How Severe, How Many and When – Of the 10 domains included in the IPC Acute Malnutrition analysis, 4 domains are classified in IPC Phase 3 (Serious) acute malnutrition while the other 6 domains are in IPC Phase 2 (Alert). The situation is expected to get worse in 3 domains and a total of 7 domains are expected to reach IPC Phase 3 (Serious) acute malnutrition by April 2020. Major disparities exist in some of the domains where some Local Government Areas are more affected by acute malnutrition than others. A total of 921,618 children aged 6-59 months are expected to suffer from acute malnutrition during the course of 2020.

Where – According to the IPC AMN classification, the Northern, Central, and Southern domains of Yobe State, as well as the Eastern domain in Borno State, are classified in IPC Phase 3 (Serious). Both domains in the Adamawa State (Southern and Northern), 3 domains in Borno State (Southern, Central, Northern), in addition to MMC/Jere, are classified as being in IPC Phase 2 (Alert).  Acute malnutrition levels in Borno State’s Northern, Central, and Southern domains are expected to deteriorate further during the projection period of January-April 2020.

Why – The major contributing factors of acute malnutrition in all the analysed domains include very poor food consumption (both quantity and quality) and the high prevalence of diarrhoea and malaria among the targeted populations. Other factors include insecurity, which has displaced many people and prevented the delivery of and access to humanitarian aid. The major contributing factor in the projected period is the expected further deteriorating security situation, decreased food accessibility, possible outbreaks of measles and high incidences of Acute Respiratory Infections.

Population estimates for September - December 2019

Response Priorities

• Scale up treatment of acute malnutrition (SAM and MAM) for children in all affected areas during the course of 2020.
• Strengthen the promotion of IYCF practices with a focus on increasing the proportion of children receiving a minimum acceptable diet (MAD), including household food access, by promoting livelihood interventions that aim to reduce food gaps at household level.
• Strengthen the promotion of early breastfeeding and exclusive breastfeeding in affected areas and providing necessary support to women who are breastfeeding.
• Scale up WASH interventions, with a focus on improving the proportion of households following proper sanitation methods, such as handwashing with soap.
• Improve the coverage of immunization of people in affected areas, especially for measles, with the goal of boosting immunity. 
• Improve the coverage of Vitamin A supplementation and Micronutrient powder for affected populations, especially those in IPC AMN Phase 3 (Serious).
• Promoting nutritional and other health-related information for affected populations through Social Behaviour Change Communication (SBCC) exercises, such as focus group discussions and awareness raising campaigns.
• Possible re-design of surveillance system to provide adequate data for Local Government Association-based IPC AMN analysis.

Situation Monitoring and Update of Activities

It is paramount to monitor the humanitarian situation and factors that contribute to acute malnutrition in order to re-evaluate the nutrition response accordingly. Some indicators to be monitored include: measles and Acute Respiratory Infection outbreaks due to environmental changes; IYCF practices, especially exclusive breastfeeding, water availability and access, displacement of people due to insecurity, food availability and market prices, and loss of employment. 

It is important to address the changes of key drivers of acute malnutrition in a timely manner and plan/adjust the nutrition interventions to meet new emerging needs. 

The possible outbreak of measles paired with increased food insecurity are expected during the projection period for the analysed areas and it is important the Nutrition, Health, Food Security and WASH sectors plan accordingly to mitigate the effects on the affected populations.