Transcript Slide 1
Post Deyr ’10/11 Food Security and Nutrition Analysis Unit Somalia Information for Better Livelihoods January 24th 2011 Integrated Nutrition Situation Analysis Hiran Lower Shabelle Middle Shabelle Banadir Swiss Agency for Development and Cooperation SDC EUROPEAN COMMISSION Map: SE Livelihood Zones Middle Shabelle Agropastoral Livelihood Zone, Summary of Findings Outcome indicators Child Nutrition status o GAM (WHZ<-2 or oedema) o o o o o o SAM (WHZ<-3 or oedema) Oedema MUAC (<12.5 cm or oedema) MUAC (<11.5 cm or oedema) Stunting (HAZ<-2) HIS Nutrition Trends o TFPs/SFPs Admission trends Crude death Rate/10,000/day (90days) Under 5 death Rate/10,000/day (90days) OVERALL NUTRITION SITUATION Deyr’09/10 (N=649) Gu’10 (N=212) Deyr ’10/11 (N=1650) 12.5(9.8-15.2) >6.2% (Pr=0.9) but Adale 16.8% 3.5 (2.2-4.9) 0.5 (0.0-1.0) 8.5 (6.5-10.5) > 1.7% (Pr=0.9); but Adale 2.4% 0.5% 7.1 (3.0 -11.2) 19.9(16.3-23.5) Low (<10) & stable trend (Jul-Dec’09) 18.9 (12.1-25.6) Low (<10) & stable trend (JanJun’10); lower than 09 trends N/A 0.93 (0.62-1.38) 1.05 (0.47-2.33) N/A N/A N/A Serious Alert but Critical for Adale ** deterioration No outbreak Morbidity – 43.3% No outbreak Morbidity – 33.7% Outbreak –AWD, measles and whooping cough in all the livelihood 0.2 > 15% but poor quality data - R3) > 3% but poor quality data - R3 High (>20%) & increasing trend (July-Dec10); higher than 09 trends Child Morbidity, Immunization, IYCF o o Disease Oubreaks: Morbidity based on 2wk recall o o o Immunization status/Vit. A Measles: 38.2; Vit. A: 40.7 Children eating from <4 fdgps Children meeting min. feeding freq. Measles: 44.3; Vit. A: 40.7 Public Health Indicators; Gender N=478 o Households (HH) accessing safe 34.2 water o HH accessing sanitation facilities 26.0 N=116 32.8 o o o Insignificant Insignificant HH accessing health facilities 47.7 Relation between GAM & child sex Insignificant Relation between GAM & sex of hh Insignificant head Food Security Phase Proportion of hh consuming <4 fd gps Overall Risk to Deterioration 30.0 HE/AFLC AFLC/BFI HE/AFLC POTENTIAL TO IMPROVE STABLE POTENTIAL TO DETERIORATE HIS Malnutrition Trends in Shabelle Agropastoral MCHs 2009-2010 (Data Source: COSV/MSF-S) Proportion of acutely malnourished children 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Jan Feb Mar Apr May 2009 2 per. Mov. Avg. (2009) Jun Jul Aug Sep Oct 2010 2 per. Mov. Avg. (2010) Nov Dec Middle Shabelle Riverine Livelihood Zone, Summary of Findings Outcome indicators Deyr’09/10 (N=640) Gu’10 (N=222) Deyr ’10/11 (N=1650) Child Nutrition status o o o GAM (WHZ<-2 or oedema) SAM (WHZ<-3 or oedema) Oedema 11.6 (7.7-15.4) 4.2 (2.7-5.8) 0.9 (0.0-1.9) >8.2% (Pr=0.9) > 0.6% (Pr=0.9) 0.5% 0.55.50.5 o MUAC (<12.5 cm or oedema) 11.7 (8.3-15.1) 8.6 (4.5 -12.6) > 15% (but poor quality data - R3 o MUAC (<11.5 cm or oedema o Stunting (HAZ<-2) 19.9(16.3-23.5) 17.6 (11.7-25.5) o HIS Nutrition Trends High (>15) but stable trend (JulDec’09) N/A 0.61 (0.36-1.05) 0.79 (0.38-1.67) Serious High (>20%) & stable trend (JanJun’10); higher than 09 trends N/A N/A N/A Alert o TFPs/SFPs Admission trends Crude death Rate/10,000/day (90days) Under 5 death Rate/10,000/day (90days) OVERALL NUTRITION SITUATION Child Morbidity, Immunization, IYCF > 3% (but poor quality data - R3 o o Disease Oubreaks: Morbidity based on 2wk recall No outbreak Morbidity – 42.3% Outbreak- AWD Morbidity – 43.7% o o Immunization status/Vit. A Children eating from <4 fdgps Measles: 54.7; Vit. A: 49.2 Measles: 57.2; Vit. A: 51.8 29.3 o Children meeting min. feeding freq. High (>15%) & stable trend JulyDec’10); consistent with 09 trends ** deterioration Outbreak –AWD, measles and whooping cough in all the livelihoods 32.9 Public Health Indicators; Gender N=434 N=120 o Households (HH) accessing safe water 51.6 25.0 o HH accessing sanitation facilities 31.7 70.0 o o o HH accessing health facilities Relation between GAM & child sex Relation between GAM & sex of hh head 56.9 Insignificant Insignificant Insignificant Insignificant AFLC CFI HE/AFLC POTENTIAL TO IMPROVE STABLE POTENTIAL TO DETERIORATE Food Security Phase Proportion of hh consuming <4 fd gps Overall Risk to Deterioration HIS Malnutrition Trends in Shabelle Riverine MCHs 2009-2010 (Data Source: COSV/MSF-S) 50.0 Proportion of acutely malnourished children 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Jan Feb Mar 2009 Apr 2010 May Jun Jul 2 per. Mov. Avg. (2009) Aug Sep Oct 2 per. Mov. Avg. (2010) Nov Dec Afgoye IDPs, Summary of Findings Outcome indicators Child Nutrition status o GAM (WHZ<-2 or oedema) o Mean WHZ o SAM (WHZ<-3 or oedema) o Oedema o MUAC (<12.5 cm or oedema) o Stunting (HAZ<-2) o HIS Nutrition Trends Deyr’09/10 (N=734) Gu’10 (N=639) Deyr’10/11 (N=682) 15.1 (11.4 – 19.8) -0.37 1.7 (1.0 – 3.0) 0.0% 7.2 (5.0 -9.4) 14.8 (104-20.7) N/A 21.6 (18.2 -25.3) -1.08 (±1.12) 3.2 (2.2 -4.6) 0.1 16.9 (12.4 _22.5) 11.4 (8.7 – 14.9) N/A N/A 0.99 (0.71 – 1.37) 1.40 (0.78 – 2.51) Critical N/A 0.62 (0.26 -1.46) 1.44 (1.03 -2.0) Very Critical No outbreak Morbidity – 47.4% Measles: 69.8; Vit. A: 70.8 No OutbreakMorbidity – 34.6% Measles: 61.7; Vit A: 59.2 Outbreak of AWD and malaria Morbidity – 43.8% Measles: 75.5 Vit A: 73.3 N=403 98.3 15.5 36.6 N=383 83.2 86.2 32.8 N=397 96.0 o HH accessing sanitation facilities o HH accessing health facilities Women Nutrition Status o Proportion with MUAC<18.5 cm (non pregnant and non lactating) o Proportion with MUAC<23.0 cm (pregnant + lactating) Gender: Relation between GAM & child sex Relation between GAM & sex of hh head 99.0 48.8 99.7 - 98.7 - Insignificant Insignificant Insignificant Insignificant Insignificant Insignificant Food Security Phase Proportion of hh consuming <4 fd gps OVERALL RISK TO DETERIORATION HE AFLC 10.1 UNCERTAIN UNCERTAIN o TFPs/SFPs Admission trends Crude death Rate/10,000/day (90days) Under 5 death Rate/10,000/day (90days) OVERALL NUTRITION SITUATION Child Morbidity, Immunization, IYCF o Disease Oubreaks: o Morbidity based on 2wk recall o Immunization status/Vit. A o Children eating from <4 fdgps o Children meeting min. feeding freq. Public Health Indicators; Gender o Households (HH) accessing safe water 15.9 (11.7-20.2) 5.5 (2.7-8.2) 0.1 (0.0-0.4) 11.2 (8.0-14.3) 27.5(21.6-33.4) High (>10) & stable(JulDec’09) N/A 1.27 (0.79-2.04) 2.32 (1.32-4.06) Critical 0.7 (N=135) 5.1 (N=253) STABLE Lower Shabelle Agropastoral Livelihood Zone, Summary of Findings Outcome indicators Child Nutrition status o GAM (WHZ<-2 or oedema) o Mean WHZ o SAM (WHZ<-3 or oedema) o Oedema o MUAC (<12.5 cm or oedema) o o o MUAC (<11.5 cm or oedema Stunting (HAZ<-2) HIS Nutrition Trends Deyr ‘09/10 (N=???) Gu ’10 (N=2200) Deyr ‘10/11 (N=2200) 0.1 (0.08 -1.02) 8.7 (8.3-9.1) 0.2 > 15% but poor quality data R3 > 3% but poor quality data - R3 Low (<10) & declining trend (JulDec’09) High (>20%) & increasing trend (July-Dec10); higher than 09 trends o TFPs/SFPs Admission trends Crude death Rate/10,000/day (90days) Under 5 death Rate/10,000/day (90days) N/A N/A N/A OVERALL NUTRITION SITUATION Serious ** deterioration Outbreak –AWD, measles and whooping cough in all the livelihood Child Morbidity, Immunization, IYCF o o Disease Oubreaks: Morbidity based on 2wk recall Outbreak – localized AWD Morbidity – o Immunization status/Vit. A Measles: o o Children eating from <4 fdgps Children meeting min. feeding freq. Public Health Indicators; Gender o Households (HH) accessing safe water o HH accessing sanitation facilities o o o HH accessing health facilities Relation between GAM & child sex Relation between GAM & sex of hh head Food Security Phase Proportion of hh consuming <4 fd gps Overall Risk to Deterioration N= - Insignificant Insignificant BFI BFI STABLE POTENTIAL TO DETERIORATE Outcome indicators Child Nutrition status o GAM (WHZ<-2 or oedema) o Mean WHZ o SAM (WHZ<-3 or oedema) o Oedema o MUAC (<12.5 cm or oedema) o MUAC (<11.5 cm or oedema o Stunting (HAZ<-2) o HIS Nutrition Trends Lower Shabelle Riverine Livelihood Zone, Summary of Findings Gu ‘10 (N=2200) Deyr ‘10/11 (N=2200) - - 0.05 (0.04 -0.06) 9.4 (9.2-9.6) High (>20%) & stable trend (Jan-Jun’10); higher than 09 trends 0.3 > 15% but poor quality data - R3 > 3% but poor quality data - R3 High (>15%) & stable trend JulyDec’10); consistent with 09 trends o TFPs/SFPs Admission trends Crude death Rate/10,000/day (90days) Under 5 death Rate/10,000/day (90days) N/A N/A N/A OVERALL NUTRITION SITUATION Serious ** deterioration Outbreak –AWD, measles and whooping cough Child Morbidity, Immunization, IYCF o o Disease Oubreaks: Morbidity based on 2wk recall Outbreak –AWD, measles and whooping cough Morbidity – o Immunization status/Vit. A Measles: Food Security Phase Proportion of hh consuming <4 fd gps Overall Risk to Deterioration BFI BFI POTENTIAL TO IMPROVE POTENTIAL TO DETERIORATE Hiran Pastoral Livelihood Zone, Summary of Findings Outcome indicators Child Nutrition status o GAM (WHZ<-2 or oedema) o SAM (WHZ<-3 or oedema) o Oedema o MUAC (<12.5 cm or oedema) o MUAC (<11.5 cm or Oedema) o Stunting (HAZ<-2) o HIS Nutrition Trends o TFPs/SFPs Admission trends Deyr’09/10 (N=695) 21.2 (16.5-25.8) 5.3 (3.1-7.6) 0.1 (0.0-0.4) 5.1 (3.1-7.6) Gu’10 (N=1100) Deyr ’10/11 (N=1100) - - 0.0 15.4 (15.1-15.8) 3.7 (3.5 -3.9) 0 14.7 2.5 22.0(16.9-27.0) High (>15) & stable trend (JulDec’09) High (>10%) & stable trend (JanJun’10); lower than 09 trends High and increasing numbers N/A N/A Low(<10%) and stable due to closure of HF’s in June’10 – therefore reduced numbers of children Crude death Rate/10,000/day (90days) Under 5 death Rate/10,000/day (90days) 0.50 (0.27-0.95) 0.82 (0.40-0.67) High and increasing numbers in Mahas (upto 400) in Apr-Jun’10 N/A N/A OVERALL NUTRITION SITUATION Very Critical Likely Very Critical Likely Critical Outbreak –whooping cough in Mahas (30 cases with 4 deaths) and Mataban (40 cases) in Apr-Jun’10 Morbidity – Measles: ------- VitA: --------- Out breaks –whooping cough in B/burti (Nov – Dec) Child Morbidity, Immunization, IYCF o o Disease Oubreaks: Morbidity based on 2wk recall No outbreak Morbidity – 51.4% RDT – 4.9% o o o Immunization status/Vit. A Children eating from <4 fdgps Children meeting min. feeding freq. Measles: 32.7; Vit. A: 31.7 Public Health Indicators; Gender N=403 o Households (HH) accessing safe 20.0 water o HH accessing sanitation facilities 18.1 o o o HH accessing health facilities 47.7 Relation between GAM & child sex Insignificant Relation between GAM & sex of hh Insignificant head Food Security Phase Proportion of hh consuming <4 fd gps Overall Risk to Deterioration HE/AFLC 47.5 STABLE N= Insignificant Insignificant HE/AFLC HE/AFLC STABLE POTENTIAL TO HIS Malnutrition trends in Hiran Pastoral MCHs 2009-2010 (Data Source: SRCS) Proportion of acutely malnourished children 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Jan Feb 2009 Mar 2010 Apr May Jun Jul 2 per. Mov. Avg. (2009) Aug Sep Oct Nov 2 per. Mov. Avg. (2010) Dec Hiran Agropastoral Livelihood Zone, Summary of Findings Outcome indicators Child Nutrition status o GAM (WHZ<-2 or oedema) o SAM (WHZ<-3 or oedema) o Oedema o MUAC (<12.5 cm or oedema) o MUAC (<11.5 cm or Oedema) o Stunting (HAZ<-2) o HIS Nutrition Trends Deyr’09/10 (N=795) 23.4 (19.0-27.8) 7.4 (3.9-10.9) 0.0 5.4 (2.5-8.3) Immunization status/Vit. A Measles: 32.7; Vit. A: 31.7 Children eating from <4 fdgps Children meeting min. feeding freq. Public Health Indicators; Gender N=478 o Households (HH) accessing safe 18.3 water o HH accessing sanitation facilities 30.9 o o o HH accessing health facilities Relation between GAM & child sex Insignificant Relation between GAM & sex of hh Insignificant head Food Security Phase Proportion of hh consuming <4 fd gps Overall Risk to Deterioration HE/AFLC 52.6 STABLE Deyr ’10/11 (N=1100) - - 0.1 16.7 (16.4-17.0) 3.2 (3.0 -3.4) 21.7(17.1-26.4) High (>15) & increasing trend (JulDec’09) o TFPs/SFPs Admission trends High and increasing numbers of admissions Crude death Rate/10,000/day (90days) 0.54 (0.36-0.82) Under 5 death Rate/10,000/day (90days) 0.84 (0.32-2.17) OVERALL NUTRITION SITUATION Very Critical Child Morbidity, Immunization, IYCF o Disease Outbreaks: No outbreak o Morbidity based on 2wk recall Morbidity – 51.4% RDT – 4.9% o o o Gu’10 (N=1100) 0.1 17.1 2.9 High (>10%) & stable trend (JanJun’10) High and increasing numbers in the 3 districts (upto 1800) in Apr-Jun’10 N/A N/A Likely Very Critical Outbreak –whooping cough in the three districts (604 cases) in AprJun’10 Morbidity – Measles: ------- VitA: --------- High (>10%) & stable trend (July -Dece’10) N/A N/A Likely Very Critical Outbreak –whooping cough in the three districts in Nov Dec ‘10 N= - Insignificant Insignificant HE/AFLC HE/AFLC STABLE POTENTIAL TO DETERIORATE HIS Malnutrition trends in Hiran Agropastoral MCHs 2009-2010 (Data Source: SRCS/IMC) Proportion of acutely malnourished children 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Jan Feb 2009 Mar 2010 Apr May Jun 2 per. Mov. Avg. (2009) Jul Aug Sep Oct 2 per. Mov. Avg. (2010) Nov Dec Hiran Riverine Livelihood Zone, Summary of Findings Outcome indicators Child Nutrition status o GAM (WHZ<-2 or oedema) o SAM (WHZ<-3 or oedema) o Oedema o MUAC (<12.5 cm or oedema) o MUAC (<11.5 cm or Oedema) o Stunting (HAZ<-2) o HIS Nutrition Trends o TFPs/SFPs Admission trends Crude death Rate/10,000/day (90days) Under 5 death Rate/10,000/day (90days) OVERALL NUTRITION SITUATION Deyr’09/10 (N=197) >18.8 (pr =0.90) >2.6 (pr =0.09) 0.5 10.1 (4.8-15.4 21.7(17.1-26.4) High & stable trend (Jul-Dec’09) Gu’10 (N=1760) Deyr ’10/11 (N=1100) - - 0.4 18.5 (18.2-18.8) 4.6 (4.4-4.8) 0 17.7 3.5 High and increasing numbers of admissions N/A N/A High (>10%) but declining trends in the last 3-4months trend (JanJun’10) High and increasing numbers in the 3 districts (upto 1800) in Jan-Jun’10 N/A N/A Critical Likely Very Critical Likely Very Critical No outbreak Morbidity 60.9% RDT – Outbreak –whooping cough in the B/Burti districts in Nov –Dec ‘10 Measles: 63.5; Vit. A: 63.4 Outbreak –whooping cough in the three districts (604 cases) in AprJun’10 Morbidity – Measles: ------- VitA: --------- N=434 31.6 N= - 43.5 - High (>10%) but declining trends in the last 3-4months trend (July - Dece’10 N/A N/A Child Morbidity, Immunization, IYCF o o Disease Oubreaks: Morbidity based on 2wk recall o o o Immunization status/Vit. A Children eating from <4 fdgps Children meeting min. feeding freq. Public Health Indicators; Gender o Households (HH) accessing safe water o HH accessing sanitation facilities o o o HH accessing health facilities Relation between GAM & child sex Insignificant Relation between GAM & sex of hh Insignificant head Food Security Phase Proportion of hh consuming <4 fd gps Overall Risk to Deterioration HE/ AFLC 43.0 STABLE Insignificant Insignificant HE HE STABLE Potential to deteriorate HIS Malnutrition trends in Hiran Riverine MCHs 2009-2010 (Data Source: SRCS/IMC) Proportion of acutely malnourished children 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Jan Feb 2009 Mar 2010 Apr May Jun Jul 2 per. Mov. Avg. (2009) Aug Sep Oct 2 per. Mov. Avg. (2010) Nov Dec Mogadishu/ Banadir Region, Summary of Findings Outcome indicators Deyr’09/10 (N=) Gu’10 (N=660) Deyr ’10/11 (N=1320) - - - Child Nutrition status o o o o o o o GAM (WHZ<-2 or oedema) SAM (WHZ<-3 or oedema) Oedema MUAC (<12.5 cm or oedema) MUAC (<11.5 cm or Oedema) Stunting (HAZ<-2) HIS Nutrition Trends o TFPs/SFPs Admission trends Very high numbers (>20%) and stable in at least 6 months period in three MCHs – Medina, Harmar Janjab and Hamar weyne (Source: HIS data, Jul –Dec’09). - - High and increasing numbers of admissions (in charge) in ACF managed centers (Hodan and Forlanini). Source: ACF, Mogadishu – Nov’ 2009) 1,200 new admissions reported in Mogadishu; high SAM (34%) and MAM (19.5%) among the screened children; increased death rates among U5s 0.0 11.7 (6.7-16.6) 0.3 (0.0-0.7) > 15% (29.2%; R3) > 3% (12.0%; R3) Very high (>20%) and fluctuating trends in the last 6 months in Medina, Waberi, Hamar weyne and hamar Jabjab. Low levels (<5%) and stable trends in Zam zam (JanJul’10). High and increasing numbers of admissions (in charge) in ACF managed centers (Hodan and Forlanini). Source: Jul’ 2010) Very high (>20%) and fluctuating trends in the last 6 months in Medina, Waberi, Hamar weyne and hamar Jabjab. Low levels (<5%) and stable trends in Zam zam (July-Dec’10). High and increasing numbers of admissions (in charge) in ACF managed centers (Hodan and Forlanini). Source: Jul – Dec ’ 2010) Crude death Rate/10,000/day (90days) Under 5 death Rate/10,000/day (90days) OVERALL NUTRITION SITUATION Child Morbidity, Immunization, IYCF o Disease Oubreaks: o Morbidity based on 2wk recall N/A N/A N/A N/A Likely Very Critical Likely Critical Likely Very Critical No outbreak No outbreak Morbidity: 17.9% (12.9-22.9) Out break AWD, cholera o o o Measles: ------- Vit A: --------- Measles: 80.2%; VitA: 88.0% Food Security Phase Proportion of hh consuming <4 fd gps HE/ AFLC 43.0 HE HE Overall Risk to Deterioration UNCERTAIN UNCERTAIN UNCERTAIN Immunization status/Vit. A Children eating from <4 fdgps Children meeting min. feeding freq. HIS Malnutrition Trends in Mogadishu MCHs 2009-2010 (Data Source: MSF-S) 50.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 2009 2 per. Mov. Avg. (2009) Banadir 2010 2 per. Mov. Avg. (2010) Dec Nov Oct Sep Aug Jul Jun May Apr Mar Feb 0.0 Jan Proportion of acutely malnourished children 45.0 HIS Malnutrition Trends in Merka MCHs 2009-2010 (Data Source: COSV) 50.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 Merka 2009 2010 2 per. Mov. Avg. (2009) 2 per. Mov. Avg. (2010) Dec Nov Oct Sep Aug Jul Jun May Apr Mar Feb 0.0 Jan Proportion of acutely malnourished children 45.0 TFC Admission Trends in Mogadishu Jan - Dec 2010 (Data Source: ACF) 1400 Number of children 1200 1000 800 600 400 200 0 Jan Feb Admissions March April Incharge May June July 2 per. Mov. Avg. (Admissions) Aug Sep Oct Nov 2 per. Mov. Avg. (Incharge) Dec OTP Admissions Trends in Hiran Region Jan-Dec 2010 (Data Source: SC-UK) 1200 Number of children 1000 800 600 400 200 0 Jan Feb March Admissions Apr Incharge May Jun Jul Aug 2 per. Mov. Avg. (Admissions) Sept Oct Nov Dec 2 per. Mov. Avg. (Incharge) Key Driving Factors Aggravating factors – – – – – – – – Civil Insecurity – Shabelle and Hiran are the most affected; Mogadishu remains the epicentre. Limited humanitarian space - displacement associated with civil insecurity Disease Outbreaks – AWD, cholera, malaria Taxation Limited access to health centres Limited medical supply in the area New IDPs Outbreak of AWD, Measles and malaria in M. & L. Shabelle; and Whooping cough /AWD in Hiran Mitigating Factors – – – Limited access to SF programs Income from sale of fodder and some labour opportunities among the riverine Social support Nutrition Situation Estimates Nutrition Situation Estimates, July 2010 Nutrition Situation Estimates, January 2011