Drought and COVID-19 response update 18 Aug 2020 Key Highlights Total funding Number of children Number of children with Number of children 6-59 Number of caregivers of received – with SAM admitted for SAM successfully months who received children under 2 reached nutrition specific treatment treated Vitamin A with IYCF-e counselling 3.6K 19% 11,183 59% 6,254 45% 614,040 62% 952k 167% Background Operational presence Map Widespread economic shocks and the drought, have left over 1.1 million children and women in need of humanitarian nutrition assistance. Approximately 95,000 children under age 5 are suffering from acute malnutrition, with the national global acute malnutrition (GAM) prevalence at 3.6 percent (ZimVAC rural 2019). Pockets of increased cases of malnutrition particularly in Epworth and Gutu and Mutare districts remain a concern. The advent of COVID-19 and its restrictions had socio-economic negative impacts limiting access to nutritious foods by families. The Pandemic has also negatively impacted the supply and demand of essential Health and nutrition services. According to recent global estimates, these effects would translate into a 15 percent increase in acute malnutrition (14,250 children being malnourished in Partner presence Zimbabwe) resulting from increased food insecurity. Pellagra CERF funded cases have been on the rise in the country with double the cases being recorded from Jan to June 2020 as compared to Partner presence other the same time in 2019. funding sources Plans by partners to Nutrition response expand into these The nutrition response focused on groups that are most vulnerable to malnutrition, including pregnant and lactating No partners women, children under age 5, and people living with HIV in the 56 hardest-hit districts and three urban and peri-urban Response activities areas. 25 most affected districts were targeted for a more The nutrition cluster coordination platform was activated at intensive nutrition response. Of these 25 districts, 17 were national level and held regular bi-weekly meetings with supported by (Implementing partners) IPs. Gutu and Bikita leadership from UNICEF together with MoHCC and districts emerged as malnutrition hotspots and GOAL participation from national and provincial level MoHCC Zimbabwe moved in to support these districts. There are plans cadres, cluster partners, donors and members of other to support Matobo, Beitbridge and Mutare-Urban districts by clusters. Subnational coordination platforms were activated in other IPs to make the districts supported, 24. 8 provinces and 25 priority districts. Regular technical emergency meetings were also held by UNICEF together with IP Districts supported IPs. SCI Bulawayo, Binga, Kariba, Hurungwe, In the 25 priority districts, the response focused on active Chimanimani (plans to extend to screening of all children 6-59 months for acute malnutrition led Matobo and Beitbridge) by Village Health workers (VHWs). Family-led MUAC was WVI Makoni, Mt Darwin, Mudzi (plans to adopted for screening in communities to limit the risk of extend to Tsholotsho and Lupane) transmission of Covid-19. Children with yellow or red MUAC ADRA Seke, Gokwe North, Umguza were referred to the health facilities where life-saving GOAL Chipinge, Mutare-Rural, Masvingo, therapeutic foods had been prepositioned. An extended Buhera (plans to extend to Highfields, protocol for treatment of MAM using RUTF was put in place. Harare) Children with acute malnutrition were given 4 weeks supply of NAZ Mwenezi, Chiredzi (plans to extend to RUTF instead of 2 weeks supply to limit contact with the health Mutare-Rural) facility. Treatment services were provided at health facility level for acutely malnourished children. A disruption in OPHID Gutu, Buhera, Makoni, Mutare, demand and supply of services was witnessed in April 2020 Chimanimani, Chipinge, Masvingo where there was a dip in numbers of children admitted for No partner support Mbire, Gwanda, Harare SAM treatment as shown in DHIS2. In May 2020 the numbers of children being admitted for treatment of SAM had improved 1 | P a g e but was still the lowest number compared to the previous 3 messages and face to face feedback. To date the feedback years. that is received through the platforms has been on the The sector closely worked with the Food Security cluster to programme and requirements for either PPE or essential expand the reach of nutrition services through utilizing the nutrition commodities. General Food Distribution for integrating nutrition interventions. Additionally, the nutrition cluster advocated HRP targets VS Achievements through the food security cluster to include supplementary specialized products targeting under-five children and PLW for Indicator In Targeted Achieved all household benefiting from general food distributions. need IYCF-E counselling and support was done at community level Number of Sector 12 12 13 being led by VHWs with support from Ward Nutrition coordination meetings held. 108% Coordinators and utilizing community structures such as care Number of children 1.9M 991K 1,738,087 groups. Infection prevention and control (IPC) measures like screened for acute 175% malnutrition. (cumulative) washing of hands and maintaining social distancing were Number of children with 38K 19K 11,183 adopted at the care group meetings. Mid-mass media (eg. SAM admitted for treatment. 59% community radio shows) were used for communication of key nutrition and Covid-19 messages reaching over 2 million Number of children with 57K 17K 1,913 people nationwide. MAM admitted for treatment. 11% In order to prevent relapse of children admitted with malnutrition GOAL is planning to complement the nutrition Number of acutely 19K 14K 6,254 programme through targeted supplementary feeding, malnourished children 45% supporting the children with CSB. A cash transfer programme successfully treated. is also planned by the same organization for Harare in Number of caregivers 1M 570K 952,404 reached with IYCF-e 167% Highfields targeting HH with children under 5. messages Capacitation of health workers at facility level and community level is an ongoing activity to improve the quality of the Number of children who 1.9M 991K 614,040 programme implementation. The Pediatric Association of received micronutrient 62% Zimbabwe (PAZ) is also developing remote training materials supplements. aiming at strengthening the capacity of health workers and Number of Health 1.3K 950 98% clinicians through an e-learning platform. facilities reporting on a reporting monthly basis. rate in Results DHIS2 Approximately 5,175 village health workers were trained on Nutrition Assessments 2 2 1 active screening and 1,247 health-care workers on integrated conducted 50% management of acute malnutrition (IMAM) cumulatively from Number of health 1,500 1,300 94% April to June 2020 in the 17 districts that are supported by facilities with no partners. A total of 1237 VHWs and 217 lead mothers were stockouts of essential trained on community infant and young child feeding (cIYCF- nutrition commodities. e). Implementation modalities adjustment are progressively rolled-out to ensure infection prevention and control. AAP Plan for the sector 1 1 1 developed and 100% implemented. Number of Community 87 50 344 meetings/dialogues 688% conducted. What went well Partners resumed operations in the field in May which allowed continuity of the emergency programme. Family-led MUAC has enabled screening of children for acute malnutrition while limiting risk of infection. The Use of the RapidPro SMS-based reporting system made monitoring of the response easier. Timely data was available cIYCF-e training for village health workers at Nyanyadzi rural compared to the 1 month behind lag of the DHIS2. hospital in Chimanimani supported by Save the Children Photo cred: Lovemore Sorofa Challenges To ensure accountability to affected populations during the Most challenges are related to the advent of the covid-19. response, the cluster has put in place mechanisms for getting A delay in implementation of activities by partners was feedback from the communities. The community dialogues experienced between March and April 2020. However, most that were planned for, were disrupted by Covid-19 where partners were able to catch-up on their activities and targets. people could not congregate. Partners provided the The travel restrictions by Covid-19 have affected demand and communities with alternative feedback mechanisms which supply of key health and nutrition services. include hotlines, suggestion boxes, phone calls/text Shortages of PPE have hugely affected provision of services 2 | P a g e at community level by VHWs. Shortage of MUAC tapes due to slow movement of goods has affected rolling out of Family-led MUAC eg. in Buhera and Chipinge in Manicaland district. The restrictions on use of mobile money platforms have affected some of the activities planned by partners. Limited funding to meet the needs of the response. Priorities going forward To effectively, reduce rates of acute malnutrition through protecting vulnerable households and build resilience to minor shock through cash transfers in Harare urban. Continue to circumvent death caused by malnutrition through early detection and treatment. and restocking health facilities with low supplies of nutrition commodities. Strengthen coordination at national level by ensuring that there is better representation of Provincial nutritionists on the platform. Support IPs to have PPE for use in the field and for distribution to village health workers so that community level activities in the communities can continue. To improve community engagement for AAP activities. 3 | P a g e .