By ALHASSAN Hamza Hussaini,
In 2021, the Gates Notes highlighted a stark reality: “a child in northern Nigeria is 20 times more likely to die before the age of five than a child in a rich country.” This alarming statistic is driven by high levels of illiteracy and harmful gender and social norms. Underlying these issues are the socioeconomic conditions of the people, with increasing rates of poverty forcing many families to struggle daily for basic necessities like food, water, medical care, sanitation, and hygiene. Sadly, malnutrition and economic hardship affect people across Nigeria, transcending regional boundaries.
Malnutrition is a major cause of morbidity and mortality among women and children in Nigeria. According to a UNICEF report, Nigeria has the second-highest burden of stunted children in the world, with a national prevalence rate of 32 percent among children under five. The report also notes that “an estimated 2 million children in Nigeria suffer from severe acute malnutrition, but only two out of every 10 children affected are currently reached with treatment, and only seven percent of women of childbearing age suffer from acute malnutrition.” The 2018 Demographic and Health Survey stated that one in every eight children does not reach their fifth birthday, largely due to limited access to basic healthcare services, especially in rural areas, despite policies aimed at achieving Universal Health Coverage.
The scourge of malnutrition affects all demographics, including people with disabilities (PwDs), particularly women and children, who face the compounded issues of disability and malnutrition amidst the country’s worsening economic conditions. The intersectionality of nutrition and disability remains largely overlooked, despite provisions in the Discrimination Against Persons with Disabilities (Prohibition) Act 2018 and the 2017 National Policy on Disability in Nigeria. PwDs confront numerous challenges, including poor access to healthcare services, poverty, low literacy, discrimination, and neglect from both family members and society.
A recent World Health Organization report indicates that approximately 35.1 million Nigerians live with disabilities. A significant proportion of these individuals are women and children who face discrimination and challenges that extend beyond their individual struggles, impacting their families and communities at large. Pregnant women with disabilities, in particular, experience consistent neglect, exposing them and their children to heightened risks of malnutrition.
In nutrition programs, this neglect is evident through the lack of sensitivity to the unique needs of PwDs. Accessing health and nutrition services is often difficult due to the absence of disability-friendly environments or infrastructure, such as ramps, elevators, assistive devices, and sign language interpreters. Additionally, the distance from their homes to health centers exacerbates the situation, forcing some to traverse long distances for care.
Beyond the lack of inclusive infrastructure, there is also a scarcity of data for decision-making. Disability data is insufficient at local, state, and national levels, leaving policymakers unaware of the needs of PwDs. Sometimes, the discrimination against PwDs is embedded in the development of data collection tools. The attitude of some nutrition service providers towards PwDs is another barrier; they often treat PwDs with disdain due to a lack of training on disability inclusion. Furthermore, there is a mismatch between policy implementation and legislation intended to protect the rights of PwDs, leading to unintended neglect and missed opportunities to address discrimination in nutrition service delivery.
The over 35.1 million Nigerians living with disabilities have the potential to add significant value to the country’s economy if they are empowered through increased access to health and nutrition services. This would enhance their productivity and contribution to the country’s GDP and tax revenues. Conversely, leaving them in poverty and with poor access to services will exacerbate their plight and hinder the country’s economic growth.
This understanding underpins the partnership between the World Bank, Niger State Government, and Plan International Nigeria in implementing the Accelerating Nutrition Results (ANRiN) project. The project revealed the daily realities of PwDs within the nutrition value chain. After identifying multiple dimensions of discrimination against PwDs in delivering the community-based basic package of nutrition services across 134 communities in 12 LGAs, the project adopted a clustered targeting approach. This approach identified settlements predominantly populated by PwDs, such as ‘Ungwan Nakassasu’ (the land of disabled people in Hausa) in Kontagora Local Government Area of Niger State.
Through consultations with local stakeholders, it became clear that community participation is critical in addressing development challenges. For instance, Nana, a 24-year-old woman with a hearing impairment, received maternal and infant nutrition counseling, as well as medications, in her settlement through the project. Other disabled residents also expressed excitement about their inclusion. Previously excluded from interventions, they now have access to nutrition education and medications at their doorstep, significantly reducing their exclusion.
To eliminate discrimination against PwDs in nutrition service delivery, it is crucial for the government, private sector, and international organizations to align policy with practice. This includes raising awareness and advocating for policies and legislation that protect the rights of PwDs in all forms.
The establishment of the National Commission for People with Disability by the Federal Government of Nigeria in 2019, and the subsequent creation of Disability Commissions in various states, are positive developments. Many development organizations now include disability in their work policies. However, ensuring that PwDs in Nigeria have access to nutrition services requires bridging the gap between policy and practice. All stakeholders must collaborate to dismantle discriminatory norms by creating inclusive infrastructures, as mandated by law, to ensure that every individual, regardless of ability, has access to essential health and nutrition services. This noble mission must be sustained until true equality is achieved.
