Nutrition Explained: Breakthrough ACTION Nigeria’s Nutrition Intervention in Five States

Breakthrough ACTION, the United States Agency for International Development's global flagship social and behavior change project, operates a nutrition activity in five states of Nigeria: Bauchi, Ebonyi, Kebbi, Sokoto, and the Federal Capital Territory. Breakthrough ACTION Nigeria's intervention is a critical part of its integrated social and behavior change approach focused on improving reproductive, maternal, newborn, and child health, as well as nutrition outcomes. The project utilizes multichannel approaches to promote messaging for improved health behaviors, including nutrition.

Breakthrough ACTION Nigeria works with communities to address factors preventing the adoption of good nutrition practices and enhance knowledge on including and accessing nutritious foods. To do this, community members receive nutrition counseling using innovative approaches such as food demonstrations, household and community gardening, and a nutrition card game.

The Project’s program officers and a representative from the Federal Ministry of Health (FMOH) share why this intervention is important to individuals and communities in the journey to a healthy Nigeria and how it is implemented.

Malnutrition is a significant public health problem in Nigeria, as seen by the stunting, underweight, and wasting rates. The stunting rate is 37% among children under five (NDHS 2018), falling short of the global target. Malnutrition contributes to about 45% of child deaths under five, according to the World Health Organization (WHO). Addressing this issue requires promoting breastfeeding, diverse diets, improving food security, and implementing social behavior change interventions.

“This nutrition intervention specifically targets the first 1,000 days of life, promoting essential behaviors for optimal nutrition during this critical period, including early initiation of breastfeeding, exclusive breastfeeding, appropriate complementary feeding, and maternal nutrition.”

Angela Samba, Senior Maternal, Newborn, and Child Health and Nutrition Advisor, Breakthrough ACTION Nigeria

Improving Health Through Early Initiation of Breastfeeding and Exclusive Breastfeeding

"Breastfeeding is the foundation for life and the most single cost-effective nutrition for babies."

Adenike Bayode, Nutrition Officer, FMOH

Early Initiation of Breastfeeding and Its Importance to Mother and Child

“Early Initiation of breastfeeding is the provision of a mother`s breast milk within the first hour of birth. This avails the newborn with colostrum, the first form of immunization against infections, while creating a strong bond between mother and child. Colostrum provides the baby with all the necessary vitamins, nutrients, and antibodies to sustain the baby for three days before breast milk is produced.”

Hajara Aliyu, Community Capacity Strengthening Assistant, Breakthrough ACTION Nigeria, Bauchi State

“Early Initiation of breastfeeding has numerous benefits. For the mother, early breastfeeding initiation after delivery helps the uterus contract and return to its normal position. This also initiates the production and flow of breast milk, and the mother is psychologically satisfied.”

– Hauwa’u Abubakar, Women Empowerment Group Local Government Area Supervisor, Breakthrough ACTION Nigeria, Bauchi State

Exclusive Breastfeeding for Optimal Child Health

“Exclusive breastfeeding is feeding a child with only breast milk, without any other food or liquids, not even water, from birth to six months of age, with one exception: medication prescribed by a skilled health care provider can be administered as prescribed. It does not require extra money or extra work to breastfeed. It is ready and available for the baby at the time of need and contains all the nutrients that the baby needs.”

– Christiana Y. Rambo, Nutrition Assistant, Breakthrough ACTION Nigeria, Kebbi State

“Exclusive breastfeeding is crucial because breast milk contains all the nutrients that the baby needs for growth and development for six months of age. Exclusive breastfeeding reduces childhood illnesses like diarrhea, allergy respiratory and ear infections, it also stimulates a close bond between the mother and her baby.”

– Hannatu Bala, Women Empowerment Group Local Government Area Supervisor, Breakthrough ACTION Nigeria, Kebbi State

What is Complementary Feeding and When Should Mothers Transition From Exclusive Breastfeeding?

“At six months, the growth and nutritional demand of your child increases, and breastmilk alone is no longer sufficient to meet the nutrition requirements of your baby and ensure healthy growth and development. From the age of six months, there is a need to introduce a variety of nutritious food and liquids to your child in addition to breastfeeding. The frequency, consistency, density, and introduction of additional meals to the child depends on their age: six to nine months, nine to 11 months, and 12–24 months. This process is known as complementary feeding.”

– Sadiya Abbas, Community Capacity Strengthening Assistant, Breakthrough ACTION Nigeria, Sokoto State

“Nutritionally adequate and safe complementary feeding is essential to ensure children's healthy growth and development through the variety of nutritious food introduced in addition to breastmilk. It contains an excellent nutritional and hygienic meal, especially in the first two years of life. Complementary feeding is also necessary to prevent children from becoming stunted as they grow.”

– Hindatu A. Faruk, Women Empowerment Group Local Government Area Supervisor, Breakthrough ACTION Nigeria, Sokoto State

Feeding Matters Greatly to a Child’s Health

“Feeding a child is about satisfying hunger and nourishing the body and mind. Neglecting this relationship can lead to illness while prioritizing it can lead to a healthy and vibrant life.”

– Clinton Ofoegbu, Nutrition Assistant, Breakthrough ACTION Nigeria, Ebonyi State

“Feeding a sick child can be very challenging and requires a lot of patience and support from people. The best way to feed a sick child that is exclusively breastfed is to continue breastfeeding frequently because it provides comfort, helps the baby fight disease, and regain lost energy and weight. In the case the baby refuses to suck, keep trying. In addition to breastmilk, a baby above six months who is sick should be fed with simple foods and liquids frequently and with small pieces at a time, especially if the baby does not have an appetite.”

– Chineye Alobu, Women Empowerment Group Local Government Area Supervisor, Breakthrough ACTION Nigeria, Ebonyi State

Improving Family and Communal Health Using the FMOH Four-Star Meal Concept

The “Four-star meal” has foods from each of the following four food groups:

  • Animal sources of foods for bodybuilding and repair. Examples include fish, meat, crayfish, grasshoppers, eggs, and dairy products.
  • Staples to provide energy. These include grains (maize, corn, rice, and millet) and roots and tubers (yam, cassava, cocoyam, and potatoes).
  • Legumes and seeds to maintain body function. These include beans, groundnuts, sesame seeds, cashew nuts, Bambara nuts, soybeans, and Egusi.
  • Fruits and vegetables to build the body. These include spinach, Ugwu leaves, carrots, tomatoes, pawpaw, oranges, mangoes, and guava.

Breakthrough ACTION Nigeria developed a Nutrition Card Game to explain the four-Star meal concepts to improve the understanding and application of dietary diversity for better nutritional choices.

“Breakthrough ACTION Nigeria has a nutrition card game that is an innovative approach using a deck of cards to promote dietary diversity for families using the four-star meal concept. Dietary diversity is important for optimal health and well-being, as it provides the body with a range of essential nutrients and helps to prevent nutrient deficiency. It is a fun and interactive way for individuals to learn about the nutritional value of the different food groups and how to combine them to make adequate nutritious diets. The game typically includes cards representing the four food groups, and players are tasked with creating a four-star meal-a meal that contains at least one food item from the four food groups.”

– Grace Sule, Nutrition Assistant, Breakthrough ACTION Nigeria, Federal Capital Territory

“Playing a nutrition card game is vital for promoting dietary diversity in several ways. It is an interactive way to learn about the nutritional value of local foods available within the community. The nutrition card game helps identify the food categories that belong to each food group. The pictures on the card make learning fun and easy to understand, which can be valuable for individuals who may have low illiteracy levels, and the knowledge gained while playing the card can guide the players in preparing nutritious meals for themselves and their families.”

– Stella Patrick, WEG Women Empowerment Group Local Government Area Supervisor, Breakthrough ACTION Nigeria, Federal Capital Territory

Program Officers Playing Breakthrough ACTION Nigeria's Nutrition Card Game

Promoting nutrition knowledge, including dietary diversity and access is key to supporting Nigeria in achieving health outcomes.

Photos from the Nutrition Training for Program Officers and Local Government Area Supervisors in Keffi, Nassarawa State

This resource is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Breakthrough ACTION and do not necessarily reflect the views of USAID or the United States Government.