Ethiopia: Emergency nutrition quarterly bulletin (First Quarter 2008)




Moyale and Mi'oo Woredas

Baseline nutrition surveys: The Oromia Regional ENCU (R-ENCU) and the Regional DPPB and Food Security Commission (DPPB/FSC) conducted two standard nutrition surveys in adjacent woredas, Moyale and Mi'oo of Borena Zone between the 1st and the 11th of January 2008. The surveys were requested by the DPPB to assess the nutritional status and observe food security issues in both woredas were water shortage and untimely population movement had been reported following poor Ganna and Hageya rains, increasing food prices and reports of low EPI coverage. Technical support for both surveys was provided by IMC and GOAL. Both Mi'oo and Moyale populations are largely pastoralist and the woredas are situated along the Ethiopia-Kenyan border in the south of Oromia.

Methodology: SMART was used to assess the anthropometric status of 833 children aged between 6-59 months in Moyale and 750 children in Mi'oo woredas using two-stage random cluster sampling with 21x39clusters and 20x37 clusters respectively. Mortality estimates were calculated using 90-day recall from 2,800 people in Moyale and 2,754 people in Mi'oo. Anthropometric and mortality data was analysed using ENA software and vaccination and morbidity information was analysed using Epi Info (6.04). One result was flagged in Moyale woreda. In both surveys the younger age group aged between 6-29 months were slightly under represented estimated at 38.6% and 35.5% for Moyale and Mi'oo respectively. This falls below the distribution norm recommended by WHO (2000) of circa 49.4%. Otherwise the findings were found to be plausible and were endorsed by the F-ENCU.

Nutrition: In Moyale global acute malnutrition (GAM) was estimated at 10% (CI: 7.5-12.4%) and severe acute malnutrition (SAM) was 0.6% (CI: 0.1- 1.1%). This was bordering 'serious' in a chronically food insecure area and in the presence of aggravating factors (DPPA, 2002). The observed aggravating factors were listed as deteriorating food security, insufficient rainfall, increasing market prices and low EPI coverage. In Mi'oo, GAM of 7.5% (CI: 5.6-9.3%) and SAM of 0.5% (CI: 0.0-1.0%) were presented. In the presence of the same aggravating factors, the nutrition status of children was considered as 'poor' (DPPA, 2002). Comparison with previous surveys conducted in January 2006 during a drought period, were similar with GAM of 10.9% (CI: 8.9-13.1%) in Moyale and 10% (CI: 8.1-12.2%) in adjacent Dire woreda (formerly part of Mi'oo) in January 2006.

Health: Mortality rates were below emergency thresholds, estimated at CMR 0.17 (CI:0.0-0.33) deaths/10,000/day and U5MR 0.38 (CI: 0.1-0.86) deaths/10,000/day in Moyale and 0.11 (CI:0.0-0.23) deaths/10,000/day and 0.59 (CI: 0.07- 1.25) deaths/10,000/day in Mi'oo woreda. Major causes of U5 mortality were not recorded. Morbidity rates in children were relatively low at 12.7% in Moyale and 11.2% in Mi'oo. Major causes of morbidity were diarrheoa and ARI in both woredas. Measles coverage in children (9-59 months) by card only was 18.6% (CI: 12.0-25.2%) in Moyale and 10.2% (CI: 5.3-15.2%) in Miyo. Considering mother's recall as well as EPI card raised the measles coverage to 81.8% (CI: 71.1-89.5%) and 71.3% (CI: 63.1-79.5%) respectively. However, this is still low coverage. Immunisation against TB estimated by visible BCG scar was 73.9% (CI: 67.6-80.1%) in Moyale and 69.5% (CI: 62.7-76.4%) in Mi'oo. Vitamin A coverage distributed during the 6th round of EOS screening in October/November 2007 was reported as 86.5% in Moyale and 80.1% in Mi'oo (CI: not available). Access to safe drinking water and sanitation is extremely low.

Livelihood / Food security: In general these woredas are considered chronically food insecure. There is little opportunity to produce crops. The majority of the population are vulnerable to market price hikes especially when rainfall is insufficient, grazing pasture is depleted and livestock quality drops. While no human or animal disease outbreaks were observed during the survey, it was predicted that both human and animal health could be vulnerable in the months ahead if the dry period is prolonged.