MOZAMBIQUE Humanitarian Situation report No. 4 Reporting Period: 1 – 31 May 2021 Highlights Situation in Numbers 689,000 children in need of • The situation in Cabo Delgado remained mostly humanitarian assistance calm in May though access is a challenge with tens of thousands in hard-to-reach or inaccessible areas 1.3 million • Over four million people were reached in 2021with people in need UNICEF’s COVID-19 prevention messages (OCHA Dec 2020) • UNICEF supported set up of 20 temporary learning 732,000 spaces and provision of kits 9,000 children this year Internally displaced • Over 4,800 households in Cabo Delgado were (IOM, April 2021) reached in May with cash transfer for three months >67,000 • UNICEF immunized 7,094 children aged 9 to 23 Internally displaced from months in May 2021 Palma (IOM, 3rd June 2021) UNICEF’s Response and Funding Status UNICEF Appeal 2021 US$ 96.5 million 1 Funding Overview and Partnerships UNICEF’s 2021 Humanitarian Action for Children appeal, revised in June 2021 due to escalating needs, requests $96.5 million to provide lifesaving and life-sustaining services for children and their caregivers in Mozambique. Thus far in 2021, UNICEF Mozambique has received $16,3 million for its humanitarian response from the Governments of Canada, Japan, Norway, Sweden, Italy, the United Kingdom, Education Cannot Wait and the UN’s Central Emergency Response Fund. This includes UNICEF’s Global humanitarian funding allocations of $3.9 million to support ongoing response activities. UNICEF expresses its sincere gratitude to all our donors. The 2021 appeal, however, still has a funding gap of 69 per cent as detailed in Annex B. Significant needs remain for all of UNICEF’s ongoing emergency programmes. Without the required funding, UNICEF will be unable to provide access to safe water, health and nutrition services, learning opportunities, critical child protection support and support to survivors of gender-based violence. Situation Overview & Humanitarian Needs Insecurity in Cabo Delgado, including Palma District, led to further population displacements. Since the attack on Palma town on 24 March, 67,848 people1 have sought refuge in neighbouring districts mostly in Nangade, Mueda and Pemba, of whom 86 percent are living within host communities. About 43 percent of the IDPs are children and nearly 850 were identified as unacompanied or separated from their parents. In a 12-month period (April 2020-April 2021), the number of IDPs has quadrupled standing at 732,227 people 2 displaced and living in five provinces in central and northern Moambique as per the last assessment report provided by IOM (April 2021). Over 90 percent of the IDPs are in Cabo Delgado, while the remaining are living in Nampula, Niassa, Sofala and Zambézia provinces. Fortysix percent of the IDP population are children and a total of 2,733 children have been uncompanied or separated since the start of tracking. IDPs continue to note their top three needs are food, shelter and access to water and sanitation services. Lack of access and security restrictions have hampered data collection efforts and hence Mocimboa da Praia, Muidumbe, and Palma were not assessed. In Cabo Delgado, closure of health facilities have been reported in Ibo and Quissanga districts and to a lesser extent in Meluco and Mueda districts. Health challenges reported by IDPs include overcrowded facilities and lack of doctors. Figure 1: Map of population displaced due to conflict in Cabo Delgado as of April Education is also a concern, especilliay in Ibo, 2021- IOM. Quissanga and Macomia districts, where reports indicates IDP children cannot access learning opportunities due to lack of school materials, teachers and classrooms. According to Integrated Phase Classification (IPC) analysis for malnutrition conducted in Cabo Delgado in February 2021, it is estimated that 75,000 children under five years3 will suffer from acute malnutrition. The analysis indicates that districts with limited/no access—including Palma, Nangade, Macomia and Quissanga—will likely deteriorate to severe (IPC 3) and critical (IPC 4) levels. Contributing factors for this deterioration are partly due to conflict (access to health services) but also food insecurity, very low quantity and quality of food consumption, weak access to safe water and sanitation. 1 https://reliefweb.int/report/mozambique/displacement-tracking-matrix-mozambique-emergency-tracking-tool-ett-report-no-101 2 https://reliefweb.int/report/mozambique/iom-mozambique-dtm-baseline-assessment-report-round-12-cabo-delgado-nampula-niassa 3 2 Summary Analysis of Programme Response Health UNICEF is committed improving the welfare of children affected by humanitarian crises in Mozambique with particular focus on those affected by the conflict in the north. To strengthen the response in Cabo Delgado, UNICEF is developing new partnerships (Doctors with Africa - CUAMM, and Action Contre la Faim - ACF), to support delivery of essential services at health facility and community levels. The approach includes integrated mobile health brigades and outreach to children and mothers in remote communities. UNICEF supported the delivery of 3,000 mosquito nets to prevent malaria as part of survival kits, distributed in hard-to-reach areas to 1,500 families. UNICEF also distributed 18 community health workers medical kits for treatment of common illnesses in communities with IDPs of which 10 in Montepuez, 4 in Ancuabe, and 4 in Chiúre districts, UNICEF2021/Sualei reaching 4,500 patients. Four temporary clinic tents were deployed and raised in IDP camps in Ancuabe and Chiúre districts while two were raised in Montepuez district, expected to benefit over 1,700 families in resettlement centres. To respond to reported cases of measles in Sofala and Cabo Delgado, UNICEF increased efforts on routine immunization reaching, in May, 7,094 children of 9 to 23 months including 5,705 in Cabo Delgado, 420 in Manica, 853 in Sofala, and 116 in Nampula provinces. The support to measles prevention in 2021 included an immunization campaign in Cabo Delgado which reached 294,230 children under 15 years. With support from UNICEF 26,991 children under one year have been completely immunized, and 189,644 children and women accessed primary health care. UNICEF also supported COVID-19 vaccination that covered 3,432 people above 50 years in the resettlement centres in Sofala province. Nutrition The nutrition landscape in Cabo Delgado is deteriorating and is likely to further deteriorate, particularly in northern districts, due to the significant disruption of health and nutrition services. UNICEF and the Ministry of Health are conducting cluster coordination meetings at the national and Cabo Delgado levels to strengthen actions for prevention, case detection and treatment. Through an established partnership with the NGO AVSI Foundation, UNICEF is supporting nutrition screenings, referrals and infant and young child feeding (IYCF) counselling and support to caregivers and children 6 to 59 months among both host communities and IDPs. At the transit centre in Pemba, AVSI is conducting regular cooking demonstrations teaching mothers to prepare nutritious meals for their children. A nutritional screening conducted in Matemo island (part of Ibo District) reached 202 children 6 to 59 months and 30 pregnant Figure 2: IPC Acute Malnutrition projected situation in Cabo and breastfeeding women (PLW). Of those, ten children Delgado, October 2021 to January 2022. and three PLW were found with acute malnutrition and enrolled in treatment programmes. Tents and therapeutic nutrition supplies—including ready-to-use-therapeutic foods and therapeutic milks—were delivered to Médecins Sans Frontières to expand nutrition assistance in Mueda, Montepuez and Nangade districts allowing for treatment of 300 children 6 to 59 months for two months. Similar support was provided to the Provincial Health Directorate of Cabo Delgado, including eight inpatient outpatient kits sufficient for the treatment of 500 children over three months. As part of the response to Cyclone Eloise, UNICEF delivered 3,591 cartons of RUTF and 100 cans of therapeutic milk to reinforce acute malnutrition treatment in resettlement sites in Sofala and Manica Provinces. This will allow for treatment of 3,591 children with severe acute malnutrition (SAM) over four months. Integrated mobile brigades working 3 in these areas screened 443,766 children 6 to 59 months, of whom 3,220 were referred for treatment, while 27,389 mothers and caregivers of children under two received IYCF counselling. Child Protection In Cabo Delgado, UNICEF conducted a child protection response and situation analysis within the Child Protection Area of Responsibility which identified significant gaps. Child protection agencies are currently reaching less than 30% of the targeted communities. To expand our reach, UNICEF is currently in the process of signing new agreements with six partners in Cabo Delgado to cover six districts. In addition, increased vulnerabilities of displaced children, especially those without documentation, have been identified. Unverified reports on child recruitment and use, and cases of child right violations, have also been received. UNICEF continued to provide psychosocial support to displaced and host communities, reaching 256 children (121 girls). The response to unaccompanied and separated children has been ongoing, and UNICEF partners registered 18 unaccompanied children (7 girls) who have been placed in family-based alternative care. Through