Acute malnutrition is a major public health problem in all the 8 drought affected districts in the Sindh province. Two districts in the province have Extremely Critical levels (IPC AMN Phase 5) of acute malnutrition – i.e. about every third child in these districts is suffering from acute malnutrition. Six other districts have Critical levels (IPC AMN Phase 4) of acute malnutrition. Although the 6 districts are classified in IPC AMN Phase 4, 2 of them have acute malnutrition levels very close to IPC AMN Phase 5.

Among the 8 drought affected districts notified by the Government of Sindh in 2018, the districts with Extremely Critical levels (IPC AMN Phase 5) of acute malnutrition are namely Tharparkar and Umerkot. The other 6 districts – Jamshoro, Kambar Shahdadkot, Badin, Dadu, Sanghar, and Thatta – are classified as being in IPC AMN Phase 4. Of these 6 districts, 2 of them, i.e. Kambar Shahdadkot and Badin, have acute malnutrition levels very close to IPC AMN Phase 5.

The major factors contributing to acute malnutrition include very poor quality and quantity of food, high food insecurity, poor sanitation coverage, and high incidence of low birthweight. Additionally, exclusive breastfeeding and access to safe drinking water are also of concern in several districts. Although not the direct focus of this analysis, anaemia among children of 6-59 months of age is at an alarming level.

Population estimates May - August 2019

Ensuring treatment for all children with acute malnutrition is a top priority. Although there is inadequate information from coverage surveys on the acute malnutrition treatment coverage, the very high magnitude of the problem warrants scaling up of the treatment programmes. While improving the treatment capacity and coverage, improving early detection of children with acute malnutrition (particularly children with moderate acute malnutrition in order to prevent them from becoming severely malnourished) and referring them for treatment may also be necessary, otherwise the burden of acute malnutrition will persist.

While ensuring universal treatment for acute malnutrition is the first priority, attention must also be given to addressing other factors identified as major contributing factors to acute malnutrition as a way to prevent acute malnutrition in the future. The prevention efforts should focus on the key contributing factors identified as major contributing factors during the analysis. These include improving quality and quantity of food consumed by children, household food security, and sanitation coverage. It is recommended that a response analysis involving all nutrition, health, food security, as well as water and sanitation stakeholders in the province be carried out to identify appropriate interventions to mitigate these contributing factors and address acute malnutrition. This response analysis should cover all the 8 drought affected districts.