•How non-implementation of food fortification policy promotes malnutrition
By Kafilat Akinwumi
In Nigeria, many are the afflictions of the populace. From hardship and gruelling poverty to challenges of insecurity, Nigerians wallow in uncertainties from day to day, unsure of the havoc the next moment might wreak. And now, another ill has emerged – the prevalence of malnutrition and micronutrient deficiencies, with the attendant consequences for children and the workforce.
Indeed the statistics are a cause for worry. The World Health Organisation (WHO) in 2015 classified micronutrient deficiency in Nigeria as severe. In 2016, anaemia prevalence in Nigeria was 68.3 per cent, 48.8 per cent, and 57.8 per cent among children under five years, non-pregnant women 15-49 years of age, and pregnant women 15–49 years of age, respectively. WHO says no less than a third of the anaemia is attributable to iron deficiency. About 42 per cent of children between six and 59 months are vitamin A deficient. Overall, an estimated 21 per cent of the Nigeria population are at the risk of inadequate zinc intake.
The disheartening situation is giving some Nigerians and groups sleepless nights. Among such is the Civil Society Legislative Advocacy Centre (CISLAC). The body, in collaboration with Nigerian Economic Summit Group (NESG) and e-Health Africa, recently organised a media roundtable on promoting fortification compliance and workforce nutrition in Nigeria. The theme was Fortifying Nigeria’s Future. The event, held at Sheraton hotel, Lagos on Thursday May 18 2023, raised awareness on promoting fortification compliance and better workforce nutrition in Nigeria.
The organisers said the event was borne out of the growing concerns about malnutrition and the need for healthier diets. It was emphasised that the media could play a critical role in influencing public opinion and driving policy changes in favour of food fortification and improved nutrition in Nigeria.
Some of the guest speakers at the event were Chairman, Senate Committee on Health, Senator Ibrahim Oloriegbe; Executive Director, Civil Society Legislative Advocacy Centre (CISLAC), (CISLAC), Auwal Musa Rafsanjani; President/CEO, Consumer Advocacy for Food Safety and Nutrition Initiative (CAFSANI), Prof. Gbenga Ogunmoyela; President, Nutrition Society of Nigeria, Prof. Wasiu Akinloye Afolabi; Head Corporate Affairs and Stakeholder Management, Nigerian Economic Summit Group (NESG), Mrs. Ogechi Obiorah; Project Manager (LSFF Project), e-Health Africa, Toju Ogele and media executives.
In his welcome address, Executive Director of CISLAC, Rafsanjani said the nation was facing a serious nutrition crisis, explaining such as the reason for the organisers’ intervention. He noted that food fortification was the way to go in improving nutrition and health as well as the wealth of the nation. He tasked the stakeholders to take the issues of children and workforce nutrition more seriously to improve the productivity level of their employees by implementing relevant measures.
“According to the National Demographic and Health Survey (NDHS) 2022, 44.1 per cent of children under the age of five in Nigeria are stunted, meaning they are too short for their age. This is a decrease from 46.0 per cent in 2018, but it is still a high number. Stunting is a sign of chronic malnutrition and can have long-term consequences for health and development.
“The NDHS also found that 20.3 per cent of children under the age of 5 in Nigeria are too thin for their height. This is an increase from 19.9 per cent in 2018. This is a sign of acute malnutrition and can be a life-threatening condition.
“The NDHS also found that 18.7 per cent of adults in Nigeria are overweight and 4.4 per cent are obese. This is an increase from 17.4 per cent and 3.4 per cent respectively, in 2018. Overweight and obesity are major risk factors for chronic diseases such as heart disease, stroke, type 2 diabetes, and some types of cancer,” Rafsanjaji said, adding that food fortification prevents micronutrient deficiencies, such as anaemia, vitamin A deficiency and iodine deficiency.
He said: “Workers who are not getting the nutrients they need are more likely to be sick, less productive. This can have a significant impact on the economy. To ensure a healthy workforce, employees should provide their workers with the nutrients they need, as fortification can help to reduce absenteeism, increase productivity, and improve safety.”
He appealed to the media executives present to help in raising awareness of the importance of food fortification and workforce nutrition. “The media plays a critical role in shaping public opinion and influencing policy because by shining a spotlight on this issue, you can help to make a real difference in the lives of millions of Nigerians,” he stated.
Rafsanjani also sought the support of regulators, members of the National Assembly, civil society organisations and food producers. “Together, we can work to ensure that the food fortification policy of 2019 is implemented effectively to ensure healthier Nigerians.
Senator Oloriegbe, at the event, tasked the Federal Government to ensure improved nutrition with a law that will compel stakeholders in the food and fortification industry to ensure that food products pushed to the market for the consumption of Nigerians are food fortification compliant. Oloriegbe noted that Nigeria was in urgent need of laws that would enforce compliance with the food fortification policy and compel companies in the sector to prioritise effective workforce programme for their workers.
“Malnutrition is lack of proper nutrition,” he noted. “You may have food but cannot eat and can eat but have no food to eat. If you eat food that your body system cannot process, it is the same thing to say that one is susceptible to malnutrition.
“We need a law that compels nutrition companies to provide nutrition for their workforce because, currently, there is no such law, as it is optional. A law should compel compliance with food fortification and promotion of workforce nutrition in Nigeria.
“When you talk about nutrition, you have to talk about the health of the woman that is pregnant, then you talk about the baby because it is a healthy body that gives birth to a healthy baby. The workforce is also involved.”
He expressed worry that over two million children under age five in Nigeria are malnourished, insisting that government and stakeholders in the food industry must arrest this urgently. He also spoke on the right of workers in food and fortification industry to get good nutrition.
“If you don’t have good nutrition as an adult, you are prone to getting sick and you will be unproductive. When human resources are not working well, the industry and the nation are bound to have their productivity level depleted,” he submitted. He tasked the media to help shape opinions on the issue as well as push out more advocacy on malnutrition in Nigeria.
Prof. Afolabi delivered a paper entitled ‘The role of food fortification in addressing micronutrient deficiency.’ He admitted that nutritionally adequate diets are a major challenge in many parts of the world, noting that some food systems are lacking in adequate nutrition. But he noted that if well-fortified, they would be safe and nutritious.
While enumerating the benefits of fortified foods, Afolabi said a recent systematic review and, meta-analysis revealed that large scale food fortification: reduced anaemia by 34 per cent, goitre by 74 per cent and neural tube defects by 41 per cent.
He called for more nutrition education on the need to consume more nutritious diets for a healthier and strong immune system, less risk of chronic illness, infectious diseases and increased productivity.
Prof. Ogunmoyela’s paper – ‘The challenges and successes of fortification compliance and opportunities for promoting workforce nutrition in Nigeria – explained that globally, poverty, hunger and malnutrition remain a nightmare both to the government and the vulnerable community comprising mostly children and youths, notably in the developing countries, including Nigeria. At the root, he said, is lack of money which leads to low purchasing power. “Today, an estimated 72 per cent of Nigerians are believed to be living in extreme poverty with income of less than US$2 per day. Any wonder why our nutritional indices have become one of the worst in the world with stunting rates and malnutrition at up to 60 per cent in some states,” he wondered.
He noted that investing in micronutrients would have higher returns than investing in trade liberalisation, in malaria, or in water and sanitation. “No other technology offers as large an opportunity to improve lives at such low cost and in such a short time,” he insisted.
He noted that nutrition, wellness, health, and food safety (NWHFS) issues are quite topical today and present significant challenges and opportunities in a developing economy like Nigeria. Food fortification, he explained, is the addition of micronutrients to food at higher levels than what the food can provide naturally for micronutrient deficiency control. “Examples include Vitamin A in flour, sugar and vegetable oils, folic acid in flour, iodine in salt and so on.”
He said workplace nutrition “has an immediate impact on employee performance as studies repeatedly show that healthier, less stressed employees are more productive. Nutrition is one of the most important yet neglected components. He then called for an overhaul of the nation’s existing food fortification policy and laws.
Mrs. Ogechi Obiorah, Head Corporate Affairs and Stakeholder Management, Nigerian Economic Summit Group (NESG), said the food fortification policy is a collective responsibility of all stakeholders involved. She called on the Manufacturers Association of Nigeria, West African Cotton Companies and other stakeholders involved in food production to get more involved in the drive. She also advocated for budgetary allocation and fund releases for relevant government agencies such as (FCCPC, NAFDAC and SON) to ensure efficient monitoring of food fortification by producers.
A communiqué at the end of the roundtable was jointly signed by Rafsanjani, Senator Oloriegbe, Professor Ogunmoyela and Professor Afolabi. In the nine recommendations, the organisers called for prioritisation of food fortification across manufacturing process and production chains through proactive media reportage that promotes well-informed citizens on appropriate food choices.
They called for the integration of food fortification into the organisations’ policies coupled with targeted sensitisation and awareness at employees’ levels to activate compliance to workforce nutrition, while enhancing productivity in the work environment.
They highlighted the cost-benefits of development and implementation of workplace nutrition policy incorporating food fortification to encourage investment that promotes employees’ health and socio-economic well-being as well as best practice at organisational levels.
The organisers also called for formulation and implementation of food fortification policy incorporating effective regulatory framework, compliance to standards and food safety as well as social behavioural change communication for consumers.