Persistent misconceptions surrounding child malnutrition are hindering timely medical intervention in Kebbi State, leading to hundreds of avoidable child fatalities despite the availability of treatment facilities and humanitarian assistance.
The consequences of such delays are starkly illustrated by the experience of families like Halima Abdullahi's in Birnin Kebbi.
Mrs. Abdullahi, residing in the Aleiru quarter, brought her one-year-old daughter, Hauwa, to Sir Yahaya Memorial Hospital in Birnin Kebbi in August 2025. Medical professionals diagnosed the child with severe acute malnutrition.
Initially, Mrs. Abdullahi's family attributed the child's ailment to supernatural causes and opted for traditional remedies. "We were reluctant and relied on traditional medicine because we believed it was witchcraft," she stated. "When we eventually took her to the hospital, she was admitted to the intensive care unit."
Tragically, the child passed away seven days later. "I was sitting beside her bed when I noticed her head shaking rapidly. I realised she was dying and called the doctors. They asked me to step outside, and a minute later they told me my daughter had died."
Halima Abdullahi
Her narrative is representative of a widespread issue in Kebbi State, where health officials report that ingrained misconceptions about malnutrition are impeding access to care and resulting in preventable deaths among children.
A Cycle of Loss
Rabiatu Usmanu endured a similar devastating loss when one of her daughters succumbed to malnutrition years prior. At the time of a visit in October, she was attending to her one-year-old twins, Hassan and Hussaina, at the Takalau Malnutrition Treatment Centre in Birnin Kebbi.
"My first daughter survived malnutrition, but I lost the second," Mrs. Usmanu recounted. "Now my twins are being treated for the same illness. Thankfully, they are responding to treatment, and we will soon be discharged."
Mrs. Usmanu, from Gwandu Local Government Area, expressed a newfound understanding of the critical importance of prompt medical attention.
Rabiatu Usmanu from Gwandu LGA and her twin babies at the Takalau Malnutrition Treatment facility at Birnin Kebbi.
Delays Fueled by Misconceptions
Healthcare professionals indicate that deeply entrenched cultural beliefs, which often interpret malnutrition as a spiritual affliction, have exacerbated child mortality rates in Kebbi State.
Data from the Kebbi State Nutrition Office reveals that between January and September 2025, 608 children suffering from severe malnutrition died. These fatalities occurred across 21 treatment centres situated in five local government areas, with three of these centres receiving support from Médecins Sans Frontières (MSF).
Statistics from the 2018 Nigeria Demographic and Health Survey (NDHS) underscore the severity of malnutrition in the state. The survey indicated that among children under five, 66.1 per cent experience stunting, 16.6 per cent are wasted, and 80.8 per cent suffer from anaemia. Furthermore, only 38.1 per cent adhere to minimum dietary diversity standards, and a mere 25.1 per cent of newborns are breastfed within the first hour of life.
The World Health Organisation (WHO) highlights that malnutrition not only elevates the risk of death but also contributes to stunting, impaired cognitive development, and reduced intelligence.
Why Caregivers Arrive Late
Comfort Joel, a nursing team supervisor at Maiyama Hospital in Kebbi, observed that many caregivers delay seeking professional medical help until a child's condition becomes critical.
"Most of the children come in with severe acute malnutrition, often complicated by diarrhoea or other illnesses," she explained.
Ms. Joel cited cultural norms, household decision-making processes, and a distrust of medical advice as factors contributing to delayed treatment.
"Some mothers need permission from their husbands before seeking treatment. Others are discouraged by in-laws who insist the illness can be treated at home," she added.
She also noted that some caregivers expect immediate recovery and request early discharge if improvements are not immediately apparent.
Malnutrition Treatment Facility at Maiyama LGA jointly managed by Kebbi State Government and MSF
Economic Pressures, Culture, and Access Drive Malnutrition
Mairo Idris, a paediatric nutritionist, pointed to Nigeria's escalating inflation and rising poverty as significant factors worsening malnutrition, particularly in the North-west region, including Kebbi State.
Beyond economic hardships, she elaborated, entrenched cultural practices and suboptimal dietary habits continue to fuel the crisis.
Mrs. Mairo Idris
Ms. Idris identified a critical, though often overlooked, issue: the disconnect between crop production and household food availability. "In Kebbi and many other North-west states, men are largely responsible for cultivating nutritious crops needed for child development. However, many sell their entire harvest for income without reserving a portion for household consumption," she stated.
This practice, she explained, leaves women struggling to combat child malnutrition without access to the very foods produced in their communities.
Knowledge Gaps and Misconceptions
Even when food is accessible, a lack of adequate nutritional knowledge presents a significant hurdle, Ms. Idris noted. "Many mothers have the right ingredients but lack the knowledge to prepare balanced meals. This leads to over-reliance on Ready-to-Use Therapeutic Food (RUTF) only after a child’s condition has deteriorated to a critical stage," she said.
She emphasized that RUTF should supplement, not substitute, proper household nutrition.
Myth of “Spiritual Attacks”
Ms. Idris further highlighted that misinformation continues to perpetuate the belief that malnutrition symptoms are attributable to spiritual attacks. Consequently, families often prioritize traditional or spiritual treatments over medical care, delaying hospital visits until a child's condition is severe.
"By the time many families arrive at health facilities, the child’s condition is already critical. These are deaths that could largely be prevented through early detection and timely care," she stated.
She also pointed out that geographic isolation in rural areas exacerbates the problem. While global health standards recommend primary healthcare facilities be within a two-kilometre radius, many families in the North-west live much farther away.
The cost of transportation discourages clinic visits, and domestic dynamics can prevent women from seeking medical assistance.
Rapid population growth, Ms. Idris warned, is also placing an immense strain on already fragile healthcare systems.
"As cases continue to rise, existing facilities lack the capacity to provide quality care to every child in need. Without addressing both economic pressures and cultural misconceptions, malnutrition in the North-West will continue to worsen," she concluded.
State Government Response
Bello Aliyu, the Kebbi State Nutrition Officer, announced that the state government allocated N500 million as counterpart funding to UNICEF's Child Nutrition Fund (CNF) for the acquisition of Ready-to-Use Therapeutic Food (RUTF) and other nutritional supplements. He also confirmed that Governor Nasir Idris has approved the statewide distribution of Small Quantity Lipid- Based Nutrient Supplements (SQ-LNS) and Ready-to-Use Supplementary Food (RUSF).
Mr. Aliyu further stated that the government has re-established 140 outpatient treatment centres, increasing the total number of nutrition facilities to 161, inclusive of the existing 21 centres. He indicated that ongoing awareness campaigns have been instrumental in dispelling long-held misconceptions, leading to an increased number of caregivers seeking medical treatment for malnourished children at health facilities.
The state's food and nutrition policy aims to achieve a 20 per cent reduction in hunger and malnutrition by 2027. This policy also targets an increase in exclusive breastfeeding rates to 30 per cent, expanded zinc supplementation coverage to 50 per cent, and a 70 per cent increase in the cultivation of nutrient-dense and fortified crops.
Mothers receiving counselling on malnutrition by MSF medical worker at the Takalau treatment centre, Birnin Kebbi.
Northern Nigeria in Crisis
In November, Médecins Sans Frontières (MSF) issued a stark warning regarding the escalating child malnutrition crisis across northern Nigeria, noting that thousands of children continue to perish annually despite intensified humanitarian and governmental efforts. During a high-level conference in Abuja focused on "Mobilising Against Malnutrition in North-West Nigeria," the organization reported a sharp increase in admissions and deaths among children under five in 2025, characterizing the situation as a recurring emergency demanding immediate and coordinated action.
Ahmed Aldikhari, MSF Country Representative, identified Nigeria as the global epicenter for the organization's malnutrition response, treating more children there than in any other country worldwide. He stated that MSF admitted nearly 300,000 children with severe acute malnutrition (SAM) across northern Nigeria in 2024, representing over half of the organization's global admissions for that year. Aldikhari attributed the crisis's magnitude to Nigeria's large population and the high prevalence of malnutrition in the northern Sahelian belt, where factors such as hunger, seasonal food scarcity, and recurrent disease outbreaks converge.
While acknowledging the federal government's declaration of malnutrition as a national emergency in March 2025, Mr. Aldikhari called for enhanced collaboration among governmental bodies, humanitarian organizations, and financial backers.
Rise in Cases
Evgenia Zelikova, MSF medical manager, informed PREMIUM TIMES that admissions saw at least a 20 per cent rise in 2025, with over 120,000 children treated by September, exceeding the total of 90,000 from 2024. The majority of affected children are under two years old, although nearly 40 per cent are older. Recurrent outbreaks of malaria and cerebrospinal meningitis have worsened the crisis, overwhelming healthcare facilities. Despite expanding inpatient capacity from 100 to 800 beds, over 1,000 children died from malnutrition and related illnesses in 2025.
Federal Government Response
At the same Abuja conference, Uju Rochas, senior special assistant on Public Health, representing Vice President Kashim Shettima, described malnutrition as both a public health and economic crisis, estimating its annual cost to Nigeria at approximately $56 billion. She outlined federal initiatives, including the Nutrition 774 program and Accelerated Nutrition Results in Nigeria (AMRIN) 2.0, designed to integrate nutrition interventions across all local government areas through improved financing, coordination, and accountability.
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Muhammad Pate, the Coordinating Minister of Health and Social Welfare, represented by Ladidi Bako, affirmed that malnutrition remains one of Nigeria's most critical challenges, particularly in the North-west, where stunting and wasting rates surpass emergency thresholds. He acknowledged that behind every statistic lies a family enduring hardship, and while humanitarian efforts have helped mitigate the crisis, underlying issues such as poverty, food insecurity, and weak health systems persist. Mr. Pate stated that under President Bola Tinubu’s Renewed Hope Agenda, nutrition has been prioritized nationally, with the federal government intensifying both preventive and treatment interventions.
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