How Severe, How Many and When – In August 2019, an estimated 6.35 million people (54% of the population) are classified in Crisis (IPC Phase 3) or worse acute food insecurity, among whom an estimated 1.7 million people are facing Emergency (IPC Phase 4) acute food insecurity and 10,000 people are in Catastrophe (IPC phase 5). Compared to the same period in 2018, there is a slight reduction in the proportion of people facing Crisis (IPC Phase 3) or worse acute food insecurity by an estimated 5%. However, high levels of acute food insecurity still persist in the country. In both periods, these estimates are in the presence of humanitarian food assistance. In the projection period of September to December 2019, the food security situation is expected to improve as seasonal harvests become available. During this period, an estimated 4.54 million people (39% of the population) will likely face Crisis (IPC Phase 3) or worse acute food. In the post-harvest period of January to April 2020, the food security situation will deteriorate as household food stocks start depleting and an estimated 5.5 million people (47% of the total population) are likely face Crisis (IPC Phase 3) or worse acute food insecurity. The projection analyses have both factored in the presence of likely humanitarian food assistance.
Where – In August 2019, Yirol East of former Lakes State has an estimated 10,000 people in Catastrophe (IPC Phase 5). Former Jonglei State has the highest number of people estimated to be in Crisis (IPC Phase 3) or worse acute food insecurity, with 1.25 million people, followed by former Upper Nile State with 845,000 people. 28 counties are classified in Emergency (IPC Phase 4) acute food insecurity in August 2019. In the projection period of September to December 2019, Emergency (IPC Phase 4) acute food insecurity is expected to persist in the four counties of Duk county in former Jonglei State, and Longochuk, Maiwut and Ulang counties in former Upper Nile State. Between January and April 2020, 14 counties are projected to be in Emergency (IPC Phase 4) acute food insecurity. Former Jonglei State is expected to have the highest number of people estimated to face Crisis (IPC Phase 3) or worse acute food insecurity at 1.18 million, followed by former Upper Nile State, with 765,000.
Why – The slight improvement in the food security situation in 2019 lean season compared to the same period in 2018 is attributed to reduced insecurity after the signing of the Revitalized Agreement on the Resolution of the Conflict in South Sudan in September 2018, which has led to better access to livelihoods and markets. Additionally, humanitarian access has improved during this period, further contributing to the increased access to food, nutrition and livelihood support, as well as service delivery. However, acute food insecurity persists, driven by localized conficts, climatic shocks, pests and diseases, slow recovery from prolonged asset depletion, poor macro-economic conditions and sub-optimal market functionality. Below are the acute food insecurity and nutrition maps for August 2019.
Food Security
In all regions, the necessary conditions for addressing the food security crisis are:
- The cessation of all hostilities and the implementation of the revitalized peace agreement;
- Scale up provision of humanitarian assistance (in kind and cash transfers), including emergency nutrition, food, WASH and health services, to counties in Crisis (IPC Phase 3) and worse;
- Scale up and improve access to basic services (health and WASH) throughout the year and in all areas;
- Provide livelihood support to stimulate income generating activities and improve agricultural production back to former surplus levels in the more productive and stable counties;
- Support livestock keepers through veterinary support.
Nutrition
The following are the recommendations:
- Continued scale up of treatment of acute malnutrition targeting the current and future caseloads is a high priority. Expansion of services to previously insecure and inaccessible areas for treatment of acute malnutrition is also important. A robust outreach program is necessary in all OTP and TSFP services to identify children earlier and refer them for treatment as well as providing health education for prevention of malnutrition;
- While ensuring universal treatment for acute malnutrition is a priority, attention must focus on prevention of malnutrition. Efforts to reduce malnutrition should include the broader goals of improving knowledge related to childhood nutrition and infant and young child feeding (IYCF) practices through counselling of mothers on maternal, infant and young child nutrition (MIYCN). In addition, the prevention efforts should focus on child care practices including improving quality of food consumed by children. Supporting mothers by educating them on complementary foods using available foods through cooking demonstrations at OTP and TSFP centers, as well as establishment of kitchen gardening, will enhance knowledge to improve infant and young child feeding practices;
- Morbidity due to malaria, diarrhoea and cough contribute immensely to the levels of acute malnutrition in South Sudan. Cross sectoral linkages between health, nutrition and WASH will be important to address gaps in health and WASH service provision;
- It is recommended that continued surveillance be conducted in counties where the nutrition situation is Critical and projected to deteriorate. A special joint mission by key sectors and stakeholders to Renk will be important to understand the situation on the ground and identify gap areas. A causal analysis to understand the high level of malnutrition in Renk is also recommended.
The overall nutrition situation during the lean season of 2019 is Critical and worse compared to same period in 2018. Based on the IPC AMN, all the 79 counties were included in the analysis of which 58 counties are classified as IPC AMN Phase 3 and above (GAM prevalence above 9.9%). Out of these, Renk county was classified as Extremely Critical (GAM above 30%). 43 counties were classified as Critical (GAM prevalence of 15.0 – 29.9%, IPC AMN Phase 4) and 14 counties are classified as Serious (GAM prevalence of 10.0-14.9%, IPC AMN Phase 3). Most counties in Unity, Upper Nile, Jonglei and Warrap and parts of Eastern Equatoria and Lakes are in critical levels of acute malnutrition.
The prevalence of acute malnutrition in Renk county was at 32.1% and continued to show persistently extreme critical levels of acute malnutrition for the 4th year in a row. According to the IPC for Acute Malnutrition classification, the GAM rate of above 30% is considered Extreme Critical (IPC AMN Phase 5). However, crude mortality and under five mortality are not alarming at 0.78 and 0.30 respectively. The high levels of acute malnutrition could be attributed to high morbidity, poor access to health, nutrition and WASH services are assumed to play a role, particularly outside Renk Town where access to health care and safe drinking water is more difficult to reach. Several actions both immediate and longer term were recommended by nutrition cluster and nutrition information working group including conducting a coverage survey, mass MUAC screening, and joint field mission with WFP, UNICEF, Medair and nutrition cluster. Nutrition interventions accompanied by further surveillance should be undertaken to avoid a worsening nutrition situation that is likely to be accompanied by under-five mortality.
To view the Acute Malnutrition maps for this analysis, please click here.