Between August 2023 and July 2024, 480,000 children aged 6 to 59 months and almost 131,500 pregnant and breastfeeding women (PBW) are facing/expected to face elevated levels of acute malnutrition in the 37 provinces analysed. This includes 113,627 cases of severe acute malnutrition (SAM). 

In the current period of August 2023 – January 2024 (peak of malnutrition), seven provinces are classified in IPC AMN Phase 3 (Serious). In the first projection period (February to April 2024) that figure will improve significantly, with four provinces moving from Phase 3 to IPC AMN Phase 2 (Alert). However, the second projection period will see a marked deterioration, with 13 provinces moving to higher IPC AMN phases. Five provinces will move from IPC AMN Phase 1 (Acceptable) to Phase 2, seven provinces will move from Phase 2 to Phase 3 and one province will move from Phase 3 to IPC AMN Phase 4 (Critical). None of the provinces will see their situation improve. 

The main contributing factors to the acute malnutrition are low food consumption, poor dietary and care practices, high prevalence of childhood morbidities – fever, diarrhea, and acute respiratory infections – poor hygiene and sanitation conditions and the low coverage of access to drinking water. 

The security crisis prevailing in the country has caused negative effects such as massive population displacement in eight of the 13 regions and the closure/malfunction of more than 500 health structures in provinces with limited humanitarian access. 

Of the 37 provinces analysed, more than half of these areas are experiencing population movements due to the situation. These areas are mostly classified as IPC AMN Phase 2 (Alert) and IPC AMN Phase 3 (Serious). Urgent and early interventions are needed to reverse or contain possible deterioration in the nutritional status of vulnerable people - particularly children under five and FEFA.

Immediate response objectives:

• Guarantee access for all children under five and pregnant and breastfeeding women (PBW) suffering from acute malnutrition to quality treatment to reduce the mortality rate.
• Strengthen community IMCI and Maternal and Child Health MCH (capacity of Community Based Health Workers (ASBC) to treat malaria, diarrhea, ARI, etc. at home) and the use of simplified approaches for taking charge of the malnourished.
• Strengthen the surveillance and management of IDPs in areas hosting them.
• Anticipate the establishment of an emergency food assistance system for populations in Phase 3 and above of the Framework.
• Harmonize (CH) of food insecurity integrating protection programs for children under five years old and PBW.

Medium and long term response objectives:

• Improve access to drinking water and sanitation services and increase awareness-raising actions on the use of sanitation infrastructure (particularly in spontaneous settlement areas to fight against diseases: diarrhea, malaria.
• Intensify awareness among women on their good feeding practices as well as those of infants and young children.
• Strengthen resilience interventions for IDPs.
• Strengthen community awareness about attendance to early access to health centers.
• Strengthen food support for the benefit of host households and IDPs in conflict zones integrating protection programs for children under 5 years old and pregnant and breastfeeding women.