A Qualitative Exploratory Study of the Political Commitment for Nutrition Programming: A Case Study of Anambra and Kebbi States of Nigeria

In Nigeria, varying levels of malnutrition across states present a critical challenge to public health, demanding tailored policy responses. This paper delves into the specific issues and dynamics influencing nutrition programs in the country. Advocating for nutrition-sensitive actions requires analyzing context-specific political commitment. This article presents a case study on two Nigerian states with varying malnutrition profiles to explore the political economy of nutrition. The study used stakeholder analysis, in-depth interviews, and semi-structured interviews through workshops, incorporating the Political Commitment Rapid Assessment Tool. The objective was to measure political commitment, the window of opportunity for action, and stakeholder analysis. The results showed that despite having a significant child malnutrition problem, Kebbi State received a high political commitment to nutrition, with proportions ranging from 0.67 to 1 in each of the six domains measured. On the other hand, Anambra State, where malnutrition was less severe, had varying commitment levels. Institutional commitment was marginally high (0.67), expressed commitment was high (0.71), and budgetary commitment was lower at 0.33. Kebbi had better support for programs dependent on foreign donors than Anambra. Both states need to use media to increase awareness about nutrition issues. When the nutrition situation is severe, foreign donors' influence grows. In conclusion, there are opportunities for strategic framing and advocacy of the nutrition profile of the states. Local state media can be effective, and institutional coordination committees that include various sectors already facilitate commitment to nutrition actions. However, individual, uncoordinated sectoral action can counterbalance the benefits of these committees. Further possibilities to generate political commitment for nutrition in the states are available. This study not only offers insights into the effectiveness of political strategies in addressing malnutrition but also lays the groundwork for future research and provides actionable recommendations for government policymaking.

Maternal mortality ratio in selected rural communities in Kebbi State, Northwest Nigeria

Background

Maternal mortality remains a topical issue in Nigeria. Dearth of data on vital events posed a huge challenge to policy formulation and design of interventions to address the scourge. This study estimated the lifetime risk (LTR) of maternal death and maternal mortality ratio (MMR) in rural areas of Kebbi State, northwest Nigeria, using the sisterhood method.

Methods

Using the sisterhood method, data was collected from 2917 women aged 15–49 years from randomly selected rural communities in 6 randomly selected local government area of Kebbi State. Retrospective cohort of their female siblings who had reached the childbearing age of 15 years was constructed. Using the most recent total fertility rate for Kebbi State, the lifetime risk and associated MMR were estimated.

Result

A total of 2917 women reported 8233 female siblings of whom 409 had died and of whom 204 (49.8%) were maternal deaths. This corresponds to an LTR of 6% (referring to 11 years before the study) and an estimated MMR of 890 deaths/100,000 live births (95% CI, 504–1281).

Conclusion

The findings provide baseline information on the MMR in rural areas of the State. It underscores the need to urgently address the bane of high maternity mortality, if Kebbi State and Nigeria in general, will achieve the health for all by year 2030 as stated in the Sustainable Development Goals (SDGs).

Electronic supplementary material

The online version of this article (10.1186/s12884-018-2125-2) contains supplementary material, which is available to authorized users.