Nearly 18 percent of children in the north are acutely malnourished according to a July 2008 nutritional survey by the UN World Food Programme (WFP) and UN Children's Fund (UNICEF) conducted in collaboration with the national government nutrition programme.
The survey showed a global acute malnutrition rate of 17.5 percent among children from six months to five years old - up from 11.6 percent two years ago. Global acute malnutrition, or wasting, means children have low weight for their height because they lack required nutrients.
"This situation is really alarming," Abdelhak Bendib, head of UNICEF's child survival section in Cote d'Ivoire, told IRIN on 23 October from Odienne, capital of the northwest region of Denguele, about 800km from the commercial capital Abidjan. "This level is nearly double what is considered a nutritional emergency."
Following the July survey, Médecins Sans Frontières-Belgium (MSF-B) did a study of children in eight villages in Denguele, finding that 23.9 percent of children aged six months to five years are acutely malnourished, MSF-B head of mission Nathalie Cartier told IRIN.
Côte d'Ivoire is emerging from years of conflict triggered when a 2002 rebellion split the country in two - the government-controlled south and rebel-held north. While humanitarian assistance has decreased as the conflict wanes, conditions like those in the north indicate that significant needs remain, nutrition experts told IRIN.
Northern Côte d'Ivoire's malnutrition level stems from a number of factors, UN and NGO nutrition experts told IRIN - primarily: poor agricultural production, livestock disease, lack of access to a variety of nutritious foods, lack of a fully functioning health system and global food price hikes. Many of the factors are linked to the conflict.
Patrick Berner, emergency and rehabilitation coordinator for the UN Food and Agriculture Organization (FAO) in Côte d'Ivoire, told IRIN he is worried about the food security and nutritional situation in the north, which he said has deteriorated in the past year.
A September 2008 food security monitoring study in Côte d'Ivoire found that 27 percent of households in the northern Savanes region were food insecure - 12 percent severely food insecure, Berner said, adding that Savanes is representative of northern Côte d'Ivoire.
Several agricultural factors contribute to food insecurity in the north, Berner said, including a poor 2007 harvest, a doubling of the price of fertiliser and livestock mortality.
Many farmers in the north have turned away from cotton to cashews as a cash crop, but the cashew sector is not well developed and farmers have been unable to make a profit.
"Farmers are getting extremely low prices for cashews and this is yet another factor severely cutting people's buying power," Berner said.
Disease is wiping out livestock in the north, which cuts productivity as people use oxen to farm, he said. As with many institutions, the government veterinary service is not yet operating as it was before the break-up of the country.
UNICEF, FAO and WFP along with the government have drawn up a response plan, which will include therapeutic feeding and reinforcing nutritional units in hospitals and health centres across the north.
UNICEF's Bendib said the agencies are appealing for funds to implement the response. UN officials said they could not yet say how much funding is needed.
Following its survey of Denguele villages, MSF-B in collaboration with government health officials and UNICEF has begun providing nutritional care at the Odienne hospital and at five health centres, MSF-B's Cartier said.
An official with the national nutritional programme, or PNN, said the government this week began an education and awareness campaign targeted at local authorities, health officials, and community and religious leaders in the north.
"We are telling them that we have a public health problem here - that this is an emergency," Jeanne Assemien, head of the national programme for the fight against malnutrition, told IRIN. "We are telling them we need everyone on board to help us in this fight."
Assemien said in addition to an emergency response, PNN will take long-term measures such as training health workers in screening for malnutrition "so this does not repeat itself".