Hidden hunger stealing Nigeria’s children before birth – Experts

By Chioma Obinna

Every year in Nigeria, nearly 11,000 babies are born with severe birth defects that experts say could largely be prevented. Millions more children suffer impaired brain development, while countless women battle anaemia and poor pregnancy outcomes because their diets lack essential vitamins.

This is the hidden face of micronutrient deficiency; a crisis nutrition experts say is quietly undermining Nigeria’s human capital, productivity and future generations.

Unlike acute malnutrition, hidden hunger often goes unnoticed. Children may appear healthy but lack nutrients needed for normal brain development, while many women begin pregnancy deficient in nutrients essential for healthy fetal development.

Experts are now urging the Federal Government to make folate (Vitamin B9) and Vitamin B12 fortification of bouillon cubes mandatory, arguing that the evidence is overwhelming and the cost of inaction is measured in preventable disabilities and lost human potential.

Statistics have shown that Nigeria ranks second globally on the hidden hunger index among the world’s most populous countries, according to nutrition experts.

More than 40 per cent of women of reproductive age have inadequate folate intake, while Vitamin B12 deficiency remains widespread, particularly among populations with limited access to animal-source foods.

Speaking at a nutrition conference in Lagos, Country Director, Nutrition International Nigeria, Dr. Osita Okonkwo, described micronutrient deficiency as a silent epidemic.
“Micronutrient deficiency does not announce itself. Unlike acute malnutrition, it operates invisibly, eroding cognitive development in children, undermining maternal health and compounding cycles of poverty across generations,” he said.

Okonkwo also noted that Nigeria recorded the second-highest child stunting rate in the world in the 2023–2024 Nigeria Demographic and Health Survey, warning that stunting is largely irreversible after a child’s second birthday.

Among the most serious consequences of folate deficiency are neural tube defects (NTDs), including spina bifida, anencephaly and encephalocele. These birth defects develop during the first 28 days of pregnancy, often before many women know they are pregnant.

According to experts, neural tube defects occur at a rate of 14.2 cases per 10,000 live births. With about 7.5 million births annually, nearly 11,000 Nigerian babies are born each year with these largely preventable conditions. Population-wide folate fortification can reduce the risk by up to 70 per cent, making it one of the most effective public health interventions available.

The evidence supporting bouillon fortification comes from the CoMIT Trial, described as the most rigorous clinical evaluation of bouillon fortification conducted in West Africa.

The double-blind, randomised controlled trial involved more than 2,000 participants, including children aged two to five years, women of reproductive age and lactating mothers.

Participants received either bouillon fortified with folic acid, Vitamin B12, iron, zinc, iodine and Vitamin A, or standard iodised bouillon.
The study found significant increases in folate levels among participants receiving fortified bouillon, reduced folate deficiency among women of reproductive age, and improved Vitamin B12 levels across all participant groups. Reductions in Vitamin B12 deficiency among lactating women and young children were sustained throughout the nine-month study.

Researchers concluded that bouillon cubes provide an effective vehicle for delivering folate and Vitamin B12 because they are consumed daily in virtually every Nigerian household. Unlike supplements, fortification requires no change in eating habits; the nutrients remain stable during cooking and do not affect the taste, smell or appearance of food.

In a chat, the Director of Food Safety and Applied Nutrition at NAFDAC, Mrs. Eva Edwards, said micronutrient deficiencies remain a serious public health challenge. Edwards urged Nigerians to check food labels, fortification logos and NAFDAC registration numbers when purchasing food products.

Although Nigeria introduced voluntary standards for bouillon fortification in September 2024, experts argued that voluntary compliance has not delivered the expected impact. They note that Nigeria also failed to meet its anaemia reduction target, prompting the WHO African Region to extend the deadline to 2030.

Their recommendation is that mandatory fortification of bouillon cubes with folate and Vitamin B12 should be implemented without further delay.

“The science is settled. Every year of delay means more preventable birth defects, more children denied their full potential and more pressure on families and the healthcare system,” the experts said.