An estimated 4 million children and women in Afghanistan are likely suffering from acute malnutrition through April 2023 and need urgent malnutrition intervention. The latest IPC Acute Malnutrition Analysis projection shows that 875,224 children will suffer/are likely suffering from Severe Acute Malnutrition (SAM) and while those with Moderate Acute Malnutrition (MAM) are 2,347,802, About 804,365 pregnant and lactating women are suffering from acute malnutrition.
In the current analysis, Badakhshan and Paktika provinces are classified in IPC AMN Phase 4 (Critical). Badghis, Baghlan, Balkh, Farah, Faryab, Ghazni, Ghor, Helmand, Jawzjan, Kabul Rural, Kabul Urban, Kandahar, Kapisa, Kunar, Laghman, Logar, Nangarhar, Nimroz, Nuristan, Panjshir, Parwan, Uruzgan, and Zabul provinces are classified in Phase 3 (Serious). In the projection period, the acute malnutrition situation is expected to deteriorate from Phase 2 to 3 in 9 provinces and from Phase 3 to 4 in 15 provinces. The major contributing factors to acute malnutrition include acute food insecurity (AFI), with about 45% to 55% of households in IPC AFI Phase 3 or above, which contributes to poor quality of foods consumed by children (only 16% have a minimum acceptable diet), as well as a high prevalence of communicable diseases (including diarrhea, malaria and Acute Respiratory Infections – according to the SMART survey, the proportion of children under the age of five experiencing diarrhea in the fortnight before the survey ranges from 17.5% to 88.5%, more than one third in 25 provinces), compounded by poor hygiene practices and sanitation, underpinned by basic factors, such as socio-economic status, social and cultural norms, and natural disasters, including the floods, droughts and earthquakes recently experienced by the country, as reported by the Whole of Afghanistan Assessment (WoAA).
Response Priorities
This section outlines the broad recommendations for both the immediate/short-term and medium to longer-term timeframe based on the situation analysis and projection.
Immediate/short-term recommendations
• Sustain the scale-up of the Integrated Management of Acute Malnutrition (IMAM) programmes, ensuring coverage and quality of treatment services to children under five years of age and pregnant and lactating women affected by acute malnutrition. Key actions to consider are:
° Service-gap assessment;
° Identification of the best model of integration into PHC and CBHC;
° Use of simplified approaches.
• Promote preventative nutrition-specific interventions, especially:
° Sustain food supplementary programmes targeting vulnerable groups (children under, pregnant and lactating women) for prevention of malnutrition;
° Strengthen micronutrient supplementation programming;
° Strengthen Social Behavioural Change for Communication (SBCC), including through expanded IYCF messaging and counselling at Health Facilities and community levels.
• Promote integrated solutions that include nutrition-sensitive interventions, especially in health, water and sanitation, and food security.
° Continue provision of primary health care;
° Strengthen both institutional and community WASH interventions;
° Support cash programming to enhance the resilience of affected families to cope with food insecurity and access to basic services;
° Support preparedness and response plans for disease outbreaks and the seasonal increase in malnutrition.
Medium to long-term recommendations
• Support integrated livelihood and nutrition programming for improved production and accessibility of nutritious foods for improved nutrition status and food security.
• Support SBCC to improve home diets, infant and young child feeding, and proper use of nutrition products.
• Strengthen the health and community systems for effective integration of nutrition at different systems levels.