It is estimated that nearly 4.4 million children aged 0 – 59 months are suffering and will likely continue suffering from acute malnutrition in the period of May 2023 – April 2024 in northwest and northeast Nigeria. This includes 1.04 million cases of Severe Acute Malnutrition (SAM) and 3.37 million cases of Moderate Acute Malnutrition (MAM). In addition, 585,000 pregnant or lactating women are acutely malnourished and will likely continue to be malnourished and are in need of treatment. 

In the current period of May – September 2023, more than half of the 133 Local Government Areas (LGAs) included in the analysis are in IPC Acute Malnutrition (AMN) Phase 3 and above. Of the 62 LGAs analysed in northeast Nigeria, 14 were classified in IPC AMN Phase 3 (Serious) 27 in IPC AMN Phase 2 (Alert) and 21 in IPC AMN Phase 1 (Acceptable). In northwest Nigeria, there were 71 LGAs with sufficient data. Of those 71 LGAs, 12 were classified in IPC AMN Phase 4 (Critical), 46 in Phase 3 and 13 in Phase 2. 

Acute malnutrition levels are expected to remain the same in the first projected period of October to December 2023. In the second projection period of January to April 2024, the situation is projected to worsen slightly in the northeast region. Conversely, a slight improvement is expected in the northwest region.

Immediate/short-term recommendations for northeast Nigeria 

• Sustain existing response capacity and modalities throughout lean season and utilize risk monitoring indicators and early warning systems to adjust (scale-up or scale-down) response.
• Leverage rapid response mechanisms, outreaches, and simplified approaches to deliver curative nutrition interventions in hard-to-reach locations, especially in LGAs in IPC Phase 3 and above, and in the event of sudden population movements.
• Continue the scale-up of targeted supplementary feeding programs using available specially formulated foods (RUSF, Blended Flour such as Tom Brown, etc.) aimed at closing the existing gaps in MAM treatment. Strengthen delivery of treatment programs following recommendations on admission criteria (MUAC, WHZ, and oedema), therapeutic feeding, medical treatment, and discharge criteria.
• Improve coverage of immunizations (especially measles) and vitamin A supplementation through routine health service delivery points, state outreach days, campaigns such as the Maternal and New-born Child Health Week (MNCHW), World Breast Feeding Week, and Outbreak Response Vaccination. 
• Tailor support and messaging other Social and Behavioral Change (SBC) interventions to emphasize early initiation of breastfeeding, exclusive breastfeeding, continuation of breastfeeding, caregivers’ health seeking behavior, personal hygiene and use of locally available food items to prepare and feed children with nutritious foods that contain the required macro and micronutrients.
• Advocate for programs to address epidemics of malaria and diarrheal diseases that have been a recurrent event in the period of peak malnutrition. Ahead of the period of peak malnutrition, implement sets of malaria prevention interventions as well as programs to improve soft and hard components of WASH, especially at the household level. 
• Prioritize programs to address maternal and adolescent malnutrition.
• Strengthen existing mechanisms for early identification and referrals such as the family MUAC approach, routine screening by community health influencers promoters and services such as community nutrition mobilizers, and comprehensive mass MUAC screening either quarterly or in each of the three seasons.

Immediate/short-term recommendations for northwest Nigeria 

• Scale-up existing humanitarian program for prevention and treatment of malnutrition, such as strengthening Maternal Infant and Young Child Nutrition (MIYCN), Micronutrient Deficiency Control (MNDC) and Integrated Management of Acute Malnutrition (IMAM) services.
• Leverage campaigns to increase access and coverage of high-impact health and nutrition interventions for women and children under five, such as Vitamin A supplementation, deworming, micronutrient supplementation, and routine vaccination. 
• Strengthen active case finding and referral of acutely malnourished children (severe and moderate) through houseto-house screening of children aged 0-59 months by Community Health Influencers, Promoters, and Services (CHIPS) agents and the scale-up of family-led Mid Upper Arm Circumference (MUAC) screening.
• Advocate for adoption of expanded criteria for admission and treatment of moderately malnourished children to prevent the deterioration of MAM cases into SAM due to the existing gap in the management of MAM. 
• Increase access to basic amenities such as shelter, food, health, nutrition, WASH and protection services for displaced populations.
• Strengthen disease surveillance, emergency preparedness and response plans to aid in timely response, including the fall-out from the ongoing political crisis in Niger Republic.