Nutrition and Food Security Surveillance: North East Nigeria – Emergency Survey Final Report, November 2016

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Executive Summary

The Boko Haram conflict was declared to be a state of emergency at the beginning of 2012 by the government of Nigeria. In May 2013, the area under the state of emergency was extended to include all of Adamawa, Borno and Yobe states in Northeastern Nigeria. The insurgency and political violence has caused mass population displacement. According to the International Organization of Migration’s (IOM) October 2016 report, there were 1,392,927, 170,070 and 124,706 internally displaced persons (IDPs) in Borno, Adamawa and Yobe states respectively.

Conflict and resulting mass displacement often results in increased prevalence of acute malnutrition and mortality. The most recent state level estimates of global acute malnutrition are from the National Nutrition and Health Survey (July to September 2015) which found 10.9% (8.6, 13.7 95% CI) in Yobe, 11.5% (8.8, 14.9 95% CI) in Borno, and 7.1% (5.0, 10.1 95% CI) in Adamawa.
These state level estimates excluded areas of Borno that were inaccessible due to security.

Additionally, more recent data, collected since the declaration of the nutrition emergency in April 2016, suggest an increase in prevalence of acute malnutrition in some areas of N.E. Nigeria. Small scale SMART surveys conducted in the local government areas (LGAs) of Jere,Kaga,Konduga, and Monguno town between April and August 2016 documented prevalence of global acute malnutrition (GAM) ranging from 13.0-27.3%.

Additionally, screening data collected by NGOs and United Nations Children's Fund (UNICEF)-supported teams in Yobe and Borno states included assessments of IDPs with the proportion of children with global acute malnutrition [as identified by mid-upper arm circumference (MUAC) and/or oedema] reported to be over 80%. These initial assessments provide an indication of increasing levels of acute malnutrition. However, there remained many areas of the emergency states with no information to inform the ongoing response.

Given the severe situation suggested by the small-scale surveys and screening data, as well as increased access to newly liberated areas since the emergency declaration, surveys were organized with the primary objective of providing representative estimates for prevalence of acute malnutrition among children (by weight-for-height and MUAC), as well as mortality rate in N. E. Nigeria to inform the ongoing emergency response. Information on nutritional status of women, prevalence of common child health morbidities, access to health services and health status among children, infant feeding, and household water and sanitation were also collected as part of the surveys.

These surveys were carried out by the National Bureau of Statistics (NBS) in coordination with the National Population Commission (NPC), the Federal Ministry of Health (FMOH), and the Nigeria Nutrition in Emergency Working Group (NiEWG). Financial support was provided by the Government of Nigeria, United Nations Children’s Fund (UNICEF), and the United Nations Central Emergency Response Fund (CERF). Technical support was provided by the Centers for Disease Control and Prevention (CDC) and UNICEF through NBS.