Following a sharp increase in cases of severe acute malnutrition (SAM) among children in Kebbi State, north‑west Nigeria, between 2024 and 2025, Médecins Sans Frontières (MSF) has launched a nutrition initiative based on the use of Tom Brown, a locally produced complete food product designed to support children’s growth. By the end of 2026, more than 16,000 children with moderate acute malnutrition (MAM) are expected to benefit from this programme, which aims to prevent deterioration into life‑threatening malnutrition.
“Malnutrition remains alarmingly widespread in Kebbi State and is a leading cause of death among children under five,” says Stuart Alexander Zimble, MSF Nigeria Country Coordinator. “Authorities and humanitarian actors must urgently increase their support to prevent further avoidable deaths.”
In Kebbi, an estimated 30 newborns and 100 children under the age of five die every day, with approximately 50 per cent of these deaths linked to malnutrition, according to UNICEF. High rates of stunting, widespread malaria, and very low vaccination coverage—with only 7.4 per cent of children under two years old fully vaccinated—further contribute to high child mortality.
Since March 2022, MSF has been providing free, quality care for children suffering from severe and complicated malnutrition in Kebbi State through two inpatient therapeutic feeding centres (ITFCs) and four outpatient therapeutic feeding centres (ATFCs). Despite ongoing efforts by health authorities, the needs in Kebbi remains significant, and sustained efforts by authorities, humanitarian actors and other partners are essential to improve access to healthcare and alleviate the suffering among affected communities. Growing insecurity, limited access to healthcare facilities, climate change and reduced livelihood opportunities continue to undermine communities’ ability to meet basic needs and contribute to worsening health outcomes.
Between 2024 and 2025, MSF recorded a sharp increase in severe malnutrition cases. Following a decision in September 2024 to stop admitting children with moderate acute malnutrition in order to prioritise severe cases, MSF medical teams observed a 41 per cent increase in severe cases treated at outpatient level and a 39 per cent increase in inpatient admissions.
“We sadly observed that children who initially presented with moderate malnutrition deteriorated and later returned with severe, often life‑threatening symptoms,” says Zimble.
In response, MSF revised its strategy in early 2026 to strengthen early intervention for children with moderate acute malnutrition. Ahead of the lean season—which typically begins in May and marks a period of food scarcity before the harvest—MSF officially launched its Tom Brown programme.
Tom Brown is a traditional Nigerian recipe made from a blend of nutritious grains including sorghum, soya beans, and groundnuts. Also known locally as Garin Kunu, the origin of the name “Tom Brown” is believed to come from the fact that the product is meant to “turn brown” during preparation. By using a familiar, locally accepted nutritional supplement, the programme aims to strengthen sustainable approaches that communities can continue using beyond emergency interventions.
In this initial phase, MSF will distribute about 20,000 kilograms of the locally produced flour blend in Jega and Maiyama local government areas (LGAs) to treat moderately malnourished children between six months and five years old.
This preventive nutrition initiative is a priority for MSF and forms part of broader community-based efforts including health promotion, family planning and malaria testing delivered during seasonal preventive campaigns. The programme also aims to strengthen community and primary healthcare capacity for the early identification of malnutrition and support sustainable, locally accepted treatment approaches.
MSF has previously implemented the Tom Brown approach with promising results. A study conducted between 2022 and 2023 in Gombe State involving 1,207 children with moderate acute malnutrition showed a recovery rate of 90.2 per cent, with only 7.5 per cent defaulting from treatment.
“Since Tom Brown is produced using locally sourced ingredients, these approaches have the potential to be implemented at scale and adapted to local contexts, we therefore urge the authorities, humanitarian organisations and other actors to invest more in such community-based nutrition programmes to prevent children from progressing to severe and life-threatening malnutrition,” Zimble adds. “Community-led production models, including community kitchens and other local initiatives, could help strengthen ownership, improve access and support longer-term sustainability.”
MSF will introduce the programme in selected areas, with progress and outcomes reviewed after a few months of implementation. The programme may then be expanded to all five LGAs where MSF currently operates in Kebbi state. By the end of December 2026, an estimated 16,234 children are expected to benefit from the initiative.
