How Severe, How Many and When – In May-July 2019, an estimated 6.96 million people (61% of the population) are likely to face Crisis (IPC Phase 3) acute food insecurity or worse, out of which an estimated 1.82 million people will face Emergency (IPC Phase 4) acute food insecurity and 21,000 will likely be in Catastrophe (IPC phase 5). This is historically the highest number of people in South Sudan ever to face Crisis (IPC Phase 3) acute food insecurity or worse. Compared to the January 2019 projection analysis of the May-July 2019 period, an additional 81,000 people are likely to slip into Crisis (IPC Phase 3) acute food insecurity or worse. This deterioration is largely associated with the delayed rainfall that is expected to affect the improvement in the availability of wild foods, fish and livestock products as well as delay the green harvest. Of the people estimated to be in Catastrophe in May-July 2019, 10,000 are in Canal/Pigi of former Jonglei State, 10,000 are in Cueibet of former Lakes State, and 1,000 are in Panyikang of former Upper Nile State.
Where – Former Jonglei State has the highest proportion of people estimated to be food insecure between May and July 2019, with 73% of its population facing Crisis (IPC Phase 3) acute food insecurity or worse followed by former Unity State with 69% of its population estimated to face Crisis (IPC Phase 3) acute food insecurity or worse. 25 Counties are classified in Emergency (IPC Phase 4) acute food insecurity and they include: Kapoeta East of former Eastern Equatoria State; Akobo, Bor South, Canal/Pigi, Nyirol, Twic East, and Uror of former Jonglei State; Awerial, Cueibet, Rumbek North, Yirol East and Yirol West of former Lakes State; Aweil East, Aweil North, Aweil South, and Aweil West of former Northern Bahr el Ghazal State; Koch and Panyijiar of former Unity State; Longochuk, Luakpiny/Nasir, Maiwut, Panyikang, and Ulang of former Upper Nile State; and Gogrial West and Tonj North of former Warrap State.
Why – The proportion of food insecure people as projected for May-July 2019 is the highest ever and the food insecurity situation is driven by household food shortages that are typical of a lean season, but have been exacertabated by delayed rainfall, the persistent macro-economic crisis, population displacements, additional needs from returnees, prolonged years of asset depletion, and the generally eroded livelihoods due to continued years of conflict – all of which continue to compromise majority of the households’ capacity to access enough food during the ongoing lean season. High food prices occasioned by depleted harvests as well as rain-induced deterioration of road networks that disrupts market supplies and functionality are also contributing to the high levels of acute food insecurity. The rainy season, when it effectively sets in, is likely to result in increased incidences of human diseases such as malaria and acute watery diarrhoea that will affect productivity and deplete savings in the form of increased medical expenses – this will further contribute to household vulnerability and reduce resources available for purchasing food.
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 peace agreement;
- Scale-up provision of humanitarian assistance (in kind and cash transfers) and emergency nutrition to counties in Crisis (IPC Phase 3) and above.
- 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;
- Scale up and improve access to basic services (health and WASH) throughout the year.
Nutrition
Continued scale up of treatment of acute malnutrition targeting the current and future caseload is a high priority. Further expansion of services to previously insecure areas for both treatment of severe acute malnutrition is also important to reach the less accessible areas. The parallel expansion of nutrition services for both severe and moderate acute malnutrition will ensure continuity of care through seamless referral mechanisms across the different treatment programmes for children with moderate acute malnutrition (MAM) and Severe Acute Malnutrition (SAM).
While ensuring universal treatment for acute malnutrition is a priority, attention must also be given to addressing other factors identified as major contributing factors to acute malnutrition to prevent acute malnutrition in the future. The prevention efforts should focus on child care practices including improving quality of food consumed by children and treatment and prevention of childhood illness. Support access to fresh food to vulnerable households, including children and pregnant and lactating mothers. It is recommended that a response analysis involving all nutrition, health, food security, as well as WASH stakeholders in the country be carried out to identify appropriate interventions to address acute malnutrition. This response analysis may initially focus on the Greater Upper Nile, Warrap and Northern Bahr El Ghazel which have relatively elevated levels of acute malnutrition but ideally should be done for all regions. It is also recommended that resource mobilization efforts be scaled up to address treatment and prevention of malnutrition as well as sustaining the gains already made in combating malnutrition.
Acute Malnutrition Situation
No update analysis on IPC for Acute Malnutrition was done during this period due to limited availability of data. However, IPC for Acute Malnutrition (IPC-AMN) analysis conducted in January 2019 projects a deterioration of the nutrition situation during the lean period. About 57 counties are classified as Serious (IPC-AMN Phase 3) and above, therefore requiring urgent and targeted response. In addition, a total of 860,000 children are likely to suffer from acute malnutrition in 2019 including 259,000 likely to suffer from Severe acute malnutrition.
The increased number of people facing acute food insecurity (IPC AFI Phase 3 and above) in the projection period are also expected to contribute to increased prevalence of acute malnutrition. With 6.96 million people facing Crisis (IPC Phase 3) or worse acute food insecurity, about a fifth of this population are expected to be children under the age of 5 years who are more vulnerable to malnutrition due to the acute shortage of food. Based on the FSNMS round 23 findings, exclusive breastfeeding rates have improved from 45% in 2010 to 74.9% in 2018. But complementary feeding practices in South Sudan remain below standard. Only 47.8% of the children aged 6-8 months are introduced to solid and semi solid food in a timely manner. Only 20% of children aged 6-23 months received the recommended minimum dietary diversity and 7.1% received the minimum acceptable diet. About two-thirds (66%) of the total surveyed children were reportedly sick from one or more illness(es) in the two weeks prior to the date of the survey.
Key Drivers
Major contributing factors to heightened prevalence of acute malnutrition, identified during the analysis, are extremely poor quality and diversity of food intake by children and relatively high prevalence of disease. It is noted that the quality of food is poor across the country and even in States where acute food insecurity is low (based on IPC analysis). This suggests that it may be related to behaviour and/or lack of awareness of child feeding practices among caregivers.