DISCLAIMER: please note that this IPC Acute Malnutrition analysis was integrated with an IPC Acute Food Insecurity analysis referring to the same period. Please click here.

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.

• 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.