Nutrition Analysis Post Gu ‘12
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Nutrition Analysis Post Gu ‘12 Technical Series Report No VI. 47 September 26, 2012 Food Security and Nutrition Analysis Unit - Somalia Information for Better Livelihood Technical Partners Funding Agencies FSNAU Technical Series Report No. VI 47 Swiss Agency for Development and Cooperation SDC Issued September 26, 2012 Post Deyr 2011/12 Nutrition Analysis ii FSNAU Technical Series Report No. VI 47 Issued September 26, 2012 Acknowledgements FSNAU would like to thank all our 24 partner agencies for their participation and support in the Deyr 2011 seasonal nutrition assessments and analysis. Post Deyr 2011/12 Acknowledgement Nutrition Analysis From April through July 2012, a total of 46 nutrition surveys were conducted based on standard SMART methodology. Seventeen of the nutrition surveys were conducted in the south. Additionally, nutrition iii data from about 130 health and nutrition facilities was reviewed. Without the support and expertise of the 8 local NGOs, 3 International NGOs, 3 Local Authorities, 8 line Ministries and 2 UN agencies, this would not have been possible. Special thanks to UNICEF, for financial and/or technical support. A sincere note of appreciation also goes to the FSNAU nutrition team based in Somalia who work under such difficult conditions yet continue to produce such high quality professional work. Participating Partners - North Central regions only United Nations Children’s Fund (UNICEF), World Food Programme (WFP), Ministry of Health (MOH Somaliland), Ministry of Agriculture (Somaliland), Ministry of environment and rural development, and NERAD (Somaliland); Ministry of Health (Puntland), Ministry of Women Development and Family Affairs (MoWDFA), Ministry of Wildlife, Tourism and Environment (Puntland), Puntland State of Water and Energy (PSWEN), Medair, Somalia Red Crescent Society (SRCS), CAFDARO and Elberde Primary Health Care organization (EPHCO). Mahad Sanid FSNAU Technical Series Report No. VI 47 Issued September 26, 2012 TABLE OF CONTENTS 1 EXECUTIVE SUmmaRY 1 2 Cases OF ACUTELY MALNOURISHED CHILDREN IN SOmaLIA 10 3 NUTRITION ANALYSIS IN SOmaLIA 13 4. REGIONAL NUTRITION ANALYSIS 16 Post Deyr 2011/12 of Contents Table Nutrition Analysis 4.1 GEDO REGION 16 4.2 MIDDLE AND LOWER JUBA REGIONS 20 4.3 BaY AND BAKOOL REGIONS 27 iv 4.4 MIDDLE AND LOWER SHABELLE REGIONS 34 4.5 hiran REGION 39 4.6 CENTRAL SOMALIA: GALGADUD AND MUDUG REGIONS 42 4.7 Northeast REGIONS 48 4.8 Northwest REGIONS 58 5 URBAN SUMMARY FINDINGS 67 6 PLAUSIBILITY CHECKS 69 7 APPENDICES 73 7.1 Progression Of Estimated Nutrition Situation Gu ‘12 75 7.2 Nutrition Assessment Tools Post Gu ‘12 77 7.3 Nutrition Assessment Household Questionnaire, May 2012 IDP 81 7.4 Urban Rapid Assessment Record Form - Gu 2012 85 7.5 Mortality Questionnaire, June 2012 86 7.6 Field Supervisor– Verbal Autopsy 87 7.7 Southern IDPs And Urban Questionnaire - July 2012 90 7.8 Somalia Livelihood Zones 91 8. Glossary of terms 92 LIST OF FIGURes Figure 1: Global Acute and Severe Acute Malnutrition, (WHZ < 2 and 3 z Scoresor Oedema) April- July 2012 – Somalia 1 Figure 2: Retrospective crude and under 5 death rates per 10,000 per day 2 Figure 3: Median wasting rates, WHOGS (WAZ<-2 and WAZ <-3) April- July 2012 3 Figure 4: Median Stunting rates, WHO GS (HAZ<-2 and HAZ <-3) April- July 2012 3 Figure 5: Propotion of Total Cases of Acutely Malnourished Children (WHZ<-Z or Oedema) by Region, September 2012 10 Figure 6: Trend in Level of Acute Malnutrition (WHZ<-2 or oedema, WHO 2006) in Gedo Region, 2006-2012 16 Figure 7: HIS Malnutrition Trends in Gedo Agropastoral MCHs - 2011-12 17 Figure 8: Trend in levels of Acute Malnutrition (WHZ <-2Z scores or oedema, WHO 2006), Juba Regions 2007 - 2012 20 Figure 9: HIS Malnutrition trends in Juba agro-pastoral MCHs 2010-2011 21 Figure 10: Trend in levels of acute malnutrition (WHZ< -2 or oedema, WHO 2006) Bakool region, 2002- 2012 27 Figure 11: Admissions trends into OTP programmes Bakool 2012 28 Figure 12: Trend in levels of Acute malnutrition (WHZ< -2 or oedema , WHO 2006) Bay Agropastoral, 2002- 2012 28 Figure 13: Trend in levels of acute malnutrition (WHZ< -2 or oedema, WHO 2006) Bay region, 2002- 2012 30 Figure 14: HIS Malnutrition trends in Bay Agro-pastoral MCHs,2010-2011 31 Figure 15: Trends in Levels of Acute Malnutrition (WHZ<-2 or oedema) in Middle and Lower Shabelle Regions (2007- 2012) 34 Figure 16: HIS Malnutrition Trends in Shabelle Reverine MCHs 2010-2011 35 Figure 17: HIS Malnutrition Trends in Shabelle Agropastoral MCHs 2010-2011 35 Figure 18: Trend in Levels of acute Malnutrition (WHZ<-2 or oedema, WHO 2006) in Hiran Region, 2007-2012 39 Figure 19: HIS Malnutrition trends in Hiran Riverine MCHs 2011-2012 40 Figure 20: Trends in Levels of acute malnutrition (WHZ<-2 or oedema, WHO 2006) Central Regions, 2007-2012 42 Figure 21: HIS Malnutrition Trends in Hawd LZ of Central areas(2010-2012) Source: MoH; SRCS 42 Figure 22: HIS Malnutrition Trends in Addun L/Z of Central areas (2011-2012) 42 Figure 23: HIS Malnutrition Trends in Cowpebelt L/Z (2011-2012) 43 Figure 24: HIS Malnutrition Trends in Central Coastal Deeh L/Z (2011-2012) 43 Figure 25: Trends in levels of acute malnutrition (WHZ<-2 or oedema, WHO 2006) Northeast regions (2007-2011) 49 Figure 26: HIS Malnutrition Trends in Golis/ Karkaar LZ (2010-2012) 49 Figure 27: HIS Malnutrition Trends in Sool Plateau LZ (2011-2012) 50 Figure 28: HIS Malnutrition Trends in Nugal Valley LZ (2011-2012) 50 Figure 29: Trend in Levels of Acute Malnutrition (WHZ<-2 or oedema, WHO 2006) in Northeast IDPs (2006-2012) 52 Figure 30 : Trends in levels of Acute Malnutrition (WHZ <-2Z scores or oedema, WHO 2006 in North West regions 2006-2011 59 Figure 31: HIS Malnutrition Trends in Health Facilities in NW West Golis MCHs - January 2011-June 2012 60 Figure 32: HIS Malnutrition Trends in Health Facilities in NW Hawd MCHs - January 2010-June ’12 62 Figure 33: Trend in Levels of acute Malnutrition (WHZ<-2 or oedema, WHO 2007) FSNAU Technical Series Report No. VI 47 Issued September 26, 2012 in Northwest Regions Region, 2007-2012 65 LIST OF TaBLES Table 1: Nutrition Surveys Schedule April-July 2012 3 Table 2: Somalia Integrated Food Security Phase Classification, Population Numbers,Aug - Dec 2012 9 Table 3: Estimated Cases of Acute Malnutrition in Somalia, by Region, September 2012 10 Post Deyr 2011/12 of Contents Table Nutrition Analysis Table 4. The Nutrition Situation Classification Framework, Draft 8, January 2012 14 Table 5: Summary of Key Nutrition Findings in Gedo Livelihood Zones, May 2012 18 Table 6: Summary of Key Nutrition Findings in Dowlo IDPs May 2012 19 v Table 7: Summary of Key Nutrition Findings in Juba Livelihood Zones, July 2012 22 Table 8: Summary of Key Nutrition Findings in Kismayo IDPs July 2012 23 Table 9: Summary of Key Nutrition Findings in Bakool Pastoral livelihood zone - July 2012 28 Table 10: Summary of Key Nutrition Findings in Bay Regions-July 2012 32 Table 11: Summary of Key Nutrition Findings in Mogadishu Town - April- July 2012 35 Table 12: Summary of Key Nutrition Findings in Mogadishu IDPs - April- July 2012 36 Table 13: Proportion of the malnourished women in Banadir and Hiran Regions 40 Table 14: Summary of Key Nutrition Findings in Hiran region - July 2012 41 Table 15: Summary of Key Nutrition Findings in Hawd, Addun and Dhusamareb IDPs Central regions 44 Table 16: Summary of Key Nutrition Findings in Cowpea Belt Agro-pastoral and Coastal Deeh Pastoral of Central regions - July 2012 46 Table 17: Summary of Key Nutrition Findings in Northeast Regions - July 2012 51 Table 18: Summary of Key Nutrition Findings in Hawd, Addun and Coastal Deeh Northeast Regions 53 Table 19: Summary of Key Nutrition Findings among Northeast IDPs (Bossaso, Qardho, Garowe and Galkayo) May 2012 55 Table 20: Summary of Key Nutrition Findings in West Golis/Guban, Nugal Valley and Sool Plateau Livelihood Zones, December 2011 61 Table 21: Summary of Key Nutrition Findings in Hawd, East Golis and Agro-pastoral Livelihood Zones, July 2012 64 Table 22: Summary of Key Nutrition Findings for Hargeisa, Burao and Berbera IDPs, June 2012 66 Table 23: Summary of Urban Assessment Findings: Northwest and Northeast Regions – Post Gu ‘12 Table 24: Plausibility checks 72 Table 25: Summary of Nutrition Assessments (April - July 2012) 73 LIST OF MAPS Map 1: Somalia Nutrition Situation, January 2012 5 Map 2 Somalia Nutrition Situation, August 2012 5 Map 3: Estimated Nutrition Situation (September-November) 2012 6 Map 4: Somalia Acute Food Insecurity Overview, Rural, Urban and IDP Populations, July 2012 8 Map 5: Distribution of estimated Cases (%) of Acutely Malnourished Children in Somalia by Region, based on Prevalence, August 2012 11 Map 6: Gedo Region Livelihood Zones 16 Map 7: Juba Regions Livelihood Zones 20 Map 8: Bay and Bakool Regions Livelihood Zones 27 Map 9: Shabelle Livelihood Zones 34 Map 10: Hiran Livelihood Zones 39 Map 11: Northeast Livelihood Zones 48 Map 12: Northwest Livelihood Zones 58 SPECIAL ARTICLES Sustained high levels of acute malnutrition across Somalia and Kenya border 24 Case study 1: A family’s experience during a hunger period, in Huddur district 29 Case study 2: Increased nutritional vulnerability among the families in the besieged Huddur town, Bakool region 33 Nutrition Survey Results in Mataban and Beletweyne, Hiran Region Indicate an Extremely Worrying Health Situation 38 Food safety and malnutrition in Somalia 47 Strengthening of Infant and Young Child Feeding Programming and Planning for Emergency; The Infant and Young Child Feeding (IYCF) London Workshop (25-29 June 2012) Preparedness and Response. 69 FSNAU Technical Series Report No.