Attachments
Description of the Event
Date when the trigger was met
10-10-2024
What happened, where and when?
The burden of malnutrition has been a major public health concern in Afghanistan for decades due to intricate, underlying, and immediate causes including prolonged drought, natural shocks, displacement of populations, sudden rise in the cost of living, food insecurity and massive unemployment.
Although the aforementioned factors have been insidiously contributing to malnutrition over years, the situation deteriorated significantly between May and September 2024, when levels of malnutrition reached unprecedented and alarming levels, calling for concerted, lifesaving, humanitarian efforts. There was a sudden spike in the trends of acute malnutrition among children and pregnant and lactating women across the country. This trend on the field has been further confirmed and validated with the release of the 2024 Global Hunger Index on the 10 of October 2024, highlighting that the malnutrition and hunger situation in Afghanistan has further deteriorated, with news reports indicating the worsening of situation due to factors such as increasing in humanitarian need with the decrease seen in humanitarian funding. While this affects the entire country, Kandahar and Paktika provinces were among the worst affected provinces in Afghanistan. The situation and fatalities are expected to deteriorate further with the onset of the winter season hence the need to reduce acute hunger before its peak in December and February to avoid significant loss of lives.
Scope and Scale
3.2 million children under five years and 840,000 pregnant and lactating women are now suffering from acute malnutrition in Afghanistan. Out of these, 1.7 million children are suffering from severe acute malnutrition and associated medical complications, a situation that has pre-disposing them to premature death and other lifelong complications including poor cognitive performance and stuntedness.
Kandahar and Paktika provinces are among the worst affected provinces in Afghanistan. With an estimated population of 2,067,723 people, outcomes of the 2024 Integrated Phase Classification (IPC) report for Afghanistan revealed a Global Acute Malnutrition (GAM) rate of 15.5 in Kandahar province, which is categorized as "critical," with 103,386 children under five years suffering from severe acute malnutrition and 41,354 pregnant and lactating women suffering from moderate acute malnutrition. Likewise, with an estimated population of 852,934 people, Paktika province is the worst affected, with a GAM rate of 17.5 which is classified as "crisis," according to the 2024 IPC report. Over 47,647 children and 17,058 pregnant and lactating women in Paktika province are suffering from acute malnutrition, a situation which has never been experienced before. In total, 151,033 children under five years and 58,412 pregnant and lactating women in Kandahar and Paktika provinces (collectively) are suffering from severe acute and moderate acute malnutrition respectively and are in dire need of urgent life-saving interventions.
Through 13 ARCS-supported MHTs and 15 static health facilities in Paktika and Kandahar, 6257 children and 4283 PLW were screened in the months of August and September using mid-upper arm circumference (MUAC). Out of these, 4280 children (68 per cent) and 2654 PLW (62 per cent) had severe and moderate acute malnutrition respectively. Additionally, in the month of September alone, MHTs and static health facilities reported a death rate of 6.4 per cent among children due to malnutrition and associated medical complications - a malnutrition related death rate that is significantly beyond the SPHERE recommended threshold of <3 per cent.
The aforementioned cases of acute malnutrition are increasing daily, a situation that continues to exert more pressure on limited available supplies and capacities of existing health facilities and MHTs hence the need for urgent response through this DREF allocation, without which there will be high levels of malnutrition that will be significantly beyond the capacities of available health facilities and MHTs. Lack of immediate intervention will also lead to steady increase in the number of malnutrition-related deaths, particularly among children under five years. Without urgent intervention, pregnant women will be at the risk of delivering low-birth-weight infants with other related congenital malformations which, regardless of the efforts made to address them, may not be cured throughout their lifetime and will have permanent growth, developmental and cognitive effects. As a preventive measure for malnutrition, children less than 6 months of age ought to breastfeed exclusively, then be introduced to complementary foods in addition to continued breastfeeding up to 2 years. However, without these emergency interventions, malnourished lactating women will not be able to breastfeed adequately and as a coping mechanism, they will resort to mixed feeding of the infants who ought to be breastfeed exclusively - a practice that will predispose them to malnutrition, common infections due to their compromised immunity, stunted growth, poor cognitive function and untimely death.
The current situation will be exacerbated by the onset of the winter season which will be at the peak between December 2024 and February 2025. It is therefore imperative for these life-saving interventions to start immediately because most of the locations in Paktika and Kandahar provinces will be completely inaccessible due to heavy snowing, a situation that will impede logistical arrangements including delivery of essential supplies, leading to deterioration of the nutrition status of the beneficiaries. It is worth noting that winterrelated infections including Acute Respiratory Infections (ARIs), and diarrheal diseases will further worsen the situation and predispose more children to premature deaths. Based on 'community-based integrated management of acute malnutrition' protocols, children with severe acute malnutrition without any underlying medical complications require at least 2 months of intensive treatment using RUTF in order to recover completely and be discharged from the treatment program. It therefore means 'treatment of malnutrition' interventions ought to begin immediately so that children can be treated and be discharged before peak of winter season. Otherwise, the situation will undoubtedly get out of control such that even with concerted efforts after winter season, the impact will be minimal.