In June and August 2022, USAID Advancing Nutrition hosted a series of state- and national-level consultations with stakeholders working on wasting prevention and treatment in Nigeria to prioritize areas of interventions across various sectors. Participants found that the systems for providing counter-referrals to families recovering from malnutrition or at-risk of malnutrition are both inadequate and poorly understood. In fact, a study led by Oxford Policy Management and Valid International in collaboration with UNICEF Nigeria found that 24 percent of children cured of severe acute malnutrition at an outpatient therapeutic center in Sokoto relapsed within two months. Counter-referrals enable families to be connected to other supportive services and programs that address underlying causes of malnutrition - such as livelihood development programming, which can support increased incomes.

To better understand current counter-referral systems, USAID Advancing Nutrition Nigeria is undertaking a counter-referral and support system mapping exercise in Bauchi, Ebonyi, Kebbi and Sokoto states and the FCT. The results will provide local decision makers with information they need to strengthen referral systems to reduce the rate of relapse and prevent other children in the same household from becoming wasted.