How Severe, How Many and When: Over half a million cases of children aged 0 to 59 months, and more than a quarter of a million cases of pregnant and lactating women, are expected to suffer from acute malnutrition during the course of 2020. Out of the 19 zones included in the IPC Acute Malnutrition (IPC AMN) analysis, two zones are classified in Critical (IPC AMN Phase 4), eight in Serious (IPC AMN Phase 3) and the remaining zones in Alert (IPC AMN Phase 2) during the current period of January July 2020. The situation is expected to deteriorate further during the projection period of August – December 2020. A total of seven zones will likely move into a higher Phase, with 15 of the 19 zones in IPC AMN Phase 3 or IPC AMN Phase 4.
Where: In the current analysis period, Taizz Lowland and Hodeidah Lowland zones are classified in Critical (IPC AMN Phase 4). Abyan highland, Abyan Lowland, Aden, Marib City, Lahj Highland, Lahj Lowland, Taizz City and Taizz Highland zones are classified in Serious (IPC AMN Phase 3). The remaining zones: Al- Bahydha, Al-Dhalea, Al-Jawf, Marib Rural, Al-Maharah, Socotra, Hadramawt Coastal, Hadramawt valleys and desert, and Shabwah are classified in Alert (IPC AMN Phase 2). In the projection period (August – December 2020) the acute malnutrition situation is expected to deteriorate further from Alert (IPC AMN Phase 2) to Serious (IPC AMN Phase 3) in the Al-Jawf, Marib Rural, Socotra, Hadramawt Coastal, and Shabwah zones. Meanwhile, the Abyan Lowland and Lahj lowland zones are expected to move from Serious (IPC AMN Phase 3) to Critical (IPC AMN Phase 4). The situation will likely remain at Serious or Critical levels in the following zones: Abyan Highland, Aden, Marib City, Lahj Highland, Taizz City, Taizz Highland, Taizz Lowland, and Hodeidah Lowland.
Why: The major contributing factors to the acute malnutrition situation include: poor quality of foods consumed by children with <50% meeting minimum dietary diversity requirements, acute food insecurity (about 40% of households are facing high levels of acute food insecurity (IPC Phase 3) or worse), high prevalence of communicable diseases (according to the available data at least a quarter of all children are suffering from diarrhoea, malaria and Acute Respiratory Infections), and poor infant and young child feeding practices (less than 25% in many zones), which is all compounded by poor sanitation. Additionally, poor access to nutrition and health services, and poor immunization (measles and polio) coverage (around 60% in most zones) are also of concern. During the current analysis period (January - July 2020) – service access and utilization was affected by a number of factors including: floods, conflict, Ramadan and Eid, the impact of COVID-19 travel restrictions, fear of beneficiaries to visit health facilities, and the suspension of some mobile and outreach services.
TOTAL NUMBER OF CASES OF 0-59 MONTHS AND PREGNANT AND LACTATING WOMEN AFFECTED BY ACUTE MALNUTRITION AND IN NEED OF TREATMENT
Immediate/short term recommendations and objectives in host and IDP communities
Nutrition specific
- Implement blanket supplementary programs targeting vulnerable groups (children under 2, pregnant and lactating women) for prevention of malnutrition based on solid needs assessment and identified gaps in priority locations.
- Ensure treatment: strengthen Community-based Management of Acute Malnutrition (CMAM) program - ensuring coverage of treatment of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM). Expansion of appropriate treatment services should be based on solid needs assessment and identified gaps; and ensuring service utilization by strengthening a) community and facility based screening for acute malnutrition and referrals to facilities for treatment and b) referrals from Out- patient Therapeutic Programme (OTP) to Therapeutic Feeding Centre (TFC) (support transport and caregiver costs).
- Ensure additional nutrition specific interventions.
- Strengthen Micronutrient Powder supplementation and Vitamin A supplementation programming.
- Strengthen health promotion activities, which should aim to increase healthcare seeking behaviour for children under 5 years old and population trust in health and nutrition services, particularly in light of the COVID-19 pandemic.
- Strengthen IYCF messaging and counselling at Health Facilities and at the community level.
- Support the Social Behavioural Change for Communication (SBCC) to improve home diets, infant and young child feeding as well as proper use of nutrition products.
- Strengthen nutrition program monitoring.
- Strengthen nutrition information systems and community screening programmes (surveillance system and surveys and system for routine screening) by ensuring that the system is adapted to the response; that the monitoring provides timely information for decision making and actions, and is based on quality assured data and analysis and it addresses challenges of information gathering in the context of COVID-19.
- Strengthen and maintain coordination and relationships between nutrition partners and the Ministry of Public Health and Population (MoPHP) in order to improve the nutrition services.
Nutrition Sensitive (Prevention)
- Ensure continued provision of quality primary health care including vaccination services.
- Scale up efforts for community awareness building and engagement with relevant authority to mitigate the likely impact on food security and nutrition status,
- Strengthen WASH interventions including: water chlorination, distribution of chlorine tablets for water chlorination and hand washing, WASH in health facilities including nutrition program sites, update WASH assessments in health facilities.
- Support cash programming to enhance the resilience of affected families to cope with food insecurity and access to health and nutrition services.
- Support the local authorities to develop preparedness and response plans for health outbreaks and seasonal increases of malnutrition.
Medium to long term recommendations and objectives in host and IDP communities
Nutrition Sensitive (Prevention)
- Support infrastructure development to reduce the impact of flooding and its likely impact on food dimensions and nutrition status, particularly in lowland and flood-prone areas in districts of the following zones: Shabwah, Lahj Lowland, Hadramawt coast, Hadramawt, Valley , Al-Dhalea and Al-Bahydha.
- Support integrated livelihood and nutrition programming for improved nutrition status and food security by supporting locally feasible livelihood projects including support for fisheries in coastal areas, supporting small businesses, promoting kitchen gardening at household and community levels and supporting cash programming.