Combating childhood multinutrient undernutrition and its inequalities in Nigeria: Whitehead’s typology as a policy framework for urgent action
Malnutrition is a global public health issue. Multinutrient deficiency is more rampant in developing countries like Nigeria, affecting mainly children and pregnant women. Direct causes are reduced intake due to shortage, and infections which reduce intake/absorption or increase body demand. Underlying causes include poverty, illiteracy, food insecurity, and poor environmental sanitation. Multinutrient deficiency is a threat to any country’s growth and development because it is a major cause of child morbidity and mortality. It disrupts growth and development of organs such as the brain leading to cognitive impairment, chronic diseases in adult life, and reduced productivity. The Nigeria Multiple Indicator Cluster Survey 2016-17 revealed high proportions of multinutrient deficiency with regional, rural/urban, and socioeconomic inequalities. Cultural practices such as food taboos and differential allocation of food in the family, sociopolitical instability, and lack of political will have contributed to this scourge, though more data in terms of the relative strengths of these factors are needed to prioritize interventions. In any case, interventions must address the four levels of social determinants of health namely individual lifestyle factors (health education, social protection of vulnerable households, and protection of children from infections), social and community networks (setting up community linkages that support individuals in health and finance), living conditions (provision of adequate water and sanitation, essential health services, and education which safeguard nutritional level), and general socioeconomic, cultural, and environmental conditions (equitable income distribution, structural linkages for healthy public policy, and developmental interventions in rural and poor communities).
Keywords: Childhood undernutrition, Nigeria, inequalities, whitehead’s typology, policy