NUTRITION RESPONSE IN EMERGENCY SITUATION IN MALAWI

ISSUE# 4 SEPTEMBER 2016

Highlights * Mass screening for the drought response phase II will be rolled out

from September in all 28 districts; however, during month of August the referrals to the facilities were made by field functionaries and also self motivation and awareness of families. The commencement of phase II has got delays due to few operational constraints. The mass screen-ings activities will be conducted through partnerships established by UNICEF and DNHA.

* Malawi is experiencing its worst food security crisis in over a decade. According to MVAC, 6.5 million people, including 3.5 million children, currently affected and in need of food assistance. SMART nutrition survey has shown an increase in malnutrition rates as compared to last years SMART survey results. The admissions in CMAM facilities have

been on rise since the drought state was declared in the country.

* During the month of August, 2,950 children under five suffering from Severe Acute Malnutrition (SAM) were provided with lifesaving treat-ment at OTPs and NRUs.

* 5,021 children were provided the treatment Moderate Acute Malnutri-tion (MAM) conditions.

* 2,494 Pregnant and Lactating Women (PLW) were provided with supplementary feeding at SFPs.

* 7,943 malnourished adolescents and adults on TB and ART treat-ment were reached under NCST program.

37,313

SAM Children admitted in OTPs and NRUs (Jan—Aug 2016)

MAM Children admitted in SFPs

(Jan–Aug 2016)

77,150 36,133

Program Performance Overview

26,467 SAM Children admitted in OTPs and NRUs in Jan-Aug 2015

PLW admitted in SFPs

(Jan–Aug 2016)

20,925

45,949

MAM Children admitted in SFPs in Jan-Aug 2015

PLW admitted in SFPs in Jan– Aug 2015

41% 68% 58%

Overall 41% in-

crease in SAM ad-

missions from

26,467 in Jan - Au-

gust 2015 to 37,313

in Jan-August 2016

SHERE minimum standards

OTP– Cure Rates ≥75%; Default Rate <15% Death Rate <10%

SFP– Cure Rate ≥ 75% Default Rate <15% Death Rate <3%

NRU– Cure Rate ≥ 75% Default Rate <15% Death Rate <10%

Overall 68% in-

crease in MAM

Children admis-

sions from 45,949

in Jan - August 2015

to 77,150 in Jan-

August 2016

Overall Jan to Au-

gust 2016 Death

Rates is at 8.3%

which is within the

SPHERE Standards

of <10%. ( 394

deaths out of 5071

discharges)

1.7 Million Children

Reached Through Mass

Screening and Community

Mobilization Campaign

During Phase I.

The 1st report for phase II

will be recieved in Octo-

ber 2016

Emergency Program Updates

UNICEF continues to co-lead the Malawi Nutrition Cluster with continuous monitoring of the evolution of the humanitarian nutri-tion situation in the country and advocating for the needs of chil-dren in line with the in-country humanitarian imperative and ensur-ing the uninterrupted continued lifesaving support to vulnerable children. UNICEF has established partnerships with six key NGOs for 2016/2017 on nutrition emergency response covering 14 of 28 districts in the country with the remaining 14 covered with World Bank support and positioned 12 field monitors to support govern-ment in coordination and scale up of the nutrition emergency re-sponse. An additional seven field monitors will be deployed in September to ensure each district in the Southern Region has a dedicated field monitor supporting the emergency nutrition re-sponse. In addition, UNICEF placed an Emergency Specialist in the highly hit Southern Region to support monitoring and coordi-nation of the response. In August, UNICEF conducted field moni-toring visits and mentorship support to all 28 districts, offered technical support for children with SAM to health workers and monitored supplies and distributions.

Mass screening for the 2016/2017 response, referral and treat-ment of children 6-59 months with malnutrition will be rolled out in September across the country with UNICEF and DNHA support-ing 28 districts through the established partnerships. Stakehold-ers’ sensitization and district level planning meetings for the 2016/2017 nutrition response have been held with all 28 districts jointly by government and UNICEF. UNICEF continues to ensure pre-positioning and supporting last mile delivery of critical lifesav-ing nutrition commodities for the treatment of SAM to 598 OTP and 102 NRU sites across all districts in the country. During the month of August, UNICEF completed the distribution of Ready to Use Therapeutic Food (RUTF) across the country.

Nutrition Cluster met on 31st August, all emergency related issues were discussed and time bound action points agreed among clus-ter partners. The next meeting is planned for September 28th 2016.

IMPACT OF EARY IDENTIFICATION OF ACUTE MALNUTRITION CASES

Machinga- Lignet Majidu, from Lipagani Village T.A Chikwe-wo, Machinga district is one of the mother who view CMAM ser-vices less important than seeking traditional help. Such behavior outcome are manifested to her stunted three children. Aubrey, 22 months old, a third born from the family of four had been sick for three weeks. He had difficulties in walking, lacked appetite and the overall health status were deteriorating. The parents viewed the sickness as any other common sickness. The child was spotted during mass screening drive, an emergency response interven-tion to drought which was supported by UNICEF to identify mal-nourished children as earlier as possible for early referral and treatment in CMAM services. During the mass screening cam-paign Aubrey was identified with edema. The HSA referred him to Chikwewo Health Centre for detailed nutrition screening. A de-tailed nutrition assessment found him with edema plus two (++). He was immediately admitted to the health facility for the immedi-ate nutrition care. In two weeks time child condition was improved and the child had started walking without difficulties, the appetite was restored and the edema changed to plus one. Looking at such instant changes the mother was very excited. “I completely lost hope and I thought am going to lose him but this is like miracle

to me,” Aubrey mother said while holding her child with sign of relief. Currently Lignet Majidu is one of the mother who encourages others within and surrounding villages during CMAM clinics on importance of early screening of their children even with ab-sence of clinical medical condi-tion. The HSAs are now using her skills and motivations as a powerful tool to encourage other to screen their children regular-ly. She is a change agent to others and because of her ef-fort more mothers screened their children resulting in more admissions in both SFP and OTPs/NRUs.

Total Funding Require-

ment for nutrition clus-$ 29.1 million

Received $ 22.69 million

Committed $ 0.62 million

Funding Gap $ 5.83 million

©UNICEF—2016 Malawi /M

achinga/Blessings Bandawe

Nutrition partners in Malawi

OVERALL SECTOR LEAD : DEPARTMENT OF NUTRITION AND HIV AIDS (DNHA) SECTOR CO-LEAD: UNICEF

SERVICES DELIVERY: MINISTRY OF HEALTH (MOH)

WORKING DEPARTMENTS: MOAIWD, DODMA, MVAC SECRETARIAT, MOGCDSW

CLUSTER PARTNERS: WFP, PLAN MALAWI, SAVETHECHILDREN, WORLD VISION, LUANAR, CONCERN

WORLDWIDE, CONCERN UNIVERSAL, ACF- SPAIN, JHEPIGO, WHO, CRS, OXFAM, FAO, FANTA.

DONORS: DFID, WORLD BANK, IRISH AID, JAPAN GOVERNMENT, SWISS NATCOM, GERMAN NATCOM, GER-

MAN BMZ, KFW, CERF, USAID, SCOTTISH GOVERNMENT

CMAM PROGRAM COVERAGE IN MALAWI

Outpatient Therapeutic Programs (OTPs) Supplementary Feeding Programs (SFPs) Nutrition Rehabilitation Units (NRUs)