WIDESPREAD FOOD SECURITY AND MALNUTRITION ALONGSIDE POOR ECONOMIC INDICATORS CHARACTERIZED THE REGION BEFORE COVID-19 PANDEMIC
Before the start of the pandemic, the cadre harmonize projections estimated the food insecure population during March - May 2020 at 2,885,288 (IPC phases 3 – 4), with only a small proportion of those (273,328) experiencing emergency level (IPC Phase 4) food insecurity. In the 2020 lean season this number was expected to rise to 3,705,186, with 543,457 at emergency levels (IPC Phase 4). Already flagged as most at risk were the approximately 300,000 people in need of emergency assistance who were situated in Hard-to-Reach (H2R) areas, beyond humanitarian support (FAO 27/03/2020).
In a region marred by high unemployment rates and poverty levels, communities in the northeast are characterized by inadequate access to basic services, poor public infrastructure, limited income sources and livelihood opportunities, and increased resource demands. These conditions are exacerbated by the additional pressure of hosting over 2 million IDPs (UN OCHA 31/03/2020, UN OCHA 01/04/2020).
Malnutrition, combined with malaria and acute watery diarrhea are major killers of children in the northeast. At the end of 2019 the Global Acute Malnutrition (GAM) rate was 11.5% in Yobe State, 8.1% in Borno and 7.2% in Adamawa. Malnutrition rates were thought to be higher in H2R areas. Organizations struggled to find staff and capacity to provide the needed nutrition services especially in conflict affected parts of Borno and Yobe states (UN OCHA 01/04/2020, NBS 30/01/2020).
COVID-19 CONTAINMENT MEASURES HEAVILY IMPACTED LIVELIHOODS AND REDUCED HOUSEHOLDS’ ABILITY TO MEET BASIC NEEDS INCLUDING FOOD
Between April and June 2020, COVID-19 containment measures including a lockdown, curfews and movement restrictions severely curtailed livelihoods and reduced access to lands for farming. Amongst the hardest hit were daily laborers and people engaging in cash-forwork activities, many of whom lost access to their normal income sources due to restricted labor migration and the closure of small businesses. Youth and women working in the informal sector were also badly affected. The lockdown accompanied by market shutdowns and movement restrictions triggered panic buying to stock up food, compounded further by the Ramadan season, and consequently led to a surge in food prices with the price of milled in Maiduguri doubling between January and May. This led to a significant decrease in household purchasing power and pushed many families into negative coping mechanisms to meet their basic food needs. Humanitarian organizations for the most part were able to continue food distributions however (FEWS NET 07/07/2020, FEWS NET 12/08/2020, FEWS NET 31/08/2020).
Nutrition service provision was also disrupted by the COVID-19 pandemic with COVID-19 prevention measures necessitating an adaptation of nutrition interventions to ensure the protection of both the service providers and beneficiaries. COVID-19 related challenges included an inadequate supply of personal protective equipment (PPE), a lack of disinfectant and a reduced number of health workers at health facilities (UN OCHA 09/07/2020, UN OCHA 30/06/2020).
THE WIDESPREAD ECONOMIC IMPACT OF COVID-19 CONTAINMENT MEASURES LED TO HEIGHTENED LEVELS OF FOOD INSECURITY AND MALNUTRITION AND THE ADOPTION OF CRISES AND D EMERGENCY COPING STRATEGIES
With the widespread disruption to employment and trade, price inflation and the increased pressure on food security brought on by lean season it is unsurprising that large numbers of households across Borno, Adamawa and Yobe (BAY) states faced living standard gaps in food security and livelihoods. Results from the MSNA found 1,263,953 households faced Food Security & Livelihoods LSGs in August 2020. IDPs had the highest proportion of households (ranging from 63% - 45% across the BAY states). This is in part due to the increase in vulnerability and lack of access to land (for farming) that can result from displacement. Returnees were the next most affected group and are also characterized as being more vulnerable (due to prior displacement) and lacking access to goods and services in their areas of return. However, even for the non-displaced, the proportion households with Food Security and Livelihood Living standard Gaps (FSL LSGs) were still significant, numbering 53% in Adamawa, 40% in Borno and 30% in Yobe (REACH 14/12/2020, REACH 14/12/2020, REACH 14/12/2020).
Loss of income and the increased cost of living were therefore driving a loss of household purchasing power and increasing household vulnerability. By October 2020,
57.4% of surveyed households had expenditures below the Monthly Expenditure Basket (MEB), meaning that these households did not have enough economic capacity to meet their adequate needs. Across the BAY states 37% of households adopted stress coping strategies, 7% crisis strategies, and 27% adopted emergency coping strategies. Crisis and emergency coping strategies can reduce household long-term financial security, eroding a household’s savings and assets and increasing debt (WFP 19/02/2021, World Bank 21/02/2021).
The Northeast Nigeria Nutrition and Food Security Surveillance Emergency Survey Round 9 was completed during October and results showed that acute malnutrition had risen in both Yobe and Borno states with the prevalence ofGlobal Acute Malnutrition (GAM) at 12.3% in Yobe, 10.0% in Borno, and 6.2% in Adamawa. Within the states, SAM (MUAC) rates were highest in Northern Yobe (2.8%), Central Yobe (2.7%) and highest of all in Northern Borno (3.1%). To what extent COVID-19 containment measures had contributed to this increase is difficult to quantify, but with the economic impact on incomes, increased food prices and disruption to farming activities it is likely containment measures were a contributing factor to increased food insecurity, reduced food consumption and an increase in malnutrition rates. In addition, fear of COVID-19 and movement restrictions will have also contributed to fewer malnourished children accessing the nutritional support programs they needed (Govt Nigeria 19/03/2021).
CONFLICT DRIVEN DISPLACEMENT AND SEASONAL FACTORS CONTINUE TO DRIVE FOOD INSECURITY AND MALNUTRITION WHILST INHIBITING ANY ECONOMIC BB RECOVERY FROM COVID-19
Although 2021 began with a large ‘second wave’ of COVID-19 cases, this had only a limited impact on the humanitarian situation in the northeast, with few new containment measures introduced. The biggest impact of COVID-19 continued to be economic, with inflation continuing to rise until April 2021 and unemployment rates remaining high.
The main driver of humanitarian needs in the first half of 2021 were conflict and insecurity. The first six months of 2021 saw large scale displacements, damage and destruction caused by Non-State Armed Groups (NSAG) attacks in Damasak Town, Dikwa and Marte (Borno state) and Geidam, Yunusari, and Gujba LGAs (Yobe state). In some cases this led to the suspension of humanitarian operations and the evacuation of humanitarian staff. Hospitals, schools, WASH infrastructure, homes and shelters were damaged or destroyed during the attacks and many households were unable to access land for cultivation (iMMAP 30/07/2021, iMMAP 02/07/2021, iMMAP 31/05/2021, iMMAP 04/05/2021, iMMAP 31/03/2021, iMMAP 03/03/2021).
The latest Cadre Harmonise report, released in April, indicated that 3,168,947 people were food insecure (IPC Phases 3 – 5) between March and May 2021, with 476,462 people facing IPC 4 (emergency) food security outcomes. Again, populations in H2R were flagged as at risk and likely to face large food consumption gaps. For the coming lean 4.37 million people were projected to be food insecure (IPC Phases 3 – 5), with those in H2R areas likely the worst affected. This represented a small increase compared to the lean season in 2020 (4.30 million). Continued high food inflation and below normal levels of labor employment and wages were contributing factors (FEWS Net 13/07/2021,
Malnutrition rates in many LGAs are forecast to increase during the 2021 lean season, with 11 LGAs expected to be in IPC AMN Phase 4 (Critical) and 34 LGAs in IPC AMN Phase 3 (Serious). Around 1.15 million children aged 6-59 months are expected to suffer from acute malnutrition during the course of 2021, with more than half of them (605,000) expected to be severely malnourished. Over 123,000 pregnant or lactating women are also expected to suffer from acute malnutrition (IPC 17/03/2021)
LEAN SEASON BRINGS WIDESPREAD FOOD INSECURITY AND A FAMINE RISK FOR INACCESSIBLE AREAS OF BORNO STATE
COVID-19 now appears relegated to a minor issue as some communities may be facing IPC level 5 (Catastrophe) food security outcomes, with acute malnutrition at critical levels amongst the youngest children in H2R areas.
With ongoing insecurity and regular NSAG attacks in the BAY states have limited income earning activities and many households are dependent on humanitarian food assistance. As a result, food insecurity is widespread across most parts of Borno and Yobe States, with the majority of LGAs classified as experiencing Crisis levels of food insecurity (IPC Phase 3). However, especially in areas affected by conflict some households are likely to be in Emergency (IPC Phase 4) and possibly in Catastrophe (IPC Phase 5). Findings from the (June) Famine Monitoring System (FMS) revealed concerning consumption patterns in inaccessible areas. More than half of all sampled households (56%) struggled to have sufficient food intake and 67% experienced crisis or higher levels (CH Phase 3 and above) of food deprivation and hunger, further evidenced in the pervasive use of food-based coping strategies. A small minority of the inaccessible population (≤10%) were found to have a famine-like food consumption although higher-level indicators (acute malnutrition and mortality) were insufficient to confirm famine conditions.
Malnutrition rates increased in all 3 states during the months of March – June, with Borno and Yobe states seeing the biggest rise. Total Severe Acute Malnutrition (SAM) admissions for June numbered around 30,000, a 20% increase on the same time last year. According to the June FMS findings, the levels of acute malnutrition among new arrivals from inaccessible areas is Critical (Phase 4 IPC Acute Malnutrition Classification). The overall Global Acute Malnutrition (GAM) rates were 20.7% and SAM at 4.9%. This is way above the GAM and SAM rates identified in last year’s Nutrition Survey (round 9). Even more concerningly, children aged 6- 17 months were four times more likely to be acutely malnourished than older children (30 – 59 months), with a GAM rate of 38.2% and a SAM rate of 10.9% for the 6 – 17-month age group. Reduced food consumption added to factors such as the recent measles outbreak and increase in malaria and acute watery diarrhea may lead to increased malnutrition and mortality levels. Therefore the situation in H2R areas is of the utmost concern (Govt of Nigeria 16/07/2021).