Evaluation of nutrition therapeutic program, Katsina, Nigeria

Objective 

to estimate the prevalence of acute malnutrition among children aged 6-59 months of the LGAs of Jibia, Katsina and Mashi at the same time as the nutrition survey carried out the previous year, to compare and monitor changes in the nutritional situation.

Methodology (for 2024 but recurring in previous years) 

a cross-sectional nutritional survey based on the Standardised Monitoring and Assessment of Relief and Transitions (SMART) methodology with nested vaccination coverage surveys conducted from July 20th to 31st, 2024. A standard two-stage cluster sampling method was used in which we randomly selected clusters using systematic sampling with probability proportionate to population size (PPS) in the first stage and in the second stage households selected by systematic random sampling method. The sampling in each LGA was done independently with 36 clusters in Mashi, 36 clusters in Jibia and 41 clusters in Katsina. In each selected cluster, 13 households were selected for the survey. Three insecure wards of Jibia were excluded from the selection process (Faru, Gangara and Gurbi). Nutrition status of children 6-59 months was assessed using mid-upper arm circumference (MUAC), bilateral pittng oedema, and Weight-for-Height Z-score (WHZ).

Results

In 2022, the Global Acute malnutrition (GAM) prevalence by combined WHZ and/or MUAC and/or oedema was 

• In Jibia, 18.4 % (95% CI 15.3 – 22.0), including Severe Acute Malnutrition (SAM) of 3.2% (95% CI 1.7 – 5.8). 
• In Katsina, 21.1 % (95% CI 17.1 – 25.8), including SAM of 5.4% (95% CI 3.7 – 7.8).
• In Mashi, 27.4 % (95% CI 22.2 – 33.2), including SAM of 7.1% (95% CI 4.7 – 10.6).

 In 2023, the GAM prevalence by combined WHZ and/or MUAC and/or oedema was 

• In Jibia, 17.4% (95%CI 13.7 – 21.8), including SAM of 2.9% (95% CI 1.6 – 5.2). 
• In Katsina, 14.6% (95%CI 11.3 – 18.8), including SAM of 4.1% (95%CI 2.6 – 6.5). 
• In Mashi, 26.6% (95%CI 21.7 – 32.2), including SAM of 8.8% (95%CI 6.2 – 12.3).

In 2024, the GAM prevalence by combined WHZ and/or MUAC and/or oedema was 

• In Jibia, 30.7% (95% CI 26.6 – 35.2) and SAM of 6.8% (95% CI 4.9 – 9.4). 
• In Katsina, 24.5% (95% CI 21.1 – 28.3) and SAM of 9.0% (95% CI 7.0 – 11.5). 
• In Mashi, 33.4% (95% CI 28.2 – 39.0) and SAM of 14.4% (95% CI 10.8 – 19.1).

In 2024, The nutrition program reached a point coverage of 13.5% of eligible children according to admission criteria in Jibia, 20.8% in Katsina and 6.1% in Mashi. Fever prevalence in the last 2 weeks was 10.2% among children 6-59 months old in Jibia, 16.9% in Mashi and 19.1% in Katsina. Among children with fever, 83.2% sought treatment for fever in Katsina, 88.1% in Mashi and 91.0% in Jibia. When no care was sought, the primary reasons given were the belief that the child is not sufficiently unwell to need treatment (44.4% in Katsina), purchasing medication from the market (57.1% in Jibia and 27.8% in Katsina), or high cost of treatment / expensive transportation costs. 

Routine measles vaccination coverage is highest in Jibia at 96.3%, while Katsina and Mashi have lower rates of 83.0% and 84.0%, respectively. During mass campaigns, Jibia maintains its high coverage of 96.3%, with Katsina at 75.9% and Mashi at 89.5%.

Conclusion

In 2024, the nutritional situation in Katsina, Jibia, and Mashi LGAs has deteriorated further than in 2023, with high levels of GAM and SAM representing a critical food crisis classified as phase 4 according to Integrated Food Security Phase Classification (IPC). The situation requires interventions not only in case management but equally in the prevention of malnutrition.