Updated on December 6, 2024
Doctors Without Borders/Médecins Sans Frontières (MSF) has found extremely critical levels of malnutrition in northwestern Nigeria through a survey conducted with regional health authorities, highlighting how climate, inflation, and insecurity are causing an increasing number of children to become malnourished each year.
More than 2,000 children were surveyed in three areas of Katsina state in July, in collaboration with Epicentre, MSF’s epidemiology arm, and the Katsina State Ministry of Health. In some areas, levels of global acute malnutrition have doubled since last year, when the situation was already dire, while aid to the region is decreasing.
“As the number of malnutrition cases keeps rising year over year, our projections are catastrophic for 2025,” said Avril Benoît, chief executive officer of MSF USA, during a recent visit to Katsina. “We are calling on everyone who can to step up their assistance, including the government of Nigeria and international aid organizations. We are seeing a vast crisis of food insecurity and malnutrition in northern Nigeria, including the northwest, that requires a heightened response.”
Major nutritional crisis
The survey shows a major nutritional crisis underway in the local government areas of Katsina, Jibia, and Mashi. Over 30 percent of children suffer from global acute malnutrition in some places, up from 22 percent two years ago, and severe acute malnutrition rates—the most dangerous form of malnutrition—now range from 6.8 to 14.4 percent. These are extremely critical levels of malnutrition according to the Integrated Food Security Phase Classification, and MSF has seen further increases in malnutrition cases since the survey was conducted.
This survey has been carried out yearly since 2022 during the same period, in the same areas, and with the same methodology in order to estimate the prevalence of acute malnutrition in children between 6 months and 5 years old. The nutritional status of children 6 to 59 months old was assessed using a combination of three methodologies: mid-upper arm circumference, bilateral pitting edema, and weight-for-height z-score.
“These survey results are, quite frankly, terrifying,” said Dr. Raphael Kananga, MSF medical coordinator. “We have seen figures rising steadily for the past couple of years and now we are moving from critical to extremely critical levels. In Mashi LGA [local government area], 14 percent of children we surveyed were severely malnourished, and a prevalence this high is catastrophic. We really need to see more, not less action from organizations, otherwise we are going to see children dying in record numbers.”
MSF’s emergency response in northwest Nigeria
MSF, which runs four therapeutic treatment centers for malnourished children in Katsina state, has treated more than 100,000 malnourished children there from January until now, which represents a 20-percent increase compared to the same period last year. Admissions for hospitalization have increased by more than 50 percent compared to 2022 and 2023. More than 800 children could not be saved due to the severity of their condition and died in our facilities in Katsina state between January and September 2024.
This is a trend we are seeing across all our nutrition facilities in northern Nigeria. Earlier this year, MSF conducted a mass screening in several areas of Zamfara state in northwest Nigeria, and found 27 percent of children suffering from global acute malnutrition. Overall, MSF medical teams responding in seven states spanning northern Nigeria have treated 294,000 children for malnutrition from January to September this year. This is 43 percent higher than the number of children treated in that same period in 2023.
The projections of a further deterioration in food insecurity in the near future are also very worrying. Inflation is currently very high in Nigeria, the devaluation of the local currency is continuing, and agricultural yields have severely decreased again this year. The cost of living is increasing, insecurity remains a concern in several parts of the region, and climate events are expected to continue–impacting livestock and crops. All of these factors mean that if no additional support is set in place, MSF fears a deadlier catastrophe in 2025.
Funding cuts reduce ability to treat malnutrition
Despite the huge increases in the prevalence of global acute malnutrition, the northwest region is still not included in the UN’s humanitarian response plan for Nigeria.
Global funding cuts are reducing organizations’ ability to respond and treat children with malnutrition. Insufficient amounts of therapeutic food globally have been a challenge over the last year and are still worsening. In some areas, such as Zamfara, there have only been limited supplies available since March. UNICEF has recently launched a global appeal with fears that nearly 2 million children across 12 countries are at risk of death due to these shortages.
“We have consistently raised the alarm about the escalating malnutrition crisis in northern Nigeria, and the findings of recent surveys confirm our worst fears: conditions have not improved; they have significantly deteriorated,” said Dr. Simba Tirima, country representative for MSF in Nigeria. “This year, our teams across locations such as Kebbi, Zamfara, Katsina, and Maiduguri have been overwhelmed by an unprecedented number of malnourished children requiring urgent care. We have utilized every available resource, from overflow tents to spare mattresses, to manage the influx of patients arriving at our hospitals. Without meaningful and immediate action, I fear the situation could worsen dramatically in the coming year. We recognize the Federal Ministry of Health and Social Welfare's recent and ongoing efforts toward tackling malnutrition. If all stakeholders increase funding and ensure a reliable supply of therapeutic food, there is hope that we can save the lives of many children next year.”
MSF’s malnutrition response in Nigeria
MSF runs nutrition projects in seven states in Nigeria: Borno, Bauchi, Katsina, Kano, Sokoto, Zamfara, and Kebbi. This includes 10 inpatient facilities, including those in Maiduguri, and in Katsina city, as well as over 30 outpatient feeding centers across these states to treat children with moderate and severe malnutrition who do not need to be admitted to hospital.
