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Is well-known Nigerian doctor correct about malnutrition in women and children?

Dr Ibijoke Sanwo-Olu, medical doctor and first lady of Lagos, wants the state to be healthier. But do her claims about the extent of poor nutrition check out?

  • Africa Check did not receive confirmation of any sources used from the first lady’s team and relied on local experts and data from agencies such as Unicef. 

  • Sanwo-Olu doctor was correct or mostly correct in most of her assertions about the effects of malnutrition in Nigeria.

  • How many malnourished children are being treated or not is however difficult to prove, as interventions vary, both internationally and from state to state within Nigeria.

Malnutrition is hurting growth in Nigeria’s commercial capital of Lagos, Dr Ibijoke Sanwo-Olu said at an event focused on nutrition policy. 

Sanwo-Olu is a medical doctor and married to the state’s governor. In an April 2021 speech read on her behalf, she reportedly urged the state to approve two policies focused on nutrition. 

Sanwo-Olu also gave statistics to show how bad malnutrition is for women and children in Nigeria. We checked five of them.

Claim

A Unicef report showed that Nigeria has the second highest burden of stunted children globally.

Verdict

Correct

Africa Check reached out to both Sanwo-Olu’s media team and Cecilia Mabogunje, the director of a children’s hospital in Lagos who delivered the speech, for more details about the source of the claims. We will update this report with their response.

The World Health Organization (WHO) defines a burden as the impact of a health problem on a population. This can include death or the loss of health and is a useful measure to compare countries, the organisation says.

Stunting occurs when poor nutrition impairs the growth and development of children. A child is considered stunted if their height is lower than would be statistically expected for their age.

Does the most recent publicly available data show Nigeria has the second highest burden of stunted children globally? 

The speech attributed this claim to a “Unicef report”. Africa Check traced it to a country summary on nutrition by the UN agency, which works to help children.

For percentage of child population stunted, Nigeria comes 5th, not 2nd

Helen Wylie, a Unicef spokesperson, referred us to the global database on child growth and malnutrition. This is maintained by the agency together with the WHO and the World Bank.

The joint malnutrition estimates were most recently updated in April 2021. They show Nigeria has the second highest burden of stunted children worldwide, with about 12 million children under five, behind India’s 36 million.

Children under five have the highest burden of disease due to malnutrition, or the inadequate, imbalanced or excessive consumption of energy.

When stunting is considered as a share of the population of children, Nigeria’s proportion is 35%, fifth after countries such as Burundi (57.6%), Eritrea (49.1%) and Niger (46.7%).

Claim

[Nigeria has] a national [stunting] prevalence of 32% for under fives.

Verdict

Mostly correct

According to the WHO, prevalence measures the amount of disease in a population at a period in time. It is often expressed as a percentage or number of cases per population.

The joint estimates show that in 2020, the stunting prevalence for Nigerian children under five was 35.3%.

This figure is “slightly different” from the 32% in the database as “we now use a country-level model”, Helen Wylie of Unicef told Africa Check. The model does not yet account for Covid-19, she said. 

Nigeria’s Demographic Health Survey for 2018 also has data on stunting. The survey examined the height and weight of 12,695 children under five and estimated a prevalence rate of 36.8% (39.4% in boys and 34.2% in girls). 

There are also regional differences, with some northern states having as much as 60% stunting, while those in the south had figures as low as 14%.

Claim

About two million children in Nigeria suffer from acute malnutrition.

Verdict

Mostly correct

Acute malnutrition, also referred to as wasting, is characterised by a rapid deterioration in nutritional status over a short period of time.

Wasting statistics are usually expressed for children under age five. Estimates show that in 2020, some 6.5% of Nigerian children in that age group suffered from wasting. 

Unicef did not yet have a country model for wasting as it did for stunting and overweight, spokesperson Wylie told Africa Check.

She added that applying the 6.5% estimate to the population under five for the survey year yields about two million children.

Nigeria’s population figures are contested and there isn’t a recent breakdown of these by age groups.

Emmanuel Aguwa is professor of public health at the University of Nigeria in the southeastern state of Enugu. He said that the figure for acute malnutrition would have increased due to health crises, insecurity and insurgency in some parts of the country.

“The truth is that it is difficult to get accurate figures,” Aguwa said.

Michael Asuzu, a professor at the college of medicine at University of Ibadan, also agreed that the figure was likely higher “considering all that has been happening in the country in the past few months”. 

“Two million is sort of a benchmark; the figure could be more,” said Asuzu, whose research areas include epidemiology, occupational health and health policy.

Dr Mary Stephen, a technical officer at the WHO Africa regional office, told Africa Check: “It is possible the figure has increased. Usually, in emergency situations, the rate of malnutrition increases because of food insecurity.”

Claim

Only two of every 10 children suffering from malnutrition are being treated.

Verdict

Unproven

We have asked Sanwo-Olu’s office to clarify what kind of treatment she meant and if the statistic was for Lagos or all of Nigeria. 

The WHO and Unicef said they had no data for this claim, as specific interventions vary in countries. According to Unicef, foods that are high in energy, fortified and ready to eat are suitable for treating severely malnourished children. 

Prof Tanimola Akande, a public health physician and epidemiologist at the University of Ilorin Teaching Hospital in western Nigeria’s Kwara state, said the claim could be correct for some parts of the country. 

“The health-seeking behaviour of mothers and level of access to care are contributory. Health facilities caring for malnourished people are rare in rural areas,” he said.

But in the absence of clarity from the first lady’s office as to the evidence for the claim, we rate it unproven.

Claim

7% of women of childbearing age suffer from acute malnutrition.

Verdict

Correct

The National Nutrition and Health Survey 2018 contains estimates on acute malnutrition in adults. 

By interviewing 23,798 women between ages 15 and 49 across the country, the survey estimated that 6.9% of the women were suffering from acute malnutrition. 

The women were asked about their weight and body mass index. 

The UN and Nigeria’s government will in September 2021 launch the Food Systems Summit Dialogue which aims to tackle hunger and malnutrition in the country. 

In December 2020 the government approved a national strategy on food and nutrition to run from 2021 to 2025.

Photo by Benson Ibeabuchi of AFP

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