Based on the IPC Acute Malnutrition (IPC AMN) scale, 9 of the 18 provinces in Burundi are classified as in Phase 2 while the other provinces are categorised as being in Phase 1. According to the IPC AMN scale, Phase 2 indicates ‘Alert’ situation, which requires strengthening of existing response capacity and resilience and addressing of contributing factors to malnutrition as well as monitoring of the situation.

Of the nine provinces classified as being in “Alert” situation with regards to acute malnutrition, 3 provinces (namely Karusi, Kayanza, and Kirundo) have relatively high levels of acute malnutrition which require particular attention. It's worth to recall that at least 3 cases of Noma have been registered this year in Kirundo province.

Approximately about 125,000 children are expected to suffer from acute malnutrition in 9 of the 18 provinces in the country. Available data on the coverage of acute malnutrition treatment suggests that the coverage is not optimal.

Major contributing factors to acute malnutrition identified during the analysis are:

1. very poor quality of food intake by children
2. relatively high prevalence of diseases (particularly malaria)
3. poor sanitation – see annex II for details on major contributing factors to acute malnutrition by province.

It is noted that the quality of food intake by children is poor even in provinces where acute food insecurity is low. This suggests that it may be related to behaviour and/or lack of awareness of child feeding among caregivers. Poor quality of food in other provinces may likely be the result of both food insecurity as well as behaviour and lack of awareness. Several structural issues especially human, physical, and financial capital were also identified as major factors contributing to acute malnutrition in these areas. Anaemia is a major public health problem that calls for urgent attention in all provinces.

According to the IPC AMN projection analysis, the situation is likely to remain the same in all 9 provinces that are classified as Phase 2 during the upcoming rainy season (February-May 2018). However, slight deterioration in acute malnutrition levels are likely in some provinces because of seasonality and disease trends.

Estimated caseload for 12 months (taking into account an incident rate of 2.0 as per the practice in country and 100% coverage).

Ensuring treatment for all current as well as future cases of acute malnutrition is high priority. Although data on the coverage of acute malnutrition treatment is not available for all provinces, available data suggests that the treatment coverage is not optimal. Therefore, availability of as well as access to treatment programmes should be ensured. This may involve scaling up of existing treatments as well as opening new treatment programmes for acute malnutrition.

While ensuring universal treatment for acute malnutrition is a first priority, attention must also be given to addressing other factors identified as major contributing factors to acute malnutrition as a way to prevent acute malnutrition in the future. The prevention efforts should focus on improving of quality of food consumed by children, treatment and prevention of childhood illness, and addressing poor sanitation situation. It is recommended that a response analyses involving all nutrition, health, food security, as well as WASH stakeholders in the country be carried out to identify appropriate interventions to address acute malnutrition. This response analysis may initially focus on the 3 provinces (i.e. Karusi, Kayanza, and Kirundo) with relatively high levels of acute malnutrition.

Although it was not a focus of the IPC AMN analysis, very high levels of anaemia across all provinces calls for immediate attention. A detailed analysis of the causes is needed to design appropriate intervention to tackle anaemia.

The quality of the analysis depends of the quality and variety of data available. It is indispensable to plan timely in advance the collection and analysis of nutrition specific data (i.e. national SMART) to enrich the next IPC AMN analysis.