Nigeria’s Malnutrition Funding Crisis: Why Lagos and Other States Must Increase Investment

Nigeria faces a profound and persistent malnutrition crisis, with devastating consequences for child survival and national development. A stark funding gap threatens to undermine progress, as revealed by the Civil Society Scaling Up Nutrition in Nigeria (CS-SUNN). According to CS-SUNN, only a small cluster of states is making substantial and consistent financial commitments to combat child undernutrition, while the majority, including economically significant Lagos, are failing to match their resources to the scale of the problem. This analysis examines the critical state of malnutrition funding in Nigeria, evaluates the performance of states under the Child Nutrition Fund (CNF) mechanism, and outlines the urgent steps required to avert a catastrophic failure to treat severe acute malnutrition nationwide.

Introduction: A Deepening Crisis of Commitment

The statistics on malnutrition in Nigeria are alarming. Millions of children suffer from stunting, wasting, and micronutrient deficiencies, conditions that weaken immunity, impair cognitive development, and increase mortality risk. While the technical solutions for treatment and prevention are well-established, the primary constraint is financial. The Executive Secretary of CS-SUNN, Mr. Sunday Okoronkwo, states the core challenge plainly: the magnitude of the malnutrition problem vastly outweighs the funds currently allocated. This malnutrition funding crisis is not uniform across the country; it reveals a disturbing geography of commitment, where political will and budgetary priority are concentrated in a few regions, leaving vast populations unprotected. The recent re-approval of funds by Lagos State, while a positive step, is cited as insufficient given the state’s population and disease burden, symbolizing a broader national failure to treat nutrition as a fundamental development priority.

Key Points: State-by-State Performance on Nutrition Funding

CS-SUNN has rated Nigerian states based on the size, consistency, and timeliness of their financial contributions to the Child Nutrition Fund. This creates a clear hierarchy of commitment.

Top Performers: Leading by Example

• Kano State: The undisputed leader, consistently committing and releasing approximately N600 million annually. This sustained investment ensures a steady supply of life-saving Ready-to-Use Therapeutic Foods (RUTF) and medicines in primary healthcare centres and outpatient therapeutic programme (OTP) sites.
• Kaduna State: Commits N400 million annually.
• Zamfara and Kebbi States: Both have committed N500 million (Kebbi’s for 2025).
• Jigawa and Katsina States: Commit N250 million each, with Katsina increasing its commitment to N450 million for 2025.
• Borno and Niger States: Commended for the timely release of their pledges (N100m and N250m respectively), ensuring commodities are available when needed.

Mid-Level Performers: Commitment with Implementation Gaps

• States like Adamawa (N100m in 2023/2024; N300m pending for 2025), Oyo (N233m), Plateau (N300m), and Ebonyi (N150m) have made pledges.
• Critical Issue: For these states, delays in fund release are common. This leads to stock-outs of nutrition commodities and inconsistent treatment services, meaning children still fall through the cracks despite official commitments.

States Lagging Behind: The “Sideline Watchers”

• Numerous states, particularly in the southern region, have either not joined the CNF or treat nutrition funding as a non-recurring, low-priority budget line.
• CS-SUNN warns these states are “watching from the sidelines” as a limited-time opportunity for pooled funding and matched support potentially expires, leaving children without treatment.

Background: The Child Nutrition Fund and Nigeria’s Malnutrition Burden

To understand this crisis, one must grasp the structure of the response and the scale of the need.

The Scale of the Problem

Nigeria bears one of the highest burdens of child malnutrition globally. Key indicators include:

• Approximately 2.5 million children suffer from severe acute malnutrition (SAM) annually.
• Only about one in three of these children with SAM currently receives the life-saving treatment they need, according to CS-SUNN.
• A 68% funding gap exists for nutrition treatment and human resources, as highlighted by a UNICEF report referenced by CS-SUNN. This gap covers costs for therapeutic foods, medicines, and the trained health workers required to manage treatment programs.

The human and economic cost is immense, contributing to over 50% of under-five mortality and perpetuating cycles of poverty and poor productivity.

The Child Nutrition Fund (CNF) Mechanism

The CNF is a pooled funding initiative designed to catalyze state government investment in nutrition. Its key features include:

• Matching Funds: It often operates on a model where donor partners match state government contributions, effectively multiplying the impact of each naira spent.
• Focus on Commodities: Funds are primarily used to procure essential, ready-to-use therapeutic foods (RUTF), medicines, and micronutrient supplements.
• Service Delivery: The goal is to ensure these commodities are consistently available at Primary Healthcare Centres and OTP sites for community-based management of acute malnutrition.
• Time-Bound: CS-SUNN cautions that the CNF window is not open indefinitely. There is a finite period for states to access this matched funding opportunity.

The fund represents a strategic, cost-effective mechanism to close the treatment gap, but its success is entirely dependent on consistent state government budget allocations and releases.

Analysis: Political Will vs. Population Need

The data from CS-SUNN reveals a critical disconnect between a state’s financial capacity, its population’s malnutrition burden, and its actual budget commitment.

The Lagos Paradox: High Revenue, Inadequate Nutrition Investment

Lagos State, Nigeria’s economic hub with one of the largest populations and internally generated revenues, is highlighted as a case of underperformance relative to its capacity.

• Governor Babajide Sanwo-Olu re-approved and released N100 million to the CNF. While this is a formal commitment, CS-SUNN argues it is grossly insufficient.
• Why it’s insufficient: Lagos has a massive population of pregnant women and children. The risk of low birth weight and malnutrition is high. The N100 million allocation likely covers only a tiny fraction of the required Multiple Micronutrient Supplements (MMS) for antenatal care and RUTF for treating SAM cases.
• Okoronkwo warns that insufficient MMS supply “sets children up for malnutrition” from birth, creating a preventable pipeline of disease.
• The implication is that Lagos is not prioritizing nutrition in its budget in a manner commensurate with its wealth and the health needs of its citizens. This represents a failure to translate economic strength into foundational human development outcomes.

The Northern Leadership Model: Consistency and Impact

States like Kano, Kaduna, and Jigawa demonstrate that political will is the primary driver. Their success is characterized by:

• Early and Annual Commitment: Budgeting for nutrition as a recurring, annual line item, not an ad-hoc expense.
• Prompt Release of Funds: Ensuring allocated money is disbursed in a timely manner to avoid supply chain disruptions.
• Ownership: Moving away from reliance on donor projects and taking “ownership of the malnutrition challenge,” as noted by CS-SUNN.
• Tangible Results: This consistent approach has “stabilised treatment services” in high-burden communities, directly saving lives.

This model proves that with dedicated leadership, even states with significant poverty can marshal resources to address a health crisis. It also suggests that cultural prioritization of the issue and effective advocacy by civil society and health officials play a key role.

The Federal Government’s Pending Role

The federal government’s pledge of N1.2 billion to the CNF remains unreleased. This is a critical missing piece. As a coordinating body and a significant funder in health, the federal government’s release would:

• Signal national priority and encourage reluctant states to follow suit.
• Provide a substantial injection to the pooled fund, increasing the overall matching capacity for all states.
• Help sustain the CNF mechanism itself. The failure to release this pledge undermines the entire partnership model.

The federal government’s action is not just about money; it’s about setting the tone for sub-national governments.

Practical Advice: A Roadmap for Action

Addressing the malnutrition funding crisis requires coordinated action from multiple stakeholders.

For State Governments (The Primary Duty-Bearers)

1. Conduct a Nutrition Budget Analysis: States must quantify the exact cost of covering all children with SAM and all pregnant/lactating women with MMS within their jurisdiction. This creates a evidence-based funding target.
2. Integrate Nutrition into Annual Budgets: Allocate a specific, adequate, and recurrent line item in the state’s annual budget for the CNF or direct procurement of nutrition commodities. Aim for a minimum benchmark (e.g., N500 million for larger states, scaled for population and burden).
3. Ensure Timely Release: Establish a fast-track disbursement mechanism for nutrition funds to the State Primary Healthcare Board to prevent stock-outs. Link release to procurement and distribution schedules.
4. Strengthen Supply Chains: Invest in last-mile distribution systems to move commodities from state stores to primary health centres and OTP sites reliably.
5. Lagos-Specific Action: The Lagos State Government must immediately review its N100 million allocation against a needs-based costing. Given its GDP, a commitment in the range of N1-1.5 billion annually would be a credible starting point to match its population’s needs.

For the Federal Government

1. Release the N1.2 Billion Pledge Immediately: This is non-negotiable to sustain the CNF and demonstrate leadership.
2. Advocate and Convene: The Federal Ministry of Health and Budget Office should host a forum for states to share best practices (like Kano’s model) and peer-pressure laggards into action.
3. Strengthen Regulatory Frameworks: Consider policies that incentivize state investment in nutrition, potentially linking it to certain health grants or performance-based allocations.

For Civil Society and the Media

As urged by Geoffrey Njoku of True Communications, the media must shift its narrative.

• Reframe Nutrition: Position it not as a “charity” or narrow social issue, but as a core governance, economic productivity, and national security issue. Link malnutrition to future workforce capacity, education outcomes, and GDP growth.
• Accountability Reporting: Move beyond event coverage. Track and report on state budget allocations for nutrition, the timeliness of fund releases, and commodity availability at health facilities. Use data to name and praise or shame.
• Humanize the Data: Tell the stories of children being saved in Kano and those going untreated in Lagos. Feature voices of mothers, community health workers, and local officials.
• Demand Transparency: Advocate for public disclosure of state nutrition budgets, expenditure reports, and supply chain data.

CS-SUNN’s media training is a step in this direction, aiming to create a cadre of “catalysts” for an anaemia-free (and by extension, malnutrition-free) Nigeria.

FAQ: Frequently Asked Questions on Nigeria’s Nutrition Funding

What is the Child Nutrition Fund (CNF)?

The CNF is a pooled financing mechanism in Nigeria, primarily supported by donors like UNICEF and the Foreign, Commonwealth & Development Office (FCDO). It provides matching funds to state governments that commit their own resources to procure essential, life-saving nutrition commodities (like RUTF and MMS) for the treatment of severe acute malnutrition and prevention of micronutrient deficiencies.

Why is Lagos State specifically criticized despite its wealth?

Lagos is criticized because its financial contribution (N100 million) is grossly disproportionate to its population size (estimated over 15 million), its internally generated revenue (over ₦1 trillion annually), and the high absolute number of children and pregnant women at risk of malnutrition within its borders. It symbolizes a failure to translate economic capacity into foundational health investments.

What is the role of the Federal Government in state nutrition funding?

The Federal Government’s role is multifaceted: 1) It has pledged N1.2 billion to the CNF, which if released would significantly boost the fund’s capacity. 2) It provides overall policy guidance and coordination through the National Primary Health Care Development Agency. 3) It can use its convening power to advocate for state-level action and share best practices. 4) It is responsible for the national nutrition strategy and ensuring states adhere to their constitutional obligations regarding health.

What happens if states do not increase funding?

The consequences are dire and measurable:

• Continued stock-outs of RUTF at treatment centres.
• Only 1 in 3 children with severe acute malnutrition will receive treatment; the other 2