Feeding Trust: Nigerian Community Mobilizers Fight Not Just Polio, But Malnutrition

"Clearly, polio eradication efforts must now be seen as a piece of the larger puzzle of child survival. Networks established to end polio are beginning to help provide other life-saving benefits for children."

This reflective piece explores the strategy of integrating polio vaccination with other children's health concerns in Bichi, Kano State, Nigeria. It uses as a springboard the on-the-ground efforts of a woman named Hauwa Ibrahim, who is one of over 3,000 Volunteer Community Mobilisers (VCMs) in Nigeria who work in settlements where a high number of caregivers do not accept polio immunisation for their children. The VCMs work largely in the most underserved communities, which have been traditionally marginalised and lack basic health facilities. As detailed here, "these women are increasingly emerging as vanguards for promotion, demand creation and accountability for other services, including malnutrition." In Nigeria's Kano State, nearly one in five children dies before reaching their fifth birthday. Malnutrition rates show that 37% of children under five are underweight (15% of them severely); 54% are stunted (33% severely); and 11% show wasting (3% severely).

According to the article, previously, Hauwa's visit to a child's home would have almost exclusively focused on counseling his or her parents about the importance of accepting the polio vaccine. Now, thanks to the expanded VCM training she received, she also looks out for signs of severe acute malnutrition, measuring infants' arms to assess nutritional status during her polio community mobilisation visits. She then helps parents get treatment at a CMAM (Community-based Management of Acute Malnutrition) centre.

One of the children's stories told here indicates that "[b]y giving the right advice at the right time, Hauwa brought Usman's parents on board as active supporters in her mission to increase caregiver acceptance to polio immunization. 'We like the way she works and her genuine care and concern,' says Abdul, adding that he tells his friends not to oppose polio immunization for their children, now that Hauwa has explained the benefits. 'Many of us used to think the polio vaccine was a plot by Western countries to make our children impotent. Not anymore.'"