March-April 2011Food Security and Nutrition

Analysis Unit - Somalia

FSNAU

The FSNAU is managed by FAO and funded by the EC, SIDA, UKAID, DFID, ITALIAN COOPERATION, SDC, UNICEF, UNHCR, CHF and HRF

Current Nutrition Situation• Ananalysisofhistoricaldatafromsimilarseasons,2008-2010wasconductedtoforecastthelikelysituationforApril2011,as illustrated in Map 1. This shows Sool Plateau of BariRegionintheAlertphase,withtherestofSomaliainSerioustoVery Criticalphases.

• FindingsfromanutritionsurveyconductedinMogadishuinApril 2011, anda rapid nutritionassessment inShabelle,regions in February-May 2011 reflect a Critical nutritionsituation inthesepopulationgroups.ThenutritionsituationinShabelleriverine,JubaPastoral,andpartsofSoolPlateau(Bariregion),appearslikelyCritical-Very Critical.

Food Security Situation:ThefoodsecuritysituationremainsasprojectedduringthepostDeyr 2010/11 analysiswith an estimated 2.4million people incrisis.However,theeffectsoftheongoingdrought,deterioratingpurchasing power, rampant conflict and limited humanitarianspacecontinue toaggravate thesituation inmostpartsof thecountry.TheJilaal (January-March)2011seasonwasparticularlyharsh,witha longspellofdryconditions foralmost9months,followingfailureofthe2010shortrains,duetotheLa-Ninaeffect.Theoutcomehasbeenseverewatercrisiswithextremelyhighpricesofwater, lowcereal availability andanupward trendoffoodprices, depletedpasture, deteriorated livestock condition,increased cases of livestock deaths, displacements andincreaseddestitutionincentralregions.Nevertheless,accordingto the April 2011 FSNAU/FEWSNET Climate Data Update,commencementofGu 2011 rains isobserved inmostpartsofthecountry,especiallyinBay,JubaandShabelleregions,andislikelytoleadtoimprovedwateravailability,pastureandbrowseconditions,andeventuallyproviderecoverytoanimalsafterthedryspell.AccordingtotheApril2011FSNAU/FEWSNET MarketDataUpdate,thepricesoflocallyproducedcerealsincreasedby23-33percentacrossthemainmarketsofallregionsapartfromLowerJuba(9%increaseforthewhitemaizeprice).Thepriceincrementsinthecurrenthungerperiodaresubstantiallyhigherthanthesametimelastyearduetodwindlinggrainstocksheldbyproducersandtraders,highdemand,risingtransportcosts,aswellasstockhoardingbyretailersandfarmersduetouncertaintyinthe Gu2011harvest.SinceAprillastyear,theredsorghumpriceshavemorethandoubled(137-183%)inallregionsoftheSorghum Belt. The white maize prices are also considerablyhigherthanayearagoinproducingregionsofShabelle(73%)and Juba (92%). These circumstances have exacerbated theprecarious household food access in Somalia. Details of thefoodsecurity,marketandclimateupdate,areaccessibleathttp://www.fsnau.org/downloads.

OVERVIEW

•Mogadishu: Findings from a nutrition survey conductedin Mogadishu in April 2011, in which 902 children aged6-59 months were assessed, indicate a Critical nutritionsituation, with a global acute malnutrition (GAM), (WHZscores<-2oroedema)of15.2% (10.9-20.7)andasevereacutemalnutrition(SAM)(WHZscore<-3oroedema)rateof 1.7% (0.9-3.1). The 90 days retrospective crude andunderfivedeathratesreportedare1.81(1.38-2.37),and2.2(1.41-3.48),indicatingaSerioussituationaccordingtoWHOclassification.Themain causes of death reported throughrespondent’srecallwerethroughaccidents/physicalinjuries,diarrhoeaandotherillnesses.Thenutritioninformationfromhealthfacilityreportsshowsahighandstableproportionofmalnourishedchildren(>20%).(Figure1).

According to theApril 2011 FSNAUMarket Data Update,local cereal prices increased significantly (26-35%) whencompared to the previous month. However, importedfood commodity prices remained stable in April. As poorhouseholds are mainly dependent on locally producedfoods,thehighpriceincreasestheirlimitedaccess,andisariskfactortotheCriticalnutritionsituation.

Ongoingresponseactivitieswhichalsomitigatedthenutritionsituationinclude4stabilizationcentersrunbyACF(2),SOS(1),BPHCC(1),33siteswithtargetedsupplementaryfeedingprograms(TSFP),51siteswithoutpatienttherapeuticcare(OTP),andoneblanketsupplementaryfeedingprogramsite.TheseareundertakenbyUNICEFandWFPincollaborationwith Oxfam Novib/Saccid, ACF, Concern Worldwide, withlocal non-governmental organizations namely, Sorrdo,Jumbo,MuslimAid,Hacda,SEA,Zamzam,SRCS,SOS,Dawa, and Wardi. (Source: IASC – Nutrition Cluster 3W Matrix – Who does What Where, Feb’11).

Overview 1MogadishuNutritionSurvey 4ShabelleRapidNutritionAssessment 6JubaRapidNutritionAssessment 7NutritionSurveyGuidelines 8BariRapidNutritionAssessment 8ChildDietaryDiversityAndMilkFeedingFrequencies 9EffectsOfDroughtInM&LShabelleRegions 10

Map 3: Estimated April 2011 Nutrition Situation

2

FSNAU Monthly Nutrition Update March - April 2011

•Lower and Middle Shabelle Regions: Results from tworapid mid upper arm circumference (MUAC) assessmentsconducted inApril 2011 in which 2,200 children from 20accessible villages in Lower Shabelle agro-pastoral andriverinepopulations,indicate21.7%(16.7-27.8),and19.1%(13.8-25.7)respectively,oftheassessedchildrenasacutelymalnourished(MUAC<12.5cmoroedema).IntheMiddle Shabelle region, rapid MUAC assessment findings in theagro-pastoral, and riverine livelihood zones inwhich 2,200children were assessed indicates 25.3% (23.1-27.6) and21.6%(20.4-23.0) respectivelyof theassessedchildrenasacutelymalnourishedchildren.ThenutritioninformationfromhealthfacilitiesinShabelleagro-pastoralareasshowsahighproportionof acutelymalnourishedchildren (>20%),withadecreasingtrendsinceJanuary2011(Figure2).ThenumberofadmissionsofacutelymalnourishedchildrenintoselectivefeedingprogramsshowsanincreasingtrendsinceFebruary2011(866-1090).

Integratedanalysisof thesefindings indicatesa likelyVery Critical nutrition situation in the assessed villages, andreflectsadeteriorationfromtheDeyr2010/11nutritionphase.AdetailednutritionsurveyisscheduledforJune2011.

According to the FSNAU/FEWSNET Market Update,April 2011,maize prices are 73% higher than a year ago.However, cattle prices declined in most markets whereasmilk, cereal and diesel prices escalated at varying levels.StabilityinwageratesandrisingcerealpricesoverthemonthofApril2011reducedthetermsoftradebyabouthalfofitslevelsayearago.Thisnegativelyimpactedonfoodaccessduringthisperiod,therebyaggravatingthenutritionsituation.Gu rains have been reported in Shabelle regions and arelikelytomitigatewaterandpasturestress.(Source, FSNAU/FEWSNET Climate Data Update April 2011).Ongoing response activities that mitigated the nutritionsituationinLowerShabelleinclude:onestabilizationcenter(SC)managedbyMSF-CH,and threemanagedbyCOSV,withsupport fromUNICEF. Additionally, thereare51OTPsites, 10TSFP and 1 BSNP, run byUNICEF andWFP incollaboration with Sorrdo, Jumbo, Concern Worldwide,MuslimAid,SRCSandSWISSO-Kalmo.InMiddleShabelle,therearetwostabilizationcentersrunbySaccid(Adale)andIntersos (Jowhar), 36OTPsmanaged by Intersos, Saccid,MercyUSAandMuslimAid,andeightTFSPsites. (Source: IASC – Nutrition Cluster 3W Matrix – Who does What Where, Feb’11).

•Middle and Lower Juba Regions: A rapid MUACassessment conducted in February 2011 among 3,432children from 31 villages, indicated a likely sustainedVery Critical nutrition situation in the assessed pastoral andagro-pastoral populations. The proportions of the acutelymalnourished children, withMUAC < 12.5 cm or oedema,is 15.0% and 15.6% respectively and 3.1% and 3.6%being severely malnourished (MUAC <11.5 or Oedema)respectively. However the riverine livelihood populationsindicates a likely Critical nutrition situation, with theproportion of children acutely malnourished (MUAC <12.5cm or Oedema) as 14.6% and severely malnourished as3.2% (MUAC <11.5 cm or oedema). This shows a slightimprovement1fromtheVeryCriticalnutritionsituationreported

1A tally sheet was used during data collection. Hence the confidence intervals are unavailable

in theDeyr’10/11 season,mostlyattributable tooff-seasoncrop production andmilk availability due to in-migration oflivestockhealthinterventions.Healthfacilityreportsshowahigh (>20%)but decreasing trendof acutelymalnourishedpastoralchildrensinceJanuary2011(Figure3and4).Intheagro-pastoral livelihoodzone, the trend ishigh (>20%)butstable,whileintheriverine,itishigh(>20%)andincreasing.Data fromselective feedingprograms indicateahigh (104inFebruary,156 inMarchand182 inApril)and increasingtrend of admissions of acutely malnourished children. Anintegrated analysis of this findings indicates a likely Very Critical situation across the three livelihoods, sustainedsincetheDeyr’10/11.Pricesofmostmonitoredcommoditiesremainedgenerallystableinthepastonemonthexceptformaize,charcoalandfirewood,whichacceleratedfromtheirMarch 2011 levels. The marginal decline in casual laborwage rate and increasedmaizeprice havedropped termsoftradebetweenlaborandmaizeby15and68percentfromMarch’11andApril’10respectively,limitingfoodaccess.

Ongoing responseactivitieswhichhavealsomitigated thenutrition situation in Lower Juba, include 2 stabilizationcentersinKismayobyMuslimAid,6OTPand81TSFPsitesimplementedbyUNICEFincollaborationwithSAF,AFRECAPD,SRCS,DIAL,MuslimAid,WRRSandSordes.InMiddleJuba, there is one stabilization center, in Marere, run byMSF-H,4OTPsitesand8sitesfortargetedsupplementaryfeeding program sites managed by APD, Zam zam, andSRCS.(Source: IASC – Nutrition Cluster 3W Matrix – Who does What Where, Feb’11).

Forcomments related to responseactivities,pleasecontactlmatunga@unicef.orgormuli@un.org.

•Bari Region – Sool Plateau Livelihood Zone: Fieldreportsbya localagency, followedbyarapidMUACassessmentof133childrenaged6-59months from threevillagesofBariregionindicateaworryingnutritionsituationwith 19.5%, with a MUAC <12.5cm or oedema and 5.3%severelymalnourished (MUAC<11.5 or oedema). Detailsareprovidedinthisupdate,andasurveyscheduledforJune2011. Health facility data from the assessed area showshigh (>15%) and fluctuating trend of acutelymalnourishedchildrenbeingscreened.PreliminaryintegratedanalysisofthesituationinSoolisthereforelikelyVery Critical.

Pitting of bilateral oedema - Juba riverine, FSNAU, Feb 2011

3

FSNAU Monthly Nutrition Update March - April 2011

FSNAU Nutrition Survey Plans for the Gu 2011 SeasonFSNAU, in collaboration with partners is scheduled toconduct 34 nutrition surveys, based on the standard twostageclustersamplingmethodology,duringApriland July2011.Thetargetpopulationsareeight internallydisplacedpersons’ settlements, and 26 rural livelihoods both in thenorthandsouthcentralSomalia. Currently,sevensurveysareongoinginSomaliland(Hargeisa,Burao,BerberaIDPs),and Puntland (Bossaso, Qardho, Garowe and GalkayoIDPs),inpartnershipwiththeMinistriesofHealth.

In addition FSNAU, is scheduled to conduct nutritionand household food security surveys in at least sevenurban centers.Mogadishu survey was undertaken inApril2011, while studies are scheduled in Hargeisa, Boroma,Berbera, Bossaso,Garowe andGalkayo, to estimate boththenutritionandhousehold foodsecuritysituation in theseurbanpopulationgroups.TheremainderofthesurveysarescheduledaspertheplaninTable1.

National Immunization Days (NIDs)Somaliamarked the 4th anniversary of being polio-free on25th March2011,after jointpolio immunizationcampaignsspearheadedbyhealthauthoritiesatnationalandlocallevels,incollaborationwithWHO,UNICEF,otherpolioeradicationpartners and the Somali communities. To maintain highimmunity of children under the age of five, two rounds ofNational Immunization Days (NIDs) were planned for thisyear,thefirstroundintheweekof20-26thMarch2011.Formoreinformation,visittheSomaliaHealthClusteronhttp://www.emro.who.int/somalia/.

SPECIAL STUDIES

Knowledge, Attitudes and Practices (KAP) study on Fish Consumption

FSNAU is currently undertaking a KAP study on fishconsumptioninSomalia.

Themainpurposeofthestudyistogainafullunderstandingon the common practices, attitudes and beliefs on fishconsumption in Somalia, and the level of knowledge thecommunity has on the health and nutritive benefits of fishconsumption.This informationwill thenbeusedasabasisfordevelopingrelevantcommunicationstrategiespromotingthe consumptionof fish. Inaddition the informationwill beusedtosupplementbaselinefisherieslivelihoodinformationthatiscurrentlybeingcollectedinSomalia,inordertodesignappropriateinterventionsinthefisheriessector.Thespecificstudyobjectivesare:

1.TodeterminethemaintypesandformsoffishconsumedbycommunitiesinSomalia.

2.Todeterminethemaintypesandformsoffishconsumedby various groups (e.g. gender, age-groups, socio-economicgroups)inSomalia.

3.To identify the main factors affecting or influencing fishconsumptionamongthecommunities.

4.To gain understanding on the cultural beliefs, practicesandattitudesregardingfishconsumptioninSomalia.

5.To determine the preferred/popular storage, preparationandcookingmethodsusedinpreparingfish.

Studyfindingswillbesharedoncompletionofthestudy.

Multiple Indicator Cluster Survey (MICS) - UNICEF

The UNICEF led multiple indicator cluster survey (MICS) iscurrently ongoing in Somalia. InApril-May 2011, the studywas undertaken in Puntland, while plans are underway forSomalilandfromJune-July2011.Theobjectivesare:

1.Toprovideup-to-dateinformationonthesituationofwomenandchildreninSomalia

2. To furnish data needed for progress towards MDGs andotherinternationallyagreedgoals.

3. To contribute to improvements of data and monitoringsystemsinSomalia.

Infant and Young Child Feeding (IYCF)

A meta-analysis of data from 22 nutrition assessmentsconducted in 2010 by FSNAU, on two indicatorsmeasuringinfant and young child feeding: child dietary diversity andnumber of milk feeds, among children aged 6-24months inSomalia,showsthatchilddietarydiversityandthelevelofmilkconsumptionarekeydeterminantsofbothwastingandstuntingindices. This highlights the necessity to continue collectionandanalysis of thedataasproxy indicators of thenutritionsituation.Adetailedreportispresentedwithinthispublication.

Nutrition Survey Planned Period Status

1 TogdheerPastoral June-July Planned2 WestGolis/GubanPastoral June-July Planned3 Agro-pastoralists-NW&Togdheer June-July Planned4 SoolPlateau June-July Planned5 HawdofSool/Togd/Galbeed June-July Planned6 EastGolis/Gebbi/KakarPastoral June-July Planned7 NugalValleyPastoral June-July Planned8 CoastalDeeh-NE July2011 Planned9 CoastalDeeh-Central July2011 Planned10 HawdLivelihood July2011 Planned11 AddunLivelihood July2011 Planned12 Cowpea-Central July2011 Planned13 NWUrban(Hargeisa,Berbera,Boroma) June-July Planned14-16 NEurban(Bossaso,Garowe,Galkayo) June-July Planned17-19 NWIDPs(Hargeisa,Burao,Berbera) May2011 On-going22 NEIDPs(Garowe,Galkayo,Bossaso) May2011 On-going25 HiranPastoral June-July Planned26 HiranRiverine June-July Planned27 HiranAgropastoral June-July Planned28 Shabelleriverine May-June Planned29 ShabelleAgropastoral May-June Planned30 ShabeleIDP May-June Planned31 MogadishuCity April Completed32 BakoolPastoral June-July Planned33 BakoolAgropastoral June-July Planned34 BayAgropastoral June-July Planned35 GedoRiverine June-July Planned36 GedoAgropastoral June-July Planned37 GedoPastoral June-July Planned38 JubaRiverine June-July Planned39 JubaAgropastoral June-July Planned40 JubaPastoral June-July Planned

Table 1: Summary of Nutrition Surveys

4

FSNAU Monthly Nutrition Update March - April 2011

Mogadishu,thecapitalcityofSomalia,hasremainedinastateofcivilunrestandtheepicentreofconflict,sinceJanuary1991.Thisconflicthashadanimpactonthegeneralhealthandwellbeingofthepopulationinthetown.Thelastnutritionsurveyinthetownwasconductedin2004andreportedaGAMandSAMrate of 13.8% (12.8- 19.6) and 3.2% (2.2- 4.7) respectively,while the under five and crudemortality rates reportedwere0.7per 10,000/day, and0.5per 10,000/day.Due to thehighlevel of insecurity experienced in the town, it has been verydifficult for FSNAU and partners to conduct regular surveysandin-depthnutritionsurveillanceactivities.Consequentlythenutrition informationcollected from theareahasbeenmainlythroughrapidMUACnutritionassessments.Between18th–26thApril2011,FSNAU/UNICEF,ACFwithpartnersnamely,WFP,SAACID,SORDO,MURDO,TRG,SRCS,CBO(Hamarweyne,Hamarjabjab andWaaberi) andZAMZAMwith support fromlocal authorities, conducted a SMART nutrition assessmentin six districts1 in Mogadishu. Using a two-stage probabilityproportionate to size (PPS) sampling methodology, a totalof 902 children aged 6-59 months were assessed from 502households,while737householdswereassessedformortalityfrom a total of 35 clusters in the six districts. The surveycollectedanthropometric,morbidityandmortalitydata.

Results from the nutrition survey indicate aCritical nutritionsituation inMogadishu town,with a global acutemalnutrition(WHZ scores <-2 or oedema) of 15.2% (10.9-20.7) and asevereacutemalnutritionrateof1.7% (0.9-3.1).The90daysretrospective crude and under five death rates reported are1.81 (1.38-2.37),and2.2 (1.41-3.48),bothratesbeingabovetheemergencythresholdaccordingtoWHOclassificationandindicatingaSerioussituation.Themaincausesofdeathreportedthroughrespondent’srecallwereaccidents/physicalinjuries,diarrhoeaandotherillnesses2.TheFSNAUPostDeyr‘10/11integratednutritionanalysis,generallyclassifiedthenutritionsituationofthepopulationsinMogadishutownaslikelyVery Critical.DatafromrapidMUACassessmentsconductedinDecember2010reportedaglobalacutemalnutrition(MUAC<12.5oroedema)rateof>15%;inadditiondatafromthehealthfacilities3intheareareportedahighandstabletrendinthenumberofacutelymalnourishedchildren.ThecurrentdatafromthehealthfacilitiesintheareafromthemonthofJanuarytoApril2011indicateshighandstablenumbersofacutelymalnourishedchildren(Figure1).

Highmorbidityratesinapopulationpredisposethepopulationtomalnutrition;inMogadishu,ahighproportionofthechildrenassessedinthesurveyhadreportedlyfallenilltwoweekspriortothesurvey,thetotalwithreportedrateofmorbidityreportedis37.7%.Theproportionofchildrenreportedtohavesufferedfromdiarrhoeainthe2weekspriortotheassessmentis11.8%,whilethosereportedlysufferingfrompneumoniaandmeaslesis12.6%and1.9%respectively.ThemeaslesimmunizationandvitaminAsupplementationstatusfortheassessedchildreninthe6monthspriortotheassessmentiswellbelowtherecommendedSpherestandards(24.5%and70.5%respectively),increasingthechildren’ssusceptibilitytodisease(Table2).

Qualitativedatacollectedduringthesurveyindicatessomeofthemainfactorsaffectingthenutritionalstatusofthepopulationas:increasedincidencesofdiarrhoeaandmeasles,reducedpurchasingpowerofhouseholds,lessincomeopportunityduetotheclosureoftheBakaramarket,householdsfromthedrought-affectedsurroundingruralareashavecometoMogadishulookingforopportunities,populationdisplacementsduetoconflictinpartsofthetown,verylimitedhumanitarianinterventionspace,highcerealpricesforbothlocalandimportedcommodities,inadditiontothedisruptionofregionalmarketsduetohightaxationfromthelocalauthorities.Currentlythereareselectivefeedingprogrammesbeingundertakenbyseveralpartnersinthetown(seepage1).ACFisconductingfeedingprogrammesin4districts,datafromtheirprogrammesindicateanincreasingnumberofacutelymalnourishedchildrenbeingadmittedtotheprogrammes.

1Wadajir,Dharkenley,Hamarweyne,Hamarjabjab,WaaberiandHodan2Diabetes,heartfailure,TB,whoopingcough,hypertension,etc3Medina,Waberi,HamarweyneandHamarjabjab

MOgADIShU NUTRITION SURVEY: Findings show Critical Nutrition Situation in the conflict-stricken Somalia Capital

0.0

10.0

20.0

30.0

40.0

50.0

Ja

n

Fe

b

Ma

r

Ap

r

Ma

y

Ju

n

MOGADISHU

Pro

po

rtio

n o

f m

aln

ou

rish

ed

ch

ildre

n 2010 2011 2 per. Mov. Avg.(2010) 2 per. Mov. Avg.(2011)

Figure 1: hIS Acute Malnutrition Trends in Mogadishu MChs 2010-11

Mother with child during the Mogadishu nutrition survey, FSNAU April 2011

5

FSNAU Monthly Nutrition Update March - April 2011

Indicator N % (CI)Total number of Clusters assessed 35Total number of Households assessed for children 502Total number of Households assessed for mortality 737Total number of Children assessedMaleFemale

902451451

100.050.050.0

47.0-53.047.0-53.0

Child MalnutritionGlobal Acute Malnutrition (WHO 2006)MaleFemale

137 15.2 10.9-20.771 15.7 11.5-21.266 14.6 9.6-21.6

Severe Acute Malnutrition (WHO 2006)Male Female

15 1.7 0.9-3.16 1.3 0.6-3.29 2.0 0.9-4.4

Oedema 1 0.1 0.0-0.3

Global Acute Malnutrition (NCHS)MaleFemale

118 13.1 9.3-18.259 13.1 9.3-18.159 13.1 8.8-19.2

Severe Acute Malnutrition (NCHS)MaleFemale

7 0.8 0.3-2.03 0.7 0.2-2.04 0.9 0.3-2.8

Global Acute Malnutrition (WHM<80% or oedema - NCHS) 63 7.0 4.2-9.8Severe Acute Malnutrition (WHM<70% or oedema - NCHS) 0 0.0 -

Severe to Moderate Acute Malnutrition by MUAC (<12.5 cm or oedema) Male Female

110 12.2 8.3-16.146 10.2 6.4-14.064 14.2 8.8-19.6

Severe Acute Malnutrition by MUAC (<11.5 cm or oedema) Male Female

21 2.3 1.1-3.67 1.6 0.3-2.814 3.1 1.6-4.6

Proportion of children Stunted (HAZ<-2)Male Female

147 16.3 12.2-21.580 17.7 13.0-23.767 14.9 10.2-21.1

Proportion of children Underweight (WAZ<-2)MaleFemale

131 14.5 10.8-19.271 15.7 11.6-21.060 13.3 9.1-19.1

Child MorbidityChildren reported ill in the previous 2 weeks 340 37.7 30.6-44.7Children reported with diarrhoea in 2 weeks prior to assessment 107 11.8 8.5-15.2Children reported with ARI within two weeks prior to assessment 114 12.6 8.2-17.0Children reported with febrile illness in 2 weeks prior to assessment 25 2.8 1.6-4.0Children reported with suspected measles within one month prior to assessment 17 1.9 0.15-3.6Child Immunization statusChildren immunized against measles 637 70.5 64.6-76.5By Recall 235 36.9 25.8-48.0By Card 402 63.1 52.0-74.2Children reported to have received vitamin A supplementation in last 6 months 221 24.5 18.3-30.7MortalityUnder 5 Death Rate (U5DR) as deaths/10,000/ day* 2.2 1.41-3.48Crude Death Rate (CDR) as deaths/10,000/ day 1.81 1.38-2.37

Table 2: Summary of Results for Mogadishu Nutrition Survey (N= 902)

Location Criteria Missing/ Flagged data

Overall sex ratio

Overall age distribution

Dig Preference score-weight

Dig Preference score-height SD WhZ Skewness

WhZKurtosis WhZ

Poisson Distribution

MogadishuNutritionSurvey

Category Good Acceptable Poor Good Acceptable Acceptable Good Good Unacceptable

Score 0 2 4 0 2 2 0 0 5

Table 3: Quality checks for survey data

6

FSNAU Monthly Nutrition Update March - April 2011

WFPisconductingwetfeedingactivities,InadditionUNICEFthroughOXFAM/SAAIDandotherpartners1areprovidingfeedingandhealthprogrammes to thepopulation.Although theseeffortsareassisting inmitigating thesituation, it isnot sufficient,scalingupofhealthandnutritionrelatedprogrammesareessentialgiventheeffectsofthepersistentconflictinthetownanditsresultantnegativeimpactonthefoodsecurity,healthandnutritionalwellbeingofthepopulation.Therearealsoalargenumberofinternallydisplacedpopulationslivinginthearea,thesepopulationshaveintegratedwiththelocalresidentsandfacethesamechallengesoftheurbanpoor.

Overall,thenutritionsituationinMogadishuisCritical,andthepopulationremainshighlyvulnerableduetothepersistentconflictinthetownwhichhasadirectimpactonhouseholdincome,foodsecurity,healthandnutritionalwellbeingofthepopulation.Pooraccesstohealthfacilitiesinthetownisalsoaninstigatingfactor.Diseaseoutbreakssuchasmeaslesandacutewaterydiarrhoeahaveadirectimpactonthehealthandnutritionalstatusofthechildren.Chronicunderlyingfactorssuchaspoorchildcareandfeedingpractices,inadequatesanitationfacilitiesandlackofaccesstosafedrinkingwaterwillremainaslongtermchallengestothehealthandnutritionwell-beingofthepopulation.Itisthereforeimperativetocloselymonitorthewellbeingofthepopulation,andtocontinueinterventionstargetingtheunderlyingcausesoffoodinsecurityanddiseaseintheregion.

ShABELLE RAPID NUTRITION ASSESSMENT

Between31stMarch and7thApril 2011,FSNAUconducted a rapid nutrition assessment in 40 purposively selected villages(basedonaccess)inMiddleandLowerShabelleregions.Thiswasafollowupassessmenttodeterminethenutritionsituationinthearea,followingtheDeyr ‘10/11integratednutritionassessmentandanalysiswhichwasnotconclusiveduetodataqualityconcerns.UsingMidupperArmCircumference(MUAC)measurements,atotalof4,395children,fromtheentireShabelleregionwereassessed.FromeachlivelihoodzoneinMiddleandLowerShabelle,10villageswereselectedand110children(aged6-59months)assessedpersite.

Findingsindicatethattheproportionofchildrenatriskofacutemalnutrition,withMUAC<12.5cmoroedema,as21.7%(16.7-27.8)and19.1%(13.8-25.7)intheLowerShabelleagro-pastoraland riverine populations respectively. In the Middle Shabelleregion,theproportionis25.3%(23.1-27.6)and21.6%(20.4-23.0)among theagro-pastoraland riverinepopulations respectively.Nocasesofoedemawerereportedamongtheassessedagro-pastoralpopulations,however,10cases (0.9%)were reportedamongtheassessedinLowerShabelleriverinepopulationandone(0.1%)intheMiddleShabelleriverinepopulation(See table 4 for a summary of the results).Thenutritioninformationfromhealthfacilityreportsshowsahighanddecreasingproportionofmalnourishedchildren(>20%).(Figure2).Theseresultsindicatea likelyVery Critical nutrition situation in the assessed population groups, a likely deterioration from the previous nutritionsituationofDeyr‘10/11.

ThelikelyVery Criticalnutritionsituationismainlyattributedtotheimpactoflimitedfoodaccessincludingreducedmilkconsumptionandpoordietarydiversity.Inaddition,informationfromhealthfacilitydataindicateshighcasesofmorbiditywithmeasles,acutewaterydiarrhea(AWD)andwhoopingcough.Thesefactorscombinedwiththechronic issuesaffectingmalnutritionsuchaspoorchildcareandfeedingpracticesandlackofadequateandappropriateaccesstosafewater,healthandsanitationfacilitiesfurtheraggravatethepoornutritionsituation. AccordingtotheApril2011FSNAUFoodSecurityandNutritionBulletin,thewatersituationintheareaiscritical,withseveralboreholesandshallowwellsdryingup,andextremeovercrowdingatthewaterpoints.Theagro-pastorallivelihoodsarethemostaffectedbythedroughtintheregion,theyarelosinglivestockeitherthroughmortalityorsalesatlowerpricestopurchasefood.

LowerShabelle MiddleShabelleAgro-pastoral

N=109910sites

RiverineN=110010sites

Agro-pastoralN=110010sites

RiverineN=109510sites

ProportionofassessedchildrenwithMUAC<12.5cmoroedema

238(21.7%)CI:16.7-27.8

210(19.1%)CI:13.8-25.7

278(25.3%)CI:23.1-27.6

237(21.6%)CI:20.4-23.0

ProportionofassessedchildrenwithMUAC<11.5cmoroedema

36(3.3%)CI:1.7-6.1

61(5.5%)CI:3.2-9.5

106(9.6%)CI:8.4-11.0

125(11.4%)CI:10.1-12.9

Oedema 0(0.0%) 10(0.9%) 0(0.0%) 1(0.1%)

Table 4: Summary of Rapid Assessment Findings in Lower and Middle Shabelle regions

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Pro

port

ion o

f m

aln

ourished c

hild

ren

2011 2010 2 per. Mov. Avg.(2011) 2 per. Mov. Avg.(2010)

Figure 2: hIS Acute Malnutrition Trends in Shabelle Agropastoral MChs 2010-11 (Source: COSV/MSF-S)

1 SORDO, HACAA,ZAM ZAM,SEA,DAWA

7

FSNAU Monthly Nutrition Update March - April 2011

InadditiontoMUAC,ahighproportionoftheassessedchildren(about25-30%)inMiddleShabelleriverineandagro-pastoral,and40-47%inLowerShabellewerereportedtohavesufferedfromaninfectionintheprecedingtwoweekstotheassessment.ThereportedcausesofmorbidityinMiddleShabellelivelihoodswerefever(about10-12%),anddiarrhoea(9-12%)intheriverineandagro-pastorallivelihoodzones.IntheLowerShabelleregions,morbiditywasmainlyattributedtodiarrhoea(24-31%),fever(10-11%andsuspectedmeasles,(10-9%)intheagro-pastoralandriverinelivelihoodsrespectively.

Interventionsgearedtowardsimprovedaccesstofood,healthcareservices,safedrinkingwaterandsanitationservicesremainaprioritytopreventfurtherdeteriorationofthenutritionsituationinShabelleregion.Thisneedstobecombinedwithrehabilitationofacutelymalnourishedchildrenintheregion.FSNAUwillcontinuetomonitorthesituationintheregion.

JUBA RAPID NUTRITION ASSESSMENT

Between21stto28thofFebruary2011FSNAUconductedrapidMUACassessmentsinthethreelivelihoodsofMiddleandLowerJubaregions,namelypastoral,agro-pastoralandriverine.Thiswasafollowupassessmenttomonitorthenutritionsituationinthearea,fromtheDeyr ‘10/11integratednutritionanalysis,whichindicatedaVery Criticalnutritionsituationamongthepopulationsgroups.Atotalof3,432children,(1,214fromtheriverine,1,102fromtheagro-pastoraland1,116frompastorallivelihood)aged6to59wereassessedusingMidupperArmCircumference(MUAC)measurement.Tallysheetswereusedinrecordingofdata(ratherthanrecordingofactualmeasurements)therebylimitingcalculationofconfidenceintervals.

Resultsof the rapidMUACassessmentspoints toVery Critical situation in thepopulationsof thepastoralandagro-pastorallivelihoods of Juba regions.The proportion of acutelymalnourished childrenwith MUAC< 12.5 cm or oedema among thepastoral and agro-pastoral population was 15.0% and 15.6% respectively, with 3.1% and 3.6% respectively being severelymalnourished(MUAC<11.5oroedema).Amongtheriverinepopulation,theproportionofacutelymalnourished(MUAC<12.5cmoroedema)childrenwas14.6%,including3.2%severelymalnourishedchildren(MUAC<11.5cmoroedema)(Table5).Thenutritioninformationfromhealthfacilityreportsshowsahighandstableproportionofacuteleymalnourishedchildren(>20%)intheagro-pastoralists,buthighanddecreasingtrendinthepastoralists(Figures3and4).IntegratedanalysisoffindingsindicatesaVery Criticalnutritionsituation,thoughwithslightimprovementsintheriverinesincetheDeyr ’10/11assessment.(see table 5 for a summary of the results).

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Pro

port

ion

of m

alno

uris

hed

child

ren

2010 2011

2 per. Mov. Avg.(2010) 2 per. Mov. Avg.(2011)

Figure 3: hIS Acute Malnutrition trends in Juba Agropastoral MChs 2010-11

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

50.0

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Pro

port

ion o

f m

aln

ourish

ed c

hild

ren

2010 2011 2 per. Mov. Avg.(2010) 2 per. Mov. Avg.(2011)

Figure: 4 hIS Acute Malnutrition trends in Juba Pastoral MChs 2010-11

OveralltheresultsshowalikelysustainedVeryCriticalnutritionsituationamongthepopulationsinthethreelivelihoodsduetotheimpactofDeyr’10/11rainfallfailureandfollowedbytheabnormallyextendeddry Jilaal(January-March)season.Thesustainedworryingnutritionsituationisalsoattributedtothereducedaccesstocattleandcamelmilkduetopoorlivestockbodycondition,following the impact of drought. In addition, limited food access and reduced incomeamong the pastoral and agro-pastoralpopulation remainsa challenge.Furthermore, the chronicunderlying causesofmalnutritionwhich include inadequatehealthservices,highmorbidity,poor infantandyoungchildfeedingpractices, lackofaccesstosafedrinkingwaterandpoordietarypersistintheareaaggravatedthepoornutritionsituation.Theslightimprovementnotedamongtheriverinepopulationislikelyattributedtotheavailabilityoftheoff-seasoncrop,fruitsandvegetablefromtheriverinecommunitiesandthemutualbenefitfrommilkaccessfromcattlethathavein-migratedtotheriverbanksforfodderandwater.AccordingtotheFSNAUquarterlybriefApril,2011,theoff-seasonharvest,mainlymaize,sesameandcowpea,washarvestedintheriverinelivelihoodofJubaregions,fromthedesheks (depressionareas)andpumpirrigatedfarmsinJammame,Jilib,BualeandSakowdistricts.Thecurrentoff-seasonharvestindesheks isaresultofnaturalfloodsinMay2010,whichrechargedmostofthedesheks therebybringingopportunitiesfortworoundsofoff-seasoncropproduction(Sep‘10andMar’11).InadditiontothatthereisanincomefromthesaleoffodderandTFCandOTPinterventionprogramstargetingtheseverelymalnourishedchildrenattheriverineareas.

Riverine(N=1214;11sites)

Agro-pastoral(N=1102;10sites)

Pastoral(N=1116;10sites)

ProportionofassessedchildrenwithMUAC<12.5cmoroedema 178(14.6%) 173(15.6%) 168(15.0%)

ProportionofassessedchildrenwithMUAC<11.5cmoroedema 3.2% 35(3.1%) 40(3.6%)Oedema 9(0.7%) 5(0.4%) 2(0.2%)

Table 5: Summary of Rapid Assessment Findings in Juba regions

8

FSNAU Monthly Nutrition Update March - April 2011

NUTRITION SURVEY gUIDELINES AND DATA MANAgEMENT WORKShOP BASED ON EPI-INFO-ENA

InlinewiththeFSNAUandnutritionclusterobjectivetoenhancecapacityinearlywarningofgovernmentinstitutionsandpartners,FSNAUconducteda3daytrainingworkshopforthekeypartnermembersoftheSomaliaNutritionClusterinNairobifrom16thto18thMarch2011.Atotalof17participants,consistingof2UN,7internationalNGOsand8localNGOstookpartinthetraining.Theoverallaimoftheworkshopwastoempowerthepartnerstoconductnutritionsurveillanceactivitiesusingthestandardizedguidelinesendorsedbytheclustermembers.

Thetrainingcovereddifferentpartsofthenutritionsurveyprocessincludingsurveyplanning,datacollection,entry,processingandanalysis.Otheraspectsemphasizedintheworkshopincludedsamplingtechniques,qualitycontrolofdata,anthropometricmeasurementsandagedetermination.Theparticipantswerealsoprovidedwithpractical sessionsondatamanagementandanalysisusingtheEPIInfoandENAsoftware,includinghowtocreatedataentrytemplates,datacleaningandprocessing,andcomputingindices.Differentmethodologieswereusedduringthetrainingcomprisingof:powerpointpresentations,demonstrations,groupdiscussionsandquestionsandanswerssessions.

Participants self evaluation pre and post training indicated significant improvement in their understanding of the key areascovered.Priortothetrainingmostparticipantsindicatedhavingalimitedunderstandingofcertainsurveymethodologiesanddatamanagement,howevertheyhadfairknowledgeinareasofsurveyplanning,datainterpretationandpresentation.Theposttrainingevaluationindicatedthattheparticipantsimprovedtheirknowledgeonalltheareascovered.

RAPID ASSESSMENT IN AFFECTED AREAS IN SOOL PLATEAU, BARI REgION

On26thApril2011,FSNAUreceivedaworrying report froma localNGO inPuntland,claiming increasedhumanandanimalmortalityarisingfromfoodinsecurityanddiseaseinBaqbaqandsurroundingvillages.Inanefforttoascertainthesituation,FSNAUconductedanexhaustiverapidMidUpperArmCircumference(MUAC)assessmentwithfocusgroupdiscussionsintheaffectedvillageson3rdand4thMay2011.Atotalof133children(aged6-59months),fromthethreeaffectedvillagesofBaqbaq,Usuguse,andElmadobeinSoolPlateauofBariRegionwereassessed.

FindingsindicatethattheproportionofacutelymalnourishedchildrenwithMUAC<12.5cmoroedemais19.5%,with5.3%severelymalnourished(MUAC<11.5oroedema),and3(2.3%)casesofoedemawerereported.Thenutritioninformationfrom health facility reports shows a high and fluctuatingproportionofacutelymalnourishedchildren(>15%).(Figure5).Thoughnotrepresentativeofthelivelihood,theseresultsindicate a likely Very Critical nutrition situation in theassessedaffectedpopulation,a likelydeteriorationfromthepreviousnutritionsituation.

ThelikelyVery Criticalnutritionsituationismainlyattributedtothenegativeeffectsofthedroughtfrompreviouspoorrains,thereasonwhichhasresultedinlimitedaccesstofood,poordietarydiversityandreducedmilkconsumption.Inaddition,qualitative information from the area indicates livestockdeaths,increaseddestitution,andreducednumberofmealsconsumed.Thesefactorscombinedwiththechronicissuesaffectingmalnutritionsuchaslackofadequateandappropriateaccesstosafewater.Atpresent,wateraccessisaffectedbyhighpriceswiththecostofonedrumofwaterrangingfromSoSh. 170.000-200.000 (US$ 5.3-6.3) compared to SoSh20,000-30,000atthesameperiodlastyear;andconstrainedaccesstobasicservicesinthearea-onlyUsgurevillagehasarecentlyopenedhealthpost.Theothervillagershavetogothroughadifficult terrain to reachAllula/KandalaorQardhofurtheraggravatesthepoornutritionsituation

Interventionsgearedtowardsimprovedaccesstofood,healthcare services, safe drinking water and sanitation servicesremainaprioritytopreventfurtherdeteriorationofthenutritionsituation inBaqbaq,UsuguseandElmadobe inBari region.This needs to be combined with rehabilitation of acutelymalnourishedchildren in thearea. FSNAUwill continue tomonitorthesituationintheentirelivelihood.

Increased livestock mortality in Sool plateau, Bari Region, FSNAU April 2011

Figure 5: hIS Acute Malnutrition Trends in Sool Plateau of Bari Region

0.0

5.0

10.0

15.0

20.0

25.0

30.0

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Pro

po

rtio

n m

aln

ou

rish

ed

(%

)

2010 2011 2 per. Mov. Avg.(2010) 2 per. Mov. Avg.(2011)

9

FSNAU Monthly Nutrition Update March - April 2011

ThE ASSOCIATION BETWEEN ChILD DIETARY DIVERSITY AND MILK FEEDINg FREqUENCIES WITh ACUTE MALNUTRITION IN SOMALIA

IntroductionThe impactof infantandyoungchild feeding (IYCF)practiceson thenutritionandhealthstatusand theextent towhichanindividualorpopulationismeetingtherecommendedfeedingstandardscanbeclearlydemonstratediftheappropriateIYCFindicatorsareusedinassessments.Inviewofthis,FSNAUhas,overtheyears,beenrefiningthemethodsofdatacollectionandanalysisofIYCFdata.In2010,FSNAUmodifiedthenutritionassessmentquestionnaireforcomprehensivenutritionsurveystoincludechilddietarydiversityandmilkfeedingfrequenciesindicators.Thisarticlepresentsthefindingsofametadataanalysisof the twonew IYCF indicators froma totalof twenty twoassessmentsusing thePopulationProportionate tosizesamplingmethodologyconductedduringtheGu(April-June)andDeyr(October-December)seasonsof2010byFSNAUandpartners.

Data analysisAtotalof3,883childrenaged6-24monthswereidentifiedfromthedatabase,ofwhom15.2% wereacutelymalnourished(WHZ4<-2oroedema)while23.4%werestunted(HAZ5<-2).Amedianof2.5foodgroupsoutofalistofeight6foodgroupsandamedianmilkfeedingfrequenciesof3.0(arangeof0-5times)wasconsumedbytheassessedchildren.

When analyzed against the recommended minimum feedingthresholdoffourfoodgroupsandtwomilkfeedingfrequencies,majority (81.7%), of the children consumedmilk at least twotimes in a day as recommended. On the other hand, only15.9%ofthechildrenwerefedonadietthatcomprisedoftherecommendedfourormorefoodgroups.Thisshowsahighmilkconsumptionbutpoordietarydiversity.Table6givesasummaryofthefindings.

Further statistical analysis shows that child dietary diversity(numberof foodgroupsconsumed) is significantlyassociatedwithbothWHZ-scoresandHAZ-scores,whereconsumptionofahighernumberoffoodgroupsisassociatedwithimprovedWHZandHAZscores(p<0.01).Evenaftercontrollingforbreastfeedingstatus,theassociationremainedsignificant,implyingthatbesidesbreastmilk,childreninthisagegroupneedtoconsumemanyfoodgroupstopreventbothwastingandstunting.

Similarly,increasedfrequencyofmilkconsumptionisassociatedwithacorrespondingincreaseinWHZscore(p<0.01),(Table6).Thestrengthoftheassociation(τ)increaseswhenbreastfeedingstatusiscontrolled,showingtheimportanceofbreastfeedingonthenutritionstatusofthechildren.Further,theresultsshowtheimportantnutritionalroleplayedbymilkamongchildrenintheSomalipopulation.However,milkfeedingfrequencyisnotsignificantlyassociatedwithHAZ(p=0.06),butwhenthebreastfeedingstatusiscontrolled,asignificantbutnegativeassociationisobserved(p=0.025).Thisrelationshiprequiresfurtherinvestigationbutmaysuggestthepresenceofotherconfoundingfactorsnotaccountedforintheanalysis,suchasqualityofthemilkfeeds,illness,orfrequencyofbreastfeeding.

4WeightforHeightZscores5HeightforAgeZscores6Cereals,Milk,Meat/fish,Legumes,Whiteroots/tubers,Yelloworangefleshedtubers/VitaminArichvegetables,VitaminArichfruits,othervegetablesandfruits

Variable N %Totalchildrenassessed 3883 100ProportionAcutelyMalnourished(WHZ<-2oroedema) 591 15.2Meanweight-for-heightz-score -0.790±1.32Proportionstunted 911 23.4Meanweight-for-heightz-score 1.038±1.26Proportionconsuming≥ four foodgroups inaday 617 15.9Medianfoodgroupsconsumed 2.5Proportionconsumingmilkfor≥twotimesinaday 3175 81.7Medianfoodgroupsconsumed 3.0

Table 6.Summary of Findings of IYCF Data Analysis (2010)

Variables Nutrition Indicators Correlation(Kendall’s tau_b) p Value

Foodgroups WHZ-scores 0.080 0.000*HAZ-scores -0.039 0.001*

Milkfeedingfrequency WHZ-scores 0.041 0.000*HAZ-scores -0.022 0.060

Proportion malnourished RR (95% CI) p ValueDietaryDiversity

≥Fourfoodgroups<Fourfoodgroups

Proportion Wasted (WHZ<-2) 108(17.5%)483(14.8%) 1.18(0.98-1.43 0.085

DietaryDiversity≥Fourfoodgroups<Fourfoodgroups

Proportion Stunted (HAZ<-2)155(25.1%)756(23.1%) 1.09(0.93-1.216) 0.289

Milkfrequencyfornonbreastfedchildren≥Twotimes<Twotimes

Proportion Wasted (WHZ<-2) 225(14.5%)125(17.7%) 0.85(0.66-1.15) 0.326

Milkfrequencyfornonbreastfedchildren≥Twotimes<Twotimes

Proportion Stunted (HAZ<-2)310(20%)42(13.2%) 1.5(1.12-2.04) 0.004*

Table 7: Associations between Child dietary diversity and Milk feeding frequency with malnutrition

*Indicatessignificantassociation

10

FSNAU Monthly Nutrition Update March - April 2011

On thecontrary,analysisof theassociationbetween theproportionofwasted (WHZ<-2scoresoroedema)andstunted (HAZ<-2scores)children,withtheproportionofthosemeetingtherecommendedthresholdsofatleasttwomilkfeedingsandaminimumoffourfoodgroupsinaday,showsmixedresults(Table7).Thereisnostatisticallysignificantassociationbetweentheproportionmeetingthedietarydiversitythresholdbothwithglobalacutemalnutrition(GAM)rate,andglobalstunted(p>0.05).However,thereissignificantassociationbetweenthemilkfeedingfrequencythresholdwithstunting(p<0.01),butnotwithwasting(p>0.05).ThelackofassociationbetweentheseindicatorswhenusingcategoricalthresholdsandtheproportionsofthewastedandstuntedchildrenmayimplythatthesethresholdsarenotsensitivemeasuresfortheminimumrequiredmilkfeedingfrequenciesandnumberoffoodgroupsforSomalipopulation.

Inconclusion,themetadataanalysisshowsthatthenumberoffoodgroups,andfrequencyofmilkconsumptionarekeydeterminantsofbothWHZandHAZscores.Italsojustifiestheneedforcontinuedcollectionandanalysisoftheseimportant indicatorsofIYCFpractices.ThecategoricalthresholdsfortherequiredminimumnumberoffoodgroupsandmilkfeedingfrequenciesarenotsensitiveandmayneedtobereviewedtolevelsthatarespecificandsensitivetotheSomalicontext.

FSNAU Technical Series Report, Nutrition Situation Post Deyr 2010/11 , February 2011 FSNAU Technical Series Report, Post Deyr 2010/11, March 2011FSNAU/FEWSNET Market Data Update, April 2011FSNAU/FEWSNET Climate Data Update, April 2011FSNAU Food Security and Nutrition Brief, April 2011NOTE: The above publications and releases are available on the FSNAU website: www.fsnau.org

CAPACITY BUILDINg Aspartof thecapacitydevelopmentstrategy,FSNAUconducted four trainings in themonthsofMarch,AprilandMay2011 targetingdifferentgroupsofnutritionprofessionalsandpartners.Theaimoftheseworkshopswastoempowertheparticipantstoconductnutritionassessmentsusingthestandardinternationalnutritionguidelines(SMART),andtoequipthemwithskillstoconductbasicdataanalysisandinterpretation.

•FSNAU Nutrition Cluster Partners:Athreedaypartners’trainingonnutritionassessmentsanddatamanagementbasedonSMARTmethodologywasconductedinNairobi,with17participantsfromagenciesworkinginSomaliainMarch2011.

•Academic Institutions:o University of Hargeisa: AtwodaydatamanagementtrainingwasprovidedtomedicalstudentsattheUniversityofHargeisainApril

2011.o University of Nairobi:Msc.NutritionStudentsinApril2011onNutritionSurveillanceandInformationSystemso Kenyatta University:Msc.NutritionStudentsinMay2011NutritionSurveillanceandInformationSystems

CASE STUDY: Effects of the Drought on households in Middle & Lower Shabelle regions

Thepopulationoftheagro-pastoraldistrictsnamelyWalanweyneandQoryoleyareamongthoseseverelyaffectedbythedroughtintheregion.Thelackofadequaterainfallinthearearesultedinbelownormalcropproductionlastseasonandtheabnormaloutmigrationoflivestocktotheriverineareasinsearchofwaterandpasture;thisincreasedthepressureforresourcesinthearea.Householdsintheagro-pastoralareaarereportingreducedlivestockherdsizes,asaresultofthedrought,asisthecasewithFilayAdan.AdanAli,Filay’sfatherownedalargeherdofover100cows,butthat’snomore.‘We are only left with two cows now’,saysFilay.Filayiscurrentlylivingalonewithheracutelymalnourishedson,hersistersandbrothershaveleftthevillagetoseekcasuallabouropportunitiesinthetown.‘We have lost many animals and due to this we are not able to purchase food and get milk like we used to,water is also a big problem in the area’,shesays.Eventheremainingtwocowsarejusthand-fedandworse,thereisagreatfearofwideoutbreakofdiseasesifitrainsduetothehighrateoflivestockdeatheventhoughtherainsarestillsporadic.TherearemanyfamiliesinthesamesituationasAdan’sfamily,experiencingthenegativeimpactthedroughthashadonthelivelihoodsofpopulationsinthearea.Thelackofsafecleanwater,reducedhouseholdincomeandconsumption ofmilk are some themain factors affecting poor food access and poornutritionsituation in thearea.Malnutritionrates indicatea likelyVery Criticalnutritionsituationintheregion.Thesituationisworsenedbydiminishedaccesstohumanitarianhealthandnutritionservicesprovidedby internationalorganization this lead to limitedaccesstobasichealthservicesandlackofmedicalsuppliestothefewexistingMCHintheregion.ImmediateinterventionsthataimatrehabilitatingmalnourishedchildrensuchasFilay’ssoninadditiontointerventionstomitigatethenegativeimpactofthedroughtonthepopulation’slivelihoodisimperative.MURDOalocalNGOintheregionhascarriedoutsomewatertruckinginthearea,andhasalsosetupafeedingprogrammeforacutelymalnourishedchildreninQoryoleyhospital.

Acutely malnourished mother and child in Shabelle, FSNAU April 2011

Recent FSNAU publications: