Attachments
EXECUTIVE SUMMARY
Kismayo district is in Lower Juba Region, South Central Somalia and has an estimated population of 376,293 (early December 2016) of which 8.2% (30,690) are in Internally Displaced Person (IDP) camps. The district is home to Kismayo town which is a port city and the third largest city in Somalia; it serves as the headquarters of the autonomous Jubaland State. The district borders Afmadow District to the North, Badhadhe District to the East, Jamaame District to the West and the Indian Ocean to the South. The major livelihood zones in Kismayo include pastoral and agro-pastoral in the rural areas and petty trading in the urban areas of Kismayo Town. The nutrition situation in Kismayo urban is estimated as 8.8%, which is classified as “alert” based on the World Health Organization classification of malnutrition, while the situation in the IDPs is estimated as 14.5%, which is classified as “serious”. The 10 sites included in the assessment were under one implementing partner of which three sites were in the IDP camps. In addition, there are five sites, which offer the Targeted Supplementary Feeding Program (TSFP) and are run by Himillo Foundation and there are two other sites run by International Committee of the Red Cross (ICRC) and Physicians Across Continents (PAC) that offer inpatient services for complicated Severe Acute Malnutrition (SAM) cases. This assessment took place between 8th and 26th December 2016 and was led by a Semi-Quantitative Evaluation of Access and Coverage (SQUEAC) specialist trained by Coverage Monitoring Network (CMN). The program for the 10 Outpatient Therapeutic Program (OTP) sites that was included in the assessment commenced in January 2016 with some sites being operational as of April 2016. Oxfam was among the Non-Governmental Organizations (NGOs) that implemented OTP previously before Skills Active Forward United Kingdom (SAF UK) came into Kismayo District. Currently, the OTP implementing organizations include SAF-UK, PAC, Somali Aid and ICRC. The single coverage estimate realized by use of the 10 OTP sites in Kismayo district that availed their program data is 46.8% (40.8% - 53.1%). The coverage is much lower than the Sphere standard for an urban set up (70%).
Several recommendations were drawn based on the findings of the assessment. These included: sensitization meetings in the community on malnutrition and its treatment by Ministry of Health with village elders, other community groups, and influential individuals in the community; beneficiaries to bring back the empty sachets during their visits before being given more ration; sensitization of caregiver groups on income generating activities in order to counter the sale of RUTF; admission into the program to consider all the admission criteria including Mid Upper Arm Circumference; and caregivers to be informed of the admission procedures without promise of OTP admission. Other recommendations included: OTP sites to scale up the services offered to include some medical treatment services; increase number of TSFP sites; have agenda for program information sharing with partners during coordination meetings; increase RUTF buffer supplies to ensure needs remain met even when there are challenges with transportation and delivery; and increase active case finding during months of population influx.