MSF Expands Efforts to Combat Acute Malnutrition in Northern Nigeria with 'Tom Brown' Recipe

In Kebbi state, MSF outreach teams are promoting the ‘Tom Brown’ recipe as a key tool in the fight against malnutrition.

Since April 2024, Médecins Sans Frontières (MSF)-supported healthcare facilities in North-West and North-East Nigeria have been overwhelmed by a surge in acute malnutrition cases among children. In response, MSF teams are intensifying their efforts, not only providing lifesaving medical care but also strengthening community-led prevention initiatives. In Kebbi state, MSF outreach teams are promoting the 'Tom Brown' recipe as a key tool in the fight against malnutrition.

This year, Kebbi state has seen a dramatic increase in malnutrition cases. In May alone, nearly 1,000 children were admitted for severe acute malnutrition at MSF's inpatient therapeutic feeding centre (ITFC) in Maiyama Hospital—an 80% increase from the previous year. The crisis persisted into June and July, with over 260 new patients admitted in just the second week of July. The 210-bed facility is so overstretched that patients often share beds.

In addition to the ITFC, MSF supports more than 11,000 children in Kebbi through an outpatient nutrition treatment programme at five smaller health centres. "The scale of this crisis necessitates significant preventive measures," says Maryam Muhammad, head of MSF's health promotion team in Kebbi. "Our community outreach is crucial in helping parents prevent severe malnutrition."

The 'Tom Brown' initiative represents a local solution to the crisis. Four days a week, Maryam and her team travel across Kebbi with supplies to demonstrate how to prepare Tom Brown, a nutritious porridge made from a blend of sorghum, soybeans, groundnuts, and optional additional ingredients like palm oil and moringa leaves. The recipe, based on traditional Nigerian 'Kwash pap', has been refined by nutritionists to effectively combat moderate acute malnutrition.

During these demonstrations, Maryam and her team set up in village squares, where they engage with local women and teach them how to prepare Tom Brown. The outreach also includes catchy songs to help villagers remember the recipe. "We aim to empower families with the knowledge to prevent malnutrition," Maryam explains. "Preventing malnutrition is more effective than treating it."

In addition to cooking demonstrations, Maryam's team conducts rapid malnutrition screenings using mid-upper arm circumference (MUAC) bracelets. On a recent visit, a third of the 28 children screened were referred to MSF's therapeutic nutrition programme.

Maryam's outreach efforts have reached over 13,300 people, including 1,461 men, through 554 demonstrations between January and May 2024. Despite these significant efforts, the scale of the crisis remains daunting. Recent statistics reveal that nearly 4.4 million children under five suffered from acute malnutrition in North-East and North-West Nigeria between May 2023 and April 2024.

Maryam emphasizes the importance of sustainable solutions: "Prevention is always better than cure. We aim to equip people with the knowledge and tools to address malnutrition long after MSF's support ends. The people we train will continue to share this vital knowledge, helping to build a more resilient community."

While MSF's initiatives are crucial, they highlight the need for broader efforts by authorities and partners to tackle malnutrition comprehensively. Strengthening infant feeding practices, healthcare access, and food security remains essential in addressing this urgent public health challenge.