FSNAU Technical Series Report Post Deyr 2012/13 Nutrition Analysis

Issued: February 28, 2013

Nutrition Situation Overview

Integrated analysis of core nutrition indicators for the Deyr 2012/13 reflects improvements in the overall nutrition situation as compared to the Gu 2012 six months earlier (Maps 1 and 2). This is mostly a result of improved access to household food and disease outbreak control. Recent improvements in food security are attributed to continued humanitarian interventions, improved own production (crops, milk), increased incomes (farm labour, livestock sales at high prices) and improved purchasing power in light of the reduced cost of living. Although morbidity levels remained high, no seasonal outbreaks of acute watery diarrhoea /cholera or measles were reported during this period. This was a mitigating factor for the overall nutrition situation.

A total of 215 000 (14.3% of 1.5 million children aged below 5 years) are acutely malnourished, a slight improvement from 236 000 (16%) in August 2012. Out of these 45 000 (3.0% of 1.5 million children aged below 5 years) are severely malnourished, a slight improvement from 54 000 (3.5%) in August 2012. South Somalia hosts 147 000 (66%) of the country’s total of acutely malnourished children (down from 168 000 in August 2012).

Between October and December 2012, FSNAU and partner agencies conducted a total of 41 nutrition surveys based on the Standardized Monitoring and Assessment of Relief and Transitions (SMART) methodology. Of these surveys, which covered rural and urban livelihoods in addition to IDP settlements, 22 were conducted in the northern regions, 5 in Central and 14 in southern regions. Thirteen of the surveys were done in IDP camps, 11 in urban settlements and 18 in rural livelihoods.

Survey findings

Survey findings of three core indicators: global acute malnutrition rates, severe acute malnutrition rates, and death rates (Table 29) show a declining trend compared to the Gu 2012.

• Global acute malnutrition (GAM) rates have reduced since July 2012 from Very Critical (20 -29.9%) to Critical levels (15.0-19.9%) among the pastoralists of West Golis/Guban and agropastoralists of Bay; and to Serious level (10.0-14.9%) in Nugal Valley. Other areas remain unchanged, except for Mataban in the Hiran Region where the GAM rate has deteriorated to Very Critical. IDPs remain Critical – Very Critical except for the Hargeisa and Garowe IDPs who are considered in the Serious phase.

• Severe acute malnutrition (SAM) rates have either reduced or are sustained within Acceptable levels (<2.5%) since July 2012. The exceptions are the Hawd of Northwest, and Addun livelihood zones with SAM rates within Alert level (2.5-3.4%), North Gedo Agropastoralists in Serious, (3.5-4.4%), Beletweyne District with Critical (4.5-5.9%), and Mataban in Very Critical levels of (6.0-9.9%).

IDPs in settlements within Dolow, Dobley, Berbera and Qardho have Critical –Very Critical levels.

• Crude death rates across the country are below the emergency threshold level of 2 per 10 000 per day, while under five death rates are below the emergency threshold level of 4 per 10 000 per day (UNICEF 2005).

The WHO (October-December 2012) Somalia Emergency Health Updates show that there were no disease outbreaks during the Deyr 2012 season. This was a mitigating factor for the nutrition situation, especially in the South. Nevertheless, with the exception of East Golis in the Northwest (16%), morbidity levels among the assessed <5 year old children (based on two weeks recall period) remained high, above 20 percent on average, across the country, exceeding 40 percent in parts of the South, and IDPs settlements. Morbidity was highest in Beletweyne District (53.2%), Mataban (50.3%), N. Gedo Pastoral livelihood zone (52.5%), Mogadishu IDPs (47.4%) and Bossaso IDPs (46.6%).

Meta-analysis of datasets from 220 nutrition surveys conducted from 2001-2011 indicates positive association between acute malnutrition and morbidity, with children reportedly suffering from childhood illnesses (suspected fever, measles, pneumonia and diarrhea) being 1.37 times more likely to be malnourished. The relationship between diarrhoea and acute malnutrition is of statistical significance (RR=1.43).

Southern regions – Rural Livelihood Zones

SMART nutrition surveys were conducted in the rural livelihood zones of northern parts of Gedo and Bakool Regions, Mataban and Beletweyne Districts in Hiran, and Bay Region. Due to insecurity, it was not possible to conduct SMART surveys in Juba, Southern Gedo, southern Hiran and Shabelle regions. Rapid nutrition assessments based on mid-upper circumference (MUAC) were nevertheless undertaken in the 6-59 months age group in accessible areas of Juba and southern Gedo.

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