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CHILD NUTRITIONAL SUPPLEMENTATION PROGRAM (SCHOOL MILK PROGRAM)

CHILD NUTRITIONAL SUPPLEMENTATION PROGRAM (SCHOOL MILK PROGRAM)
In February 2003, the Lagos State Government under the leadership of Governor Bola Ahmed Tinubu initiated the Child Nutritional Supplementation Program with its first phase as the School Milk Programme. The programme was designed to provide 10 fluid oz of constituted milk drink to primary one pupil in the State Public Primary Schools, twice per week during the academic session, with the aim of positively impacting their dietary intake, functional capabilities as well as school performance, school attendance and enrolment.
The programme has been sustained in spite of all odds by the visionary leadership of Governor Babatunde Fashola, SAN, with the understanding that nutritional supplementation of children in their formative years (i.e. 0-5 years, and 6-18 years) is crucial to their development and academic performance.
Since the inception of the School Milk Programme till date, a total of 26,963,328of10gms sachets of milk have been distributed to 587,845Primary one pupils in Lagos State Public Primary Schools, and the State Public Schools have also recorded steady increase in enrolment to primary one 0.5% increase in 2003 to approximately 4.2% increase in 2010.
The Programme continues to provide twice weekly milk drink to primary one Pupil in all the State public schools through scheduled allocation of milk directly to the school head teachers at designated points closest to the individual schools. The head teacher is therefore held accountable for timely consumption of the milk drinks by the Pupils.
The programme is supervised and monitored by nutrition Officers in the State and focal nutrition officers at the LGAs. Officers from SUBEB also monitor the programme, while stakeholders meet from time to time in the Ministry of Health to address issues concerning the programme.
S/N YEAR No of Schools No of Pupils Quantity of milk given in sachets
2003/2004 981 52,810 4,119,180
2004/2005 981 57,429 4,479,462
2005/2006 981 64,435 5,025,930
2006/2007 981 43,970 1,670,852
2007/2008 981 42,388 1,127,964
2008/2009 901 43,383 1,610,752
2009/2010 1,008 50,440 1,534,018
2010/2011 1,008 53,585 1,550,210
2011/2012 1,023 60,080 2,766,720
2012/2013 1,023 60,025 1,918,080
2013/2014 1,023 59,300 1,160,160
TOTAL 990 587,845 26,963,328

A total of 112,347 cartons of milk powder were distributed

IMPACT:
– Improvement in the academic and general school performance noticed in the Pupils.
– Enrolment into public primary schools improved.

2. MANAGEMENT OF SEVERE ACUTE MALNUTRITION (SAM) MODERATE ACUTE MALNUTRITION (MAM)
Screening, Rehabilitation and Follow-up: Children 1-5 yrs for Malnutrition and Management.
Malnourished children indentified were rehabilitated with RUTF (High Energy Biscuits) which was supplied by UNICEF in the past. In the recent times, malnourished children are managed and rehabilitated with “A Food, developed and produced by Nutrition Unit consist of local ingredients ready to use malnutrition rehabilitation meal (RUTF) known as ‘’Eko baby chop up’’ for management of uncomplicated/severe malnourished children.
Care givers were also encouraged to enroll for Food Demonstration Classes and Nutrition Education Sessions in all the LGAs and LCDAs Primary Health care Centers (PHC) in the state.
The State also established 1,128 community volunteers (3 per ward) as Community Malnutrition Trackers for early identification of malnutrition/referral within the locality to the nearest PHC.
MALNUTRITION SCREENING2009 – 2014.
S/N Year Number Screened Number Malnourished Rehabilitated Number Rehabilitated
1. 2009 243,453 883 450
2. 2010 1,011,374 3803 2281
3. 2011 1,377,743 3519 3428
4. 2012 2,870,238 3734 3,644
5. 2013 3,342,233 1,012 1,006
6. 2014 1,682,135 437 281
TOTAL 10,527,176 13,388 11,090
NB: Number not rehabilitated- did not return, and gave fake residential addresses
However, three secondary facilities were identified for facility based management of SAM namely:
• Massey Children Hospital on Lagos Island
• LASUTH in Ikeja
• General Hospital, Agbala, Ikorodu LGA..
3. MICRONUTRIENTS:
3.1 VITAMIN A ADMINISTRATION, UTILIZATION AND DISTRIBUTION.
Administration of Vitamin A supplements to Children 6-59 months and 6-8 weeks post partum mothers. The supplementation for the children is to prevent blindness, improves healing process and reduces the susceptibility to measles disease during their formative years. Monitoring is carried periodically to promotion the use of micronutrient fortified foods, such as iodised salt, fortified flour, sugar, Palm and vegetable oil by the citizens. Routine supplementation from 6 months is on-going in all PHCs however below is the Maternal, Newborn and Child Health Week trend between 2010 and 2014
YEAR TARGET NO SUPPLEMENTED % COVERAGE
R1 2010 3,416,664 835,492 25
R2 2010 1,828,114 54
R1 2011 1,899,180 620,422 33
R2 2011 1,610,535 85
R1 2012 1,959,954 1,566,992 80
R2 2012 1,935,256 99
R1 2013 2,022,672 2,000,314 99
R2 2013 1,464,067 72
R1 2014 2,087,398 1,674,381 80
R2 2014 2,188,139 105

Routine Vitamin A supplementation
YEAR Attendance Vitamin A given (6-59months) Attendance Post partum
2013 162,540 160,203 23,288 22,325
2014 626,766 598,368 191,156 626,766
3.2 IODINE DEFICIENCY CONTROL
Promotion on the use of iodized salt through various communication channels. Regular salt testing at markets, schools and household samples for iodization.

IMPACTS: Nigeria attained USI certification in 2007, and salt testing exercise in markets, schools/ households ongoing
4. .PROMOTION, PROTECTION AND SUPPORT FOR EXCLUSIVE BREASTFEEDING (EBF) PRACTISES
Activities carried out for EBF included Capacity Building of Health Workers / Mothers on appropriate positioning and attachment for sustainable breast feeding practices,
Counselling during ante-natal visits of pregnant women,Media promotion of exclusive breastfeeding practices,Promotion on early initiation of breastfeeding, Promotion of family/community support to breastfeeding and Promotion of infant nutrition (exclusive breastfeeding) in the context of HIV/AIDS.
Data generated from the PHCs

EXCLUSIVE BREASTFEEDING
(0-6months)
YEAR
Total attendance
(0-6 months) No. EBF
2010 715,869 635,274
2011 706,308 622,654
2012 749,878 674,682
2013 766,545 682,682
2014 607,763 551,768
Expectation: Promotion and support of exclusive breast feeding from 0-6months of child’s life and continuous breast feeding with appropriate complementary feeding to 2 years of age and beyond.
5. CAPACITY BUILDING OF HEALTH WORKERS AND COMMUNITIES MEMBERS ON ESSENTIAL NUTRITION INTERVENTIONS AND ACTIONS
Training of nutrition focal persons and other health workers at the Local Government Areas (LGAs)/Primary Health Care Facilities on essential nutrition interventions/actions.
Establishment of 1,128 community volunteers as community malnutrition trackers/community at 3 per ward in year 2013.

Capacity building of 20 nutrition focal persons and 249 PHC nutrition liaison persons on malnutrition screening and community level management/referral.

Capacity building of 240 Lagos state volunteer health workers on malnutrition screening and community level management/referral.

Capacity building of 250 midwives in selected private health facilities in year 2012 (100 participants), 2013 (100 participants) and year 2014 (50 participants) on early initiation/essentials of breastfeeding to infant and young child survival.

Family enlightenment seminar on essential breastfeeding issues for 714 community/NYSC members at the three (3) senatorial districts.114 participants in year 2012, 300 participants in year 2013, 300 participants in year 2014.

Sensitization meeting for medical officers of health (MOH)/apex nurses on the activity of community volunteers as malnutrition trackers, referral and follow –up.
IMPACT: Empowerment of LGA nutrition focal persons and relevant health workers for effective nutrition service delivery.
Continuous community malnutrition screening activity within each ward or community in the state.

Community/youth corps members empowered on relevance of b breastfeeding in todays’ changing world.

Decrease in malnutrition rate in the state.

Mid wives of selected private health facilities are carried along their contemporaries at the public health facilities on essentials of breastfeeding, thereby increasing the scope of breastfeeding impact on the infant and young children.

MOHs/apex nurses sensitized on activities of community volunteers as malnutrition trackers/referral.

6. PUBLIC AWARENESS CAMPAIGN
• Media (TV/Radio) appearances on essential nutrition issues
• Press Release/Briefing on essential nutrition actions
• Production/Distribution of IEC materials for behavioural change of the citizenry.
IMPACTS:
Promotion of essential nutrition knowledge amongst the populace.

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