Uganda (Refugees) IPC Acute Malnutrition Analysis, November 2020 - September 2021 (issued July 2021)

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How Severe, How Many and When: Of the14 refugee settlements included in this analysis, six settlements had Alert levels of acute malnutrition (IPC Phase 2) and eight settlements had Acceptable levels of acute malnutrition (IPC Phase 1), according to the Integrated Food Security Phase Classification (IPC) Acute Malnutrition analysis during the low acute malnutrition season of 2020/2021, November 2020 – April 2021. It is anticipated that three settlements will have Serious levels of acute malnutrition (IPC Phase 3), five settlements will have Alert levels of acute malnutrition (IPC Phase 2), and six settlements will have Acceptable levels of acute malnutrition (IPC Phase 1) during the high acute malnutrition season of 2021, May – September 2021. About 24,581 children in the 14 settlements included in the analysis are likely affected by acute malnutrition and in need of treatment. 18,940 children are likely experiencing moderate acute malnutrition while 5,641 children are likely experiencing severe acute malnutrition. Additionally, 2,961 pregnant or lactating women are likely affected by acute malnutrition, also in need of treatment.

Where: Adjumani, Bidibidi, Palabek, Palorinya, Rhino Camp and Kiryandongo refugee settlements were classified in IPC Phase 2 (Alert) with Global Acute Malnutrition (GAM) prevalences of 8.3%, 6.7%, 8.2%, 5.3%, 6.9% and 8.7% respectively during the period of November 2020 to April 2021. On the other hand, Imvepi (4.3%), Lobule (3.5%), Kampala (3.7%), Kyaka II (1.2%), Kyangwali (1.1%),
Nakivale (2.2%), Oruchinga (2.1%) and Rwamwanja (2.2%) were all classified in IPC Phase 1 (Acceptable). In the projection period of May – September 2021, it is anticipated that Adjumani, Palabek and Kiryandongo refugee settlements will be classified in IPC AMN Phase 3 (Serious), Bidibidi, Imvepi, Lobule, Palorinya, and Rhino Camp will be classified in IPC Phase 2 (Alert), while the other settlements will remain classified in IPC Phase 1 (Acceptable).

Why: The major factors contributing to acute malnutrition in the refugee settlements are: 1) inadequate food consumption, both in terms of quality and quantity due to 40% of refugees food rations cut, with only 22% of the children able to attain a Minimum Dietary Diversity, 36% of the rural refugee population being food insecure according to the CARI indicator, and only 29% of the women able to attain a Minimum Dietary Diversity; 2) declining health seeking behavior as a result of the COVID-19 disruptions, stigma and fear; 3) high disease burden, especially malaria, diarrhea and acute respiratory infections; 4) inadequate IYCF and MIYCAN practices, with only about 62% of infants exclusively breastfed and complementary feeding for children 6-8 months at 70%; 5) low CMAM coverage in most settlements and low Vitamin A supplementation (70%). Furthermore, anaemia among refugee children aged 6-59 months and non-pregnant women aged 15-49 years is of public health concern in most settlements (Severe 2%, Moderate 28%, Mild 24%). Consumption of iron rich foods is still low at 24%.

It is projected that in the period of May – September 2021, disease burden will increase (especially malaria and diarrhea), food consumption will deteriorate further, yet there may be an influx of more refugees in some settlements, as border restrictions are eased, coupled with instability in DRC and South Sudan. These and other factors will most likely lead to increased acute malnutrition among under fives and PLWs (Pregnant or Lactated Women).