FSNAU Bi-Monthly Nutrition Update, March-April 2014 FSNAU FSNAU Food Security and Nutrition Analysis Unit - Somalia March - April 2014 OVERVIEW A review of the health facility data and field reports for the period Overview 1 of January-March 2014 suggest critical/very critical prevalence Nutrition Situation in Northwest Regions-Somaliland 3 of acute malnutrition persist in south central regions of Somalia Nutrition Situation in Northeast and Central Regions 3 (Table 1). Increasing trends in acute malnutrition are reported Nutrition Situation in Juba and Gedo Regions 4 by health facilities in NW Agro pastorals in NW and Hawd Nutrition Situation in Bay and Bakool Regions 5 Nutrition Situation in Shabelle Region 6 livelihood in NW, NE and Central region as well as in Addun Nutrition Situation in Banadir 7 livelihood in NE and Central. Further delays in seasonal Gu Nutrition Situation in Hiran 7 rains will lead to deterioration in malnutrition situation in these Nutrition Causal Analysis in North Gedo and in Qardho and regions. Increasing trends of acute malnutrition were also Galkayo IDPs 7 reported by health facilities in Juba pastorals and Agropastorals Baseline Survey for Strengthening Nutrition Security in South in Lower Shabelle. Central Somalia 10 Post Gu Nutrition Assessment Schedule (May– July 2014) 13 Southern regions The integrated nutrition situation analysis conducted by FSNAU and partners in January 2014 classified the nutrition situation in Bakool Pastoral, Bay agro-pastoral, Beletweyne District, Kismayo IDPs, Dolow IDPs and Dhobley IDPs as Critical. On the other hand, nutrition situation in North Gedo riverine, North Gedo Pastoral, North Gedo Agro-pastoral, Baidoa IDPs, and Middle Shabelle and Mataban district was classified as Serious. In Lower Shabelle, nutrition assessments could not be done due to prevailing insecurity and the available health facility data was insufficient to classify the nutrition situation in these areas1. Data from health facilities in January- March 2014 suggest increasing trends in prevalence of acute malnutrition in pastoral livelihoods of Juba and Agro pastorals in Lower Shabelle and limited humanitarian access suggest situation is likely to deteriorate. Prevalence of acute malnutrition is critical but stable in Bay, Bakool, Juba Agro pastoral and Juba Riverine, Gedo riverine and Gedo Agro pastoral and in Banadir region. Serious nutrition situation but stable trends were recorded by health facilities among Gedo pastoral livelihood. This suggests that southern region remains highly vulnerable. However, the nutrition situation is expected to improve due to increased access to milk in all livelihoods following early onset of Gu rainfall which boosts livestock production in the region. Health Facility data from Middle and Lower Shabelle indicate a high (>20%) and fluctuating trends of acutely malnourished children across livelihoods in the two regions. In addition, field reports indicate a seasonal increase in cases of acute watery diarrhoea in these regions which is likely to aggravate nutrition situation. It was observed that a number of MCH (Maternal and Child Health) centres in south region have closed due to insecurity/access. This will impact the regional capacity to respond to malnutrition, prevent disease outbreaks by providing essential vaccinations and increase prevalence of severe acute malnutrition. Northern and Central regions The integrated nutrition situation analysis conducted by FSNAU and partners in January 2014 indicated a Serious nutrition situation across livelihoods in Northwest, Northeast and Central Somalia with exception of Sool plateau and Addun in Northeast/ Central regions livelihoods which were in an Alert level. A review of the health facility data and field reports indicate a generally stable nutrition situation across livelihoods in Northwest, Northeast and Central regions i.e. same levels as in Deyr 2013/14. Data from health facilities show critical levels of acute malnutrition and increasing trends in NW Agro pastoral (>15%). However, the increasing trend noted in the Agro-pastoral livelihood is linked to availability of supplies in feeding programme which attract more people to the facilities. Hawd central recorded > 50 percent acute malnutrition because of closure of OTP site (Abudwaaq) by Save the Children and long distances families have to cover to reach existing OTP to access lifesaving care. Health facilities in Addun central also reported high levels of acute malnutrition (critical situation), but trends are stable. Health facilities in West Golis/Guban, East Golis, and Sool Plateau, Nugal Valley in Northwest and Sool plateau and Nugal valley in North East reported alert levels of acute malnutrition (< 10%) and stable trends . Field reports indicate increased milk access in all livelihoods of northwest, and the situation may improve further following the onset of Gu’ rainfall. However, there are sporadic cases of diarrheal diseases, ARI and measles reported in Northwest regions especially in Sool regions which are likely to aggravate the nutrition situation in the affected livelihoods. 1 Nutrition Technical Series Report, March 2014 Technical Partners FSNAU Funding Agencies FSNAU FSNAU Bi-Monthly Nutrition Update, March-April 2014 Serious levels of prevalence of acute malnutrition and increasing trends were recorded by health facilities in Hawd livelihood in both northwest and northeast region. According to the MOH surveillance reports, Measles outbreak has been reported in most of districts since January 2014 and the trend was increasing every week where 12 samples collected from Burtinle district 4 of them were confirmed positive for measles. The increased case of measles was also reported from livelihood zones in central regions and this could have a negative impact to the nutritional status of the children. For children under five, the risk of developing severe or fatal measles is increased by overcrowded living situations ( IDPs) and malnourishment .The cholera transmission season will begin with the onset of the Gu rains at the end of March and this will lead to increase in prevalence of severe acute malnutrition during the post Gu period. Table 1: Nutrition situation as per reports from health facilities REGION MCH CENTERS HIS TRENDS JAN-MAR 2014 REMARKS SOUTH Degroor Medical organization, Badbaado GREDO/SAVE THE CHILDREN/ Bay Medical Organization, Degaras Health >30% and stable trend SOS in BAIDAO. Insecurity a major Organization, Baidao Referral hospital obstacle. GREDO/SAVE THE CHILDREN/ Gasweyne- Hudur district Bakool >30% and stable trend SOS in BAIDAO Insecurity a major Biyooley- Teiglow district obstacle. Closed MCH- RABDHURE, TEIGLOW Juba pastoral Afmadow APD ,Dobley APD >20% and increasing trend and WAJID because of security Jamame Muslim AID ,Badhadhe SRCS (Agro p) Juba agro-pastoral >20% and stable trend Closed MCH- GADUDEY Salagle JCC (Agrop) Juba riverine Mugambo SRCS ,Buale JCC >20% and stable trend Closed KUDHA &BULA HAJI MCH SRCS, El-wak/Bardera (Pastoral) Gedo Pastoral >15% and stable trend Trocaire,Belethawa/ Dollow (Pastoral) AMA Bardera (Riverine) >20% but decreasing trend Insecurity a major obstacle. Gedo Riverine HIRDA Bardera (Riverine) HIRDA Bardera (Agro pastoral), Gedo Agropastoral High (>20%) and Fluctuation Trocaire Luuq (Agropastoral Medina,Waberi,Hamarweyne,Hamarjajab Closed MCH-Merka Town, Banadir >20% and stable Zamzam Horseed,Wadajir,Holwadag L Shabelle Closed MCH-Kulmis, Bulasheik, Shalambod,Kurtunwarey,Brava >20% increasing trend Agropastoral Mahaday Shabelle Riverine Closed MCH-Buraene,Gololey Closed MCH-Bulorburti, Hiran Jalalaqsi,Buqdha qable, Mogokori, Elale, Kooshin NORTH WEST Lughahya, Lowyado, Garbodadar, Boon, West Golis/Guban Geerisa, Darbudhug, Mandera, Harirad, Low <10% and stable Abdikadir Hadaftimo, Kulmiye, Barwaqo, Gar-adag, East Golis Low <10% and fluctuating Badhan Increased milk access Sool Plateau Awrbogays, dharhar, Hingalool, Elafweyn Low < 10% and stable Lasanod Central, Daami, Farxaskule, Taleh, Nugal Valley Low >10% and decreasing Huddun, Yagori, Ainabo Odweine, Sheik, Gebiley, Dilla, Allaybaday, Availability of supplies in feeding Agro-pastoral High (>15%) and increasing Idhanka, Qolijeed programme attract more people Kalabayd, Buhoodle, Salahlay, Bali-Gubadle, Moderate (>10%) and Hawd Measles outbreak Haji Salah, Adadlay, Durugsi, Buhodle, Balidhig increasing NORTH EAST and CENTRAL Hawd central Abudwaq and Galinsor >50% and decreasing trend Save the Children has pulled out from Abudwaaq OTP site. Only 4 OTP Aduun Central Dusomareb and Adaado <40 and stable feeding sites and long distances to reach OTP East Golis Ufeyn, Carmo, Calula , Iskushuban Moderate >10% and decreasing Increased Malaria cases reported Sool plateau Qarhis*, Dangaroyo, Rako ,Waaciye Low <10 % and stable trends Nugal valley Sinujiif, Gambool and Waaberi Low <10% and decreasing trend No Alarming situation reported. Coastal Deeh Eyl, Bayla, Bargal, Hafun Moderate >10% and Stable Kalabayr, jalam, Bacadweyn, Harfo Moderate >10 % and increasing Persistent drought in Hawd. Hawd NE Burtinle*, Goldogob,Hasbahalle trend Measles cases reported Moderate <10 % and increasing Persistent drought in Addun. Measles Addun NE Godob, Ballibusle, Jerriban trend cases reported Interpretation of HIS trends during preceding 3 months relative to ≥ 2 yr. seasonal trend Acceptable Alert serious Critical Very Critical Low proportion (5 to Moderate (10 to <15%) and V. low (<5%) High (> 15%) and stable High (> 15%) and increasing <10%)