Doctors Without Borders/Médecins Sans Frontières (MSF) teams in Nigeria have recorded a surge in malnutrition cases in the country's north, raising major concerns over potentially devastating and long-term consequences for the children who survive.
At an MSF-supported inpatient therapeutic feeding center in Maiyama General Hospital in Kebbi state, 2-year-old Ummul Khairun Mohammed is receiving treatment for severe acute malnutrition. Due to developmental delays caused by her condition, she is still unable to walk.
The little girl is one of thousands of children under 5 years old currently being treated by MSF teams across northern Nigeria during the country’s annual peak malnutrition season. For several days—sometimes for up to several weeks—these children receive treatment to stabilize their condition, address medical complications, and promote rapid weight gain.
The effects of childhood malnutrition can last a lifetime
Most children treated for malnutrition will recover, but many of those who survive still face irreversible damage with consequences lasting long into their adulthood. Survivors often experience physical and cognitive delays that affect brain development and weaken the immune system.
“Malnutrition is not just a short-term emergency—it is a lifelong struggle for many children,” says Dr. Jamila Shuaibu Bello, an MSF doctor in the northern state of Kano. “It affects brain development. Malnutrition weakens the immune system, making children more susceptible to communicable diseases. It is also linked to chronic conditions like diabetes and hypertension.”
Even a few weeks of experiencing severe malnutrition can severely disrupt a child’s motor development. These children may miss key milestones, such as crawling by the time they’re 8 to 10 months old, or walking at 18 months. Chronic malnutrition often results in stunting—a condition that impairs mental development, school performance, and cognitive abilities. In girls, stunting can also lead to obstetric complications later in life due to smaller pelvis size.
If these issues are not addressed early, the damage can be irreversible. To respond to long-term effects of malnutrition, MSF is pioneering two new approaches integrating pediatric physiotherapy and mental health support with malnutrition treatment.
Restoring movement through pediatric physiotherapy
With the support of the MSF Foundation—which develops new medical tools for the most neglected patients where we operate around the world—our teams recently launched pediatric physiotherapy programs in Nigeria’s northwestern states of Kano and Katsina. These sessions include guided exercises, play-based therapy, and training for caregivers to continue therapy at home. Each intervention is tailored to the child’s developmental stage and condition, helping to rebuild their strength, coordination, and confidence.
While the two projects are still in their pilot stage, they are already showing promising results in helping children regain motor functions and achieve developmental milestones.
At 13 months old, Usman Aliyu was treated for malnutrition at Unguwa Uku hospital in Kano before participating in physiotherapy sessions. “Before Usman fell ill, he could crawl and stand, but he lost those abilities due to the sickness,” says his mother, Aisha Aliyu. “In the physiotherapy sessions, he was taught to stand again and he is now taking steps towards walking.”
"When I first arrived [in Kano], I was shocked by the severity of motor delays,” says Fatima Abdulmajid. “But seeing the children’s progress week after week through motor stimulation makes me proud of the work we are doing.”
Mubarak Mutawakkil, pediatric physiotherapist
"This child has a chance"
I met Isah* when he was two and a half—31 months, to be exact. He was severely malnourished and had never walked, which is something we would expect an 18-month-old to do. That was concerning enough, but Sadiya*, his mother, told us that he had also stopped crawling.
Isah was regressing. This was a clear red flag. He had just arrived at the malnutrition unit at Unguwa Uku Hospital, where I work as a pediatric physiotherapist. I’ve worked in pediatrics for years, and while I knew that malnutrition exists in rural areas of our state, I didn’t realize how widespread it is, or the dire consequences.
Severe acute malnutrition affects the body in different ways: It stunts growth, causes muscle wasting, and in some cases results in restricted joint mobility and painful skin lesions. Without the energy to move or play, children become physically weaker, and they don’t get the stimulation they need to learn. They stop progressing through the milestones, or start to regress. Without the right care, these developmental delays can have lasting physical and cognitive impacts, leaving children with long-term disabilities.
Mental health support for children and caregivers
Malnutrition also affects mental health. Children with malnutrition are more likely to develop anxiety and depression, while caregivers often feel helpless and overwhelmed as they watch their child grow weak and unresponsive.
To address this, MSF provides psychosocial support as part of our malnutrition projects in several state, including Zamfara, Bauchi, Sokoto, Borno, Kebbi, Kano, and Katsina. Services include play therapy, counseling, and caregiver education to help families manage emotional and behavioral challenges.
“It's one thing to treat the child medically, and it's another to assess which areas of development have been emotionally affected,” explains Kauna Hope Bako, MSF's mental health supervisor in Bauchi. “Mental health support helps manage the child's overall well-being. We stimulate the child emotionally and engage all these areas that have been compromised due to malnutrition.”
The integration of physiotherapy and mental health support into malnutrition treatment marks a critical step toward holistic care that goes beyond just survival to support a child’s quality of life.
A public health emergency in Nigeria
According to UNICEF, an estimated 3 million children are currently suffering from severe acute malnutrition (SAM) in Nigeria—up from 2.6 million in 2024. Of these children, 1.65 million are located in six conflict-affected northern states where MSF operates.
Malnutrition is a public health emergency in Nigeria, and MSF has been raising the alarm about the worsening situation in the north since 2022. In 2024 alone, more than 250,000 children with severe acute malnutrition were admitted to MSF-supported outpatient facilities and 76,000 acutely malnourished children with medical complications were admitted to inpatient facilities—representing an increase of 38 percent and 53 percent respectively compared to 2023.
This year, anticipating an even earlier start of the peak season that typically runs from June through September, MSF increased inpatient bed capacity, scaled up outpatient therapeutic feeding centers, and hired more staff. We also boosted health promotion activities in several communities, including education on how to prevent, detect, and treat malnutrition, and the need to take children for medical treatment early.
From January to May 2025, MSF admitted 24,784 severely malnourished children to inpatient therapeutic feeding centers, and 107,461 children to outpatient therapeutic feeding centers in northern Nigeria. This is an increase of 13 percent compared to the same period in 2024.
Roots of a crisis
The persistent malnutrition crisis in northern Nigeria stems from a variety of factors including inflation, food insecurity, insufficient health care infrastructure, ongoing security issues, and disease outbreaks worsened by low vaccine coverage. The situation is further exacerbated by funding shortages for the already inadequate nutrition response.
To address such a complex issue, a holistic approach is needed from all local and international actors involved—not only to treat malnourished children in the short term, but also to tackle the long-term consequences.
