Between January and December 2024 more than 41,301 children aged 6 to 59 months are facing or expected to face high levels of acute malnutrition, including 9,260 cases of severe malnutrition (SAM). Approximately 1,046 pregnant and breastfeeding women are facing or expected to face acute malnutrition in the same time period. 

In the current period (January to April 2024), considered a period of low prevalence of acute malnutrition, two of the seven cities analysed (Balbala and Arta), are in IPC AMN Phase 4 (Critical) and Obock, Djibouti-Ville and Tadjourah are in IPC AMN Phase 3 (Serious). In terms of the five rural areas, Obock is in Phase 4, and Tadjourah and Dikhil are in Phase. Ali Addeh refugee camp is in Phase 4 while the Markazi and Holl-Holl refugee camps are in Phase 3. 

For the projected period (May to December 2024) marked by an increase in cases of acute malnutrition, a deterioration of the nutritional situation is anticipated. 

The major contributing factors to acute malnutrition are Acute Watery Diarrhea as well as high and recurrent acute food insecurity at the household level which is reflected by very low food consumption (quantity and quality). Poor quality of food intake, high levels of childhood illnesses, poor hygiene conditions, low coverage of access to drinking water and the low vaccination coverage against measles are also contributing factors. 

• Improve the coverage and quality of treatment for acute malnutrition in order to urgently reduce the number of children and pregnant and breastfeeding women facing acute malnutrition.
• Improve the routine data collection and nutrition survey system.
• Carry out nutritional awareness-raising and training activities to increase the consumption of diversified foods and good cooking practices in refugee camps.
• Support and strengthen nutritional care, awareness-raising and nutritional training activities in order to increase dietary diversification, particularly in areas with a high prevalence of moderate acute malnutrition (MAM) and Severe Acute Malnutrition (SAM).
• For refugees, continue actions aimed at facilitating their access to quality food, in sufficient quantity, and strengthen their local integration through support for resilience-building activities.