malnutrition

Every Thursday, 35-year-old Fatima Sani joins hundreds of other women from neighbouring communities across Demsa, a local government area in Adamawa State, northeastern Nigeria, to obtain Ready-to-Use Therapeutic Food (RUTF) for her one-year-old malnourished daughter at the Demsa Primary Healthcare Centre. The mother of nine has made several trips to the centre to ensure her daughter recovers from malnutrition. Her treatment includes RUTF, a paste made from powdered milk, peanuts, butter, vegetable oil, sugar, and a mix of vitamins and minerals. A sachet contains 500 calories and essential micronutrients. 

“My youngest children are twins, and both of them were diagnosed with malnutrition,” Fatima told HumAngle. “One of them has been declared healthy and discharged by the centre, so I no longer bring him here, but I come to obtain RUTF for his twin, and hopefully, she recovers and gets discharged too.”

She noted that the twins were the only children in her household ever to be diagnosed with malnutrition in her household. When asked what the cause might be, Fatima replied: “Hunger.” 

She sells fresh vegetables at the local market in Demsa, and her husband, whom she referred to as Sani, is a rice farmer. She explained that most of his harvest is kept for household consumption, while the rest is sold to meet other needs. Then, a disaster repeatedly washed away his produce. 

“For three years in a row now, floods have been destroying my husband’s farm,” she said, adding that the destruction in 2025 left him devastated. “The rice had reached maturity, but on the expected day of harvest, the flood came and washed everything away.” 

‘Food is scarce’

UNICEF, in its 2025 report, highlighted that flooding is worsening the nutrition crisis in Adamawa, as the destruction of farmlands, disruption of livelihoods, displacement of households, and damage to health and nutrition facilities have all contributed to reduced access to food and essential nutrition services in the state. This has led to a surge in malnutrition levels, doubling the previous year’s estimates and placing children, pregnant women, and lactating women at increased risk. 

After the flood ravaged her husband’s farm, Fatima said, feeding her family became extremely difficult. “We now eat once or twice a day. Some days, there is nothing at all,” she said.  She added that her husband, Sani, left Demsa about two months ago in search of greener pastures due to feeding difficulties in their household. 

Helen Daniel, another woman who collects RUTF for her malnourished granddaughter at the healthcare centre in Demsa, told HumAngle that the 20-month-old child was almost dying when she first saw her. “I had gone to the village to check on my daughter when I noticed that my granddaughter’s ribs were visible. At close to two years, she could barely stand, and she was struggling to keep her head firm,” Helen said.  

Her daughter and son-in-law are full-time farmers in Wuro-Laka, a nearby village in Demsa, so when floods ravaged rural communities around their area, including their farmland, they lost their only means of livelihood.

“Food is scarce, and they only eat what they can get,” Helen said. 

Since she had seen women trooping into the Demsa Primary Healthcare Centre with their children who exhibited the same symptoms as her granddaughter, Helen returned to Demsa town with the child after her visit and headed there too. There, the child was diagnosed with malnutrition in March.

“This is my sixth trip to the centre, and I can boldly say there has been a significant improvement in my granddaughter’s health since I started feeding her the RUTF. She has gained weight, and I can’t wait for her to start walking,” Helen said. 

Dr Innocent Agaba, Senior Registrar at the Department of Paediatrics, Modibbo Adama University Teaching Hospital, Yola, explained that malnourished children who are left untreated do not attain their full intellectual potential and may eventually die. “They will be duller than their peers, and they are literally going to be shorter and smaller than their peers,” he said. 

His observation is consistent with global research. Studies by the World Food Programme, World Health Organisation, and UNICEF have found that childhood malnutrition and stunting are linked to poorer cognitive development, reduced educational outcomes and delayed physical growth, with long-term consequences that can persist into adulthood.

The paediatrician also noted that malnourished children are prone to health complications and organ failures. 

Across flood-prone areas 

According to the Integrated Food Security Phase Classification, armed conflict, inflation, and extreme weather are the main drivers of acute malnutrition in Northern Nigeria, which is affecting about 6.4 million children aged 0 to 59 months, as well as 786,000 pregnant and breastfeeding women. 

The 2025 analysis shows that, of the 21 local governments analysed in Adamawa State, the malnutrition rate was reported to be in the Alert Phase (Phase 2), indicating a deteriorating nutrition situation requiring close monitoring and targeted interventions. Meanwhile, some LGAs in Borno were in the Critical Phase (Phase 4), meaning malnutrition levels had reached an emergency threshold, with a high risk of illness and death among affected children and urgent action was needed to prevent further deterioration.

The effects of repeated flooding on child nutrition are not limited to Demsa. Across Adamawa State, other flood-prone communities are facing similar challenges. In Imburu, a community in Numan Local Government Area of Adamawa State, families are also grappling with rising cases of malnutrition linked to the loss of farmland and livelihoods.

Twenty-one-year-old Shaawalatu Yakubu is one of the RUTF recipients at the primary healthcare facility in Imburu. She told HumAngle that her family is yet to recover from the devastating impact of last year’s flooding. The family relied on produce from their maize farm. Before the damage, she explained, her family’s needs were fully met, and her daughter was on a different meal plan that included soya beans and custard pap with milk, but now, the child is fed whatever is available.

“The flood washed away our maize farmland that reached maturity, including other farmlands and households in the area,” she said. 

Shaawalatu, who resides in Ngbalang, a neighbouring community around Imburu, receives RUTF for her malnourished daughter every Wednesday. “The RUTF is free, and I have seen changes in my daughter since I started feeding her with the supplement,” she said. 

Aisha Musa, whose son is being treated at Imburu Primary Healthcare Centre, said that the prices of foodstuffs in the area had gone up because most farmers are trying to make up for losses incurred in the previous flood. “One mudu of maize was ₦550 Naira, but now, it’s ₦750,” she said.  To help her son tackle the crisis, she feeds him soya beans and guinea corn pap alongside the RUTF supplement. 

An assessment conducted by the National Emergency Management Agency (NEMA) and the Adamawa State Emergency Management Agency (ADSEMA) in June 2025 found that over 9,000 hectares of farmland were destroyed by floods across Adamawa State, while over 23,000 people were displaced. Communities in Numan, including Imburu, Ngbalang, Lure, and Zangun, were severely flooded. Farmlands were submerged, and residents were forced to seek shelter in makeshift homes. 

Still, there’s a challenge 

Every registered woman receives 14 packs of RUTF per child each week across the state’s nutrition centres. Two sachets are to be administered daily. However, there are times when supply is inconsistent, and the children don’t meet the feeding standard.

Norah Noel, a healthcare provider at a nutrition centre in Fufore, another flood-prone local government area in Adamawa, said that RUTF shortages affect recovery rates among malnourished children in the region and that, despite assistance from the Adamawa State government and humanitarian agencies, these shortages persist. 

“Since last October, we haven’t had RUTF on the ground. The rate of malnutrition is increasing because we have plenty of cases that are coming,” she told HumAngle. 

Norah stressed that children aged six to 10 months are among the most affected in the region, adding that more cases are recorded during the rainy season because repeated flooding in the area causes food scarcity. 

The healthcare provider also explained that the Fufore facility, located in the town centre, is always overwhelmed with cases from neighbouring villages. Since there is a shortage of RUTF, Norah stated that the centre is seeking alternative measures to provide care for those affected, while critical cases are referred to larger healthcare facilities. 

She explained that some people spend an average of ₦6,000 to ₦10,000 on transport to reach the centre, only to be disappointed by RUTF shortages. 

“What we do is show them how to make Tom Brown,” Norah said. Tom Brown is a locally produced flour mixed with grains to prevent relapse in malnourished children. 

While the healthcare centre carries out outreach in some of the rural communities in order to reach the malnourished children, Norah believes some children might never make it to the facility, especially those in inaccessible areas. 

In June 2025, UNICEF revealed that over 400,000 children in Nigeria’s northeastern and northwestern regions would be at risk of imminent nutrition stockouts. This means a shortage of RUTF and Supplementary Food, with data indicating a reduction in overall partner and financial volume.  

According to the paediatrician, it is important for malnourished children to complete their full course of RUTF, which can last several weeks or even months. Recovery is considered complete only when a child reaches the recommended weight-for-height Z-score or when their Mid-Upper Arm Circumference (MUAC) returns to a normal range. 

Stopping treatment too early can undo any progress that has been made. “If a person begins to enjoy some benefits from some recovery and then stops, he just reverses back to his initial stage and returns to a pre-morbid state,” he said. 

Yet for many families in rural Adamawa, completing treatment is often easier said than done. During the rainy season, flooding frequently cuts off access to healthcare facilities, making it difficult for caregivers to obtain RUTF or attend follow-up appointments.

Smith Jocthan, the Facility Manager at Demsa Primary Healthcare Centre, told HumAngle that residents from communities like Kodomun, who rely on the facility for RUTF, do not usually show up during the rainy season. Other residents in Fufore raised a similar concern. 

“Their culverts have a problem. When it is flooding season, it’s not easy for them to come to the facility,” he said. 

For health workers on the frontlines, these access challenges underscore a broader problem. Both Jocthan and Norah identified flooding as a major driver of the malnutrition crisis in Adamawa. In Demsa, Jocthan said, repeated flooding is affecting children’s well-being.

Beyond the physical barriers created by flooding, health workers say social and cultural factors also hinder efforts to tackle malnutrition. Jocthan noted that certain misconceptions also contribute to the slow recovery rate in the region, which leads to low rates of discharge among the malnourished children in Demsa. “One such tradition among some people is that a child under five years should not eat eggs. Because if they do, they will become thieves. We know eggs are a source of protein, but most children are denied the opportunity of getting that protein,” he said.

Despite the setbacks, he said the facility is making progress. “This is because many are educated on how to prepare local foods. Before, there was no knowledge of that,” Jocthan said.

In May, Médecins Sans Frontières (MSF), an international humanitarian organisation, warned that malnutrition is no longer a seasonal emergency but a permanent feature of Nigeria’s humanitarian landscape, especially in the northern region, where cases are extremely critical. 

Dr Agaba stated that RUTF supplementation alone is far from enough. “One of the biggest challenges to dealing with malnourished children, especially in impoverished settings, is that people assume RUTF is enough,” he said. The paediatrician stressed the importance of other aspects, such as a healthy, well-fed mother, understanding of a balanced diet, and exclusive breastfeeding.

What to do with the floods?

A study on the causes and effects of floods in Adamawa State has identified the opening of dams, excessive rainfall, rising water levels, and poor drainage as major factors.

When floods pushed families out of their homes in the Benue River Valley in 2025, Agoso Bamaiyi, an environmental scientist, noted that the overflowing of the Benue River through its tributary, the Gongola, is the main driver of flooding in the region. Even though the expert acknowledged climate change and global warming as contributing factors to the rising frequency and intensity of floods, he argues that the Benue’s overflooding remains the central cause in Adamawa. He says dredging the Benue River and constructing a reservoir dam will address the flooding situation. 

In May, the National Emergency Management Agency (NEMA) met with the Adamawa State Governor, Ahmadu Fintiri, as part of its response to rising climate-related threats. Zubaida Umar, NEMA’s Director-General, disclosed that no fewer than 33 states are at risk of flooding this year, with Adamawa listed among the most vulnerable according to projections. 

Governor Fintiri has said that his administration is preparing ahead of the disaster. While measures such as monthly sanitation and drainage clearing are already in place, he emphasised the need for continuous sensitisation of residents in high-risk areas and revealed the government’s plan to establish temporary shelters to accommodate displaced persons in the event of flooding. 

Fintiri also advocated for stronger federal support so as to ease the impact of the flood on affected communities.

HumAngle reached out to the National Emergency Management Agency (NEMA) and the Adamawa State Management Agency (ADSEMA) for comments on their efforts to address the root causes of the flooding, but has not yet received a response. 

With little clarity on what is being done to prevent future flooding, families continue to grapple with its consequences on their own. Helen is determined to nurse her granddaughter to full health. “I will make sure she eats well and is taken care of, and once she recovers, I won’t send her back to the village but will live with her instead. I’m not sure she can survive another cycle of hunger,” she said. Fatima shares a similar hope for her child. She wants her daughter to fully recover and eventually get cleared of malnutrition, just like her twin brother. 

Médecins Sans Frontières (MSF), an international humanitarian organisation, has released its 2025 activity report for Nigeria, and the findings are sobering. The medical emergency organisation, also known as Doctors Without Borders, unveiled the report during an event in Abuja, North Central Nigeria, on Wednesday, May 13, documenting the disturbing rise in malnutrition cases in the country’s northern region.

With more than 3,500 workers delivering essential healthcare services across ten states, MSF reported treating over 440,000 children for malnutrition, more than 300,000 individuals for malaria, and assisting with over 33,500 deliveries in 2025.

This surge, according to the humanitarian organisation, underscores the fragility of Nigeria’s health system and the growing vulnerability of women and children in conflict-affected regions.

The 2025 report shows that MSF recorded more than 600,000 outpatient consultations, 48,000 inpatient admissions, and treated 341,239 patients for malaria, 38,753 children for measles, 6,123 patients for diphtheria, and 985 others for meningitis across its facilities in the region.

These findings are specific to the ten Nigerian states where MSF has been operating since 1996, including Jigawa, Kano, Katsina, Kebbi, Sokoto, Zamfara, and Cross River. The organisation says it has provided a wide range of essential medical services, including paediatric and maternal health care, treating children with malnutrition, responding to disease outbreaks, caring for survivors of sexual violence, offering mental health support, and performing life‑saving surgical interventions. 

The MSF country representative, Ahmed Aldikhari, revealed that in 2025, the organisation observed a pattern consistent with that of previous years, starting in 2022. Aldikhari stated that malnutrition is one of the year’s greatest challenges, linking it to the region’s fragile conditions, which are severely affected by insecurity that has worsened food security.

“We are seeing a vicious cycle where malnutrition is both a cause and a consequence of diseases such as measles, malaria, and diphtheria, among others, which continue to affect vulnerable communities, especially when healthcare is delayed or inaccessible,” he said, suggesting that Nigeria might soon experience the peak of the malnutrition crisis. 

“That is why we are consistently working side-by-side with the ministries of health, humanitarian affairs, budget and planning at the state and federal levels, and also, with our Nigerian colleagues to ensure that efficient services are provided, but they are not enough.”

HumAngle has previously reported on the broader impact of the crisis, stressing how displacements, insecurity, and climate change, among other natural and human-induced disasters, have compounded the problem. In July 2025, MSF, in collaboration with the Katsina State government, mobilised state and non-state actors to address the escalating malnutrition crisis in the northwestern region. 

During the 2024 MSF conference in Abuja, organised in collaboration with the North West Governors’ Forum and the Katsina State Government, stakeholders emphasised that malnutrition in the northwestern region is no longer a seasonal emergency but rather a structural crisis that requires urgent mobilisation. The governors acknowledged that insecurity and climate pressures were eroding food systems, but MSF urged greater investment in therapeutic feeding centres and preventive programmes.

Northern Nigeria continues to face a critical malnutrition crisis, with Katsina particularly affected, according to MSF’s 2025 activity report. Findings reveal that since 2021, MSF has been present in the state, with the organisation’s leadership revealing that they have witnessed a sharp rise in the number of malnourished children since responding to the growing crisis in recent years.

In 2025, MSF reported treating the highest number of malnourished children in Katsina. With the support of the state Ministry of Health, the organisation focused on preventing illness and malnutrition to reduce mortality and morbidity among children suffering from acute malnutrition.

“Katsina State has faced a chronic malnutrition crisis for over a decade, driven by insecurity, climate shocks, limited primary healthcare services, and high birth rates,” the report revealed. “Throughout 2025, MSF admitted 26,445 patients for inpatient care, provided treatment to 146,301 children through its outpatient centres, and conducted 15,387 outpatient consultations for malaria.”

In response to this, MSF established a new Ambulatory Therapeutic Feeding Centre (ATFC) in Mashi and a second inpatient therapeutic feeding centre at the Turai Yar’aduwa Hospital to handle the increased patient load during peak seasons.

Beyond nutrition in Kebbi, the report states that MSF responded to multiple infectious disease surges and outbreaks by tackling the increase in meningitis cases from February to May, while supporting the Ministry of Health facilities in Jega, Gwandu, and Aliero with logistics, medical supplies, staff training, and facility rehabilitation.

Following the escalating insecurity in neighbouring Zamfara and Niger that led to mass displacement to the Danko-Wasugu areas of Kebbi State as of June, the humanitarian organisation provided basic healthcare and distributed non-food relief kits to vulnerable households.

In Zamfara alone, MSF admitted 47,164 children to inpatient therapeutic feeding centres and provided 14,167 outpatient consultations in 2024, with numbers continuing to rise in 2025. According to Aldikhari, this increase in admissions is due to multiple overlapping crises, including conflict and insecurity in the northwestern and northeastern regions, which have displaced thousands of families, cutting them off from farmlands. 

While the 2025 activity report warns that malnutrition is no longer a seasonal emergency but a permanent feature of Nigeria’s humanitarian landscape, it also highlights the fact that the sheer scale of admissions suggests the crisis is outpacing the humanitarian response. 

Famine was confirmed in two places in 2025 – areas of the Gaza Strip and Sudan – the first such dual confirmation since formal famine reporting began, according to the Global Report on Food Crises (GRFC) 2026.

The annual report, produced by a coalition of 18 humanitarian and development partners, found that acute food insecurity remained widespread in 2025.

Across 47 countries and territories experiencing food crises, 22.9 percent of their populations – or about 266 million people – experienced acute food insecurity last year, a marginal rise from 22.7 percent in 2024 but nearly double the 11.3 percent recorded in 2016.

The proportion of analysed populations facing acute hunger has now stayed above 20 percent every year since 2020. In absolute terms, the number of people affected has grown from 108 million in 2016 to 265.7 million in 2025, having peaked at 281.6 million in 2023.

The GRFC cautioned that the slightly lower headline figure compared with 2024 mainly reflects a reduction in the number of countries covered – from 53 to 47 – rather than any real decline in needs.

Famine, catastrophe and emergency

Famine – the most extreme classification under the hunger-monitoring Integrated Food Security Phase Classification (IPC) system – was confirmed in parts of the Gaza Strip and Sudan in 2025. The risk of famine remained in other areas of Gaza, Sudan and South Sudan, and those projections extended into 2026.

According to the IPC, famine is when:

• At least 20 percent of households face extreme food shortages.
• Acute malnutrition affects more than 30 percent of the population.
• The death rate due to starvation or hunger-related causes exceeds two deaths per 10,000 people per day.

Six countries and territories had populations facing “catastrophic conditions”, or Phase 5, the highest level in the IPC’s classification of food insecurity. They numbered 1.4 million people, a more-than ninefold increase since 2016.

The Gaza Strip was the worst affected, with 640,700 people facing famine conditions, equivalent to 32 percent of its population, the highest share recorded globally. Sudan followed with 637,200 people, or 1 percent of its population.

Four other countries recorded catastrophic food shortages among specific groups of people: South Sudan – 83,500 (1 percent of the population), Yemen – 41,200 (0.1 percent), Haiti – 8,400 (0.1 percent) and Mali – 2,600 (0.01 percent).

Additionally, more than 39 million people in 32 countries were in Phase 4, or emergency conditions, representing 3.8 percent of the population analysed, a marginal increase from 2024.

Conflict remains the main driver of hunger

Conflict and violence were the primary drivers of acute food insecurity in 19 countries where 147.4 million people were affected. They represented more than half of those facing acute hunger globally.

Weather extremes were the primary driver in 16 countries, affecting 87.5 million people, while economic shocks led in 12 countries, with 29.8 million people affected.

Against that backdrop, humanitarian and development financing for areas facing food crises declined in 2025, falling back to levels last seen in 2016-2017, the report said.

As for 2026, the report said that based on a partial picture as of March, severity levels remain critical in multiple contexts. It added that the escalation of conflict in the Middle East exposes food-crisis countries to direct and indirect risks of global agricultural and food market disruptions.

A generation of malnourished children

An estimated 35.5 million children were acutely malnourished in 2025 across 23 countries experiencing nutrition crises, including just under 10 million with severe acute malnutrition, the most life-threatening form.

A further 25.7 million children suffered from moderate acute malnutrition. About 9.2 million pregnant and breastfeeding women were also acutely malnourished across 21 countries with available data.

Displacement is concentrated in food-crisis countries

The number of forcibly displaced people in the 46 countries covered fell slightly in 2025 to 85.1 million.

About 62.6 million of them were internally displaced across 34 countries, and 22.5 million were refugees and asylum seekers in 44 countries.

Without a sustained push to address the structural drivers of hunger, the world’s most fragile countries will continue to bear a disproportionate share of the global hunger burden well into 2026, the report concluded.