EMERGENCY NUTRITION QUARTERLY BULLETIN (First Quarter 2008) Emergency Nutrition Coordination Unit Early Warning Department (Disaster Prevention and Preparedness Agency)

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OROMIA REGION BORENA ZONE MOYALE AND MI’OO WOREDAS, Page 2 DHAS WOREDA, Page 3 SNNP REGION SIDAMA ZONE BONA WOREDA, Page 6 This bulletin compiles findings from a total of thirteen surveys conducted in the first quar- COFFEE LIVELIHOOD ZONE (CLZ) & ENSET ter of 2008. Ten surveys were conducted in SNNPR-Sidama, Wolayta and Gamo Gofa LIVELIHOOD ZONE (ELZ) - DALE, ALETA WONDO & WONSHO WOREDAS zones and three in Borena Zone of Oromia Region. While some of the surveys were part Page 7 of ongoing monitoring of the nutrition situation in areas were NGOs are operational, the BORICHA, AWASSA ZURIA & HAWELLA TULLA majority of the surveys were conducted to investigate the nutrition situation amid reports WOREDAS Page 9 of rising food insecurity due to delayed and untimely rains and lower than average har- vest yields particularly in parts of SNNPR in 2007. The ENCU in collaboration with DPPB GAMO GOFA ZONE collaborated with NGOs to support these surveys. The prevalence of global acute mal- MIRAB-ABAYA AND BOREDA WOREDAS Page 10 nutrition ranged from a low of 3.0% (CI: 1.4-4.6%) to a high of 12.8% (CI: 9.2-16.3%). A summary of the results from all thirteen surveys is presented in graph 1 below. Full WOLAITA ZONE reports are available on request from the ENCU/EWD of DPPA. HUMBO & SODDO ZURIA WOREDAS Page 12 Graph 1 SURVEY DATA QUALITY CONTROL Page 15 Nutrition Survey Results - Ethiopia January - March 2008 NUTRITION CLUSTER / MANTF News Page 16 14 NUTRITION SURVEY DATABASE 12 Page 17 10

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Prevalence of malnutrition acute (%) 0

Bona Miyo Dhas Humbo Boreda Moyale Boricha Sodo Zuria Mirab Abaya Hawella TullaAwassa Zuria

ENCU/DPPA Sidama Coffee LZ Sidama Enset LZ Addis Ababa Tel. (011) 5 523556 Severe Acute Malnutrition Moderate Acute Malnutrition e-mail: [email protected] http://www.dppc.gov.et ENCU March 31, 2008 Page 1 OROMIA REGION

BORENA ZONE

Moyale and Mi'oo Woredas Baseline nutrition surveys: The Oromia Regional ENCU (R-ENCU) and the Regional DPPB and Food Security Commission (DPPB/FSC) conducted two standard nutrition surveys in adjacent woredas, Moyale and Mi'oo of Borena Zone between the 1st and the 11th of January 2008. The surveys were requested by the DPPB to assess the nutri- tional status and observe food security issues in both woredas were water shortage and untimely population movement had been reported following poor Ganna and Hageya rains, increasing food prices and reports of low EPI coverage. Technical support for both surveys was provided by IMC and GOAL. Both Mi'oo and Moyale populations are large- ly pastoralist and the woredas are situated along the Ethiopia-Kenyan border in the south of Oromia. Methodology: SMART was used to Health: Mortality rates were below assess the anthropometric status of 833 emergency thresholds, estimated at children aged between 6-59 months in CMR 0.17 (CI:0.0-0.33) Moyale and 750 children in Mi'oo deaths/10,000/day and U5MR 0.38 (CI: woredas using two-stage random clus- 0.1-0.86) deaths/10,000/day in Moyale ter sampling with 21x39clusters and and 0.11 (CI:0.0-0.23) 20x37 clusters respectively. deaths/10,000/day and 0.59 (CI: 0.07- Mortality estimates were calculated 1.25) deaths/10,000/day in Mi'oo wore- using 90-day recall from 2,800 people in da. Major causes of U5 mortality were Moyale and 2,754 people in Mi'oo. not recorded. Morbidity rates in children Anthropometric and mortality data was were relatively low at 12.7% in Moyale analysed using ENA software and vacci- and 11.2% in Mi'oo. Major causes of nation and morbidity information was morbidity were diarrheoa and ARI in analysed using Epi Info (6.04). One both woredas. Measles coverage in chil- result was flagged in Moyale woreda. dren (9-59 months) by card only was In both surveys the younger age group 18.6% (CI: 12.0-25.2%) in Moyale and aged between 6-29 months were slight- 10.2% (CI: 5.3-15.2%) in Miyo. ly under represented estimated at Considering mother's recall as well as 38.6% and 35.5% for Moyale and Mi'oo EPI card raised the measles coverage respectively. This falls below the distri- to 81.8% (CI: 71.1-89.5%) and 71.3% bution norm recommended by WHO (CI: 63.1-79.5%) respectively. However, (2000) of circa 49.4%. Otherwise the this is still low coverage. Immunisation findings were found to be plausible and against TB estimated by visible BCG were endorsed by the F-ENCU. scar was 73.9% (CI: 67.6-80.1%) in Moyale and 69.5% (CI: 62.7-76.4%) in Nutrition: In Moyale global acute mal- Mi'oo. Vitamin A coverage distributed nutrition (GAM) was estimated at 10% during the 6th round of EOS screening (CI: 7.5-12.4%) and severe acute mal- in October/November 2007 was report- nutrition (SAM) was 0.6% (CI: 0.1- ed as 86.5% in Moyale and 80.1% in 1.1%). This was bordering 'serious' in a Mi'oo (CI: not available). Access to safe chronically food insecure area and in the drinking water and sanitation is presence of aggravating factors (DPPA, extremely low. 2002). The observed aggravating fac- tors were listed as deteriorating food Livelihood / Food security: In general

ENCU security, insufficient rainfall, increasing these woredas are considered chroni- market prices and low EPI coverage. In cally food insecure. There is little oppor- Moyale and Mi'oo Mi'oo, GAM of 7.5% (CI: 5.6-9.3%) and tunity to produce crops. The majority of Woredas SAM of 0.5% (CI: 0.0-1.0%) were pre- the population are vulnerable to market sented. In the presence of the same price hikes especially when rainfall is It was concluded that these com- insufficient, grazing pasture is depleted munities are vulnerable to wors- aggravating factors, the nutrition status ening food and nutrition security of children was considered as 'poor' and livestock quality drops. While no in the months ahead as predicted (DPPA, 2002). Comparison with previ- human or animal disease outbreaks Ganna rainfall in March/May is ous surveys conducted in January 2006 were observed during the survey, it was poor and availability of pasture during a drought period, were similar predicted that both human and animal and safe water is currently low. with GAM of 10.9% (CI: 8.9-13.1%) in health could be vulnerable in the months Moyale and 10% (CI: 8.1-12.2%) in ahead if the dry period is prolonged. adjacent Dire woreda (formerly part of Mi'oo) in January 2006. ENCU March 31, 2008 Page 2 cost ofbasicstaples inthearea. ed priceoflivestock andrising reports oflivestockdeath,deplet- health inlivestock,escalating water shortage, deteriorating vating factorssuchasacute GAM, isseriousinlightofaggra- estimated at12.8%(9.2-16.3%) The prevalenceofmalnutrition Woredas Dhas ENCU analysed usingEpiInfo6.04). nation andmorbidityinformationwas software andvacci- analysed usingENA Anthropometric andmortality data was holds (approximately3,246individuals). ly using90-dayrecallfrom541house- information wascollectedretrospective- between 6and59months.Mortality was analysedfor525childrenaged the entireworeda. Anthropometric data tering with15x35clustersselectedfrom was usedwithtwo-stage randomclus- Methodology: (>70&<80% WHM). support 422 would require SFP support (WHM<70% +/-oedema)and mated that16childrenwould need TFP recorded. BasedonWHM% itwasesti- careers, MUACforadults wasnot observed thinnessinmothers and this leveloffoodinsecurity. WhileGOAL severe malnutritioncanbe preventedat nutrition, thatsomehowtheonsetof this area,eventothedetrimentofadult priority giventoyoungchildfeedingin has suggestedthatbecauseofthehigh moderate malnutritionrecorded.GOAL 3sd +/-oedema)giventhehighlevelof sented eitherasMUAC<11cm orWHZ<- malnutrition (SAM)werereported(pre- unusual thatnocasesofsevereacute with 4.7%atrisk(12.0-<12.5cm).Itis (MAM) (MUAC11.0-12.0cm) at1.7% estimated moderateacutemalnutrition 12.8% (CI:9.2-16.3%).MUACscores acute malnutrition(GAM)estimatedat (DPPA, 2002). The prevalenceofglobal ous' inlightofaggravatingfactors household foodsecuritystatus is'seri- of childrenunder5yearsageandthe Nutrition: ahead aspredicted and nutritionsecurityinthemonths ties arevulnerabletoworseningfood It wasconcludedthatthesecommuni- Conclusions andrecommendations: area. provide supportforanimalfeedingandveterinaryservicestoselectedkebelesinthe inallkebeles.SC-US, Action forDevelopmentandCAREalso ing servicesand TSFP isprovidingwatertanker- zone. Total populationisestimatedat39,882.CurrentlyGOAL prised of12kebeleslargelyfromDireand Aero woredasinthesoutheastofBorena long dryseasontypicallybetweenDecemberandMarch.Dhasisanewworedacom- the livestock morbidityanddeathacutewatershortage duetothepoorperformance of current foodsecurity, healthandnutritionsituationinresponsetoreports ofincreased 30th ofMarch2008attherequestOromiaDPPB. The rationalwastoassessthe conductedastandard nutritionsurveyinDhasworedabetweenthe24thand GOAL Dhas Woreda Ganna The currentnutritionalstatus and Hagaya MR methodology SMART Ganna rains in2007/8. The surveywasconductedattheendof rainfall in en routineEPIservices. called foralongwithefforts tostrength- Close monitoringofthesituationwas pasture andsafewateriscurrentlylow. March/May ispoorandavailabilityof using ellaand waterrationingsources, water). 44.5 % ofhouseholdsreported only 12%(definedasspring orpiped Access tosafedrinkingwater islowat investigation andconfirmation. severe diarrheoa. This needsfurther clinic servicesduetovomiting and two kebeleswith19children needing and cough(35.8%).Suspected AWD in main illnesseswerediarrhoea(42.1%), the twoweekspriortosurvey. The years reportinganepisodeofdiseasein ed at17.8%with95childrenunder-5 at thistime.Morbiditywashighestimat- routine EPIserviceswascompromised EOS campaign andtoinitiateeffective support requiredtomanagethelast formed woreda,thattheadministrative office). Itwassuggestedthatasanewly cient vaccineswereprovided(WMOH provided anditwasreportedthatinsuffi- 59.1% (CI:47.0-71.2%).No TSF was November 2007waslow, estimatedat through thelastEOScampaign in delivered supplementation Vitamin A 25.9% (CI:19.4-32.4%).Coverageof coverage (byobservedscar)waslowat still wellbelowacceptable targets. BCG reported at36.7%(CI:32.5-40.9%)but using 'cardandrecall'washigher, 1.9-6.7%). The estimatedcoverage was verylow, estimatedat4.1%(CI: nation coverageverifiedby'cardonly' deaths wererecorded.Measlesvacci- tality rateof0.00deaths/10,000/day, no of 1death/10,000/day. Under-fivemor- fell wellbelowtheemergencythreshold ty rateestimatedas0.15(CI:0.01-0.28) 2002).Crudemortali- guidelines (DPPA emergency thresholdscitedintheDPPA Health: ENCU March 31, 2008 Page 3 Mortality rateswerebelow ENCU food consumptionwith48%consuming households suchasthereductionin nisms werebeingresortedtobysome Despite theseefforts, copingmecha- ciaries targeted inneedofreliefsupport. additional 450quintals to12,000benefi- hadalsodistributedan stock. DPPA of foodandthedepletioninvaluelive- cash tocopebetterwiththerisingcost hadrequestedgraininsteadof PSNP 200% inmanyareas),recipients of alarming riseinthecostofgrain(by ETB/month. Howeverbecauseofthe have benefitedfromPSNP, receiving30 total of5,257people food (28%). A was livestocksales(68%)andrelief income forthecomingthreemonths sale ofcharcoal/firewood.Source source frompettytrade,dailylabouror Only 16%reportedhavingincome staple, purchasedfromlocalmarkets. Almost allreliedonmaizeasthemain interviewed 83%werepastoralist. also reported. Among 175households rise andsomeclosureofschoolswas February. Schooldropoutwasonthe many as6233livestockdeathsin option. woredaofficials reportedas areas ofbetterpasture isnotaviable migration responsetoneighbouring As thesituationiswidespread,usual reduced qualityoflivestockanddeath. animal consumptionhasresultedin included. Lackofwaterforhumanand much ofBorezaZone,Dhasworeda arid conditionsspreadingthroughout March-May) hasresultedinextreme with thedelayin September-November) compounded of the remains limited. The poorperformance ment inproductivecropproduction Livelihood diversityintermsofinvolve- ucts asthemainsourceofincome. heavily onlivestockandprod- Dhas woredaispastoralist, relying majority ofthecommunitylow-lying Livelihoods/ foodsecurity: water. used handpumpand12%pond 26% usedrainwaterharvesting,11% Hagaya rains in2007(typically Ganna rains (typically The ------listed as: reported. Keyrecommendationswere closure duetodroppingattendancewas out of39,882total population).School age islowat13%(5257beneficiaries cover- services duringthesurvey. PSNP symptoms weretransferredformedical les as19childrenpresenting AWD pected AWD wasobservedintwokebe- shortage atthisstage. Worryingly sus- erly andadults indicateextremefood nisms andmalnutritionobservedineld- the area.Reports ofcopingmecha- stock andrisingcostofbasicstaples in livestock death,depletedpriceoflive- health inlivestock,escalatingreports of as acutewatershortage, deteriorating ous inlightofaggravatingfactorssuch ed at12.8%(9.2-16.3%)GAM,isseri- The prevalenceofmalnutritionestimat- Conclusions andrecommendations: of thehouseholdsinterviewed. assets werepresentedby3%and6% al migrationandsaleofhousehold only onemealaday. Reports ofunusu- woreda. mal healthandnutritioninthe Close monitoringofhumanandani- sures. in targeted schoolstopreventclo- school feedingandwaterprovision UNICEF tosupportmorefor cash atleastforthenextcycle. todistributegraininsteadof PSNP are sufficient. and humanconsumptionuntilrains Continue waterrationingforanimal ment withvitamin A. paign formeasles,BCGandsupple- MOH toconductavaccinationcam- feeding forU5,PLW andelderly. Provision oftargeted supplemetary ease whenrainsstart. port foranimalssusceptibletodis- improved veterinaryservicessup- Animal fodderdistributionand ENCU March31,2008 Page4 ENCU Table 2:FoodandNutritionInterventionsinSurveyedWoredas ofOromia * MUACbelow12.0cmand/oroedema Table 1:SurveyResults inOromiaRegion Against KeyIndicators obdt 271. 17.8 NA 11.2 0.0 86. 73.9( 12.7 NR 4.1( & Cough Diarrhea Vitamin% A in past & ARI Diarrhoea 6months CI) (95% 0.0 10.2(5.3-15.2) & ARI Diarrhoea CI) (95% (scar) BCG coverage % NR 18.6(12.0-25.2) CI) Measles card + recall by (95% coverage % CI) 0.0 Measles (95% card 0.0 by coverage % Major illnesses symptoms or 0.11(0.0-0.23) 0 Morbidity (0.0-1.0) 0.5 % (0.0-0.33) 0.17 12.8(9.2-16.3) Major causes of U5MR (0.1-1.1) 0.6 7.5(5.6-9.3) CI) Death//10,000/day (95% U5MR 10.0(7.5-12.4) CI) Death/10,000/day (95% CMR Kwashiorkor % CI) SAM (95% Z-scores % CI) GAM in (95% Z-scores % Food Aid April - Dec. 08 – No ofbeneficiaries -Dec. 08–No Aid April Food Productive Safety Net – No ofbeneficiaries –No Net Safety Productive No of children acutely malnourished* As a percentage of screened children of screened apercentage As Outreach Therapeutic Programme Estimated Under Five population EOS- 6th round screening Therapeutic Feeding Unit Estimated population size Key indicators Key % ofrural population % ofrural population 18(118.)7. 6.-95 36.7(32.5-40.9) 71.3(63.1-79.5) 81.8 (71.1-89.5) 3 01-.6 .9(.712)0.0 0.59(0.07-1.25) .38 (0.10-0.86) 7.-46 01(098.)59.1(47.0-71.2) 80.1(70.9-89.7) 5 (78.3-94.6) 778.)6. 6.-64 25.9(19.4-32.4) 69.5(62.7-76.4) 67.7-80.1) January 2008 January Moyale 01-11 01-11 Moyale 0.15 (0.01-0.28) 1.9-6.7) Nov. 07 142,198 142,198 oaeM'oDhas Mi'oo Moyale 22,000 22,000 28,440 15.5% 0.7% ENCU March31,2008 Page5 No 168 January 2008 January Borena zone Mi'oo 01-11 01-11 Mi'oo Borena zone Nov. 07 10,000 10,000 14,865 13,306 66,532 23.3% 4.7% 15% 498 Dhas , 24-30 ,24-30 Dhas March 2008 March 13.2% 39,882 39,882 Borbor HC Borbor 3,000 3,000 5,257 7,976 7.5% DP 2002). (DPPA guidelines cited intheDPPA below emergencythresholds respectively. Mortality rateswere ed at0.3%(C.I.0.0-0.7%) acute malnutrition(SAM)estimat- 6.3% (C.I.4.1-8.5%)andsevere malnutrition (GAM)estimatedat The prevalenceofglobalacute Bona Woreda ENCU NPREGION SNNP analysed usingEpiInfo. nation andmorbidityinformationwas software and vacci- analysed usingENA Anthropometric andmortality data was imately 4,045individuals). recall periodin648households(approx- lected retrospectivelyusinga90-day months. Mortality informationwascol- 720 childrenagedbetween6and59 Anthropometric data wasanalysedfor selected fromBonaworeda. random clusteringwith20x36clusters methodologywithtwo-stage SMART Methodology: ZONE SIDAMA health andnutritionsupportneedsintheworeda. estimate thelikelycontributionofCTCinterventionandidentifyadditional/further since June2007. The surveywasconductedtoassessthecurrentnutritionalsituation, ing season.SC-UShasbeensupportingtheMOHtooperateCTCinBonaworeda December andthe3rdJanuary2008whichistypicallyharvestingcoffee pick- SC-US conductedastandard nutritionsurveyinBonaworedabetweenthe27th tality rateof0.14(CI:0.0-1.15) of 1death/10,000/day. Under-fivemor- fell wellbelowtheemergency threshold ty rateestimatedas0.08(CI: 0.01-0.18) 2002).Crude mortali- guidelines (DPPA emergency thresholdscitedintheDPPA Health: 5.1%.), SC-US,May2007). (12.2 -20.6%)andSAMof3.2%(1.3 mid-hunger season(GAMof16.4% significantly sinceMaywhichistypically nutrition situation(WHZ)hadimproved findings fromMay2007survey, the between 11.0-12.0cm). Compared to acute malnutrition(MAM)(MUAC (MUAC<11.0cm) and9.0%moderate scores estimatedSAMat1.2% oedema wasobserved(0.1%).MUAC (CI: 0.0-0.7%)respectively. Onecaseof malnutrition (SAM)estimatedat0.3% 6.3% (CI:4.1-8.5%)andsevereacute acute malnutrition(GAM)estimatedat (DPPA, 2002). The prevalenceofglobal year inachronicallyfoodinsecurearea more orless'typical'forthistimeofthe the householdfoodsecuritystatus are tus ofchildrenunder5yearsageand Nutrition: Bona Woreda Mortality rateswerebelow The currentnutritionalsta- The surveyused 43.5% ofrespondents inBonaworeda. Adequate accesswasreportedbyonly (defined asspringorpipedwater). Access tosafedrinkingwaterislow rhoea (50.8%),and ARI (49.2%). survey. The mainillnesseswerediar- disease inthetwoweekspriorto under-5 yearsreportinganepisodeof estimated at8.9%with65children 92.0% (CI:88.6-94.5%).Morbiditywas November 2007washigh,estimatedat recent 8throundEOScampaign in supplementation deliveredthrough (CI: 68.2-77.5%).CoverageofVitamin A coverage (byobservedscar)was73.1% but stillbelowacceptable targets. BCG reported at75.3%(CI:70.3-79.8%), age using'cardandrecall'washigher, (CI: 18.2-27.4%). The estimated cover- in bothworedas,estimatedat22.5% coverage verifiedby'cardonly'waslow dren wasunknown.Measlesvaccination ibid). The maincauseofdeathinchil- threshold of2deaths/10,000/day(ref is alsowellbelowtheemergency deaths/10,000/day wasrecorded. This good by8.3%ofrespondents. good by50.0%,poor41.7% andvery physical conditionwasreported tobe reported asgoodby61.1%. Livestock Water availability forlivestockwas and 33.3%reporteditbelowaverage. average for30.6%mostrespondents Pasture wasreportedtobegood36.1%, normal 30.6%and25.0%belownormal. dents. and belownormal33.3%ofrespon- above normalfor27.8%,22.2% as follows. The focus groupdiscussionswasreported approximately 216householdsand from communityquestionnaires Livelihood/Food Security: ENCU March31,2008 Page6 Meher 2007 rainswereabove Belg 2007 rainswere Information 0.5%). and SAMrateof0.2%(C.I. 0.0- mated at5.9%(C.I.4.2-7.7%) insecure areawithGAMrate esti- 'Typical' forthischronicallyfood children wasconsidered as In theCLZ,nutritionstatus of Dale, Aleta Wondo and Wonsho Woredas ENCU i supplementation isrelativelygood min A age ofmeaslesimmunizationandvita- the hungerperiod. The reportedcover- ter thantheMay2007findingswhichis tion (DPPA, 2002)andsignificantlybet- for thischronicallymalnourishedpopula- among childrenisconsideredastypical (CI: 0.0-0.7%). This malnutrition rate of severeacutemalnutritionwas0.3% 6.3% (CI:4.1-8.5%)andtheprevalence tion amongthesurveyedpopulationwas The prevalenceofglobalacutemalnutri- Conclusion andrecommendations: individuals). 646 households(approximately3,596 Mortality informationwascollectedfrom measured 590children(14x42clusters). 2,825 individuals). The ELZsurvey from 524households(approximately was basedon90-dayrecalltaken (18x32 clusters).Mortality information information wastaken from560children sis. IntheCLZsurveyanthropometric 11.5) wasusedforallotherdata analy- anthropometric data andSPSS(version software wasusedforanalysisof random clusterdesign.SMART-ENA methodologyusingtwostage SMART Methodology: Livelihood Zones. survey wastoassessthenutritionstatus ofchildrenpostharvestseasoninboth porting theMOHtodeliverCTCservicesinDalesince2005,and Aleta since2006. The February. BoththeseCLZandELZareinSidamaZone,SNNPR. ACF havebeensup- the EnsetLivelihoodZone(ELZ)sameworedasbetween5thand14thof Dale, Aleta Wondo andWonsho woredasbetweenthe14thand24thofJanuaryin ACF conductedtwostandard nutritionsurveysintheCoffee LivelihoodZone(CLZ)of post-harvest period. nutrition aretobeexpected duringthis - 0.7). These relativelylowratesofmal- (CI: 4.1-7.1%)andSAM(0.3 %(CI:0.0 ducted by ACF estimating GAMat5.6% ings oftheDecember2006surveycon- but notsignificantly, compared tofind- ma wereobserved. This isslightlyless, 0.2 %(CI:0.0-0.5%).Nocasesofoede- 5.9 %(CI:4.2-7.7%)andSAMrateof cure areawithGAMrateestimatedat 'Typical' forthischronically foodinse- tus ofchildrenwasconsideredas Nutrition: Woredas, Sidama Zone,SNNPR. 2 exist, thesamesituationis consideredas'poor'. 2% and9%aretypicalfor a chronicallymalnourishedpopulation.Whereaggravating factors 1 Nutrition andretrospective mortality surveyDecember 2007,CLZ,Dale, Aleta andWonsho EmergencyNutrition Assessment guideline2002suggests thatGAMestimatesbetween DPPA Coffee LivelihoodZone(CLZ)andEnset(ELZ)- Dale, Aleta Wondo andWonsho Woredas In theCLZ,nutritionsta- Both surveysfollowed hoods intheworeda. improve safewateraccessandliveli- mended tosupportinterventions ment inMay2008.Itwasfurtherrecom- season andrepeatanutritionassess- food securitysituationduringthehunger vide 'minimumsupport',monitorthe MOH butcontinuetomonitorandpro- hand overCTCserviceoperationsto ommendations madebySC-USwereto erage withcardwasverylow. Keyrec- However themeaslesvaccinationcov- compared tothenationalaverage. key timesintheyear. access generatedincash crop areasat efit fromopportunisticimproved food GAM. These communitiescannotben- situation plateausataround10-15% year intheELZareasandnutrition ic foodinsecurityprevailsthroughoutthe in July2007,itissuggestedthatchron- from thehungerseasondata collected rate ofmalnutritiondidnotvarygreatly not thecaseforMAMandGAM. As the ing tothesamefigureinJulyandthisis lence ofSAMinFebruary2008compar- lower. There isadecreaseofpreva- 2007 (2.3%CI:1.0-3.6%)seemstobe Comparing tothesamefigureinJuly February 2008(0.8%CI:0.0-1.7%.) However, theprevalenceofSAMin ence isnotstatistically significant. showing areductionalthoughthediffer- 2007 (13.7%C.I:10.2-17.1%)is to theprevalenceofmalnutritioninJuly deteriorating watersupply. Comparing such aspoorvaccinationcoverageand 'serious' inlightofaggravatingfactors were observed. This wasconsidered (CI: 0.0-1.7%).Nocasesofoedema 11.5% (CI:8.4-14.6%)andSAMat0.8% siderably worsewithGAMestimatedat In theELZ,nutritionstatus wascon- ENCU March31,2008 Page7 ENCU in thearea. ing safewater(protectedspring,piped) remains lowwithlessthan12%access- Access tosafewaterandsanitation the maincausesreported. ry illnessesanddiarrhoealdiseasesas estimated at12.7%withfever, respirato- in November2007.Morbiditywasalso EOS roundofscreeningwasconducted was 86.6%(CI:84.0-89.0%). The last coverage supplementation Vitamin A only was22.9%(CI:19.0-26.0%). Measles coverageestimatedbycard estimated at57.6%(CI:54.0-62.0%). recalled (URMR=0).BCGcoveragewas (CI: 0.00-0.25).NoU5mortality was estimated at0.09deaths/10,000/day below emergencythresholds.CMRwas In theELZ,mortality rateswerealsowell screened. werecorrectly gible forEOS-TSFP 26.3% ofthechildreninsampleeli- mated usingMUACdata estimatedthat approximatecoverageesti- EOS-TSFP diarrhoea. vey wererespiratoryillnesses,feverand ness inthetwoweekspriortosur- estimated at12.7%.Majorcausesofill- support MOH.Morbidityinchildrenwas improvement alongwith ACF efforts to screening hascontributedtothisoverall It issuggestedthatimprovedEOS 71.4-87.8%) to88.9%(CI:86.0-92.0%). coverage increasedfrom79.6%(CI: supplemnation this survey. Vitamin A mother's recallwasnotrecordedduring 36.6% (CI:33.0-41.0%).Unfortunately increased from10.4%(CI:7.0-13.7%)to vaccination basedoncardonly 2008. Similarlythecoverageofmeasles 56.5% (CI:53.0-61.0%)inJanuary % (CI:45.2-56.9%)inJune2007to observed scar)hasincreasedfrom49.0 ducted inJune2007.BCGcoverage(by comparing findingswiththesurveycon- reports improvedimmunisationstatus 0.0-0.80) deaths/10,000/day. ACF /10,000/day, andtheU5MR,0.34(CI: CMR of0.1(CI:0.0-0.22)deaths well belowemergencythresholds,with Health: the previousharvest. recent harvest producedlessfoodthan 56% ofrespondents reportedthatthe employment opportunities reported. in ownproduction,with little external most oftherespondents wereengaged Livelihood/Food security: In theCLZ,mortality ratesare In theCLZ, cerns voicedbythesecommunities. increasing watershortage wereallcon- ed. Increasedpricesofstaples and due toprolongeddryperiodwasreport- safety netbeneficiaries.Poorpasture Approximately 4%ofthepopulationare that foodwouldbecomeshort. and wereconcernedwithdelayed respondents sharedsimilarresponse, In theELZ,approximately53%of quotas ofbeneficiariesespecially during EOS screening,increasing thePSNP and improving theperformance of TSFP and CTC, the linksbetween TSFP strengthening recommends Overall ACF concerns offoodshortage werevoiced. lower yieldfromthelastharvestand households interviewedreportedhaving 2deaths/10,000/day. Some52.5%of tively of1death/10,000/dayand below thecut-offs foralertlevelrespec- and theU5MRofzero,arebothwell The CMRof0.09death/10,000/day, ply presents aseriousnutritionsituation. and alsopossibleinadequatewatersup- supplementation nation andvitamin A factors likelowlevelofmeaslesvacci- % inthepresenceofsomeaggravating rate of11.5 %andtheSAMrateof0.8 In theEnsetLivelihoodZoneGAM year. food suppliescompared totheprevious they arefacingwithgeneraldeficitof household interviewedreportedthat 2deaths/10,000/day. However, 56.3% 1death/10,000/day and the alertlevelrespectivelyof 0.34 deaths/10,000/day, arebothbelow 0.1death /10,000/day, andtheU5MR, cies atthistimeoftheyear. The CMRof shows lowriskofnutritionalemergen- rate of5.9%andtheSAM0.2% In theCoffee LivelihoodZone,theGAM through theyear. to theabsenceofastrongcashcropall the rateofGAMappearstoplateau,due rate ofmalnutritionrisessharply. InELZ coffee isfinishedduringJulyorJunethe months after). Whenthecashincomeof crop likecoffee (February andfew to impact ofharvestastrongcash rates ofmalnutritionarerecoveringdue follows different patterns. InCLZthe the natureofhungertrendsintwozones results conductedinJanandFeb2008, Comparing bothlivelihoodzonesurvey Conclusions andrecommendations: ENCU March31,2008 Page8 Belg , area. what isnormallyafoodinsecure delay orabsenceof the currentdryspelland the vating factorslargelycaused by as poor/seriousinlightofaggra- nutrition situationisconsidered In allthreeworedasthecurrent Boricha, Awassa Zuria, Boricha, Awassa Hawella Tulla woredas Belg rains in ENCU Sidama Zoneinresponsetoreports offailed standard nutritionsurveysinBoricha, Awassa ZuriaandHawella Tulla woredasof World Vision Ethiopia(WVE)incollaborationwiththeR-ENCU,DPPBconductedthree ahead. 2008, priortothemainhungerseasonpredictfoodsecurityneedsinmonths livestock conditionsandrisingfoodinsecurity. The surveyswereconductedinMarch Hawella Tullaworeda. the 6-29monthagegroup(34.8%)in except forslightunderrepresentation of found. All data wasfoundtobeplausible other data. Noflaggedrecordswere Info andexcelwereusedtoanalyseall software. Epi analysed inSMART-ENA Hawella Tulla. Anthropometric data was in Awassa Zuriaand648householdsin households inBoricha,648 90-day recallwascollectedfrom828 woredas. Mortality informationbasedon Awassa Zuriaand836inHawella Tulla 6 and59monthsinBoricha,868 to measure873childrenagedbetween pling using36clustersineachworeda 8th ofMarch. Two stage randomsam- were conductedbetweenthe3rdand methodology surveys usingSMART Methodology: causal analysisstudytoinvestigatethe in thearea. ACF proposestoconduct Additional FSinterventionsareneeded Nutrition Programmeinfuture. the MOH/UNICEFCommunitybased woredas areconsideredforinclusionin EPI servicesandsuggestedthatthese the hungergap,strengtheningroutine higher thanfindingsfroma surveycon- 0.9%). BothGAMandSAM areslightly (SAM) wasestimatedat0.5% (CI:0.0- lence ofsevereacute malnutrition 10.3% (CI:8.1-12.5%)and thepreva- dren underfiveyearswasestimatedat acute malnutrition(GAM)amongchil- In Borichatheprevalenceofglobal most ofthesecommunitiesliveunder. chronic foodinsecuritybackdropthat ties, risingfoodpricestogetherwiththe condition observedbymanycommuni- ture andthedeteriorationoflivestock as growingwatershortage, lackofpas- ous' inlightofaggravatingfactorssuch woredas andconsideredas'poor/seri- health situationwassimilarinthethree Nutrition: Boricha, Awassa Zuria&HawellaTulla Woredas Overall, thenutritionand Three standard nutrition Belg was aslow5.1%in Awassa Zuriaand 81.5%) inHawella Tulla. Cardretention Awassa Zuriaand77.6%(CI:73.1- Boricha, 69.5%(CI:64.8-73.8%) in varied from81.2%(CI:77.0-84.8%) in dren (9-59months)bycardandrecall tetanus (1).Measlescoverageinchil- causes ofU5MRwerediarrhoeaand deaths/10,000/day werelow. Major deaths/10,000/day,0.17 0.13deaths/10,000/day,0.16 tively. Similarly, U5MR estimatesof Awassa ZuriaandHawella Tulla respec- 0.15 deaths/10,000/dayinBoricha, 10,000/day, 0.06 deaths/10,000/dayand woredas asfollows:CMR0.1deaths/ below emergencythresholdsinallthree Health: tion isconsideredas'poor'. aggravating factors,thenutritionsitua- at 0.1%(CI:0.0-0.4%).Similarly, dueto GAM at7.9%(CI:5.3-10.4%)andSAM Hawella Tulla woredafindingsestimated tors persist. considered as'poor'ifaggravatingfac- mated at0.7%(CI:0.1-1.3%). This is 9.1% (CI:5.9-12.3%)andSAMwasesti- In Awassa Zuria,GAMwasestimatedat meal consumption. supply athomeandsomereductionin above. Familiesreportedreducedfood the aggravatingactorsmentioned situation isborderingseriousinlightof not statistically significant. The nutrition of 0.3%(CI:0.0-0.7%). The difference is GAM of8.3%(CI:6.2-10.4%)andSAM ducted inMarch2007whichpresented repeated inthehungerseason. followupnutrtionsurveywillbe ly. A these LivelihoodZonesmorethorough- underlying causesofmalnutrtionin rains, poorpasture andworsening ENCU March31,2008 Page9 Mortality estimateswerewell rable toa"normal"year. situation oftheworedaiscompa- indicated thatthefoodsecurity munity atthetimeofsurvey the copingstrategiesofcom- The foodsecurityindicatorsand Mirab-Abaya andBoreda Woredas ENCU AOGF ZONE GAMO GOFA increased foodinsecurityexpected andprovideinformationforearlyresponseas needed. requested tomonitorthe nutrition status inlight ofthecurrentdryspellreportedand standard nutritionsurveysinMirab Abaya andBoredaworedas. The surveyswere development (MOARD),woreda(MOARD)and ministryofhealthtoconducttwo World Vision Ethiopia incollaborationwiththeZonaldepartment ofagricultureandrural Zuria and705inHawella Tulla. are 2,068inBoricha,764 Awassa tary feeding(TSFP)(>70%WHM<80%) children inneedoftargeted supplemen- Hawella Tulla woredas.Estimatesof Boricha, 64in Awassa Zuriaand23in (WHM<70% +/-oedema)were46in children inneedoftherapeuticfeeding extrapolated toestimatenumbersof not providedhoweverabsolutenumbers ing women.Estimatesofcoveragewere ished childrenandpregnantlactat- mentary foodformoderatelymalnour- round ofscreeningtoprovidesupple- and iscurrentlypreparing forthe2nd The EOShasalsobegunoperations 94%. Awasa Zuria,86%andinHawella Tulla, estimated at31%butverygoodin (piped/spring) wasverypoorinBoricha ness. Access tosafewater disease wasbyfarthemostcommonill- diarrhoea, malariaand ARI. Diarrhoeal main causeofillnesswasreportedly Hawella Tulla woredasrespectively. The the surveyinBoricha, Awassa Zuriaand ing fromillnessinthetwoweekspriorto of thechildrensampledreportingsuffer- woredas with18.1%,12.6%and15.8% Morbidity inchildrenwashighallthree Tulla. and 81.3%(CI:77.2-84.9%)inHawella 84.2% (CI:80.4-87.4%)in Awassa Zuria 85.5% (CI:81.7-88.6%)inBoricha, in November2007wasgoodreportedat during thelastroundofEOSscreening coveragedistributed Tulla. Vitamin A 63.8% (CI:58.9-68.3%)inHawella (CI: 32.6-41.9%)in Awassa Zuriaand 62.7%) inBoricha,verypoorat37.1% low ingeneralat58.1%(CI:53.3- TB estimatedbyvisibleBCGscarwas 10.3% inBoricha.Immunisationagainst Mirab-Abaya andBoredaWoredas low. population inthearea,coverageis ties, butgiventhehighdensityof ble withcashorfoodforworkopportuni- this area,supportingthemostvulnera- gramme (PSNP)operatesthroughout woredas. The productivesafetynetpro- sequently livestockconditioninallthree affected thequalityofpasture andsub- Additionally, thecurrentdryseasonhas and fearsoffoodshortage werevoiced. delay/lack of communities reportedthatthecurrent gency copingstrategieswereobserved, tional staples. Whilenomajoremer- sweet potatoes, haricotbeansasaddi- and maizeasthemainstaple foodsand mixed subsistencefarmingwithenset three woredasthemainlivelihoodis Food Security/Livelihood: bution interventions. routine EPIprogrammeandITNdistri- work withtheMOHtostrengthen CTC services(NGOsupported),andto gested tosupporttheMOHdeliver children andwomen.Itwasalsosug- formalnourished especially the TSFP aries andstrengthentheEOSefforts benefici- closely, toincreasethePSNP to monitorthefoodsecuritysituation recommended fortheDPPBtocontinue normally afoodinsecurearea.WVE delay orabsenceof caused bythecurrentdryspelland in lightofaggravatingfactorslargely situation isconsideredaspoor/serious In allthreeworedasthecurrentnutrition Conclusions andrecommendations: ENCU March31,2008 Page10 Belg rains wasominous Belg rains inwhatis In all ENCU other informationanalysis. Info andexcelsoftware wereusedforall to analysetheanthropometricdata, Epi software wasused Abaya. SMART-ENA Boreda and180householdsinMirab naires askedfrom150householdsin obtained usingcommunityquestion- Abaya. Foodsecurityinformationwas in Boredaand540householdsMirab recall wasaskedfrom450households Mortality informationbasedon90-day selected clustersineachworeda. 456 inMirab Abaya using30randomly children (6-59months)inBoredaand tion wascollectedfromatotal of425 Methodology: and 94.1%(CI:90.7-97.5%) inMirab was 96.4%(CI:94.3-98.7%) inBoreda November 2007EOScampaign round supplementation deliveredinthe Mirab Abaya. CoverageofVitamin A Boreda and80.5%(CI:74.2-86.8%) in erage was88.2%(CI:88.1-96.3%)in 89.8-96.9%) inMirab Abaya. BCGcov- 80.4-96.5%) inBoredaand93.3%(CI: mated bycard+/-recallwas88.2%(CI was verygood.Measlescoverageesti- Immunisation coverageinbothworedas mal. cases. Therefore, thesituationisnor- reported asthecauseofdeathinknown countries intheseworedas.Malariawas fall belowtheaveragefordeveloping respectively. BoththeCMRandU5MR 0.23 and0.85deaths/10,000/day Mirab Abaya theCMRandU5MRwere deaths/10,000/day respectively. In (U5MR) were0.08and0.21 Rate (CMR)andU5Mortality Rate Health: malnutrition wereobserved. As inBoreda,nocasesofsevereacute 1.2-3.8%) butnotstatistically significant. of February2007estimatedat2.5%(CI: which againisslightlyhigherthanthat of 3.5%(CI:1.4-5.6%)wasestimated is notsignificant.InMirab Abaya aGAM 2.5% (CI:1.2-3.8%)butthedifference than thatofFebruary2007estimatedat observed. This prevalenceishigher of severeacutemalnutritionwere as 4.5%(CI:2.5-6.5%)andnocases acute malnutrition(GAM)wasestimated food insecurearea.InBoredaglobal nutrition status typicalofthischronically Nutrition: In BoredatheCrudeMortality Both woredaspresenteda Anthropometric informa- - Mirab Abaya. beneficiaries inBoredaand27,369 withcashandfood.Some19,882 PSNP disease. Bothworedasbenefitfromthe caused bylackofrainandbecause poor becauseofinsufficient pasture the conditionoftheirlivestockwasvery Abaya and83%inBoredareportedthat viewed whoownlivestock,60%inMirab were alsoreported.Forthoseinter- for somediversitysuchassmalltrade Whereas inMirab Abaya opportunities ent onagriculturefortheirlivelihood. almost allofthepopulationaredepend- Livelihood /foodsecurity: (spring/piped) wasonly32%. ia anddiarrhoea. Access tosafewater Causes forreportedillnessweremalar- 19.1% inBoredaandMirab Abaya. woredas, estimatedat12.8%and Abaya. Morbidityrateswerehighinboth Some recommendationsmadebyWVE: shortage inthecominghungerperiod. bution inaddressingtheanticipated food willpay asignificantcontri- going PSNP Belg by onset,amountanddistributionof the monthsaheadwouldbedetermined status andfoodsecurityoftheareain three months.However, thenutritional duction asasourceoffoodinthenext dicted theywouldrelyontheirownpro- year. The majorityofhouseholdspre- the woredaiscomparable toa"normal" cated thatthefoodsecuritysituationof community atthetimeofsurveyindi- tors andthecopingstrategiesof usually good. The foodsecurityindica- son whenhouseholdfoodsecurityis the postharvesttimeof The currentsurveyswereconductedin Conclusion andrecommendations: - tional situationoftheworeda. deteriorating foodsecurity and nutri- ing systemforearlydetection of strengthen theexistingearly warn- main livestockdiseases. And immunization campaign against office tocontinueandstrengthenthe Agriculture andruraldevelopment in theworeda. nutrition andfoodsecuritysituation da DPPDtocloselymonitorthe World Vision Ethiopiaandthewore- rain. Itwassuggestedthattheon ENCU March31,2008 Page11 Meher In Boreda sea- of theyear(DPPC, 2002). ranked tobenormal forthistime prevalence ofmalnutrition is supplementation), thecurrent nization coverageandvitamin A health factors(morbidity, immu- security status andthepublic Considering theexistingfood Humbo &SoddoZuria Woredas ENCU - - of globalacute malnutritionwashigher nificant. InSoddoZuriathe prevalence %). The difference isnotstatistically sig- 1.1-3.7 %)andSAM0.3% (CI:0.0-0.7 February 2007withGAM of2.4%(CI: findings ofthesurveyconducted in tion ratesareslightlyhigher thanthe nutrition andthesevereacutemalnutri- prevalence ofboththeglobalacutemal- 1.4) with0.2%oedema.Whilethe acute malnutritionwas0.6%(CI:0.0- 1.4-4.6%) andtheprevalenceofsevere of globalacutemalnutrition3.0%(CI: for thisarea.InHumbotheprevalence lence ofacutemalnutritionwas'normal' Nutrition: lection wasconductedfrom14thto18thofFebruary, 2008. the woredaforpurposeofearlypreparedness andtimelyresponse. The data col- the surveyswastomonitornutritionalandfoodsecuritystatus ofthecommunity agriculture andruraldevelopmentworedahealthoffice. The primaryobjectiveof Zuria woreda,Wolayta Zone ofSNNPRincollaborationwiththezonaldepartment of World Vision Ethiopiaconductednutritionandmortality surveysinHumboandSoddo each cluster. nity interviewwasalsoconductedin commu- households ineachworeda. A food securityandhealthsituationofthe households toassessthehousehold tionnaires werecompletedfor150 holds inSoddoZuria.Householdques- viduals) weresampledand630house- in Humbo450households(2,716indi- Soddo Zuria.Formortality information, clusters) and701children(23x30)in measured from462children(15x30 used. InHumboanthropometrywas using twostage clustersamplingwas Methodology: - OAT ZONE WOLAITA (ITNs). viding Impregnated Treated Nets vention andcontrolactivitiesbypro- Continue tosupportthemalariapre- worming coverage. supplementation andde- vitamin A improving measlesimmunization, malnourished childrenandin continue inassistingthemoderately The EOSprogrammealsoshould cure population. address thechronicallyfoodinse- in thecominghungerperiodto shouldcontinue The ongoingPSNP Humbo &SoddoZuriaWoredas In bothWoredas thepreva- MR methodology SMART - - is notstatistically significant. (CI: 0.0-1.0%).However, thedifference is lowerthaninsamesurveyat0.4% ed at3.9%(CI:2.2-5.6%)buttheSAM GAM inFebruary2007survey, estimat- The GAMisslightlyhigherthanthe The prevalenceofoedemawas0.1%. tion wasestimatedat0.1%(C.I0-0.4%). the prevalenceofsevereacutemalnutri- estimated at4.3%(CI:2.7-5.9%)and under fivechildren twoweekspriorto In Humbo,theoverallmorbidity rateof paigns inthe area. good performanceofthe EOScam- 84.3-95.7%) inSoddoZuria indicating 72.8-83.8%) inHumboand 90%(CI: supplementation ishighat78.8%(CI: Soddo Zuria.Coverageforvitamin A with only5.2%inHumboand15.4% 2002). Cardretentionremainsverylow international benchmarkof90%(DPPC Soddo Zuria.Botharestillbelowthe Humbo and86.5%(CI:80.7-92.3%)in high at84.5%(CI:78.9-88.9%)in optimal. Measlescoveragewasalso average of46%(DHS2005),butstillnot Soddo Zuria,ishigherthanthenational Humbo and72.3%(66.4-78.3%)in estimated at64.9%(58.4-71.0%)in Health: the foodsecurity. monitor thetrendofnutritionand this timeinordertoassessand hunger periodand/ornextyearat conducted duringthecoming comparable methodologyshouldbe followupnutritionsurveyusinga A access toasafewatersupply. old structuresinordertoimprove new waterstructuresandmaintain ment organizationsshouldconstruct Word Vision andrespectivegovern- ENCU March31,2008 Page12 BCG vaccinationagainst TB ENCU tion (ARI)includingpneumonia. malaria andacuterespiratorytractinfec- death inbothadults andchildrenwere (DPPA, 2002). The maincausesof rates arebelowemergencythresholds deaths/10000/day (CI:0.00-0.87).Both the underfivemortality ratewas0.36 deaths/10000/day (C.I0.05-0.45)and The crudemortality ratewas0.25 deaths: 6inadults and2inunder-fives. spective mortality data showed8 water. InSoddoZuriatheoverallretro- behaviour, andutilizationofpotable poor withsuboptimalhealthseeking of preventative behavioursarerelatively poor hygieneandsanitation. Indicators also causesofchildillnesscausedby infections anddiarrhoealdiseasewas death ofthesamplepopulation.Skin children. ARI wasalsothemaincauseof causes ofillnessamongstthesample eases, anddiarrhoeaweretheleading ARI/cough, scabiesandotherskindis- 16.2% (n=75)inHumbo.Malaria/fever, the surveydatewasreportedtobe and holds. Inthepast fourweeksalsomaize and 0.6%(n=1)ofthesamplehouse- ple foodsfortheremaining8.7%(n=13) Sweet potato andtaro werealsothesta- households atthistimeoftheyear. (n=102) and22.7%(n=34)ofthesample ed asthemainstaple foodsfor68.0% In Humbomaizeand households issalary/wage. livelihood fortheremaining1.3%of ism arethemainlivelihoods. The main woredas, agricultureandagro-pastoral- Livelihood /foodsecurity: Humbo hastwoagro-ecologiesof Based onthetraditionalclassification, being consumed. However, unusualorwild foodswerenot decreased from74%(2007)to64%. that reportedeatingthreetimesperday In Humbotheproportionsofhouseholds 10.7% and0.7%ofthehouseholds. potato andtaro werethe mainfoodsfor sample householdsrespectively. Sweet 65.3% (n=98)and23.3%(n=35)ofthe ( woreda hastwomajorrainy seasons 30% oftheworedarespectively. The and views. Only 30% ofthecommunities was assessed usingcommunityinter- November. The rainfallsituationof2007 son knownas Belg woinadega enset and Meher were themainfoodsfor that comprises70%and Sape ) andshortrainysea- enset that fallsaround were report- In both kola observed. increases inthepriceofstaples was previous month.Inadditionsignificant 15% oflivestockpricereductioninthe of informants. This hasresulted in10- according tosignificantmajority(90.1%) as poor, mainlyduetolackofpasture the physicalconditionsoftheirlivestock owning livestock,morethan60%rated be duetothepoorrecent holds. This shift inthestaple dietcould accounting fornearly50%ofthehouse- bleak duetodelayed the prospectfor the surveywereinpoorconditionand Fields ofsweetpotato observedduring time lastyear(February2007,WVE). staple dietfor89.4%ofhouseholdsthis vest. Incontrast,sweetpotato wasthe however, ' mation). Inthepreviousfourweeks diet (WVE,February2007surveyinfor- 22.9 %and15.2ofthehouseholds' this timeofyear, accountingfor58.6%, maize arenormallythemainstaples at the root crops andcommercialfertilizerfor maturing seedsofmaize,haricotbeans, improved, droughtresistance, short months. There ishighdemandfor may deteriorateoverthenextthree ly thatfoodsecurityofthecommunity rated the In SoddoZuria,sweetpotato, in April andMay. sweet potato productiontobeharvested groups. This rainwasverycrucialfor was alsoreportedbycommunity ure oftheshortrainyseason( cessation oftherainyseason. The fail- the midofrainyseasonandearly 2006 harvestduetoexcessiverainsat vest wasworseascompared tothe munities reportedthe forty sevenpercent(46.7%)ofthecom- tion), thecurrent prevalenceofmalnutri- supplementa- coverage and vitamin A health factors(morbidity, immunization food securitystatus andthepublic respectively. Consideringtheexisting oedema inHumboand Soddo Zuria with 0.2%oedemaand0.1% with0.1% was estimatedat0.6%(CI: 0.0-1.4%) 2.7-5.9%). Severeacutemalnutrition was 3.0%(CI:1.4-4.6%)and4.3% tion amongthesurveyedpopulation The prevalenceofglobalacutemalnutri- Conclusions andRecommendations: Belg ENCU March31,2008 Page13 Belg harvest. Among households harvest. Among enset rains asnormal. About ' wasthestaple diet Belg Belg Meher rain. Itislike- harvest was Meher enset crop har- Sape har- and ) **** Total acutely malnourished in Aleta Wondo andDaleworedas *** Total affected populationinWonsho in Aleta Wondo &Dale ** Total PSNP * MUACbelow12.0cmand/oroedema obdt 122. . 811. 581. 281. 15.4 16.2 0.1 12.8 0.2 19.1 0.0 15.8 0.0 12.6 0.0 ENCU 18.1 0.0 8.9 0.0 28.7 0.1 CI) 57.6(54.0-62.0) 31.2 Vitamin% 56.5(53.0-61.0) A in past 6months (95% CI) (95% (scar) BCG coverage % 0.0 CI) (95% Measles card + recall by coverage % CI) Diarrhoea 0.14(0.0-1. Measles card (95% by coverage % 0.0 symptoms or illnesses Major 0.0 (0.0-0.9) 0.5 Morbidity % (0.0-0.7) 0.3 10.3(8.1-12.5) Major causes of (0.0-0.80) 0.34 U5MR 0.09(0.0 (0.0-1.7) 0.8 6.3(4.1-8.5) (0.0-0.22) 0.10 CI) Death/10,000/day (95% U5MR 11.5(8.4-14.6) (0.0-0.5) 0.2 CI) Death/10,000/day (95% CMR 5.9(4.2-7.7) Kwashiorkor % CI) SAM in (95% Z-scores % CI) GAM in (95% Z-scores % Food Aid April - Dec. 08 – No ofbeneficiaries -Dec. 08–No Aid April Food Productive Safety Net – No ofbeneficiaries –No Net Safety Productive Table 3:SurveyResults forSNNPR AgainstKey Indicators Table 4:Foodand NutritionInterventionsinSurveyedWoredas ofSNNPR No of children acutely malnourished* As a percentage of screened children of screened apercentage As - - rate duetothepoorpast od. Foodsecurityisexpectedtodeterio- malnutrition inthecominghungerperi- od, thereisthepossibilityofincreased WVE included: has decreased.Recommendationsfrom increased whilesellingpriceoflivestock prices ofstaples ingeneralhave of thefailed vest inthecomingfewmonthsbecause the anticipated poorsweetpotato har- typical forthepost of theyear(DPPC,2002).Whilethisis tion isrankedtobenormalforthistime urahTeaetcPormeAFAFS-SGA OLN oN oNo No No No No GOAL GOAL SC-US ACF ACF Outreach Therapeutic Programme Estimated Under Five population Key indicators Key EOS- 8th round screening Therapeutic Feeding Unit Estimated population size of theworeda. nutrition andfoodsecuritysituation shouldmonitorthe woreda DPP World Vision Ethiopiaandthe ing months. seasonal foodshortages inthecom- safety netprogramtoaddressthe desk shouldcontinuetheongoing WVE andtheworedafoodsecurity % ofrural population % ofrural population 89(609.)8. 8.-90 92.0(88.6- 86.6(84.0-89.0) 88.9 (86.0-92.0) 22.5(18.2-27. 22.9(19.0-26.0) 36.6 (33.0-41.0) fever Diarrhoea, January 2008 January Zone, 14-24 Livelihood Sape Coffee Coffee & ARI R7. C:N)7. 7.-98 81.2(77.0-84. 75.3(70.3-79.8) NR) 71.1(CI: NR Meher Diarrhoea & ARI Diarrhia andARI Diarrhia & ARI Diarrhoea February 2008 February No cases of U5 of U5 cases No rain. Inaddition Livelihood Zone, 5-14 mortality Enset Enset Yirgalem Hospital Mesenkela HC 5,429**** Bokaso HC Boricha Bona LZ Enset LZ Coffee 47,040** 47,040** Meher Nov. 07 Nov. 780*** 306,820 55,535 15.3% -0.25) 0.08 (0.01-0.18) 0.10 (0.0- 0.19) 0.06 (0.0- 0.15) 0.06(0.0- 0.19) 0.10(0.0- 0.08(0.01-0.18) -0.25) 9.2% 0.3% harvest peri- 3 January 2008 3 January Decmber 2007- 31(827.)5. 5.-27 37. 58.1(53.3-62.7) 73.1 (68.2-77.5) Bona, 27 nnw irhe irhe Tetanus Diarrhoea Diarrhoea Unknown harvest Yirgalem Hospital Sidama zone Mesenkela HC 45 55(178.)8. 8.-74 81.3( 84.2(80.4-87.4) 85.5(81.7-88.6) 94.5) Bokaso HC 5 .3(.-03) .6(.-04)01 00 .5 0.85(0.0-2.12 0.45) 0.17(0.0- 0.41) 0.16(0.0- 0.36) 0.13(0.0- 15) 152,804 152,804 )1. 761.)57(.-.)20.0(16. 5.7(3.8-8.6) 10.3(7.6-13.7) 4) 30,408 oN oN oN No No No No No No No No No Boricha, 3-8 3-8 Boricha, Diarrhoea & Diarrhoea Narch 2008 Narch malaria Sidama zone )6. 6.-38 76(318.)93.3( 77.6(73.1-81.5) 69.5(64.8-73.8) 8) Nov. 07 111,495 111,495 22,299 Awassa 3- Zuria, 9,361 9,361 8.4% 1271 Diarrhoea, ARI ARI Diarrhoea, 7% 8 March 2008 8 March 0.7 (0.1-1.3) 0.7 & malaria - 9.1 (5.9-12.3) 9.1 - - - - 3.-19 38(896.)8 63.8(58.9-68.3) 1 (32.6-41.9) Darara HC Yirba HC Yirba HC Nov. 07 229,777 229,777 45,956 39,760 39,760 17.3% 17.3% tion coverage. supplementa- nization andvitamin A and inimprovingmeaslesimmu- moderately malnourishedchildren should continueinassistingthe programmealso The EOS-TSFP tion ofimmunizationcards. and measlescoveragereten- da healthoffice toimprovetheBCG Effort shouldbemadebythewore- ed duringthecominghungerperiod. repeatsurveyshouldbeconduct- A safe watersupply. tures inordertoimproveaccessa tures andmaintenanceofoldstruc- in constructionofnewwaterstruc- organizations shouldgiveattention NGO's andrespectivegovernment the effects ofmalariadisease. and distributionofITNtominimize opment actorsinimprovingtheuse Efforts shouldbemadebyalldevel- 1025 3% 0.15 (0.02 -0.27) -0.27) 0.15 (0.02 Hawella Tulla, 3- Diarrhoea, ARI ARI Diarrhoea, ENCU March 31,2008Page14 8 March 2008 8 March and malaria 7.9 (5.3-10.4) 3.5 (1.4-5.6) 4.5 (2.5-6.5) 3.0 (1.4-4.6) 4.3 (2.7-5.9) 4.3 (1.4-4.6) 3.0 (2.5-6.5) 4.5 3.5(1.4-5.6) 7.9 (5.3-10.4) 0.1 (0.0-0.4) 0.0 (0.0-0.0) 0.0 (0.0 0.0 (0.0-0.0) 0.0 0.1 (0.0-0.4) 728.)9. 9.-75 86.8(82.0-90.6 94.1(90.7-97.5) 77.2-84.9) Nov. 07 Bushulo 106,163 Awassa 21,233 20,700 20,700 19.5% 19.5% Zuria -44 97(294.)1. 1.-2.)5. 20.7) 15.4(11.3- 39.7(32.9-46.4) 3-24.4) 3% 563 HC Diarhoa &Diarhoa malaria Mirab Abaya,Mirab 14- .3(.104)0.08(0.2-0.19) 0.23 (0.01-0.45) 18 Februray Malaria & unknown Hawella 2008 . 7.-68 72.7(66.8-78.0) 0.5 (74.2-86.8) 113,770 113,770 22,754 11,853 11,853 10.4% 10.4% Tulla Gamogofa Zone No 989.)8. 8.-10 84.5(78.9-88.9) 87.2(82.2-91.0) 89.8-96.9) Nov. 07 Boreda, 14-18 14-18 Boreda, .1(.809)02 0006)0.36(0.0-0.87) 0.23(0.0-0.67) (0.48-0.91) 0.21 ) 20,700 20,700 13,861 69,306 Gamogofa Zone February 08 19.5% 19.5% Abaya Mirab nnw R Malaria & ARI ARI Malaria & Unknown 3% 337 diarrhoa Nov. 07 oeaHumbo Boreda 16,569 16,569 14,721 73,606 22.5% 22.5% -0.0) 0.6 (0.0-1.4) 0.1 (0.0-0.4) 0.1 (0.0-1.4) 0.6 -0.0) 1030 9% February 2008 February Humbo 14-18 14-18 Humbo .8(.-.1 0.25(0.05-0.45) 0.08 (0.0-0.21) 88(288.)90.0(84.3-95.7) 78.8(72.8-83.8) ) Malaria 49(847.)72.3(66.4-78.3) 64.9 (58.4-71.0) 2892 26.3(19.3-33.4) 2 (2.8-9.2) Nov. 07 130,999 130,999 26,200 22,788 22,788 41,729 Wolaita zone Wolaita 17.4% 17.4% 31.9% 1574 6% Wolaita zone Wolaita 14-18 Februray Februray 14-18 Soddo Zuria,Soddo Malaria & diarhoea Nov. 07 193,644 193,644 86.5 (80.7-92.3) Soddo Soddo 38,729 32,970 32,970 29,536 17.0% 17.0% 15.3% 2008 Zuria 1885 6% **** Sexbiastowardsboys *** Moderatekurtosisproblem ** Lowstandard deviationofWHZ * Age biastowardstheolderchildren ENCU RENCU/Oromia RENCU/Oromia Table 5:Results ofSurveyQualityCheck DPP& FSC DPP& DPP& FSC DPP& Agency UVYDT ULT CONTROL QUALITY DATA SURVEY kurtosis ofWHZ(1.2). All otherquality One survey(WVE,Boreda)exhibited normal distributionaroundthemean. ed rangebetween-1and+1,indicating WHZ scoreswasalsowithintheaccept- degree ofskewnessandkurtosis and lowmeasurementerrors. The 0.8-1.2, indicatinggoodsurveyquality WHZ fallingwithintheacceptedrangeof All baroneofthesurveyshadSDfor the qualityofall13surveyswasgood. (October 2007)fortheanalysis.Overall ed below. The ENCUusedENA ed inthefirstquarterof2008ispresent- ed bytheENCUonallsurveysconduct- The results ofthequalitycheckconduct- CSBn oN .3 .7 .8 No 0.082 0.170 0.831 No No Bona SCUS OLDa oN .3 .2 .8 No 0.287 0.426 0.831 No No Dhas GOAL V od ui oN .1 .6 .0 No No 0.009 0.262 0.71 0.167 0.160 1.300*** 0.812 0.829 No 0.323 No No 0.957 0.101 0.12 No No No 0.086 0.595 No Soddo Zuria No No 0.874 Humbo 0.151 0.296 -0.101 No 0.858 WVE Boreda -0.072 0.165 No No 0.891 WVE 0.860 No Abaya Merab No No WVE Hawella No Tulla No WVE Awassa Zuria WVE Boricha WVE WVE ACF ACF

Woreda/Livelihood Coffee Livelihood Enset Livelihood Zone Zone Zone Zone oaeN o0810370280.12 0.298 0.317 0.871 No No Moyale io oN .4 .0 .5 0.4 0.650 0.200 0.845 No No Mi'oo egtHeight Weight oN .1 .3 006No -0.076 No 0.039 0.001 0.814 0.207 No 0.791** No No No preference Digit SD of WHZ Skewness Skewness of WHZ sentation. plausible reasonsforthisunder-repre- months). NGOswerenotabletogive ed amongtheyoungeragegroup(6-29 higher malnutritionprevalenceisexpect- malnutrition couldbeunderestimatedas these surveys,theoverallprevalenceof age groupweremorerepresentedin ple (WHO,2000). Therefore, astheolder expected inanormallydistributedsam- falling wellbelowthe49%estimate months wasexhibitedby4surveysand youngest agedbetween6and29 terms ofunder-representation ofthe accepted plausibilityrange.Slightbiasin checks onthisdata setwerewithinthe Kurtosis ENCU March31,2008 Page15 of WHZ flags (%) flags No. 0f WHZ 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 30-59 6-29 (months) Representative ness of the the of ness Representative group Age Age sample 58.0 42.0 64.5 35.5* 61.4 38.6* 59.2 40.8 56.5 43.5 60.5 39.5 56.4 43.6 65.2 34.8* 60.2 39.8 56.6 43.4 53.7 46.3 64.7 35.3* 65.4 34.6* Distributi on % Sex Ratio Sex 1.2**** 0.9 1.0 1.1 0.9 1.0 1.1 1.0 1.1 1.0 0.9 1.1 1.0 ENCU scores and/oroedema. as <-2z-scoresand/oroedema,andsevereacutemalnutritiondefined<-3z- guidelinesof2002,basedonglobalacutemalnutritiondefined mended bytheDPPA Below arethebenchmarks/alertstages ofpopulationmalnutritionratesasrecom- which include: in2002andbylookingattheinformationonaggravatingfactors status setbyDPPA the abovesurveyswereconductedwasmadeaccordingtobenchmarksofnutrition Interpretation andclassificationofthenutritionsituationineachareaswhereby Global acute malnutrition prevalenceAggravating 2-9% factors and Global acute malnutrition prevalence 5-9% Global acute malnutrition prevalenceAggravating 10-14% factors and Global acute malnutrition prevalence 10-14% Global acute malnutrition prevalenceAggravating 15-19% factors and Global acute malnutrition 5% prevalence prevalence >= malnutrition Severe 15-19% acute and/or 20% prevalence > malnutrition acute Global NUTRITION CLUSTER/MANTFnews security information, informationon methodology to collectandanalysefood veys inpastoralist areas,agreementon as guidanceonmethodology forsur- ed. Keyareastostrengthen werenoted are reviewedandsubsequently updat- considered whenthenational guidelines needs inEthiopia. These aspects willbe opment tobestsuittheassessment version1requirefurtherdevel- SMART methodologies, severalaspects of favourable tothe30x30standard approachwasconsidered SMART Concern, SC-UK).Whileoverallthe regularly conductingsurveys(ACF, analysiswithkeyorganisations SWOT Guidelines 2002,theENCUleadina Emergency Nutrition Assessment National and revisetheexistingDPPA In responsetosuggestionsreview Inadequatesafewatersuppliesandsanitation - supplementation Lowlevelofvaccination(BCG&measles)andvitamin A - Epidemicsofmeasles, AWD, malaria,etc. - - Poorhouseholdfoodavailabilityandaccessibility(duetoapoorharvest, pasture conditions,highmarketpricesofstaple foodcrops, Indicators Stage of alert Stage Indicators approach inEthiopia. out theemergencynutrition cluster UNICEF/ENCU tooffer supportinrolling ing thisperiod.Peter worked with UNICEF RegionalNutrition Advisor dur- We welcomedthe visitofPeterHailey, voiced bythenutritionpartners. best addresstheseandotherkeyissues updating oftheNationalGuidelinesto Cluster Technical Grouptosupportthe work withtheEmergencyNutrition available. The ENCUwillcontinueto when previoussurveyestimatesarenot ing, supporttoestimatemortality rates emergency surveysforprojectmonitor- tion units (woredas), guidanceonnon- sample framesratherthanadministra- using livelihoodinterventionunits as ENCU March31,2008 Page16 malnourished population Typical for achronically Serious Critical Poor NUTRITION SURVEY DATABASE

Table 6 presents the number of stan- 2000 and March 2008 a total of 468 dardized nutrition surveys conducted in standard nutrition surveys were con- Ethiopia since 2000. It does not include ducted. All raw data and final and sum- surveys conducted in resettlement mary narrative reports are kept in the areas, IDP and refugee camps. Between ENCU database.

Table 6: Nutrition surveys conducted per region per year since 2000

Region Year 2000 2001 2002 2003 2004 2005 2006 2007 2008 Total SNNPR 9 5 35 30 14 25 20 16 10 164 Oromia 3 2 20 27 22 20 14 6 3 117 Amhara 5 9 24 17 9 7 6 4 0 81 Somali 8555811122056 Tigray 00673308027 Afar 00451642022 Gambella 0000000000 Benshangul Gumez 0000000000 Harare 0000000101 Total 25 21 94 91 57 72 56 39 13 468 ENCU

ENCU March 31, 2008 Page 17