Ethiopia: Emergency nutrition quarterly bulletin (Third Quarter 2007)

Situation Report
Originally published



Dugna Fango, Damot Woyde and Offa Woredas

Three standard nutrition surveys were conducted by Concern Worldwide in Dugna Fango, Damot Woyde and Offa woredas of Wolaita zone in June 2007 as part of their routine monitoring in CTC project areas. Two-stage cluster sampling was used with 33 clusters of 16 children measured for anthropometry in Dugna Fango and Damot Woyde woredas and 29 clusters of 15 children in Offa woreda following SMART methodology and using ENA1 software for analysis of anthropometric and mortality information. Mortality was assessed retrospectively over a 120 day period in 528 households in Damot Woyde, 528 households in Dugna Fango and 435 households in Offa woredas. Focus group discussions were conducted in each agro-ecological zone
to assess the food security scenario. All three surveys were conducted in June which is typically a good season in terms of nutrition situation due to the belg harvest. However this year the belg harvest was delayed due to untimely rains in February causing many households to re-plant.

Nutrition: According to the National Guideline for conducting Emergency Nutrition Assessments in Ethiopia (DPPA, 20022), the nutrition situation was considered as 'normal' in all three woredas. The prevalence of global acute malnutrition in Dugna Fango and Damot Woyde was estimated at 2.2% (0.6%- 3.3%) and 2.2% (1.2%-3.3%) respectively with 0.2% (0.0-0.5%) severe malnutrition in both. This was found to be significantly lower than the previous GAM prevalence found in January 2006 in Damot Woyde. Dugna Fango is a newly established woreda and baseline for comparison was not available. In Offa woreda the prevalence of global acute malnutrition was estimated at 1.1% (0.2%-2.1%) and no cases of severe malnutrition were found.

Health: The crude mortality rates were estimated at 0.09, 0.07 and 0.27 deaths/10,000/day with an under-five mortality rates of 0.16, 0.18 and 0.61 deaths/10,000/day in Damot Woyde, Offa and Dugna Fango respectively. Both the crude and under five mortality rates fell under emergency thresholds3. Morbidity in the 2 weeks prior to the surveys ranged from 7.6%-16.2%. Diarrhea, RTI and malaria were cited as the main causes of morbidity and mortality. Health care utilisation was average, as indicated by measles coverage (by card and recall) of 65.3% in Damot Woyde, 72.9% in Offa and 65.8% in Dugna Fango. Likewise, BCG coverage was average estimated at 58.6%, 67.7% and 65.7% in Damot Woyde, Offa and Dugna Fango respectively. Vitamin A supplementation by EOS bi-annual campaigns was above 90% in all three woredas. Access to safe water supply was as low as 24.2% in Dugna Fango and 46.0% in Offa woredas but slightly higher at 62.6% in Damot Woyde where Concern has been supporting water rehabilitation projects.

Food Security: Most of Damot Woyde, Offa and Dugna Fango woredas are described as chronically food insecure with livelihoods mainly reliant on rainfed agriculture at the mercy of erratic rainfall patterns. Meher and belg crops are harvested in November/December, and June/July respectively. Due to a delay in the belg rains expected in January, many short-maturing belg crops were not planted on time, particularly in Dugna Fango. Additionally, heavy rains destroyed crops in five PAs ,belg harvest had yet to be reaped at the necessitating re-planting. As a result the time of the survey. The Productive Safety Net Programme (PSNP) had reached 20,753 of the most food insecure people in Damot Woyde, 19,966 in Dugna Fango and 23,382 in Offa woreda. The 7th round of EOS-TSFP screen-ing was conducted in May 2007 for malnourished children U5 and PLW. In Dugna during the screening was very high. A total of 910 children were found to be in need on TSF based on oedema +/- MUAC<12.0 cm. In Damot Woyde 17,796 children and 3,941 PLW were screened. 1,126 children were found to be in need on TSF based on oedema +/- MUAC<12.0cm. In Offa 263 children and 794 PLW were found to be malnourished, again higher than that expected from the prevalence rates reported by Concern.

Conclusion and recommendations: The prevalence of malnutrition was the lowest recorded over the last 8 years, reflecting a series of good harvests recently and an improved food security situation. In light of this Concern has ceased supporting MOH-CTC intervention but livelihoods interventions continue working with communities to improve access to safe water.

Trend analysis: The ENCU conducted a trends analysis of the anthropometric situation in Damot Woyde and Offa woredas recorded in routine surveys conducted by Concern since 2000. NSP data was also used for comparison. The objective was to observe changes in anthropometric status inline with the presence of various Government and NGO health, food security and livelihood promoting interventions operating in these food insecure areas. In Damot Woyde 17 surveys have been conducted since 2000 with GAM ranging from the current low of 2.2% (0.6%-3.3%) to a high of 10.3% (8.5%-12.5%). The ranges in NSP baseline data by season for East Wolaita (reference year 1996) are as follows: 4.9%-6.8% for post-harvest (PH=Dec.-Feb), 4.8%-6.7% for early belg (EB=March-May), 4.7%-6.5% for late belg (LB=June-Aug) and 4.4%- 6.3% for kremt (K=Sept-Nov) (presented except for the early belg season in 2003 and 2005 where it rapidly rose above the NSP reference values. Damot Woyde was allocated food aid from 2000 to 2005 to mitigate the impact of acute food shortages during this period. Since 2005 the Productive Safety Net Programme has supported the most vulnerable to mitigate the hardship caused by recurring shocks. The EOS-TSFP has been operational since 2005. It is suggested that the combined impact made by these interventions along with the MOH-Concern CTC programme and a succession of good harvests have contributed to the improved anthropometric status reported.