Clement Adeyi, Osogbo
Dr. James Oloyede is Director, Nutrition Services and Health Care Development Board, Osun State. In this interview, he sheds lights on child malnutrition, its effects as well as government’s measures in proffering solution to the menace.
What is the level of malnutrition in Osun State and its effects?
From all indications, the state of malnutrition among children in Osun State is alarming, despite government’s efforts in checkmating the worrisome trend. For instance, the nutrition status of the under five children has not really improved in the past five years. There is a high burden of child malnutrition in the state, so much that the current infant mortality rate almost doubles the rate in 2011, compared to the situation in 2017.
Records have shown that the current infant mortality rate is around 78 per 1,000 life births. This means that if mothers delivered 100,000 children alive, 78 of them die within one year of birth. Though different factors account for this, poor nutrition is a major factor.
Among children that are less than five years of age, about 101 of them also die out of 1,000 that were born alive which almost doubles what we had in 2011. This is also due to high burden of malnutrition and other factors such as high rate of infectious diseases, poor sanitation and hygiene, poor maternal care and poor health care system, especially in the past five years.
Another very significant effect of child malnutrition in the state is the low birth rate, which is about 15 percent. That means that out of every 100 children born, 15 of them weigh below 2.5 kg, which is a benchmark for low birth rate. Not only that, about 18 percent of our children are also underweight. At every point in time in 2017, 18 children out of 100 children that were gathered together were under weight. Also, about 23 percent out of 100 children are stunted or shorter for their age.
Records have shown that eight percent of our children are suffering from nutritional stunting which means reduction in growth. The implication is that if remedy is not provided promptly for these deficiencies, the potentials of the children would be limited in life. It is like a life sentence. Their intelligent quotient (I.Q) would be very low. The affected children would not be brilliant but dullards.
Many of them are in the wasting category, which means they are lighter for their height. In this case, their height is normal, but their weight falls below their height. These are negative reflections of the current child malnutrition status in the state. The first consequence of these challenges is wasting. This means that the affected child does not reduce in height but can definitely reduce in weight. This condition is more dangerous than stunting. If not corrected early enough, it can lead to death.
Odo-Oti, Obokun and Ife North have the highest rate of malnutrition in the state. There is no gainsaying the fact that the malnutrition situation in the state is occasioned by poor economy and hardship, job loss and income loss.
What measures has government put in place against the menace?
We have embarked on advocacies to policy makers and traditional rulers in the communities within the local government areas where malnutrition has the highest rate of prevalence.
Recently, we gathered the community people together and sensitised them on various approaches in tackling the menace. Our emphasis was proper dieting based on balanced diet as well as proper breastfeeding. We also trained some community volunteers and support groups on infant feeding counselling scheme. Through this, we were able to counsel mothers on the importance of breastfeeding and balanced diet for their children.
We also trained health officers on how to assist mothers in administering infant and young child feeding. During antenatal and postnatal care, they counselled mothers on the importance and the practice.
How can you use breastfeeding to solve malnutrition problem?
Breastfeeding is part of intervention for child malnutrition but not in all cases. Age appropriate breastfeeding is very crucial. This occurs in three stages. First, the child has to be introduced early to breastfeeding after 30 minutes or one hour of delivery. This first breast milk is known as colostorum.
The second stage is that the mother practises exclusive breastfeeding for six months (without giving the child any other food other than breast milk), while the third stage is that she continues with supplementary breastfeeding till two years of birth.
In complimentary breastfeeding, the child needs to first of all be given the breast milk before the supplementary food because the milk contains more energy, protein, iron and vitamin A which are more important to the child than the supplementary food.
If the mother fails to do exclusive breastfeeding for six months and is giving water or milk- based formula to the child, he would come down with diarrhea, which can lead to malnutrition. If the mother is ignorant of this and fails to combine the breastfeeding with the right formula and complementary diet without adequate nutrients and proteins, it can also lead to malnutrition.
The problem of malnutrition sets in after six months of birth of the child, not before six months and this is due to the poor composition of complementary breast feeding or proper breast feeding after the six months of birth.
If a child is put under a proper breastfeeding, he or she is 14 times less likely to die in the first six months of life than a non-breast fed child.
How would you convince mothers to show interest in the battle against child malnutrition?
There is no intervention that has a great impact against infant mortality like proper breastfeeding. Every parent or family who love children should promote exclusive breastfeeding. It is a potential weapon against malnutrition.
It makes a child to grow very well and to be in sound health, it increases high Intelligence Quotient (IQ), it increases his mental capacity. Also, the child has the chances of higher productivity in future because of his high IQ.