Severe Acute Malnutrition: CISLAC holds memorable gubernatorial debate in Jigawa By Abubakar Jimoh

An estimated 2.5 million Nigerian children under-5 suffer from Severe Acute Malnutrition (SAM) annually, exposing nearly 420,000 children under-5 to early death from common childhood illnesses such as diarrhoea, pneumonia and malaria.

Jigawa state records one of the worst malnutrition indices in Nigeria with 66% stunting, 13.8% wasting, 50.4% underweight rates of under-5, as reported by Multiple Indicator Cluster Surveys (MICS) in 2016.

Malnutrition and nutrition-related morbidity constitute serious public health concerns in the state with 15.5% exclusive breastfeeding rate. In 2017, the Community-based Management of Acute Malnutrition (CMAM) programmes admitted 62,953 with 57,201 cured, 170 death and 911 defaulters, consumption of RUTF varies along monthly admission rate.

It is against this background that Civil Society Legislative Advocacy Centre (CISLAC) organised a first time in history debate for gubernatorial candidates in the state to provoke constructive discussions and interactions on efficient Primary Health Care as a prerequisite for prevention and treatment of Severe Acute Malnutrition (SAM).

Given the importance role of political parties in the general elections, the debate elicited commitments of the candidates to address SAM in state.

The debate attended by gubernatorial candidates of All Progressives Congress (APC), SDP, PDP, PDM, People’s Trust, MPN provided them with enabling platform to articulate proposed policy and programmes to advance adequate nutrition status as a child right with assurances to strengthen Primary Health Care system for adequate and sustainable nutrition intervention.

‘We will prioritise LGs with severe cases’ – APC

As contains in its party manifesto, All Progressives Congress (APC) commits to: prioritise the reduction of the infant mortality rate by 2019 to 3%; reduce maternal mortality by more than 70%; reduce HIV/AIDs infection rate by 50% and other infectious diseases by 75%; improve life expectancy by additional 10 years on average through our national healthy living program.

The party also commits to increase the number of physicians from 19 per 1000 population to 50 per 1000; increase national health expenditure per person per annum to about N50,000 (from less than N10,000 currently); provide free ante-natal care for pregnant women, free health care for babies and children up to school going age and for the aged and free treatment for those afflicted with infectious diseases such as tuberculosis and HIV/AIDS; boost the local manufacture of pharmaceuticals and make non adulterated drugs readily available.

While responding to questions during the debate, candidate of APC also the present Governor of the State, Alhaji Mohammed Abubakar Badaru represented by his Deputy Barrister Ibrahim Hassan Hadejia said in order to attain adequate and optimum healthcare delivery across the state, the administration had commenced the implementation of Primary Health Care provisions as enshrined in the National Health Act, 2014.

According to him, apart from working to ensure functional and effective Primary Health, the administration works towards provision of one Primary Health Care centre per ward.

“Jigawa state is the first state in Nigeria to complete its conditional cash transfer programme. The 2019 budget has an extensive allocation for SAM program to nine (9) Local Government Areas.

“We will prioritise Local Governments with severe malnutrition cases, while sustaining existing coverage.

“The state has budgeted sum of N2billion for conditional cash transfer programme. Also, N160million has been budgeted for nutrition counterpart funding.

“State Government will ensure timely release to sustain existing effort.

“Through adequate mapping and preparation, we will revitalise our Primary Health Care centres to effective cater for SAM.

“We will boost human resources for Primary Health through adequate recruitment of health workers to improve access to healthcare services.

“This will be supported through our existing programme in School of Nursing and community scheme to encourage enrolment of girls into health institutions and community participation in healthcare services,” he assured.

‘We will facilitate timely release of funds’ – SDP

The Social Democratic Party (SDP) acknowledges that citizen’s productive capacities are predicated on good health.

The party in its manifesto commits to free health services for all Nigerians up to the age of 18 and seniors over the age of 65 years; and affordable health services for all Nigerians in every part of the country; create infrastructural facilities in the health sector for effective health care delivery.

Other promises by the party include to revitalise primary, secondary and tertiary health care systems; give special attention in addressing problems of WF, HIV/AIDS, maternal and infant mortality; and make functional clinics accessible to inaccessible communities.

While responding to a question on proposed strategy by the party to ensure sustainable investment for the CMAM activities and expansion to other Local Government yet to be covered, Hon. Bashir Adamu Jimbo, the Gubernatorial candidate of SDP said the party would work towards sustainable initiatives and free programmes on Primary Health Care to systematically curb malnutrition, while enhancing SAM interventions in the state.

He assured to prioritise sustainable CMAM programmes and nutrition investment through constructive collaboration with Civil Society Organisation and development partners to extend CMAM activities to other Local Government Area yet to be covered in the state.

Hon. Jimbo attributed delay in release of budgeted funds as the major factor militating against sustainable interventions to address SAM in the state, while giving assurance to facilitate timely release of funds, if elected as the Governor.

“Proper collaboration with Civil Society groups and development partners will help in adequate supervision, promote accountability and ensure compliance to the implementation of nutrition funding as contains in the budget,” he explained.

‘We will deploy adequate human resources for health’ – PDP

The People Democratic Party’s overall policy objective for the health sector aims at improving the health status of Nigerians in order to increase productivity, job creation, wealth creation and poverty reduction through improvement of healthcare services, ensuring universal access to basic health care and reproductive health, improvement of maternal and child health.

Mallam Aminu Ibrahim Ringim, the party’s gubernatorial candidate during the debate committed to fulfil the state’s commitment to adequate nutrition investment through strengthen financial and technical collaboration with relevant stakeholders.

He promised to reintroduce Guduma Health system as part of initiatives to improve efficient Primary Health Care services delivery at community level, while adopting a multi-sectoral approach to improve services.

“Adequate human resources remains paramount to effectively deliver on Primary Health Care. We will encourage appropriate training, retraining and research programmes to boost skilled healthcare personnel to be deployed across healthcare centres.

“We will enhance collaboration with development partners and Civil Society groups to sustain adequate funding for SAM prevention,” Mallam Ibrahim

‘We will strengthen accountability around PHC, nutrition funds’ – PDM

As contains in its party manifesto, Peoples Democratic Movement (PDM) commits to ensure proper coordination and reinforcement of government and nongovernmental organizations to improve access to qualitative Primary Health Care; health education and advocacy in schools and through community based associations; constructive engagement of international health management and delivery agencies on preventive medical initiatives.

Other promises by the party include support for healthy lifestyle advocacy; establishment of a National Health Board and Health monitoring and regulations blueprint; improved access to affordable medical care; reduction in infant and child mortality rate; increase in life expectancy; reduction in loss manpower arising from illness; and reduction in the need for medical treatment outside Nigeria.

In his response to a question on the immediate measures the party will put in place to ensure timely release and judicious utilisation of fund by the line Ministries, Departments and Agencies, Mallam Muhammad Sanusi, the candidate of PDM promised to ensure proper control and supervision of government finances to promote full implementation of nutrition funds in the state.

In order to ensure functional Primary Health Care, Mallam Sanusi assured to maintain regular supervision of PHC centres in the state through partnership with Civil Society Organisations.

“Our government with work with CSOs to provide adequate financial resources to nutrition activities and ensure accountability by every person in charge of nutrition programme.

“Apart from financial prudence, we will ensure timely release of budgeted funds to sustain and expand nutrition interventions in the state.

“We will boost human resources for Primary Health Care through adequate recruitment of skilled personnel of high professional competence,” he assured.

‘We will commit $160 per child to prevent SAM’ – MPN

The gubernatorial candidate of Mega Party of Nigeria, Sheik Rudman Abdullah, during the debate pledged to establish Desk Official across the 27 Local Government Areas in the state, and sustain partnership with development partners and Civil Society Organisations.

“If elected as the next governor, I will commit $160 per child to prevent SAM across Primary Health Care centres.

“I will hold responsible Ministries, Departments and Agencies accountable to ensure timely release of funds; and mainstream nutrition in primary and secondary education curricula,” he assured.

‘We will double existing budgetary provision for treatment of SAM’ – PT

“If elected as the next governor, l will double existing budgetary provision for prevention of SAM and ensure timely release of fund.

“I will operate philosophical approach to governance, secure child right and boost Primary Health Care through targeted empowerment programmes,” said Muhammad M.Y Milo, gubernatorial candidate of Peoples’ Trust party.

In her remarks at the end of the debate, Chioma Kanu, Program Manager (Health, Human Development and Social Inclusion), CISLAC, encourage each party to prioritize Community Management of Acute Malnutrition (CMAM) programmes in the state through existing policies implementation, adequate budgetary allocation, timely release, cash backing and utilization of funds and oversight activities.

She advised them to ensure Local Government autonomy to enhance full financial independence in the management of Primary Health Care systems for transparency and accountability to promote adequate and sustainable coverage of nutrition interventions in the state.

She said: “Expanding the existing CMAM programmes to additional prioritized Local Government Areas in various states for adequate coverage and timely intervention is paramount across the states.

“Prioritising full implementation of the National Health Act 2014 will promote adequate, accessible and affordable Primary Health Care for effective delivery of CMAM and other nutrition services.

“More importantly, sustain budget line for nutrition and ensure timely releases of funds for the procurement RUTF will avert stock-out in distribution, the situation that may exacerbate treatment of SAM children in the state.

The Project Coordinator further drew their attention to full implementation of Child Right Act to effect adequate nutrition status as a child right.

Jimoh is the Head of Communications at Civil Society Legislative Advocacy Centre (CISLAC), Abuja.

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