Mauritania COVID-19 Situation Report #02 © UNICEF Mauritania 2021/Pouget Reporting period: April to June, 2021 Situation in Numbers Highlights 5,947 confirmed From January 1 to June 22 2021, a total of 5,947 confirmed COVID-19 cases were COVID-19 cases reported, 8,116 people were cured, and 133 people died, bringing the cumulative total to 20,365 cases, including 804 children, 481 deaths, 19,438 cures, and 446 active 133 deaths (Jan- 22 cases. June 2021) In the multisectoral response against COVID-19, UNICEF supports the government 133,718 people by providing co-leadership on the Infection Prevention and Control and Risk have received the first Communication and Community Engagement pillars. Mauritania faces a trend COVID-19 vaccine towards a possible third wave. dose Launched on March 26, the vaccination is currently offered in 361 sites across the 740,000 country. The Health Ministry received 170,000 doses of AstraZeneca SII through the children in need COVAX facility. UNICEF supported a national immunization campaign from June 15- 17 reaching approximately 65,000 people. 11.7 M US$ As of June 22, 133,718 people over 45 years of age or with co-morbidities have required received their first dose of the vaccine, representing 0.3% of the total population (4,271,198), 0.5% of the target population (2,690,855), and 16% of the first priority target (854,239). UNICEF’s Response and Funding Status Needs US$ 17,7 million Funds Received, $3,181,390 Funding gap, $11,797,012 Carry-Over, $11,372,166 Funding Status (in US$) *Funding available includes the carry-over and funds received in the current year. The education funding is the result of a large carry-over from previous years. 1 Funding Overview and Partnerships In 2021, HAC was funded at 18% for interventions relating to nutrition, health, WASH, education, child protection, communication and social protection. During this reporting period, funding was received through HAC COVAX and from Japanese cooperation. A great need of attention must be put in sustaining efforts along the humanitarian-developmental nexus. UNICEF Mauritania wishes to express its heartfelt gratitude to all public and private sector donors. Situation Overview & Humanitarian Needs Since January 2021, Mauritania has registered 5,947 confirmed cases, 8,116 recovered (with some cases being carried from 2020) and 133 deaths. As of June 22, 2021, Mauritania has recorded a cumulative total of 20,253 cases including 804 children, 481 deaths, 19,438 recoveries and 446 active cases. An outbreak in Guidimakha occurred in April and trends continue to be closely monitored as a slow upward trend has been noted since May 2021. Regarding COVID-19 vaccination, Mauritania adopted the strategy to first focus on protecting the most exposed and vulnerable people. However, the immunization uptake is lower than anticipated as there are major challenges for securing enough doses covering all needs and organising logistics relating to transportation and storage. In addition, solid community involvement and sensitization needs to be intensified for facing vaccine hesitation in reaction to anti- vaccine rumours spread on social medias. According to the World Bank report1, the COVID-19 pandemic and all the restrictive measures have caused the first economic contraction in Mauritania since 2008. The consecutive years of drought and food insecurity followed by the COVID-19 pandemic aggravated a pre-existing precarious nutritional situation due both to the disruption of economic and livelihood activities and an increase in the price of basic foodstuffs. According to the National Meteorological Office (ONM), a normal rainy season is expected with the possibility of heavy rains in flood-prone areas. The ONM recommends that flood preparedness plans to be put in place for preventing the risk of flooding and to limit the use of flood-prone areas in the south-eastern, central, and northern regions of the country (Tagant, Hodh Chargui, Hodh El Gharbi, Adrar, Tiris Zemmour, and Nouadhibou). In the south-west of the country (Trarza and Brakna), there is a possibility of low rainfall, which could have an impact on the amount of water needed for agriculture and may accentuate food insecurity. The M’Berra camp currently hosts 67,126 Malian refugees, 39,296 being children. Refugee and host communities continue receiving humanitarian assistance. Summary Analysis of Programme Response Nutrition In January, 2021, based on the SMART surveys of the past five years and the November 2020 "harmonized framework" exercise, UNICEF, as the nutrition sector lead, supported the government in estimating their needs for prevention and treatment of acute malnutrition and developing the 2021 humanitarian response plan. The nutrition technical group estimated the burden of acute malnutrition in 2021 to be 147,312, including 36,233 SAM. Moreover, as shown in the March, 2021 Harmonized Framework (supported by UNICEF and its partners), in the projected situation (June - July - August 2021), the total number of people affected by severe food insecurity is estimated to be 484,151 (11.1% of the population), stable cases compared to the November, 2020 projection. Fourteen (14) districts are classified as being in the crisis phase (Aleg, Bababé, Boghé, Maghta-Lahjar, M'Bagne, Kaédi, M'Bout, Moudjieria, Tichitt, Tidjikja, Sélibaby, Zoueratt, Bir Mogrein, and F'Dérik), while the others are in pressure phase, with the exception of Nouakchott South, which is in the minimum food insecurity phase. Furthermore, close collaboration with the Ministry of Health (MoH) and partners, UNICEF continues to support the SAM children treatment, with a focus on the 20 emergency districts ones the most affected by acute malnutrition and food insecurity. Since January 2021, 7,077 cases of SAM were admitted for treatment, 22% of the annual target (30,798) and 19 % of the annual burden (36,233). SAM admissions are 28% lower than last year (9861 last year) at the same period. This figure could be underestimated due to the low proportion of reports completed between January and April 2021 (74%). However, through recruitment of consultants, UNICEF continues to support the MOH for activities field monitoring, the data collection and transmission. 1 “Quatrième rapport sur la Situation Économique en Mauritanie: Un meilleur avenir: accélérer la relance économique en misant sur le potentiel des femmes” (Fourth Report on the Economic Situation in Mauritania: A Better Future: Accelerating Economic Recovery by Building on Women's Potential) 2 In 2021, a total of 30,218 cartons of Ready-to-use therapeutic food (RUTF) needed for the Integrated Management of Acute Malnutrition (IMAM) programme were needed (including 2,500 cartons of RUTF estimated for IMAM treatment optimization research). Thanks to the UNICEF WCARO support, 8,360 cartons of RUTF were secured through the Accra hub. In addition, through UNICEF’s advocacy, the Ministry of Health committed itself to mobilizing domestic resources from the national social protection programme funding for the procurement of RTUF of about 50% the 2021 need and 75% of the 2022 need. The tripartite, MOU between UNICEF, MOH and national social protection program for RTUF procurement service is under review and will be signed soon. A total of 9,760 cartons of RUTF were distributed throughout the country to date; 33 cartons of RUTF are currently prepositioned in Nouakchott in addition to 2,600 cartons in the pipeline ordered through UNICEF regular/others resources to cover the 2021 distribution plan by July, 2021. To avoid RUTF stock out on the third quarter, UNICEF is supporting the Government in procuring 50% (18,157/36,314) of RUTF need from the national social protection programme fund and using the Match fund mechanism. At national level the quality of IMAM program is adequate. The three key IMAM indicators at the national level met the SPHERE standards with an 89.9% cure rate, 0.6% death rate and 8.9% defaulter rate and 0.6% non-responding rate. However, some disparities noted between health districts. As part of waste prevention, 59,052 primary caregivers of children aged 0-23 months continue receiving Infant and Young Child Feeding (IYCF) counselling through facilities and community platforms. Furthermore, in June, 584,477/679,451 children 6-59 months (86%) screened at the national level during the MOH integrated mass campaign supported by UNICEF, 2,142 severely acute malnourished (SAM) children and 13,595 moderately acute malnourished (MAM) children were detected and referred in the health facilities and at community level for their treatment. In addition, 87% (592,566/679,451) of the children 6-59 months received vitamin A supplementation and 89% (540,670/606,546) of 12-59 months dewormed. UNICEF is supporting the MOH team in preparing the 2021 SMART survey, needed for 2022 humanitarian planning. All these results were obtained thanks to the partnership between UNICEF, the Government and Non-Governmental Organizations (NGOs). In the context of the COVID-19 pandemic, UNICEF is providing technical and financial support to the Ministry of Health (MOH) for the implementation of mitigation strategies to ensure the continuity of integrated preventive/curative acute malnutrition essential services including optimal IYCF practices promotion, screening/treatment of SAM cases at health facilities and at the community level, through both a direct support to the MOH and an agreement with 13 national and international ONGs as implementing partners in 23 emergency districts (out of a total of 57 in the Country). Thus, as part of wasting prevention, 134,314 pregnant and lactating women (36,520 pregnant women and 97,774 lactating women/primary caregivers of children aged 0-23 months) received IYCF counselling through facilities and community platforms and, 54,668 children 6-23 months benefited from micronutrients powder distribution in these 23 emergency districts. However, the main challenge is the funding for maintaining partnership with these 13 NGO in 2021/2022 to ensure continuity of preventive/treatment acute malnutrition interventions within these chronically emergency nutrition districts.