Overall Nutrition Situation Overview
An integrated analysis of the nutrition information(1) collected from March to July indicates a varying nutrition situation throughout the country (Maps 1 and 2). six months, the Acute Water Diarrhoea (AWD) outbreak, which affected most parts of the country and the recent displacement from Mogadishu, are the key factors in the current analysis. The AWD outbreak(2) in south and central Somalia resulted in nearly 40,000 cases from January to June with an estimated 1,133 deaths. However, the outbreak reduction in cases in July in the 3 most affected regions (Middle and Lower Juba, Banadir) with no new cases in the other regions. In the northwest a total of 3,864 cases were reported in the January to August timeframe with 46 related deaths.
From this analysis, of most deterioration in the Shabelle regions, which has resulted in rates of global acute malnutrition of 17%(3), above the emergency threshold of 15%, with very concerning rates of severe acute malnutrition above 4%. This is the result of cumulative shocks which have had a detrimental effect on the nutritional well being of the population in both the rural riverine and agropastoral populations. A recent rapid assessment using MUAC conducted by MSF Swiss has also indicated a Very Critical nutrition situation amongst the newly displaced population near Afgoye town. Two other areas indicating Very Critical levels of malnutrition are the long term IDPs in Galkayo and Bossaso, linked to poor health, water and sanitation quality and services. An earlier rapid MUAC assessment conducted by FSAU in Baidoa in March also indicated Very Critical levels of acutely malnourished children (21%), but a repeat assessment in July indicated an improving trend (12%).
Analysis of nutrition surveys conducted in Somalia (n=84) over the last six years has highlighted the strong association of diarrhoea with acute malnutrition, caused by poor quality drinking water, poor sanitation and care practices. This is illustrated by the chronically high levels of acute malnutrition over the last few years in many parts of south and central Somalia (Gedo, Bay, Bakool, and Hiran), in spite of improved availability and access of food.
The current nutrition situation again indicates a similar trend from the Deyr '06/07 Critical nutrition situation. These regions include Bay, Bakool, Gedo and part of Hiran. The exceptions include, Burhakaba, Jalalaqsi and Buloburti district rural livelihoods, which have concern is the significant indicated deterioration from Serious in the Deyr Critical following the impact of newly displaced populations into the district and the AWD outbreak (Maps 1 and 2).
Some positive changes in the nutrition situation have however, been reported in Juba region with all three rural livelihoods experiencing some improvement from the Deyr Results from the agropastoral and pastoral population nutrition assessments now indicate a Serious situation down from Critical and a Critical situation in the riverine populations, down from the Very Critical situation in January (Maps 1 and 2). These improvements are in line with the improved food security indicators and are enhanced humanitarian response in the region over the last 6 a result of the new IDP months.
For the in northeast region, the situation varies by livelihood, though no significant changes Deyr
Along the Coastal Deeh livelihoods, however deterioration to a critical nutrition has been observed in June in line with expected seasonal trends given the lack to rough seas. Other areas remain at Alert and Serious levels with the exception of the long term IDPs, as mentioned earlier in Bossasso and Galkayo, where the nutrition situation is Very Critical.
Finally, for the northwest, in general the nutrition situation also remains stable at Alert levels, which are in line with the analysis from the Deyr ' 06/07. However, the eastern Golis livelihood, along the coast has slightly higher levels of acutely malnourished children, though still very low and therefore has been highlighted for close monitoring.
Notes:
(1) The analysis was conducted on a range of nutrition information collected from March to July 2007 including: 20 nutrition surveys (18 by FSAU & partners, 2 by ACF) , 132 sentinel sites, 110 Health facilities, rapid MUAC assessments conducted in 80 sites, data from partners selective feeding centres, WHO Acute Watery Diarrhoea updates and other secondary data.
(2) AWD Update, WHO June 29th 2007
(3) Shabelle Riverine population recorded a GAM rate of 17.0% (13.4 - 20.6) with 17.3% (13.3 - 21.3) recorded in the Shabelle Agropastoral populations.