming tablets, RUTF and nutritional counselling are provided. The project also follows up with beneficiaries through nutrition focal persons (NFP) attached to each health centre to ensure sustainability.
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However, Dr. Cassandra Akinde, Executive Director of TNCI noted that the ReachOut Project faced a lack of commitment and proactiveness on the part of some community stakeholders including some community leaders demanding for money.
But even with the cooperation of the community chiefs, the ReachOut team is still limited in the number of communities they can support as disharmony between differing authorities in some border communities has the potential for violent skirmishes.
She also identified the low supply of RUTF and other vital supplements needed to swiftly combat malnutrition in children due to the surge in cost of supplements and medications as a major constraint. To cushion this, they find partners with similar interests for collaboration and mutual benefit, “[For example] we are currently planning a ReachOut in Makoko with the support of Japanese students,” Dr Cassandra noted.
Other socio-economic factors including financial barriers and the stigma of poverty associated with malnourishment also make some mothers reluctant to seek medical help for their children. According to Dr. Cassandra, this explains why most children are already in the danger zone before getting to the doctors.
Despite these challenges, the ReachOut Project is determined leverage partnership and community buy-in to expand its support to other communities within and outside Lagos state.
Credits
Editing: Precious Ewuji
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This story was published in partnership with Nigeria Health Watch through the Solutions Journalism Network, a nonprofit organisation dedicated to rigorous and compelling reporting about responses to social problems. __________________________________________________
Chidera Eze is a freelance journalist with bias for solutions journalism, a blockchain content writer and a public relations student.