Shehu Aminu was hardly surprised when the last of his six children was diagnosed with malnutrition in April for a second time.
Nigeria: Child malnutrition worsens as cost of living climbs
He had hardly been able to feed the 18-month-old regularly, let alone with nutritious foods.
Although the family in northwest Nigeria has struggled with economic hardship, their situation deteriorated after February, when he lost his job as a taxi driver due to a spike in the retail price of petrol caused by the war in Iran.
“I could no longer keep up with my financial obligations. I now struggle to provide for my family,” Aminu said in the living area of their unvarnished two-bedroom house in the quiet town of Kware, Sokoto, as ash from the coal stove billowed into the room.
Children relapsing into malnutrition has become an increasingly common occurrence in the state and across northern Nigeria, according to local health and aid workers, who cite knock-on effects from the Iran war.
Northern Nigeria, one of the world’s poorest regions, is already under pressure from an insurgency crisis.
Now the conflict in the Middle East has worsened food security for millions of people living in poverty, especially children.
At the same time, Nigerian President Bola Tinubu’s vast economic reforms sparked high inflation after fuel subsidies were removed three years ago and the currency was devalued.
A World Bank technical report this week stated that 139 million Nigerians are now poor or vulnerable to poverty.
If the war in the Middle East continues, up to 23.4 million additional children could fall into monetary poverty — meaning a lack of income or consumption — by the end of the year, the United Nations children's agency UNICEF said in a report this week.
It warned that at least 80% would be in Africa and Asia.
Amid the Iran war, the closure of the Strait of Hormuz — through which a fifth of the world’s oil and gas passed before the war — sent a ripple effect across the world.
A worldwide fuel shock drove up the prices of everything from gas and groceries to fertilizer and airline tickets.
In Nigeria, fuel pump price jumped from 800 naira ($0.58) per liter in February to 1,400 naira ($1.02) in April, with a knock-on effect on the prices of food and necessities.
U.S. President Donald Trump has been trying to force Iran to fully reopen the route for months, turning to everything from airstrikes and naval blockades to negotiations and threats.
In Sokoto, where the soaring prices have brought more hardship for families, health workers told The Associated Press that they've been seeing more children returned to health facilities this year after falling back into malnutrition.
At a hospital in Sokoto, records shared with AP show nearly 40 children previously treated for malnutrition since February are currently under treatment again, in addition to those not documented.
“I am not happy to see the number of women coming to the health facility with their malnourished children increasing,” said health worker Halimah Muhammad.
Beyond the current realities, soaring prices and economic hardship mean that children in poor households are more likely to be stunted in the long term, UNICEF Executive Director Catherine Russell said in an interview with the AP as she was visiting Sokoto this week.
“Their development will be compromised, they are less likely to stay in school because their parents are under so much financial strain. So, the long-term implications for children are absolutely terrible,” said Russell.
The war has also affected fertilizer supplies and prices, threatening the planting season and worsening the fate of mostly farming communities in northern Nigeria who have struggled to access their farmlands amid a deadly conflict with armed groups.
"When I wake up every morning it pains me to see my family because I can no longer provide for them the way I used to," said said Shehu.
"Back then, 2,000 naira ($1.50) was enough to buy a nutritious meal for the family. Today, even 5,000 naira ($3.65) cannot buy the same items.”
Most of their meals are pap, a kind of corn pudding, and rice.
“There's nothing nutritious that my family gets to eat,” he said.
People in northwest Nigeria are caught between regular attacks by bandit groups who specialize in kidnapping for ransom and Islamist militants who have been expanding their territory.
The Iran war, analysts say, compounds the impact.