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Home , Adado District, Adale District, Baidoa District, Bardhere District, Beledweyne District, Burhakaba District

FSAU Monthly Nutrition Update January 2007 FSAU FSAU NUTRITION Food Security Analysis Unit - UPDATE January 2007

Post Deyr ’06/07 Jan to June ’07 Integrated Phase Classification: Post Deyr ’06/07 Nutrition Situation January 2007 1 The FSAU with partners has completed the analysis of the Post Post Deyr ’06/07 Jan to June ’07 Integrated Phase Deyr ’06/07 rains assessment and produced an updated Integrated Classifi cation 1 Phase Classification (IPC) based on the findings (see Map 3). Southern Zone (Juba & ) Nutrition Analysis 2 Overall an improvement in the food security and nutrition indicators Southwest Zone (Bay & ) Nutrition Analysis 4 has been reported in rain fed crop and pastoral production areas. Central and Southeast Zones Nutrition Analysis 5 This improvement is largely due to the second season of good Northeast Zone Nutrition Analysis 7 rains which has had a very positive impact on both animal and Northwest Zone Nutrition Analysis 7 rainfed agricultural production. However, riverine areas in Gedo, Juba valley and Hiran have seen a worsening of the situation due to the compound impacts of flooding and previously poor harvests, Post Deyr ’06/07 Nutrition Situation - including destruction of livelihood assets, displacement, loss of Overview agricultural opportunities, exposure to water borne diseases and destruction of crops. Nevertheless there will be opportunities for Current Nutrition Situation: A summary of the integrated analysis of the flood recession off-season cropping. (see Map 4 Livelihood Zones nutrition situation across the country indicates significant improvement for locations of livelihoods) A more detailed analysis is provided in in the northeast and northwest zones over the last three rainy seasons, the latest FSAU Food Security and Nutrition Post Deyr Brief ’06/07 . though still with localised areas of concern in the most north eastern areas as illustrated. In addition although an improvement has been noted in parts of the pastoral and rain fed production livelihoods in CLASSIFICATION OF NUTRITION SITUATION the south and central zones the nutrition situation remains of concern. The nutrition situation is classifi ed using a range of indicators as follows: Anthropometric - Acute Malnutrition (wasting) and Crude Mortality Rates, Of greater concern is the critical and very critical nutrition situation from nutrition assessments, MUAC from rapid assessments, trends in levels currently being reported in riverine areas in Hiran and Juba regions, of acutely malnourished children from both the nutrition sentinel sites and possibly attributed to high water borne disease incidence following the Health Information System (HIS) and trends in selective feeding ad- the severe flooding in November and December. The maps below missions. Non anthropometric indicators such as Dietary Diversity, Meal illustrate the progression of the nutrition situation over the last six Frequency, Disease Prevalence, Food Security Situation are also referred months with the arrows in the current map indicating areas likely to to. A minimum of 2 anthropometric indicators are required to make an improve, deteriorate or where the progression is uncertain. Where a analysis with the supporting non anthropometric indicators. The specifi c minimum of two recent anthropometric indicators are not available the classifi cation matrix is undergoing ongoing review with partners and will area is left white reflecting no data (see maps 1 and 2 below) be presented in future updates.

Map 1: Nutrition Situation - July 2006 Map 2: Nutrition Situation - January 2007 " " 12°0'0 12°0'0 Alula DJIBOUTI Gulf of Aden 12°0'0"N Alula 12°0'0"N DJIBOUTI Gulf of Aden

Kandala Kandala Zeylac Bosaso Lughaye Zeylac Bosaso Lughaye BERBERA Badhan Badhan Awdal Iskushuban Erigavo ! Berbera Awdal Iskushuban Borama Baki Sanag Berbera El Afwein Bari Borama Baki Sanag Erigavo El Afwein Bari Woq. Galbeed Sheikh Sheikh Gabiley Woq. Galbeed Hargeisa Gabiley Gardo Hargeisa Bender Beila Gardo Odweine Burco Odweine Bender Beila Caynaba Burco Xudun Taleh Caynaba Xudun Togdheer Togdheer Taleh Sool Sool 9°0'0"N 9°0'0"N 9°0'0"N 9°0'0"N

Buhodle !Lasanod !Garowe Buhodle Lasanod Garowe Nugal ! Eyl Nugal Burtinle

ETHIOPIA Jariban Goldogob! ETHIOPIA Goldogob ! Galkayo Galkayo

! ! Adado Adado Mudug Abudwaq Abudwaq Hobyo 6°0'0"N 6°0'0"N 6°0'0"N 6°0'0"N Indian Ocean Indian Ocean Dusa! Mareb Dusa Mareb Galgadud Galgadud Belet Weyne !! ! Haradhere Haradhere El Bur El Barde Belet Weyne El Bur El Barde Bakol Bakol Hiran Rab-Dhuure Rab-Dhuure Hudur El Der Hiran El Der Dolo Dolo Bulo Burti Tieglo Bulo Burti !Wajid Tieglo Luuq Wajid Aden Yabal Aden Yabal Belet Hawa Belet Hawa Jalalaqsi LEGEND Baidoa Adale LEGEND Garbahare Nutrition Situation Global (Total ) Acute Malnutrition Gedo M. Shabelle Gedo M. Shabelle Qansah Dere Wanle WeyneJowhar Qansah Dere Wanle WeyneJowhar 3°0'0"N 3°0'0"N 3°0'0"N 3°0'0"N <5% (acceptable) No Data El Waq El Waq Bay Bay Bur Hakaba Balad Bur Hakaba Balad 5 - 10% (alert) Alert Afgoye Afgoye Dinsor Qoryoley Banadir Bardera Dinsor Qoryoley Banadir Mogadishu Mogadishu 10 - 14.9% (serious) L. Shabelle Serious L. Shabelle Sakow Sakow Kurtun Warrey Marka Kurtun Warrey Marka 15 - 19.9% (critical) Critical KENYA M. Juba

KENYA M. Juba Sablale Sablale Buale Buale Over 20% (Very critical) Brava Very Critical Brava Projected Trend (Jan-Jun '07) /" Potential to Improve IDP Concentration Areas National Capital Afmadow Afmadow Jilib Uncertain Major Road Potential to Deteriorate /" National Capital Jamame L. Juba Jamame Coastline L. Juba Coastline 0°0'0" 0°0'0"

0°0'0" International Boundary 0°0'0" Kismayo International Boundary Kismayo ± Regional Boundary ± Regional Boundary Badhadhe 400408012016020 District Boundary Badhadhe 400408012016020 District Boundary Kilometers Kilometers River River Datum: WGS84 Datum: WGS84 Data Source: FSAU, 2006 Data Source: FSAU, 2006 43°0'0"E 46°0'0"E Admin. layers: UNDP,49°0'0"E 1998 43°0'0"E 46°0'0"E Admin. layers: UNDP, 49°0'0"E 1998 Updated: January , 2007

The Nutrition Surveillance Project is managed by FAO, funded by USAID/OFDA and receives support1 from the EC FSAU FSAU Monthly Nutrition Update January 2007

Map 3: Somalia Food Situation Analysis, Post Deyr ’06/07 Map 4: Somalia Livelihood Zones Projections through June ’07 41 0 0 E 44 0 0 E 47 0 0 E 50 0 0 E

Calula 12°0'

DJIBOUTI Gulf of Aden Qandala

Zeylac Bossaaso Lughaye AWDAL Ceerigaabo Las Qoray/Badhan Baki Berbera SANAG Iskushuban Borama Ceel Afweyne Sheikh BARI Gebiley W. GALBEED

Hargeysa Qardho Burco Owdweyne Xudun Caynabo Talex Bandar Beyla TOGDHEER SOOL 9°0'0"N 9°0'0"N Laas Caanood Buuhoodle Garowe Legend Eyl /" NUGAL Country capital Burtinle International boundary

Regional boundary Jariiban ETHIOPIA Goldogob District boundary Galkacyo n a e River c Coastline O n Cadaado MUDUG ia d Hobyo n Cabudwaaq I 6°0'0"N 6°0'0"N

Dhusa Mareeb

GALGADUD Harardheere Ceel Barde Beled Weyne Ceel Bur BAKOOL Livelihood zones HIIRAN Addun Pastoral: Mixed sheep & goats, camel Rab-Dhuure Xudur Awdal border & coastal towns: Petty trading, fishing, salt mining Dolo Ceel Dheere Bay-Bakool Agro-Pastoral High potential sorghum: Cattle, camel Wajid Tayeglow Bulo Barde Luuq Central regions Agro-Pastoral: Cowpea, sheep & goats, camel, cattle Aden Yabal Coastal Deeh: Sheep Beled Hawa Jalalaqsi Dawo Pastoral: Shoats, cattle, camel Baydhaba Cadale Garbaharey East Golis Pastoral: Frankinncense M. SHABELLE Fishing Qansax Dheere Gagaab Pastoral: Frankincense

3°0'0"N Wanle Weyne 3°0'0"N GEDO BAY Guban Pastoral: Sheep, goats & camel Ceel Waq Bur Hakaba Balcad Hawd Pastoral: Camel, sheep & goats Afgoye BANADIR Hiran Agro-Pastoral Baardheere Dinsor /" Hiran riverine: Sorghum, maize, cattle & shoats MOGADISHU Qoryoley Juba pump irrigation: Tobacco, onions, maize Sakow Kurtun Warrey Marka Kakaar-Dharor Pastoral: Sheep, goats, camel M. JUBA L. & M. Shabelle Agro-Pastoral Irrigated: Maize/Sorghum & cattle Sablale L. SHABELLE L. & M. Shabelle Agro-Pastoral rain-fed: Maize,cowpeas, sesame & cattle Bu'aale Brava Agro-Pastoral: Maize & cattle KENYA Hagar North-West Agro-Pastoral: Sorghum, cattle North-West Valley Agro-Pastoral: Irrigated vegetables, shoats Afmadow Jilib Nugal Valley Pastoral: Sheep & camel Potato zone & vegetables Shabelle riverine: Maize, fruits & vegetables Jamaame L. JUBA Sool-Sanag Plateau Pastoral: Camel, sheep & goats

0°0'0" South-East Pastoral: Cattle, sheep & goats 0°0'0" Kismayo Southern Agro-Pastoral: Camel, cattle, sorghum ± Southern Juba riverine: Maize, sesame, fruits & vegetables Southern coastal pastoral: Goats, cattle 020 40 80 120 160 200 Badhadhe Southern inland pastoral: Camel, sheep & goats Kilometers Togdheer Agro-Pastoral: Sheep, goats & vegetables Urban West Golis Pastoral: Goats, camel, sheep Datum: WGS84 41°0'0"E 44°0'0"E 47°0'0"E Data Source: FSAU, 200250°0'0"E admin. layers: UNDP, 1998

The livelihoods zone map is presented here for reference

Livelihoods: Southern Inland Pastoral, South-East Southern Zone (Juba and Gedo) Pastoral, Bay Bakool and Lower Juba Agropastoral Map 5: Southern Zone Gedo, and Lower Juba regions comprise of The overall nutrition seven livelihood zones: (1) Southern Inland Pastoral (2) situation in the Dawo Pastoral (3) Juba Pump Irrigation (4) Bay Bakool Agro- Southern Inland, Pastoral (5) Southern Juba Riverine (6) South-East Pastoral South-East Pastoral and (7)Lower Juba Agro-Pastoral. livelihoods in Gedo and Juba has Since the FSAU Post Deyr ’05/06 analysis, the livelihood indicated a slight

Bay-Bakool Agro-Pastoral High potential sorghum: Cattle, camel Central regions Agro-Pastoral: Cowpea, sheep & goats, camel, cattle improvement over Coastal Deeh: Sheep groups in Gedo and Juba Valley have been in a phase of Dawo Pastoral: Shoats, cattle, camel Hawd Pastoral: Camel, sheep & goats Hiran Agro-Pastoral Hiran riverine: Sorghum, maize, cattle & shoats Humanitarian Emergency with the nutrition situation the past six months Juba pump irrigation: Tobacco, onions, maize Southern inland pastoral: Camel, sheep & goats L. & M. Shabelle Agro-Pastoral Irrigated: Maize/Sorghum & cattle L. & M. Shabelle Agro-Pastoral rain-fed: Maize,cowpeas, sesame & catt ranging in areas from critical to very critical. This is primarily (Post Deyr ’06/07) Lower Juba Agro-Pastoral: Maize & cattle Shabelle riverine: Maize, fruits & vegetables Sool-Sanag Plateau Pastoral: Camel, sheep & goats South-East Pastoral: Cattle, sheep & goats Southern Agro-Pastoral: Camel, cattle, sorghum associated with the two consecutive poor rainy seasons (Gu likely associated with Southern Juba riverine: Maize, sesame, fruits & vegetables Southern coastal pastoral: Goats, cattle ’05, Deyr ’05/06) which affected water availability, crops the positive impacts Urban and livestock conditions and in turn limited access to food of the adequate Gu ’06 rains and other mitigating factors such and income. However, the heavy Deyr ’06/07 rains have as increased humanitarian support. However localised areas contributed to an improved rain fed crop and livestock of deterioration have also been reported with an increase production in the pastoral and agropastoral livelihood zones, in seasonal morbidity trends. In addition ongoing risks of leading to an improved food security situation. confl ict and disease in lower Juba are of concern. Therefore the nutrition situation in these areas is classifi ed as critical In spite of this improvement, of great concern is the riverine with an uncertain trend for the coming months. livelihood zone which is faced with a very critical nutrition situation and is classifi ed in the IPC as in a Humanitarian The key nutrition fi ndings in these areas are as follows: Emergency. This is likely attributed to the high incidence • 1Nutrition Assessments: Although a nutrition assessment of water borne diseases, displacement and loss of food stocks was planned in December this was not possible due to following the severe fl ooding in November and December. insecurity and severe fl ooding which restricted access The key fi ndings by livelihood groups follow. however the most recent assessments were conducted in Afmadow and Hagaar and reported, 22.0% (19.4-24.9) Global Acute Malnutrition (GAM) WHZ and 4.2% (3.0- 1 All nutrition assessments referred to in this update use the standard methodology of 30*30 random cluster sampling. (Source FSAU and NGO) and report GAM using WHZ

2 FSAU Monthly Nutrition Update January 2007 FSAU

5.8) Severe Acute Malnutrition (SAM) WHZ in April 06, improvement, some deterioration while others are unchanged. In Gedo Region, an assessment reported 23.8% (21.1-26.7) Therefore the nutrition situation in these areas is classifi ed GAM and 3.7% SAM (2.6-5.2) in March 06, and fi nally as critical with an uncertain trend for the coming months. in the Bardera town, the assessment reported 19% (15.9- The key nutrition fi ndings in these areas are as follows: 22.6) GAM and 3.9% (2.5-6.0) SAM in April 06. These • Nutrition Assessments: As before the most recent assessments indicated very critical levels of malnutrition at assessment conducted in these areas was the Gedo that time, which was during the peak of the drought before Regional assessment conducted in March reporting 23.8% the Gu ’06 rains. (21.1-26.7) GAM, 3.7% SAM (2.6-5.2). This was one • 2Sentinel Site Data: Four rounds of sentinel site surveillance assessment where a sample was drawn from the entire conducted in the last 12 months have indicated reductions region so cannot be extrapolated to the specifi c livelihoods in the levels of acutely malnourished children from ≥20% zones though is useful as a source of data. Again due to in January to 15-20% in August 06 in Bardera and Elwak insecurity plans to conduct more recent assessments were Districts. In the agro pastoral population in parts of lower not possible. Juba (Jilib/ Jamame Districts), a decline from 15-20% in • Sentinel Site Data: Trends in levels of acutely malnourished August to 10-15% in December was reported. Dietary children from the sentinel sites in these areas indicates a diversity has also improved with 93% of the population slight deterioration with an increasing trend in levels in the assessed consuming more than three food groups in August last three rounds from August September and November, 06 up from 40% in June 2006, mainly sourced from relief the levels however remain lower than this time last year. food. • Rapid MUAC assessment: A rapid assessment (December • 3Rapid Mid Upper Arm Circumference (MUAC) 2006) in recorded 11.5% of children 1-5 assessment: A rapid assessment (December 2006) in years with MUAC <12.5 cm, from a random sample of 200 Bardera District recorded 12.9% of children 1-5 years with children in 2 villages. In Dolo District, also in December MUAC <12.5 cm, from a random sample of 300 children in 06, 300 randomly selected children 1-5yrs from 3 villages 3 villages. In also in December ’06, 400 were also screened with 6.3% of children with a MUAC randomly selected children 1-5yrs from 4 villages were also <12.5cm. screened with 7.3% of children with a MUAC <12.5cm. • Selective Feeding Centres: Admissions of severely • 4Selective Feeding Centres: Although very diffi cult to malnourished children in Luuq and Dolo and Belet Hawa interpret due to the insecurity interrupting programme vary again depending on access and also on the coverage delivery and recent changes to a community based of the feeding centres. In general however the admissions approach to treating these children, admissions of still indicate signifi cant numbers of severely malnourished severely malnourished remain high in certain areas in children being identifi ed. Gedo Districts and with lower admissions in other areas. • Health Information System: Levels of acutely Increasing numbers of humanitarian actors are attempting malnourished children screened at health centres have to address the treatment of moderate malnutrition through shown a slight reduction in the past 4 months, again supplementary feeding programmes from January ’07 in El insecurity and access issues need to be considered while Wak, Bardera and Garbaharey Districts therefore serving interpreting these fi gures. as a potential mitigating factor for nutritional status in the coming months if successful in implementation. • 5Health Information System: Numbers of acutely Livelihoods: Juba Riverine malnourished children screened at health centre level indicates an increase from 20% in September to 28% in The overall nutrition situation in the Juba Riverine populations November 06, most notably in . This over the last 6 months has indicated deterioration from an is in line with a reported parallel increase in seasonal populations already critical situation. This is associated morbidity patterns such as diarrhoea, suspected malaria with severe fl ooding in November and December where an and acute respiratory tract infection possibly exacerbated increase in water borne diseases is being reported in addition by the increased exposure to water borne diseases due the to signifi cant loss of food stocks and crops planted. Therefore heavy rains and localised fl ooding in parts. the nutrition situation in Juba Riverine is classifi ed as very critical. Livelihoods: Dawo Pastoral and Juba Pump irrigation The key nutrition fi ndings in these areas are as follows: The overall nutrition situation in Dawo Pastoral, Juba Pump • Nutrition Assessments: The most recent assessments Irrigation in Gedo over the last 6 months does not indicate conducted in this livelihood were in Jilib riverine any signifi cant change with some indicators indicating community in May 06 where 16.2% (13.8-18.8) GAM and 4.4% (3.2-6.0) SAM were reported and in Buale and

2 Sentinel sites data is collected bimonthly or quarterly from a total of 102 sites across Sakow districts in March 06 where 21.9% (19.3-24.8) south and central Somalia by FSAU fi eld nutrition staff using WHZ, MUAC and oedema. GAM and 6.6% (5.1-8.4) SAM were reported. (Source: FSAU) • Sentinel Site Data: Trends in levels of acutely 3 Refers to the random selection of 100 children 1-5yrs per site and the proportion with a MUAC <12.5cm done in collaboration by the FSAU fi eld food security team in the Post malnourished children from the sentinel sites in these Deyr assessment December 06. (Source: FSAU) areas had indicated an improvement earlier in 2006 (Jan to 4 Refers to the trends of admission of severely and moderately malnourished children into TFC/ OTP and SFC (Source: UNICEF or individual NGO, December ’06) August) but from August 06 to December 06 deterioration 5 Refers to the trends in the numbers of acutely malnourished 1-5yrs identifi ed from regular screening using WHZ at 105 Health centres across Somalia. (Source: FSAU)

3 FSAU FSAU Monthly Nutrition Update January 2007

in the levels of acutely malnourished children has been Bay Region (Dinsor, Qansadhere, Baidoa reported in several sites. (see graph) and Districts)

Chart 1: Level of acutely malnourished children from sentinel sites in Juba valley, agropastoral and riverine livelihoods, Dec ‘05 - Dec ‘06 Map 6: Southwest Zone The nutrition situation

70% in Bay Region, from a 60% range of indicators as 50% 40% presented below, still 30% 20% remains critical in parts 10% 0% however most indicators 06

g are showing a general Jan06 Jan06 Jan06 Jan06 Jan06 Jan06 Jan06 Jan06 Jan06 Dec06 Dec05 Dec06 Dec06 Dec06 Dec06 Dec06 Dec06 Dec06 Dec06 Au Aug06 Aug06 Aug06 Aug06 Aug06 Aug06 Aug06 improving trend over the Helishid Bilisa MalendeBuloTaaq Mubarak Marere Buulo Bandar Nyirey Qalaw ile Mamo Jardid past 6 months. Due to the Riverine Agropas ongoing positive impact of the Deyr ’06 rains on the • Selective Feeding Centres: Up to date information food security indicators is lacking on the trends of admissions of severely it is hoped that this will malnourished children in Lower Juba riverine area but continue to contribute information from Middle Juba in Buale and Sakow Bay-Bakool Agro-Pastoral High potential sorghum: Cattle, cam to the improving trends. Dawo Pastoral: Shoats, cattle, camel has indicated signifi cant increases in admissions of Southern inland pastoral: Camel, sheep & goats Therefore the nutrition Juba pump irrigation: Tobacco, onions, maize both severely and moderately malnourished children in South-East Pastoral: Cattle, sheep & goats situation in Bay Region Lower Juba Agro-Pastoral: Maize & cattle November, December and January, although this needs Southern Agro-Pastoral: Camel, cattle, sorghum in Dinsor, Qansadhere to be interpreted with caution given the interruption to and most of Baidoa access to selective feeding programmes and health centres Districts remains in a critical nutrition situation with with the localised fl ooding and confl ict displacement. a projected trend to improve with Again the impact of the severe fl ooding is likely to have remaining in a serious nutrition situation. contributed to this deterioration. • Health Information System: It is very diffi cult to The key nutrition fi ndings in these areas are as follows: interpret the fi gures from the health centres due to reduced • Nutrition Assessments: the most recent nutrition access following the severe fl ooding but an increase in assessment conducted in Bay Region was in September levels of acutely malnourished children screened have 06 in Berdalle district where a GAM of 11.2% (9.5-13.6) been noted in certain centres over the past 4 months with and a SAM of 2.5% (1.8-3.9) was reported. This had a parallel increase reported in seasonal morbidity trends. indicated an improvement from the previous assessment This increase includes water borne diseases likely linked conducted in May 02 where a GAM of 17.1% and a SAM to the fl ooding. of 3.5% were reported, though it must be noted that the timing of the assessments were different with May being mid Gu rains and September just before Deyr rains. Southwest Zone (Bay and Bakool) • Sentinel Site Data: The last three rounds of sentinel site surveillance (SSS) have indicated decreasing trends in the Bay and Bakool is comprised of 4 main livelihoods zones, (1) levels of acutely malnourished children in most sites (see Southern Inland Pastoral, (2) Juba Pump Irrigation, (3) Bay graph), however, the proportion of acutely malnourished Bakool Agro pastoral - High potential sorghum and (4) South children is still high and is an indication of precarious East Pastoral (see Map 6). nutrition situation. Chart 2: Level of acutely malnourished children from sentinel sites in The FSAU Post Gu ’06 analysis classifi ed most parts of Bay and , Oct ’05 - Nov ’06 70% Bakool regions as in a phase of Acute Food and Livelihood 60% Crisis although this has indicated recovery from the previous 50% Deyr ’05/06 where there was a high risk of deterioration to 40% Humanitarian Emergency. 30% 20% Currently, the overall nutrition situation in Bay and Bakool 10% regions, although critical in parts, in general is indicating an 0% improving trend. This improving trend is most likely linked Oct05 Oct05 Jan06 Jan06 Dec05 Feb.06 Jun.06 Nov.06 Dec.05 Feb.06 Jun.06 Nov.06 Feb.06 Jun.06 Nov.06 Feb.06 Jun.06 Nov.06 Mar.06 Mar.06 Mar.06 Mar.06 May.06 Aug.06 May.06 Aug.06 May.06 Aug.06 to the positive impact of the two good rainy seasons from May.06 Aug.06 the Gu ’06 rains and now the Deyr ’06/07 particularly in the Dharqo Awdinle Berdalle Isha sorghum-producing areas in Bay regions. The good rains have led to improved pasture and livestock conditions and hence • Selective Feeding Centres: Similarly high numbers access to food in the area. As the livelihoods groups overlap in of admissions into the selective feeding centres persist both Bay and Bakool the key fi ndings per region are presented though with declining trends in recent months below:

4 FSAU Monthly Nutrition Update January 2007 FSAU

• Health Information System: data (see graphs). High • Sentinel Site Data: The last two rounds of SSS have numbers of acutely malnourished children are being indicated decreasing trends in the levels of acutely reported from screening at the Health centre level but malnourished children, however, the proportion of with decreasing trends over the last three months. acutely malnourished children is still high (>15%) and is an indication of a precarious nutrition situation. Chart 3: Level of acutely malnourished children in Berdalle District Health Centres (HIS), 2006 • Selective Feeding Centres: Admissions of severely and moderately malnourished children in selective 200 180 feeding centres varies throughout the region with high 160 though decreasing trends in Wajid, more stable trends in 140 120 Huddur and slight increasing trends in El Berde but due 100 to disruption to programme delivery following insecurity 80 Number 60 and confl ict care is needed in interpretation of results. 40 • Health Information System: Numbers of acutely 20 malnourished children being screened at health centre 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov level remain high though with decreasing trends over the Month past 3 months.

Bakool Region (Rab Dhure, El Berde, Wajid, Huddur Central and Southeast Zone and Tieglow Districts) The Central and Map 7: Central and South East Zone The nutrition situation in Bakool Region, from a range of SouthEast Zone indicators as presented below, still remains critical in parts comprises of six regions however some indicators are showing a general improving namely Galgadud, trend in the nutritional situation over the past 6 months. South Mudug, Hiran, Similar to Bay Region, with the ongoing positive impact of , Middle the Deyr ’06 rains on the food security indicators, it is hoped Shabelle and Benadir. that this will continue to contribute to the improving trends. About 13 livelihood Therefore the nutrition situation in Bakool Region in El zones6 are found in Addun Pastoral: Mixed sheep & goats, camel Central regions Agro-Pastoral: Cowpea, sheep & goats, camel, ca Coastal Deeh: Sheep Hawd Pastoral: Camel, sheep & goats Berde, Rab Dhure and parts of Tieglow remains critical, the area but generally Southern inland pastoral: Camel, sheep & goats with Wajid, Huddur and remaining parts of Tieglow comprising of riverine, classifi ed as serious. agropastoral, pastoral and urban population groups. In the The key nutrition fi ndings in these areas are as follows: FSAU Post Gu ’06 analysis large parts of central and Hiran • Nutrition Assessments: The most recent nutrition regions were faced with an Acute Food and Livelihoods assessment was conducted in December ’06 in the Crisis due to the effects of the drought compounded by confl ict pastoral area of Bakool region, El Berde District, and and underlying vulnerabilities of specifi c livelihood groups. reported a critical nutrition situation with GAM of The current IPC from the FSAU Post Deyr ’06/07 analysis has 17.7% (15.3-20.3) and a SAM of 3.2% (2.2-4.6). These indicated an improvement in the food security situation of the results, although high, are consistent with the previous populations in central region though the riverine population in assessments conducted in the area where rates of 15- Hiran is still facing a Humanitarian Emergency following 20% have been reported in the past few years though accumulation of shocks including loss of assets through the at different times of year. This area of Bakool region is fl oods, exposure to diseases and underlying vulnerabilities recovering from several shocks of drought, confl ict and with lack of opportunities for diversifying livelihoods. market disruption over recent years. Another assessment conducted in Bakool Region earlier last year by MSFB in Galgadud ( Abudwaq, Adado, Dusmareb, El Bur and El Der Huddur Town and environs in June reported 9.3% (7.1- Districts) and South Mudug Region (Hobyo and Haradhere 12.1) GAM and 0.9% (0.4-2.0) SAM. Districts) • Rapid MUAC assessment: A rapid assessment (December 2006) in Huddur District recorded 8.2% of Due to insecurity the availability of up to date nutrition children 1-5 years with MUAC <12.5 cm, from a random information from South Mudug and Galgadud remains a sample of 419 children in 7 villages. In Tieglow District, challenge however the existing available information has also in December ’06, 380 randomly selected children indicated some improvement in the nutrition situation. High 1-5yrs from 6 villages were also screened with a more morbidity levels still remain as a key contributing factor worrying 15% of children with a MUAC <12.5cm. to malnutrition levels in the area. The overall nutrition Interestingly the food security situation in parts of situation remains serious with pockets of critical, where Tieglow District is also less positive (see IPC Map 3.) up to date nutrition data has indicated localised areas of than other parts of Bakool region due to the specifi c concern likely associated with diarrhoeal outbreaks. agricultural practices which did not benefi t fully from the 6 Addun Pastoral, Hawd Pastoral, Southern Inland Pastoral, Hiran Agropastoral, Hiran good Deyr ’06/07 rains. In , 5% of 300 Riverine, Coastal Deeh, Central Regions Agropastoral, Southern Agropastoral, Lower children 1-5yrs randomly selected from 5 sites recorded and Agropastoral rainfed, Lower and Middle Shabelle Agropastoral MUAC <12.5cm. Irrigated, Shabelle Riverine, South East Pastoral and Urban

5 FSAU FSAU Monthly Nutrition Update January 2007

The key nutrition fi ndings in these areas are as follows: Districts of children 1-5yrs. In Belet Weyn districts • Sentinel Site Data: Trends in levels of acutely from a sample of 270 children - 10% of children malnourished children from the sentinel site data were reported with MUAC <12.5cm, in Buloburti indicates low and stable numbers in the agropastoral out of a sample 220 children also 10% of children zones and very low levels in the Coastal Deeh as were reported with MUAC <12.5cm, in Jalalaqsi the illustrated. Within the Hawd and Addun pastoral numbers were lower at 6% of children with a MUAC area high or slight deterioration in levels of acutely of <12.5cm from sample of 280 children. malnourished children were noted in specifi c sites: • Selective Feeding Centre Data: Trends in admissions Heraale, Waberi and Elhere. Dietary diversity also of moderately malnourished children in Belet Weyn remains good in most sites. town supplementary feeding centre remain high and stable. Chart 4: Level of acutely malnourished children from sentinel sites in South Mudug Region, Oct ‘05 - Nov ‘06 • Health Information System: The levels of acutely 70% malnourished children screened at health centre level 60% 50% remains high and increasing in Belet Weyn districts 40% 30% in parallel with higher levels of acute water diarrhoea 20% being reported likely linked to the recent fl ooding in 10% 0% the areas. The levels of acutely malnourished children at health centre level in the other non riverine areas Jul06 Jul06 Jul06 Oct05 Oct05 Jan06 Jan06 Dec05 Nov06 Nov06 Dec05 Nov06 of Hiran remain lower and decreasing. Bacadw eyn Caad Ceel Huur • Sentinel Site Data: The most recent round of sentinel site surveillance in the non riverine populations in Agropastoral Coastal Deeh Hiran in August 06 indicated high and stable levels of acutely malnourished children • Selective Feeding Centre Data: Trends in admissions of severely malnourished children from Galgadud Lower Shabelle (Sablale, Brava, Kurtan Warrey, Marka and indicate low but increasing admissions over the past Afgoye Districts) and Middle Shabelle ( Aden Yabal, Adale, three months possibly associated with an increase in Jowhar, Wanle Weyne and Balad Districts) Regions diarrhoeal cases being reported in the area. • Health Information System: The levels of acutely The nutrition situation in Lower and Middle Shabelle malnourished children screened at health centre remains alert with some pockets: Adale town, Caligudud, level remains generally low with the exception of Moiko and Jowhar Town indicating a more serious Gellinsoor where levels have increased from October situation. These pockets of concerns are possibly linked to to December ’06. recent fl ooding and exposure to water borne disease such as AWD. In addition, due to the high numbers of vulnerable Hiran Region – (Belet Weyn, Buloburti and Jalalaqsi groups (IDP/ urban poor) in Mogadishu, refl ected in the Districts) high and stable admissions of severely malnourished children into the selective feeding centres, the nutrition Hiran region includes three livelihoods groups: the Southern situation there remains critical. Inland pastoral, Hiran agro-pastoral and the Hiran riverine community. From the FSAU Post Gu ’06 analysis the The key nutrition fi ndings in these areas are as follows: pastoral community were faced with an Acute Food and • Rapid MUAC assessment: A rapid MUAC assessment Livelihoods Crisis but with the two recent good seasons was conducted in 12 villages in December: 2 villages of rain some recovery has been reported and hence a down each in Jowhar and Mahadaay, 3 villages in Alanyabaal grading to Chronically Food Insecure. However, for the and 5 villages in Adale of children 1-5yrs. In Jowhar riverine population the situation remains in Humanitarian district from a sample of 200 children - 9% of children Emergency due to the chronic vulnerability of this group were reported with MUAC <12.5cm, in Adale out of a exacerbated by the recent severe fl ooding which has caused sample 589 children 12.3% of children were reported large asset loss, crop destruction and exposure to water borne with MUAC <12.5cm although 2 villages had levels over disease with recent cases of acute watery diarrhoea (AWD) 15% where the community reported a recent diarrhoeal being reported. Therefore the nutrition situation remains outbreak. In Alanyabaal from a sample of 301 children critical for the population in Belet Weyn District and all riverine populations and serious for Chart 5: Level of acutely malnourished childrenfrom sentinel sites in Lower Shabelle Region, Dec ‘05 - Dec ‘06 eg o , ec 05 to ec 06 the population in Buloburti and 70% Jalalaqsi. 60% 50% The key nutrition fi ndings in these 40% areas are as follows: 30% 20% • Rapid MUAC Assessment: 10% A rapid MUAC assessment 0% Jul06 Jul06 Jul06 Jul06 Jul06 Jul06 Jul06 Jul06 was conducted in 12 riverine Jul06 Dec05 Dec06 Dec06 Dec06 Dec05 Dec06 Dec06 Dec05 Dec06 Dec05 Dec06 Dec05 Dec06 Dec05 Dec06 Mar06 Mar06 Mar06 Mar06 Mar06 Mar06 Mar06 Mar06 Mar06 villages in December: 4 Mukaidumis Warer Kunyo Kibilil Sablale Jeyrow Golw eyn Roobow Mungiiya villages each in Belet Weyn, Maleh Bar r ow Buloburti and Jalalaqsi Riverine Agropastoral 6 FSAU Monthly Nutrition Update January 2007 FSAU

the numbers were lower at 5% of children with a MUAC in Goldogob, Bossaso IDP’s and Allula Kandala and of <12.5cm and fi nally from Mahadaay from sample of Ishkuban. The most recent assessment was conducted 200 children, 9% recorded a MUAC <12.5cm. in Goldogob in November ’06 and reported a GAM of • Selective Feeding centre Data: The TFC’s in Mogadishu 11.1% (8.6-13.6) and a SAM of 1.1% (0.3-1.5), these city, Hodan and Forlanini, continue to report very high results are in line with previous assessments conducted yet stable numbers of severely malnourished children. at the same time in other years and therefore does not A large proportion of these children originate from the indicate any signifi cant improvement or deterioration. In IDP / urban poor populations where living conditions, Bossaso IDP’s an exhaustive assessment was conducted sanitation and access to health care are poor. in October ’06 and reported a GAM of 15.5% and a SAM • Sentinel Site Data: Trends in levels of acutely of 2.0%, although high again these results are consistent malnourished children from sentinel sites in general with the previous assessments conducted at the same time continue to report low and stable levels in the most recent of year from 2001 and indicate an improvement from round conducted in December ’06 with the exception of the most recent assessment conducted in August 2004 Golweyn and Roobow where slight increasing trends where 20% GAM was reported. Finally in Allula Kandala have been reported. and Ishkuban districts an assessment was conducted in • Health Information System: The levels of acutely September ’06 and reported a GAM of 13.8% (11.0-16.6) malnourished children screened at health centre level and a SAM of 1.6% (0.9-2.4), again similar to the other remain low and stable, though with increasing reports areas these results are consistent with previous assessments of seasonal diseases such as suspected malaria and conducted at the same time of year in the area. This fi nal diarrhoea. assessment represents districts which have very limited access to basic services with only one Maternal and Child Health Centre serving the three districts. Northeast Zone • Rapid MUAC Assessment: A rapid MUAC assessment was conducted in Eyl town and Godob village in Eyl The Northeast zone Map 8: North East Zone District in December ’06 measuring a total of 453 children is made up of eight 1-5yrs. The results reported 4% of children with a MUAC livelihood zones: Golis <12.5cm. In one village in Jariban district 79 children 1- pastoral, Gagaab pastoral, 5yrs were screened and reported 7.5% of children with a East Golis pastoral MUAC of <12.5cm. and frankincense, Sool • Health Information System: The levels of acutely Sanaag pastoral, Nugal malnourished children screened at health centre level Valley pastoral, Coastal remains low and stable in most parts of the northeast with Dheeh, Hawd pastoral the exception of the IDP population where higher levels and Addun pastoral. In of acutely malnourished children are reported. In the the Post Gu ’06 FSAU Addun Pastoral: Mixed sheep & goats, camel months of November and December ’06 localised areas Coastal Deeh: Sheep East Golis Pastoral: Frankinncense analysis large parts of the Gagaab Pastoral: Frankincense Guban Pastoral: Sheep, goats & camel of Acute Watery Diarrhoea were reported across the zone Hawd Pastoral: Camel, sheep & goats Kakaar-Dharor Pastoral: Sheep, goats, camel northeast zone were faced Nugal Valley Pastoral: Sheep & camel Potato zone & vegetables which may have had an impact on these results although Sool-Sanag Plateau Pastoral: Camel, sheep & goa with an Acute Food and the situation seems to have resolved now. Livelihoods Crisis due to the effects of the earlier drought in Deyr ’02 to Deyr ’04. However, this had indicated recovery from the previous year Northwest Zone where some proportions of population had been faced with a Humanitarian Emergency. The current IPC from the FSAU The Northwest Zone is made up of eight livelihood zones: Post Deyr ’06/07 has indicated a continuing improvement in Hawd pastoral, Northwest agropastoral (sorghum and cattle), the food security situation of the population and has resulted in Northwest agropastoral (vegetables and shoats) Guban a down grading of the situation to Chronically Food Insecure. pastoral, Sool/Sanaag plateau, Nugal Valley pastoral, West There is also a Watch of a potential deterioration due to the Golis pastoral and Togdheer agropastoral. In the FSAU Post current concerns of the unknown camel disease being reported Gu ’06 analysis, similar to the northeast zone, large parts in parts as well as the ongoing risk of confl ict in the southern areas which may have an impact on other parts of the country. Map 9: North West Zone In addition, in localised parts of northeast including the IDP population in Bossaso, the nutrition situation continues to illustrate a serious situation again likely linked to the access and availability of basic services. Therefore the nutrition situation for most of the northeast is classifi ed as alert with areas of serious in the most north-eastern areas and critical for the IDP’s in Bossaso.

Awdal border & coastal towns: Petty trading, fishing, salt mining East Golis Pastoral: Frankinncense Guban Pastoral: Sheep, goats & camel Hawd Pastoral: Camel, sheep & goats The key nutrition fi ndings in these areas are as follows: Kakaar-Dharor Pastoral: Sheep, goats, camel North-West Agro-Pastoral: Sorghum, cattle North-West Valley Agro-Pastoral: Irrigated vegetables, shoats Nugal Valley Pastoral: Sheep & camel • Nutrition Assessments: Three recent nutrition Potato zone & vegetables Sool-Sanag Plateau Pastoral: Camel, sheep & goats Togdheer Agro-Pastoral: Sheep, goats & vegetables assessments were conducted in the northeast zone, West Golis Pastoral: Goats, camel, sheep

7 FSAU FSAU Monthly Nutrition Update January 2007 of the northwest zone were faced with an Acute Food and with the previous assessments conducted at the same time Livelihoods Crisis due to the effects of the earlier drought in of year though including additional livelihood zones. Deyr 2002 to Deyr 2004. Finally in Sool Plateau an assessment was conducted in September ’06 and reported a GAM of 9.0% (7.3- This had indicated recovery from the previous year where some 11.0) and a SAM of 0.7% (0.3-1.6) and indicated an proportions of population had been faced with a Humanitarian improvement from the previous assessment conducted Emergency. The current FSAU IPC from the Post Deyr ’06/07 in 2004 where 13.4% GAM (11.5-16.1) and 3.1% SAM has also indicated a continuing improvement in the food security (2.1-4.5) was reported. situation of the population and has resulted in a reclassifi cation of the situation from an Acute Food and Livelihood Crisis Chart 6: Trends in Global Acute Malnutrition in Hawd to Chronically Food Insecure in parts. Although no recent Livelihood, 2002 - 2006 information is available on the IDP populations in Hargeisa, 12% Berbera and Burao, from previous analysis (March ’06) they 10% have been shown to be nutritionally vulnerable therefore there 8% is a risk that their nutrition situation may be worse however 6% until more recent nutrition information is available they will % GAM 4% be classifi ed with the other main livelihoods. Therefore the 2% nutrition situation for the northwest is classifi ed as alert. 0% Jun-02 Aug-03 Jun-05 Nov-06 The key nutrition fi ndings in these areas are as follows: Mnth/ Yr • Nutrition Assessments: Three recent nutrition assessments were conducted in the northwest zone, • Health Information System: The levels of acutely in Hawd of Hargeisa, Nugal Valley and Sool Plateau. malnourished children screened at health centre level The most recent assessment was conducted in Hawd of remains low and stable in most parts of the northwest Hargeisa in November ’06 and reported a GAM of 8.1% with the exception of the larger towns where higher levels (6.5-10.1) and a SAM of 1.9% (1.2-3.1). These results of acutely malnourished children are reported, this could are in line with previous assessments conducted at the be linked to the higher numbers of IDP’s/ urban poor and same time in other years and therefore does not indicate also to the recent AWD outbreaks in Togdheer. any signifi cant improvement or deterioration. In the months of November and December fl ooding and localised areas of acute watery diarrhoea were reported In Nugal Valley, an assessment also conducted in in Burao resulting in fatalities in both the under fi ve and November ’06 reported a GAM of 8.9% (7.2-11.0) and a adult population, although the situation is reported to SAM of 1.4% (0.8-2.4) again these results are consistent have resolved by now.

Other related publications and Releases o FSAU, Food Security and Nutrition, Special Post Deyr ’06/07 Brief, February 2007 o FSAU/FEWSNET Market Data Update, January 2007. o FSAU/FEWSNET Climate Data Update, January 2007

Physical address: Kalson Towers, Parklands, Nairobi. Postal address: PO Box 1230, Village Market, Nairobi, Kenya Telephone: +254-20-3741299, 3745734, 3748297. Fax: 3740598 General email: [email protected] FSAU Comments and information related to nutrition: [email protected], Website: http://www.fsausomali.org

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