Treatment of malnutrition and malaria

In Niger, one in four children does not reach the age of 5.

Malnutrition and a lack or absence of primary health care are the main causes.  ALIMA in partnership with BEFEN (Welfare of Women and Children in Niger, Nigerien Association) campaigns in one of the worst affected areas, the Zinder region to the east, against malnutrition and malaria in children in the most vulnerable age group; the under fives.

Context : Extremely high levels of endemic malnutrition and malaria

Niger, situated in the heart of the Sahel, is a country of about 14 million inhabitants. According to the WHO in Niger, «health indicators are below the international minimal standards due to low level of education, poverty, malnutrition and limited access to drinkable water and basic wastewater treatment”. Niger has the fourth highest child mortality rate in the world: one child out of four does not reach the age of five.

The very high level of infant mortality can be explained by widespread malnutrition.  This is assessed by both widespread chronic malnutrition, i.e. that which leads to stunted growth in children, and acute malnutrition, i.e. that which restricts normal weight gain in relation to a given age/size.  In the Niger, chronic malnutrition is estimated at 50%, with the Zinder region reaching 60%.

A country in which the percentage of inhabitants suffering from malnutrition is higher than 15% is considered to be a country in a state of emergency. This percentage of 15% is exceeded every year in Niger – despite a relatively stable political situation and the absence of a particular nutritional crisis in Niger. This high mortality rate is, among other reasons, the result of a strong prevalence of certain pathologies, especially deadly for children, such as malaria, diarrhea and measles and difficult accessibility of primary and secondary health care.

Despite important progress realized in the treatment of malnutrition, especially the adoption of an adapted treatment protocol by the Nigerien authorities, the coverage of treatment of malnourished children in Niger is still greatly insufficient, with only 20% of severely malnourished children being treated properly.

ALIMA intervention

The Zinder region, one of the areas where the nutritional situation has been the most worrying for several years: 17.8% of MAG and an infant mortality rate higher than the emergency threshold of 200 deaths/10.000/per day.

Wellbeing of Women and Children in Niger (BEFEN – Rayuar Iyali) is a humanitarian association under Nigerian law founded in 2002 by a group consisting mainly of Nigerian doctors.  Non-political, its purpose is to “promote the well being of women and children in Niger in the areas of health and education.”

Together ALIMA and BEFEN work with various participants to support the Niger Ministry of Health in order to reduce child mortality.  UNICEF provides therapeutic food and medicine for the Mirrah malnutrition treatment centres.  WFP (World Food Programme) provides food for accompanying mothers.  ALIMA and BEFEN ensure health care quality and good operational management of the project.

The ALIMA / BEFEN programme ensures appropriate care according to the child’s state of health: out patient care or hospital care.  Severely malnourished children who do not have medical complications and those with uncomplicated malaria are not hospitalised, and are treated as out patients. ALIMA/BEFEN ensures hospital care for children in need of more intense medical care.

To do this, ALIMA provides support to existing human resources, in appliances and medical equipment and training at the 15 Ambulatory Nutritional Rehabilitation centres for the treatment of severe acute malnutrition (CRENAS) in the Mirriah district, and the Intensive Nutrition Rehabilitation Centre (CRENI) in Mirriah hospital.

ALIMA continues its active support to BEFEN with a dual objective of high quality care and management in order to move towards BEFEN autonomy.

ALIMA has also trained 75 local officers and 120 community officers in the early detection of severely malnourished children within the community.  Early detection can not only save lives but also limit or even avoid the after effects of malnutrition.

Niger: ALIMA’s Intervention in figures

Patients: In 2010, more than 26,000 children under 5 years old were supported within this programme, as well as 32,000 malaria cases.  ALIMA / BEFEN have hospitalised more than 4,500 children since the project began.

2010 budget: 1,719,000 euro

In 2009, 4,500 severely malnourished children and 1,000 severe cases of uncomplicated malaria were cared for, and 600 children hospitalised in the paediatric unit integrated into Mirriah district hospital..

2009 budget: 320 000 euro

This ALIMA / BEFEN joint project is funded by ECHO, UNICEF, the Swiss branch of Doctors Without Borders and the Irish NGO GOAL.