Afghanistan Nutrition Cluster Bulletin - Jan to Sep 2015 Issue: 3

Nutrition Cluster Results highlights

• 125,076 children (57,386 boys, 67,690 girls) have been admitted for treatment of both IPD SAM and OPD SAM, of which 43, 350 (35%) children in the third quarter which is well within the expected trends. During the reporting period, 6,874 were admitted in IDP SAM and 36,476 were admitted in OPD SAM programmes across the country. The total admitted children is 81% of the HRP 2015 target of 155,279 children. The overall reporting rate is 67% for both IPD SAM (60%) and OPD SAM (74%). 117,315 (54,845 boys, 62,470 girls) children were admitted in OPD MAM programmes of which 40,268 (34%) children were admitted in the third quarter which is well within the expected trends. This total children reached is 84% of the HRP 2015 target of 140, 309 children in the year. The OPD MAM reporting rate is low at approximately 45%.

• Al though there are differences in the performance indicators by programme, i.e IPD SAM , OPD SAM and OPD MAM, the overall cure rate for the IMAM programmes was 87%, Death rate was 0.5 % and defaulter rate was 13% all within the sphere standards.

• A total of 127, 585 acutely malnourished pregnant and lactating women (PLW) have so far been reached from January to September 2015 of which 12,855 (10%) PLW were reached during the reporting period. The low coverage rate in the third quarter has mainly been due to shortage of some commodities for this programme related to funding constraints. It is import to note that this has already surpassed the annual target of 105, 342 PLW targeted.

• A total of 210, 965 children have been reached with micronutrient supplementation from January to September of which 70,143 were reached during the reporting period. The total reached is 36% of the annual target for the cluster hence well behind target for the year mainly due to shortage of supplies as well as under reporting. The cluster is closely following up with partners to get pending reports to be submitted.

• A total of 703,285 mothers and caregivers have been reached with IYCF messages out of a planned annual target of 624,554. The number reached has already surpassed the target for the year as there is multiple reporting of beneficiaries if they receive the promotion messages more than once.

• UNICEF, PND and partners conducted a Bottleneck Analysis (BNA) exercise covering all the 34 provinces to fully understand the bottlenecks to IMAM service delivery in the country. It was concluded that effective IMAM coverage was about 29%. It seems the main bottleneck on supply side is access as only 34.8% of health facility provide OPD-SAM followed by training of health workers on IMAM. On demand side initial utilization is the main bottleneck as only 39.9% of SAM children are admitted for treatment. It seems about 10% of SAM children who are admitted are not cured. An action plan to address the bottlenecks was prepared and agreed by all partners with an agreed timeline.

• ACF in collaboration with partners conducted 3 nutrition surveys, 5 coverage surveys (3 SQUEAC and 2 SLEAC) during the reporting period. See Results in the assessment section

• The cluster finalized the cluster advocacy strategy for 2015-2016 and shared with partners. A number of key activities were identified that will be implemented by partners to improve understanding of the nutrition issues among different stakeholders and generate support for nutrition programming.

• WHO trained 24 BPHS and government staff in Khost, Paktya and Paktika on inpatient SAM protocol. WHO also conducted a training of trainers (ToT) training for 29 lab technicians on key technics needed for analyzing nutrition surveillance biochemical data.

• WFP delivered nutrition training workshops in its field offices Jalalabad and Mazar-e-Sharif, and trained 32 BPHS partner staff, provincial nutrition officers, and programme monitors.

• A total of 34 partners are providing nutrition services through 163 IPD SAM sites, 705 OPD SAM and 582 OPDMAM sites.