Nutrition Update, March-April 2010


Issued: May 5, 2010

In March 2010, FSNAU began the Gu cycle (March to July) of nutrition surveys and conducted one representative assessment in the Togdheer Agropastoralist population. This was a repeat survey to monitor the situation from 6 months ago, when the results had indicated deterioration to Critical rates of acute malnutrition (16.1%). An interagency rapid assessment, including FSNAU members, was also conducted in Bari region following concern of a possible deterioration and the FSNAU team conducted the latest round of urban assessments across the country.

Togdheer Agropastoralists Assessment Findings:-

Results for the March Togdheer Agropastoral nutrition assessment indicate a Serious situation with a global acute malnutrition rate (GAM, WHZ<-2 or oedema) of 12.2% (9.3-15.8) and a severe acute malnutrition rate (SAM, WHZ<-3 or oedema) of 2.3% (1.6-3.5). No case of oedema was reported. Analysis using the CDC calculator confirmed that the GAM rates in March 2010 are significantly lower than in November 091 (Pr=96.2%), when a GAM level of 16.1% was reported, indicating an improvement in the nutrition situation.

The improved nutrition situation since the Post Deyr ’09/10 integrated analysis, is likely attributed to increased household access to milk, leading to improved dietary diversity. This is as a result of the February 2010 hays rains that have contributed to improved livestock access to water and pasture, and thus milk production. Consequently, water trucking activities ceased, as the high amount of rainfall replenished water sources (berkeds, communal dams, shallow wells and streams), resulting in a dramatic (80-90%) decline in water prices between February and March 2010. The 90 days retrospective Crude Death Rate was estimated at 0.97 (0.58-1.61) deaths/10,000 persons/day just below the alert thresholds of 1 death/10,000/day, so of concern as was the under-five death rate estimated at 2.2 (0.97-4.99) deaths/10,000 persons/day, just above the alert thresholds of 2/10,000/day. A detailed food security situation analysis from the livelihood is available in the latest Food Security and Nutrition Brief, released on April 20th.

Bari Region Rapid assessment Findings:-

An interagency rapid assessment was conducted in March, as a result of the prolonged dry spell in Bari region. Findings from 360 children exhaustively assessed from 15 villages in 4 districts, using weight for height, indicate the proportion of acutely malnourished children (weight for height <-2 Z score or oedema) as 13.9% with 2.5% severely malnourished. There was no reported case of oedema. These results indicate a sustained Serious nutrition situation in the assessed villages since the Post Deyr ‘09/10 nutrition situation analysis. Food security indicators for the region indicate stress from the cumulative effects of poor rainfall over several seasons, however recent rains are likely to bring some relief. The food security situation also remains unchanged from the Post Deyr ‘09/10.

Urban Nutrition Assessment Findings

Results from purposively sampled poor households in 25 assessed urban centers indicate that the most nutritionally vulnerable urban centres were Jowhar, Eldheer, Baidoa, Burao, Elberde (L/Shabelle, Central, Bay, Burao, and Bakool region respectively). The situation in Eldheer and Elberde is mainly attributed to persistent poor household food security. In Bay and Shabelle regions, disease and poor dietary diversity are the major contributing factors. Consumption of a poorly diversified diet (< 4 food groups) was only reported in Burao and Lasaanod towns. Purchase is the main way to access food, except in Buale/Sakow and Lasaanod towns, where main food sources were own food production and zakat. The urban centers with increased levels of severe coping strategies being employed compared to the same time period in 2009 were Jowhar, Hargeisa, Lasanod, Eldheer, ELberde, Huddur, Belet Hawa and Haradhere.

Acute Watery Diarrhoea Update (AWD)

WHO has reported an increasing trend in the number of AWD cases in Lower Shabelle region reviewed at the Merka Hospital cholera treatment centres (CTC) between March 27th – April 1st, 2010. Reports from Banadir Hospital indicate a steady reduction of cases in week 12 compared to weeks 10 and 11 with one case confirmed for Vibrio cholera using the Cholera Smart II® Rapid Diagnostic Test on 16th of March, 2010. Of 19 samples collected from Banadir and Habeeb hospitals CTCs, 8 additional cases have tested positive for Vibrio cholera serotype ‘Inaba’. In light of the new confirmed cases and heightened displacement from the current conflict in Mogadishu, there is likely to be multiple sporadic outbreaks. AWD preparedness and response including prepositioning of supplies, training of implementing agencies and distribution of guidelines on prevention and case management of diarrhoeal diseases, chlorination of water points, is on-going by the WHO and partners.

For latest WHO updates, please visit www.emro.who.int/somalia/ CollaborativeProgrammes-eha.htm and the Somali Health Cluster Bulletin, March 2010 at www.emro.who.int/somalia/healthcluster.htm.

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