All three districts (Jamshoro, Umerkot and Tharparkar) of Sindh Province included in the IPC Acute Malnutrition analysis have been classified as being in Phase 4 (Critical) during April – June 2017, which is lean/post-harvest period in majority of the areas of these districts. As per the findings of the IPC AMN analysis, Jamshoro and Tharparkar districts are on “borderline” with the phase 5 of IPC AMN, which is the “Extreme Critical” Phase, where nearly 1 in 5 children is acutely malnourished.
According to the IPC AMN projection analysis, the situation is likely to remain the same in Jamshoro and Umerkot districts while some improvements are expected in Tharparkar District during the monsoon season (July-September 2017). However, the improvement expected is at a small scale which will unlikely change the phase classification for the district – i.e. the district will likely continue to remain in the same Critical phase.
Major contributing factors to acute malnutrition identified are:
- very poor quality of food intake by children (most likely resulting from very high acute food insecurity in the areas)
- relatively high prevalence of diseases (particularly diarrhoea)
- poor sanitation system;
- poor feeding practices (e.g. very low level of exclusive breastfeeding).
Several structural issues especially human, physical, and financial capital were also identified as major factors contributing to acute malnutrition in these areas.
[Estimated caseload for 12 months (taking into account an incident rate of 1.5]
Treatment of all acutely malnourished children, identified across the district, is very high priority. For this, availability and access to treatment programmes should be ensured while the ongoing treatment programmes should also be scaled up.
While immediate attention must focus on the treatment of exiting cases of acute malnutrition, attention should also be focussed on 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, addressing poor sanitation situation, and promoting appropriate feeding practices. It is recommended to review the results of the recently conducted Situation and Response Analysis Framework (SRAF) exercise by Food Security Working Group and tailor the interventions based on the major contributing factors.
Furthermore, it would also be highly useful to carry out similar analyses in the other districts of Sindh province, where acute malnutrition levels are high. This analysis will not only be helpful in determining the extent of the acute malnutrition problem in these districts but also will help identify the major contributing factors to acute malnutrition so that appropriate response to tackle acute malnutrition can be planned.