Between April to May 2021, coinciding with the lean season, over 1 million people in Burundi experienced high levels of acute food insecurity, classified in Crisis or worse (IPC Phase 3 or above), due to flooding, economic decline and the effect of the COVID-19 pandemic. These include about 107,000 people (1%) classified in Emergency (IPC Phase 4), 1,507,000 (13%) in Crisis (IPC Phase 3), and 5,030,000 (43%) in Stressed (IPC Phase 2). With the upcoming harvest of the major cropping season (B), from June to September 2021, the population in high levels of acute food insecurity (Crisis and Emergency phases) is likely to fall from 1.61 million (14% of the total population) to 1.04 million (9%), a decrease of 35% between the two periods.

During the current analysis period, all livelihood zones are classified in Stressed (IPC Phase 2), except for the Northern Depression (ND), which is classified in IPC Phase 3 (Crisis), with 201,000 people in high levels of acute food insecurity, of whom 50,000 are in Emergency (IPC Phase 4). From June to September 2021, the area will move to IPC Phase 2 (Stressed), with 101,000 people (10% of its population) in Crisis (IPC Phase 3).

Recurrent climatic hazards, displacement, intense repatriation flows and the COVID-19 pandemic in a context of low resilience are at the root of the food insecurity identified in this analysis. The combined effect of structural factors (including inadequate access to land and other factors of production) and cyclical factors (including natural shocks) also explain the current levels of food insecurity. Recent shocks include water scarcity that has compromised cereal and pulse harvests in the Northern Depression. Flooding has particularly affected activities on the Lake Tanganyika coastline in a context of disruption of cross-border activities (trade and economic migration) following the strengthening of preventive measures against the COVID-19 pandemic. At the time of the analysis, people affected by the water scarcity in the north and the floods in the west having lost most of their crop production were already receiving assistance.

Response priorities for acute food insecurity:

• Provide direct food assistance in-kind and/or cash to populations classified in IPC Phase 3 (Crisis) or 4 (Emergency) to avoid likely nutritional deterioration and protect their fragile livelihoods.
• Support vulnerable households that will not benefit from the 2021B cropping season to enable them to catch up on the 2021C short season through the provision of market gardening inputs and complement this assistance with other livelihood restoration activities (income-generating activities, small-scale livestock farming, etc.), especially for households affected by climatic hazards during the last cropping season.
• Carry out awareness-raising activities and nutritional training to increase the consumption of diversified foods and good culinary practices, particularly in the Eastern Depression and Northern Depression regions where diversity is out of step with household food access.
• Strengthen early warning systems to prevent shocks and provide a rapid and coordinated response to limit their negative impact.
• Ensure market monitoring for the release of government stock to the market at the appropriate time to regulate consumer prices.
• Provide assistance for the economic reintegration of returnees and other returnees.

Response priorities for acute malnutrition:

In Ruyigi District, classified in Serious (IPC Phase 3), urgent and early interventions are needed to reverse the trends of acute malnutrition. In general for nutrition, the following priority interventions could be implemented:

In the short term

• Ensure treatment for all acutely malnourished children and pregnant or lactating women to reduce the under-five mortality rate;
• Strengthen actions to improve the coverage of prevention activities and the quality of management of malaria, diarrhoea and respiratory infections;
• Reinvigorate and strengthen the implementation of actions for the diversification of children's diets through community-based approaches for the promotion of good feeding practices;
• Reinforce and/or identify in the immediate future adequate actions to improve the coverage of drinking water supply.

In the medium and long term

• Strengthen mechanisms to promote good practice in Infant and Young Child Feeding (IYCF);
• Encourage initiatives in favour of Food Security, Nutrition and Sustainable Agriculture to strengthen food supply and food availability;
• Support development programmes that have rapid and lasting impacts on the economic situation of households;
• Increase access to improved drinking water sources and sanitation facilities;
• Strengthen advocacy to make humanitarian assistance and social protection actions nutrition sensitive.

From September to December 2020, which coincides with the peak period for acute malnutrition, only one district in Burundi is in a Serious nutritional situation (IPC Phase 3). The other 31 districts are in Alert (IPC Phase 2). Between January and August 2021, the situation is expected to improve slightly, with 12 districts moving to Acceptable (IPC Phase 1). However, the situation will remain unchanged for the remaining districts: 20 districts will stay in Alert (IPC Phase 2). It is estimated that around 140,000 children aged 6-59 months and over 26,000 pregnant or lactating women will likely suffer from acute malnutrition during 2021, based on the results of the national SMART survey conducted in September 2020.

The major contributing factors to the deterioration of the nutritional situation include inadequate food intake of children aged 6-23 months, with proportions ranging from 5.3 to 14.5%, and low minimum diet, with rates ranging from 3.4 to 13.2%. As a result, high levels of diarrhoea, malaria and acute respiratory infections are key drivers of the nutrition situation in most IPC Phase 2 or 3 districts. In addition, poor access to safe drinking water and improved sanitation facilities contribute to increased levels of acute malnutrition in the majority of the districts analysed.