Malnutrition is a global problem that affects billions and contributes to many deaths annually. In Nigeria, malnutrition rates have decreased but still affect a significant portion of the population. Government agencies, NGOs, industries and organizations like NAFDAC, SON, GAIN, and the National Fortification Alliance are working to combat malnutrition through strategies like mandatory food fortification standards. Efforts have made progress but continued efforts are needed to further reduce rates of malnutrition, ensure enforcement of standards, increase awareness and access to fortified foods, especially in rural areas.

1. FIGHTING
MALNUTRITION TO
THE GRASS-ROOT
LEVEL
BY ADIMA O. CHIKA
FCT/09B/1762
NAFDAC EID H/Q (GAIN OFFICE)
16TH JUNE 2009

2. Definitions of key words:
 Fight
Malnutrition
Grass-Root
Level

3. INTRODUCTION
Malnutrition is a global issue that affects
billions. According to Wikipedia;
“Malnutrition is the insufficient, excessive
or imbalance consumption of Nutrients. A
number of nutrition disorders may arise,
depending on which nutrients are under
or overabundant in the diet”.

4. The World Health Organization (WHO)
cites malnutrition as the gravest
threat to the world’s public health.
Improving nutrition is widely regarded
as the most effective form of aid.

5. According to Global Alliance for
Improved Nutrition (GAIN), in her
report; “Malnutrition kills 3.5 million
children every year and is directly or
indirectly associated with nearly 60% of
all child mortality. More than two (2)
billion people across the world suffer
from malnutrition including vitamins
and mineral deficiencies. It seriously
limits the growth of 178 million children
per year”.

6. According to Jean Ziegler (the United Nations
Special Rapporteur on the Right to Food for
2000 to March 2008), mortality due to
malnutrition accounted for 58% of the total
mortality in 2006: "In the world,
approximately 62 million people, all causes of
death combined, die each year. One in twelve
people worldwide is malnourished. In 2006,
more than 36 millions died of hunger or
diseases due to deficiencies in micronutrients.

7. SOME DISEASES
ASSOCIATED
WITH
MALNUTRITION:

8. Kwashiorkor Rabbit starvation
Sodium Hyponatremia Hypernatremia,
Hypertension
Iron Anemia Cirrhosis, heart disease
Iodine Goiter, hypothyroidism Iodine toxicity
Vitamin A Xerophthalmia, Night
Blindness
Hypervitaminosis A
(Cirrhosis, hair loss)
Vitamin B1
Beri-Beri
Vitamin B2
Cracking of skin and
Corneal Ulceration
Vitamin B3
Pellagra Dyspepsia, birth defects
Vitamin B12
Pernicious anemia
Vitamin C Scurvy Diarrhea
Vitamin D Rickets Hypervitaminosis D
Vitamin E Nervous disorders Hypervitaminosis E
Vitamin K Hemorrhage

12. Source: WHO

13. List of countries by percentage of
population suffering from
undernourishment as defined by
UN world food Programme & UN
FAO in its “The State of Food
Insecurity in the World “ 2009
report

14. Ranking Country % in 1990-92 % in 2004-
2006
1 DRC 29% 75%
2 Eritrea 67% 66%
3 Burundi 44% 63%
4 Haiti 63% 58%
5 Sierra Leone 45% 46%
30 Cameroon 34% 23%
30 Pakistan 22% 23%
57 Paraguay 16% 12%
62 China 15% 10%
69 Ghana 34% 8%
69 NIGERIA
15% 8%
72 Brazil 10% 6%
76 Tunisia <5% <5%
76 Ukraine <5% <5%

15. EEFORTS AND
PROGRESS TOWARDS
COMBATING THE
MENACE IN NIGERIA
By Gov. Agencies
By NGOs (Dev. Agencies)
By Industries

16. Gov. Agencies/Min
NAFDAC
SON
FMOH
NPC
FMOA
NSDC

17. NAFDAC/SON
According to Mrs. P. C. Monwuba (DD EID/Programme Manager
Nig.-GAIN Project in her report on monitoring and enforcement of
food fortification programme in Nigeria; “efforts to curb or
eliminate micronutrients deficiency disorders in Nig. Started as a
result of recommendation made during the World Summit for
children of 1990 in N/Y, USA. In 1992 at the International
conference on Nutrition (ICN), and the World Nutrition declaration
in Rome, participants called for the virtual elimination of
micronutrient deficiencies by the year 2000 A.D.
These resolutions were further adopted by the OAU at Dakar
meeting later in the year 1992.
Available evidence also showed that Nig had (and still has) one of
the highest rates of child maternal mortality in the world and Vit.
A deficiency (VAD) has been a major contributing factor.
Micronutrient malnutrition (a.k.a. Hidden Hunger) has become a
major devastating problem affecting health, especially that of
children, pregnant women and lactating mothers.. These are
majorly IDD, VAD and IDA.

18. The fortification standards were launched by SON in
2000 and mandatory fortification took off officially in
Sept. 2002. the National formal Launch organized by
NAFDAC took place on 28th Oct., 2004
It was also later found necessary for SON to set
standards for Vitamin-Mineral Premixes (Fortificants)
as well defined code of practice.
Furthermore, NAFDAC put in place regulations to give
full effect to the SON legislation. The NAFDAC food
fortification with Vit. A regulations, 2004 addresses
the following areas:

19. Prohibition of sales of the specified food
vehicles without adequate fortification
with Vit. A.
Labeling of Vit. A fortified foods, which
include an Eye Logo for its identification-
an eye with capital letter “A” inside it.
Proper packaging.
Advert materials to be censored and
granted permit by NAFDAC before airing.
Penalty for non-compliance.

20. CHOICE OF FOOD VEHICLE
Flour (wheat and maize ad their meals
e.g. Semolina)
Sugar
Edible vegetable oil
Margarine/Butter
Salt

21. DEVELOPMENT PARTNERS
UNICEF
GAIN
MI
USAID
HKI
WHO

22. GAIN
GAIN - The Global Alliance for Improved Nutrition is
an alliance driven by the vision of a world without
malnutrition. GAIN's mission is to reduce malnutrition
through food fortification and other sustainable
strategies aimed at improving the health and nutrition
of populations at risk.
GAIN was created in 2002 at a Special Session of the
UN General Assembly on Children and became a Swiss
foundation in 2003.

23. INDUSTRY PARTNERS
AFBTE
DANGOTE
FLOUR MILLS NIG. PLC
NESTLE
BIO-ORGANICS
HONEYWELL FLOURS

24. NATIONAL FORTIFICATION ALLIANCE
(NFA)
NFA was inaugurated in 2003 by the Hon. Minister of health.
According to Dr Paul Orhii (DG NAFDAC) in his address on the
occasion of the second NFA meeting in Lagos, he said “The
NFA whose responsibility it is to mid-wife the mandatory food
fortification policy of the Fed. Gov., is a true Public-private
partnership with members cutting across Gov. Ministries,
Agencies, Civil Society Organizations, Universities, Research
institutions, Industry partners, professional Associations and
Development partners. It is also a veritable platform for
sharing experiences and expertise that is available locally for
the reduction of the prevalence of micronutrient deficiencies
disorders and its effects on vulnerable and risk group in the
population.

25. NFA MANDATE
NFA sets for itself the following targets by end of 2012:
The reduction of the prevalence of anemia among children under 5,
from the then current 27.5% to 17% and that of women of reproductive
age from 59.6% to 24%.
The reduction of the prevalence of VAD among children under 5 from
29.% to 15% and that of women of reproductive age from 32.5% to 15%
To assess the level or prevalence and severity of Folic acid, Zinc and
Selenium deficiency disorders among women of reproductive age.
To review the National standards and regulations on wheat/maize
flours and semolina to include requirements for Folic acid, Zinc and
Selenium as well as review the existing mandatory levels of Vit. A and
Iron in these products.
To increase consumer awareness on the benefits of fortified
wheat/maize flours, sugar and vegetable oil from current levels to 80%
To ensure the compliance of small-scale and cottage producers of
maize flour and vegetable oil comply with the requirements of the
mandatory food fortification policy and thereby ensuring that the rural
and urban-poor households have greater access to and consume
fortified products on regular basis.

26. The NFA through its partnership and support
from GAIN (The Nigeria-GAIN Project) which
started in March 2007 in its first phase with NPC
as their EA. The project is currently in its second
phase now with NAFDAC as their EA and it is to
run till Dec. 2011 has really done so much
towards combating this menace which has
helped immensely in strengthening the
country’s efforts to monitor and enforce the
food fortification programme, and as such
should be commended.

27. POSSIBLE WAY FORWARD
There is a need for intensified effort by all stake
holders.
Enabling environment especially for industry
partners, mostly with premix procurement.
Need for house-hold/market survey on the
awareness and utilization of fortified food products.
More media publicity.
Strict enforcement of laws and penalties to
defaulters on production and sales of fortified food
products.

28. CONCLUSION
Malnutrition by no doubt is a severe Global issue and a
concern for every Nigerian as it affects us all directly or
indirectly.
We must applaud the Gov. of Nigeria through her
Ministries and agencies that are responsible for this fight.
Also, we have to acknowledge the massive impact being
made by development partners and most especially the
NFA for their immense efforts so far.
Finally, there is still a lot left to be done and all hands
must be on desk to fight and eradicate the menace by
leaving no stone on turn.

29. THANK YOU!