Nigeria: In Borno, Cash Transfers Are Helping Families Treat Malnutrition Beyond the Clinic
Bilkisu, a resident of Njimtilo in the Konduga area of Borno State, lives with a visual impairment, while her children remain out of school as the family struggles to survive day by day. For them, even necessities such as food and education are beyond reach.
However, when one of her daughters was diagnosed with severe acute malnutrition (SAM) at the Njimtilo Primary Healthcare Centre (PHC), which is at least 16 kilometres from Maiduguri, the capital of Borno, the Future Resilience and Development(FRAD) Foundation started providing some financial support.
"I was given Ready-to-Use Therapeutic Food (RUTF) to treat my malnourished child. They also provided me with a voucher card, through which I receive 45,000 Naira every month," the 38-year-old mother of six explained. "Now, with that amount of money coming to us every month, our meals have improved. Our children now go to school, and when they return, they hawk soya bean cake. This money supports our family."
In March 2026, the World Food Programme (WFP) estimated that at least 5.8 million people in northeast Nigeria, including Borno, are facing severe food insecurity due to insecurity, decades-long conflict, mass displacement, and climate shocks. Currently, about 15,000 people in Borno alone are projected to face catastrophic hunger.
Through its Multipurpose Cash Transfer Programme, which aims to improve nutritional outcomes in the state, FRAD Foundation provides RUTF to children diagnosed with SAM, trains mothers on how to prepare nutritious meals, and issues voucher cards to caregivers.
Since August 2025, the project has been implemented in Mafa and Konduga local government areas (LGAs) in Borno. FRAD collaborates with the Borno State Ministry of Health and community mobilisers who oversee the organisation's work within communities.
Why the model stands out
Hyelsinta Samaila Bwala, a nutrition officer at the FRAD Foundation, explained that they first screen children aged 6 to 59 months, then refer those with medical complications to stabilisation centres. Children without complications are then directed to the Outpatient Therapeutic Programme (OTP).
FRAD Foundation requests that the Nasarawa Geographic Information Service (NAGIS) disburse payments to community members' accounts. NAGIS is a digital payment system operated by Nigeria'sNational Social Investment Programme Agency (NSIPA), designed to deliver cash transfer stipends for social protection programmes such as N-Power and the Conditional Cash Transferscheme.
Non-profit organisations provide a registration form capturing participant details, including account information, after which payments are made directly. This process repeats monthly for as long as the participants remain enrolled, with the non-profit reimbursing NAGIS. From August 2025 to January 2026, FRAD Foundation disbursed funds to 100 families, with 50 in the first tranche and 50 in the second.
FRAD also involves health workers and community nutrition mobilisers who work directly with participants in the communities where the programme is being carried out. Plans are to expand the project to Konduga, Damasak, Bama, Gwoza, and Jere LGAs in Borno State.
What stands in the way?
Using locally available grains, the organisation also trains mothers on how to make Tom Brown, a supplement used to treat moderate acute malnutrition (MAM). Currently, they have 11 mothers in Mafa and 11 in Konduga leading and supervising this initiative. For each group, 12 mothers are selected, and a Lead Mother is then chosen to serve as the group's leader.
FRAD Foundation supplies millet, sorghum, soya beans, and groundnut in the 6:3:1 ratio, respectively, which aligns with the Integrated Management of Acute Malnutrition (IMAM) standard for Tom Brown preparation.
After it is prepared, each caregiver receives 1.5 kg of Tom Brown in an air-tight container that will sustain each child for two weeks. "We supply the Lead Mother with everything she needs [for preparation]. We give her money biweekly, which she uses to process all the grains we provide her. She will use the money to buy water for washing the grains. She will use the money to buy firewood. She will use the money for grinding the grains,"Rachael Ibrahim, a project assistant who supervises all field activities related to nutrition, pointed out.
She added that the programme also gives special attention to people with disabilities (PWD). "Apart from that, we will give her [the Lead Mother] kitchen utensils like a pot, a frying pan, a bowl, a tray and everything she needs."
The Foundation, according to Hyelsinta, the nutrition officer, also provides devices that assist PLWDs who visit Outpatient Therapeutic Programme (OTP) sites seeking care for their children. "Based on a caregiver's needs and their children, they are made to choose either a wheelchair, a white cane, or a stick for support."
Every two months, FRAD Foundation conducts joint supportive supervision with the state and local government. "If there is any gap we identify during this joint supervision, we address it."
Community pressure and insecurity remain barriers to scale
However, community members and the programme focal persons noted that they encountered problems at the beginning of the programme; some had been resolved, while others persisted.
Halima Ali, a 28-year-old community member, observed that, "after I was enrolled, my account was credited instantly. I could see the money, but when I tried to withdraw it, I could not. I had to call the focal person for the programme, and she referred me to a bank. When I arrived at the bank, the issue was instantly resolved."
She added that, aside from improving her child's nutrition, the cash-based intervention has helped her save some money, which she uses to take her child with a mental health condition to the psychiatric clinic.
On FRAD's side, Hyelsinta mentioned community members' interference as one of the issues faced when launching the programme. The programme targets only children under five, but caregivers often feel excluded because the resources are intended solely for the children, not the whole household.
The lack of security in some parts of the LGAs also creates barriers for certain workers. Rachel, the programme assistant, explained that"We do not have many challenges in Konduga, but for Mafa LGA, there are challenges due to security issues. Sometimes you plan your activities, but you would not be able to go to that place."
Nonetheless, Esther Haminu, a 37-year-old caregiver whose children were also enrolled, stated that the support has really helped improve the quality of the food they eat at home and their well-being.
This article originally appeared on Nigeria Health Watch