Coordination mechanism: Cluster
Year of activation: 2018
NCC: UNICEF P3 TA
Sub-national Cluster for a regional crisis - UNICEF lead
January to December 2019
Nutrition projects in the 2019 HRP
The humanitarian situation in the north west and south west (NW/SW) regions of the country continued to worsen as frequent fighting and incidents were reported among NSAGs (non-State armed groups) and the military. 1.3 million people were estimated to be in need of assistance with 679,393 people internally displaced. The crisis in the NW/SW continued to have a negative impact on livelihoods, trade, markets and access to land. Farmers, small-scale fishermen and their families found themselves in an extremely vulnerable position due to the disruption of their activities (Cadre Harmonise 2019). IDPs had to resort to negative food-related coping strategies including reducing the number of meals to one a day.
The level of acute malnutrition in the NW/SW regions were not well known as access constraints had hampered the realization of SMART surveys. The emergency food security assessment (EFSA) conducted by WFP in January 2019 revealed proxy global acute malnutrition (GAM) rates of 4.4% and 5.6% for the NW and SW regions respectively. The proxy prevalence of severe acute malnutrition (SAM) were 1.5% and 2.8% for SW and NW regions respectively. Preliminary findings from a follow up EFSA assessment conducted in October 2019, showed a deterioration of the nutrition situation with proxy GAM prevalence of GAM rates of 5.1% and 7.4% for the NW and SW regions respectively, with further deterioration expected in the coming months. High levels of stunting (36% NW and 28 in SW) and poor Infant and Young Children Feeding (IYCF) indicators (exclusive breastfeeding rate at 43% in NW and 58% in SW) existed prior the crisis (MICS 2014). The proportion of children who meet their minimum acceptable diet (MAD) remained extremely low at less than 30%. The majority of the women had low micronutrient intake as only 23 % in NW and 32% in SW achieved a minimum dietary diversity.
Drivers of malnutrition, namely food insecurity, sub-optimal childcare and feeding practices, diseases, lack of safe water, poor sanitary conditions and repeated internal displacements deteriorated in 2019. Reduced food production, reduced prices in rural areas, increased prices in urban areas (prices are 30 to 50 percent higher) and decline in food consumption as a coping strategy adopted in most households resulted to substantial deterioration of food insecurity and household livelihoods in 2019. This has exposed IDPs and poor host populations in urban areas to critical living conditions and acute food insecurity Crisis (IPC 3). According to Cadre Harmonize (October 2019), there was a deterioration in the food security situation, with 9 out of 13 divisions in NW and SW in crisis phase. Poor water, hygiene and sanitation situation has been reported with over 55% of the population not having enough water for their needs and more than 40% of the assessed community practicing open defecation. Health service delivery continued to be significantly affected due to the increase in the number of security incidents affecting the utilization of the functional health structures. The disease surveillance system was very weak hence putting the population at risk of epidemics with late detection and limited response capacity. Pockets of measles and cholera outbreak were been reported in SW in 2019. A combination of food insecurity, AWD/Cholera and measles outbreaks is a serious driver of acute malnutrition and mortality
The cluster response plan aimed to achieve the country’s overarching humanitarian goals of saving life and alleviating suffering (HRP Strategic Objective 1) through the following sector objectives:
1. Strengthening nutrition surveillance for data generation and advocacy – rapid nutrition assessment planned for March/April 2020.
2. Scaling up nutrition response for SAM and launch MAM treatment if possible.
3. Capacity building of nutrition partners and stakeholders.
4. Strengthening of integration with others cluster (Health, Wash and Food security).
5. Enhancing collaboration with the Nutrition Focal Person regional delegation of health for NW/SW regions.