Acute malnutrition is affecting around 0.4 million children who are under the age of 5, more than half of all children aged 6-59 months in the 14 drought affected districts of Balochistan, making it a major public health problem in these districts. Of the 14 drought affected districts, 1 district has Extremely Critical levels of acute malnutrition (IPC AMN Phase 5) while 11 have Critical levels of acute malnutrition (IPC AMN Phase 4) and 2 are in Phase 3 with Serious levels of acute malnutrition according to the IPC AMN scale. Around 396,000 of the approximately 738,000 children of age 6-59 months are suffering from acute malnutrition during the drought period of May – August 2019.

Panjgur district is affected by Extremely Critical levels of acute malnutrition and is classified as being in the highest Phase of 5, according to the IPC AMN scale, where about 1 in 3 children under the age of 5 are suffering from acute malnutrition. Although 11 other districts have Critical levels of acute malnutrition (IPC AMN Phase 4), Kachhi, Pishin, Jhal Magsi and Dera Bugti districts have acute malnutrition levels that are close to IPC AMN Phase 5 thresholds. Awaran and Gwadar districts have Serious levels (IPC AMN Phase 3) of acute malnutrition.

Although information on several contributing factors is limited, available information suggests that very poor quality and quantity of food consumed by children and high acute food insecurity are major problems across all the 14 districts. Poor water and sanitation conditions and sub-optimal feeding practices (particularly exclusive breastfeeding and complementary feeding) are major issues in most of the drought affected districts in Balochistan. Low vaccination coverage is also of concern in several districts.

Population estimates May - August 2019

Providing treatment for all children with acute malnutrition is an urgent priority. The available information on acute malnutrition treatment is extremely limited. Where available, the treatment coverage data shows very low coverage. It is recognized that the acute malnutrition treatment is likely less than adequate in all districts. The very high severity and magnitude of the acute malnutrition situation calls for urgent 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.

The Government of Balochistan Health Department is implementing the “Balochistan Nutrition Project for Mothers and Children” in Kharan, Panjgur, Noshki, Kohlu, Sibi, Zhob and Killa Saifullah, both at the community level and health facility level, to improve the nutrition services in these districts. 

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 improving quality and quantity of food consumed by children, enhancing household food security, and ensuring adequate quantity and quality of water and sanitation facilities. 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 specific interventions to mitigate these contributing factors and address acute malnutrition. This response analysis should cover all the 14 drought affected districts and ideally be carried out at the provincial level.