PAKISTAN-BALOCHISTAN IPC ACUTE MALNUTRITION ANALYSIS August 2019 – Projection until November 2019 Report # 0001 | Issued in September 2019 Key Figures August 2019 SAM* 199,811 Number of cases 395,654 MAM* Number of 6-59 months children acutely malnourished 195,843 Number of cases IN NEED OF TREATMENT GAM* 395,654 Number of cases How Severe, How Many and When – Acute malnutrition is affecting around 0.4 million under 5 children, more than half of all children age 6-59 months in the 14 drought affected districts of Balochistan, making it a major public health problem in these districts. Of the 14 drought affected districts, 1 district has extremely critical levels of acute malnutrition (IPC AMN Phase 5) while 11 have critical levels of acute malnutrition (IPC AMN Phase 4) and 2 are in Phase 3 with serious levels of acute malnutrition according to the IPC AMN scale. Around 396,000 of the approximately 738,000 children of age 6-59 months are suffering from acute malnutrition during the drought period of May-August. 2019. Where – Panjgur district is affected by extremely critical levels of acute malnutrition and is classified as being in the highest phase of 5, according to the IPC AMN scale – where about one in 3 children under 5 are suffering from acute malnutrition. Although 11 other districts have critical levels of acute malnutrition (IPC AMN Phase 4), Kachhi, Pishin, Jhal Magsi and Dera Bugti districts have acute malnutrition levels that are close to IPC AMN Phase 5 thresholds. Awaran and Gwadar districts have serious levels (IPC AMN Phase 3) of acute malnutrition. Why – Although information on several contributing factors are limited, available information suggests that very poor quality and quantity of food consumed by children and high acute food insecurity are of major problems across all the 14 districts. Poor water and sanitation conditions and sub-optimal feeding practices (particularly exclusive breastfeeding and complementary feeding) are of major issues in most of the drought affected districts in Balochistan. Low vaccination coverage is also of concern in several districts. IPC ACUTE MALNUTRITION CURRENT AND PROJECTED SITUATION MAPS Contact for further information: This analysis has been conducted under the patronage of the Balochistan Nutrition Program for Mothers IPC Global Support Unit Jahangeer, Raja and Children (BNPMC) – Health Department, Government of Balochistan and National Nutrition Program, www.ipcinfo.org IPC Coordinator Ministry of National Health Services, Regulation & Coordination, Government of Pakistan. It has benefited [email protected] from the technical and financial support of IPC Global Support Unit. It has benefited from the technical and financial support of European Commission, UK Government. Classification of food insecurity and malnutrition conducted using the IPC protocols, which are developed and implemented worldwide by the IPC Analysis Partners: IPC Global Partnership - Action Against Hunger, CARE, CILSS, EC-JRC, FAO, FEWSNET, Global Food Security Cluster, Global Nutrition Cluster, IGAD, Oxfam, PROGRESAN-SICA, SADC, Save the Children, UNICEF and WFP. IPC ACUTE MALNUTRITION ANALYSIS PAKISTAN-BALOCHISTAN August 2019 – Projection until November 2019 Report # 0001 | Issued in September 2019 0000 IPC ACUTE MALNUTRITION ANALYSIS August 2019 – Projection until November 2019 CURRENT IPC ACUTE MALNUTRITION SITUATION FOR AUGUST 2019 2 Report # 0001 | Issued in September 2019 0000 What’s on the map? Of the 14 drought affected districts in the province of Balochistan, one district is in IPC AMN Phase 5 (extremely critical levels of acute malnutrition) and 11 districts are in Phase 4 (critical levels of acute malnutrition) during the current period of analysis (May-Aug. 2019). Of the 34 districts in the province, 20 districts were not included in the current IPC AMN analysis, thus not classified. What’s in the table? Around 396,000 children of age 6-59 months in the 14 drought affected districts are affected by acute malnutrition – this is every second child in these districts is acutely malnourished. Total number of children with moderate and severe acute malnutrition is, 195,843 and 199,811 respectively. The top 3 districts with the highest number of acutely malnourished children are namely Pishin, Kech, and Killa Abdullah. District GAM (%) No. of Children No. of Children (6-59 Months) in Need of Treatment 6-59 months GAM Treatment MAM Treatment SAM Treatment Awaran 11.6 18,252 5,293 3,696 1,597 Chagai 16.5 31,453 12,975 5,583 7,392 Dera Bugti 26.5 46,890 31,065 16,294 14,770 Gwadar 12.6 39,527 12,451 6,917 5,534 Jhal Magsi 28.2 22,384 15,781 7,778 8,002 Kachhi 29.6 35,555 26,310 12,533 13,777 Kech 19.1 136,367 65,115 32,728 32,387 Kharan 20.6 23,423 12,063 4,567 7,495 Killa Abdullah 15.5 113,637 44,034 20,455 23,580 Loralai 17.8 59,610 26,526 11,028 15,499 Nushki 23.1 26,819 15,488 6,236 9,253 Panjgur 31.6 47,458 37,492 19,339 18,153 Pishin 29.0 110,472 80,092 42,808 37,284 Washuk 16.6 26,431 10,969 5,881 5,088 Total N.A. 738,278 395,654 195,843 199,811 PAKISTAN-BALOCHISTAN IPC ACUTE MALNUTRITION ANALYSIS August 2019 – Projection until November 2019 Report # 0001 | Issued in September 2019 0000 IPC ACUTE MALNUTRITION ANALYSIS August 2019 – Projection until November 2019 PROJECTED IPC ACUTE MALNUTRITION SITUATION FOR SEPTEMBER-NOVEMBER 2019 3 Report # 0001 | Issued in September 2019 3 3 0000 What’s on the map? The current acute malnutrition situation is expected to get worse in 3 of the 14 drought affected districts namely Jhal Magsi, Kachhi, and Pishin and they are all likely to move from IPC AMN Phase 4 (critical levels of acute malnutrition) to IPC AMN Phase 5 (extremely critical levels of acute malnutrition) during the projection period (Aug.-Nov. 2019). Panjgur district, which currently is in IPC AMN Phase 5 is expected to remain in the same Phase during the projection period. All other districts will also maintain at their current IPC AMN Phases in the projection period. Regardless of their IPC AMN Phases, acute malnutrition will remain a major public health problem in all the 14 drought affected districts. It should be noted that, of the 34 districts in the province, 20 districts were not included in the current IPC AMN analysis, thus not classified. IPC ACUTE MALNUTRITION ANALYSIS PAKISTAN-BALOCHISTAN August 2019 – Projection until November 2019 Report # 0001 | Issued in September 2019 0000 IPC ACUTE MALNUTRITION ANALYSIS SITUATION OVERVIEW AND TREND ANALYSIS August 2019 – Projection until Nov ember 2019 4 Report # 0001 | Issued in September 2019 Current situation overview 0000 Acute malnutrition is a major public health problem that needs urgent attention and response in all the 14 drought affected districts of the Balochistan province included in the current IPC AMN analysis – more than half of all under 5 children in these districts are acutely malnourished. Panjgur district has the highest prevalence of acute malnutrition and is classified as being in Phase 5 according to the ICP AMN scale (with nearly 1 in every 3 children in the district is acutely malnourished). Eleven other districts are in IPC AMN Phase 4 with extremely critical levels of acute malnutrition and two districts are in IPC Phase 2 (acute malnutrition is in serious levels). Information on contributing factors are limited in most of the 14 districts. However, with the available information, major contributing factors to acute malnutrition are likely extremely poor quality and quantity of food intake by children and high level of food insecurity (according to the IPC Acute Food Insecurity analysis findings). Poor water and sanitation situation coupled with sub-optimal feeding practices (especially very low levels of exclusive breastfeeding and introduction of complementary feeding at the age of 6 months) are of major concerns in the majority of the 14 drought affected districts – see below for details on major contributing factors to acute malnutrition by district. Low vaccination coverage (particularly measles coverage) is also of concern several districts. Projected situation overview The critical level of acute malnutrition (IPC AMN Phase 4) is likely to get worse in 3 districts (Jhal Magsi, Kachhi, Pishin) and become extremely critical (IPC AMN Phase 5). The current level of acute malnutrition situation is likely to remain the same at extremely critical levels in Panjgur and critical level in 8 other districts of Balochistan during the projection period. Awaran and Gwadar districts, which at present have serious levels of acute malnutrition, will also likely to remain the same during the projection period. Although historical information on both outcome indicators and contributing factors is limited, the available information inferred with expert opinion suggests that most contributing factors to acute malnutrition are either expected to remain at the current levels (poor) or slightly deteriorate further in some districts during the projection period. The factors that are likely to deteriorate in some districts are diseases based on the seasonal changes and food consumption (both quality and quantity) because of the deterioration expected in the food security situation, due to prevailing high food prices. Trend Analysis Available information on outcomes that is comparable is limited in all districts, particularly in the recent past. However, it has been acknowledged that acute malnutrition has consistently been high in all districts of the Balochistan province. According to the National Nutrition Survey of 2018, the situation has further deteriorated in several districts. The current drought appears to have further deteriorated the acute malnutrition situation in the 14 affected districts included in this IPC AMN analysis. IPC ACUTE MALNUTRITION ANALYSIS PAKISTAN-BALOCHISTAN August 2019 – Projection until November 2019 Report # 0001 | Issued in September 2019 0000 IPC ACUTE MALNUTRITION ANALYSIS RECOMMENDATIONS FOR ACTION August 2019 – Projection until Nov ember 2019 5 Report # 0001 | Issued in September 2019 Response Priorities 0000 Providing treatment for all children with acute malnutrition is an urgent priority.