Food Security and Nutrition Analysis Unit Somalia

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Food Security and Nutrition Analysis Unit Somalia
Post Deyr 10/11
Information for Better Livelihoods
January 24th 2011
Integrated Nutrition Situation Analysis Hiran Lowe
r Shabelle Middle Shabelle Banadir
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Map SE Livelihood Zones
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Outcome indicators Middle Shabelle Agropastoral Livelihood Zone, Summary of Findings Middle Shabelle Agropastoral Livelihood Zone, Summary of Findings Middle Shabelle Agropastoral Livelihood Zone, Summary of Findings
Outcome indicators Deyr09/10 (N649) Gu10 (N212) Deyr 10/11 (N1650)
Child Nutrition status
GAM (WHZlt-2 or oedema) 12.5(9.8-15.2) gt6.2 (Pr0.9) but Adale 16.8
SAM (WHZlt-3 or oedema) 3.5 (2.2-4.9) gt 1.7 (Pr0.9) but Adale 2.4
Oedema 0.5 (0.0-1.0) 0.5 0.2
MUAC (lt12.5 cm or oedema) 8.5 (6.5-10.5) 7.1 (3.0 -11.2) gt 15 but poor quality data - R3)
MUAC (lt11.5 cm or oedema) gt 3 but poor quality data - R3
Stunting (HAZlt-2) 19.9(16.3-23.5) 18.9 (12.1-25.6)
HIS Nutrition Trends Low (lt10) stable trend (Jul-Dec09) Low (lt10) stable trend (Jan-Jun10) lower than 09 trends High (gt20) increasing trend (July-Dec10) higher than 09 trends
TFPs/SFPs Admission trends N/A N/A
Crude death Rate/10,000/day (90days) 0.93 (0.62-1.38) N/A
Under 5 death Rate/10,000/day (90days) 1.05 (0.47-2.33) N/A
OVERALL NUTRITION SITUATION Serious Alert but Critical for Adale deterioration
Child Morbidity, Immunization, IYCF
Disease Oubreaks Morbidity based on 2wk recall No outbreak Morbidity 43.3 No outbreak Morbidity 33.7 Outbreak AWD, measles and whooping cough in all the livelihood
Immunization status/Vit. A Measles 38.2 Vit. A 40.7 Measles 44.3 Vit. A 40.7
Children eating from lt4 fdgps
Children meeting min. feeding freq.
Public Health Indicators Gender N478 N116
Households (HH) accessing safe water 34.2 32.8
HH accessing sanitation facilities 26.0 30.0
HH accessing health facilities 47.7 -
Relation between GAM child sex Relation between GAM sex of hh head Insignificant Insignificant Insignificant Insignificant

Food Security Phase Proportion of hh consuming lt4 fd gps HE/AFLC AFLC/BFI HE/AFLC
Overall Risk to Deterioration POTENTIAL TO IMPROVE STABLE POTENTIAL TO DETERIORATE
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Outcome indicators Middle Shabelle Riverine Livelihood Zone, Summary of Findings Middle Shabelle Riverine Livelihood Zone, Summary of Findings Middle Shabelle Riverine Livelihood Zone, Summary of Findings
Outcome indicators Deyr09/10 (N640) Gu10 (N222) Deyr 10/11 (N1650)
Child Nutrition status
GAM (WHZlt-2 or oedema) 11.6 (7.7-15.4) gt8.2 (Pr0.9)
SAM (WHZlt-3 or oedema) 4.2 (2.7-5.8) gt 0.6 (Pr0.9)
Oedema 0.9 (0.0-1.9) 0.5 0.55.50.5
MUAC (lt12.5 cm or oedema) 11.7 (8.3-15.1) 8.6 (4.5 -12.6) gt 15 (but poor quality data - R3
MUAC (lt11.5 cm or oedema gt 3 (but poor quality data - R3
Stunting (HAZlt-2) 19.9(16.3-23.5) 17.6 (11.7-25.5)
HIS Nutrition Trends High (gt15) but stable trend (Jul-Dec09) High (gt20) stable trend (Jan-Jun10) higher than 09 trends High (gt15) stable trend July-Dec10) consistent with 09 trends
TFPs/SFPs Admission trends N/A N/A
Crude death Rate/10,000/day (90days) 0.61 (0.36-1.05) N/A
Under 5 death Rate/10,000/day (90days) 0.79 (0.38-1.67) N/A
OVERALL NUTRITION SITUATION Serious Alert deterioration
Child Morbidity, Immunization, IYCF
Disease Oubreaks Morbidity based on 2wk recall No outbreak Morbidity 42.3 Outbreak- AWD Morbidity 43.7 Outbreak AWD, measles and whooping cough in all the livelihoods
Immunization status/Vit. A Measles 54.7 Vit. A 49.2 Measles 57.2 Vit. A 51.8
Children eating from lt4 fdgps 29.3
Children meeting min. feeding freq. 32.9
Public Health Indicators Gender N434 N120
Households (HH) accessing safe water 51.6 25.0
HH accessing sanitation facilities 31.7 70.0
HH accessing health facilities 56.9 -
Relation between GAM child sex Relation between GAM sex of hh head Insignificant Insignificant Insignificant Insignificant

Food Security Phase Proportion of hh consuming lt4 fd gps AFLC CFI HE/AFLC
Overall Risk to Deterioration POTENTIAL TO IMPROVE STABLE POTENTIAL TO DETERIORATE
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Outcome indicators Afgoye IDPs, Summary of Findings Afgoye IDPs, Summary of Findings Afgoye IDPs, Summary of Findings
Outcome indicators Deyr09/10 (N734) Gu10 (N639) Deyr10/11 (N682)
Child Nutrition status
GAM (WHZlt-2 or oedema) 15.9 (11.7-20.2) 15.1 (11.4 19.8) 21.6 (18.2 -25.3)
Mean WHZ -0.37 -1.08 (1.12)
SAM (WHZlt-3 or oedema) 5.5 (2.7-8.2) 1.7 (1.0 3.0) 3.2 (2.2 -4.6)
Oedema 0.1 (0.0-0.4) 0.0 0.1
MUAC (lt12.5 cm or oedema) 11.2 (8.0-14.3) 7.2 (5.0 -9.4) 16.9 (12.4 _22.5)
Stunting (HAZlt-2) 27.5(21.6-33.4) 14.8 (104-20.7) 11.4 (8.7 14.9)
HIS Nutrition Trends High (gt10) stable(Jul-Dec09) N/A N/A
TFPs/SFPs Admission trends N/A N/A N/A
Crude death Rate/10,000/day (90days) 1.27 (0.79-2.04) 0.99 (0.71 1.37) 0.62 (0.26 -1.46)
Under 5 death Rate/10,000/day (90days) 2.32 (1.32-4.06) 1.40 (0.78 2.51) 1.44 (1.03 -2.0)
OVERALL NUTRITION SITUATION Critical Critical Very Critical
Child Morbidity, Immunization, IYCF
Disease Oubreaks Morbidity based on 2wk recall No outbreak Morbidity 47.4 No Outbreak- Morbidity 34.6 Outbreak of AWD and malaria Morbidity 43.8
Immunization status/Vit. A Measles 69.8 Vit. A 70.8 Measles 61.7 Vit A 59.2 Measles 75.5 Vit A 73.3
Children eating from lt4 fdgps 15.5 86.2
Children meeting min. feeding freq. 36.6 32.8
Public Health Indicators Gender N403 N383 N397
Households (HH) accessing safe water 98.3 83.2 96.0
HH accessing sanitation facilities 99.0 99.7 98.7
HH accessing health facilities 48.8 - -
Women Nutrition Status
Proportion with MUAClt18.5 cm (non pregnant and non lactating) 0.7 (N135)
Proportion with MUAClt23.0 cm (pregnant lactating) 5.1 (N253)
Gender Relation between GAM child sex Relation between GAM sex of hh head Insignificant Insignificant Insignificant Insignificant Insignificant Insignificant

Food Security Phase Proportion of hh consuming lt4 fd gps HE AFLC 10.1
OVERALL RISK TO DETERIORATION STABLE UNCERTAIN UNCERTAIN
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Outcome indicators Lower Shabelle Agropastoral Livelihood Zone, Summary of Findings Lower Shabelle Agropastoral Livelihood Zone, Summary of Findings Lower Shabelle Agropastoral Livelihood Zone, Summary of Findings
Outcome indicators Deyr 09/10 (N???) Gu 10 (N2200) Deyr 10/11 (N2200)
Child Nutrition status -
GAM (WHZlt-2 or oedema)
Mean WHZ -
SAM (WHZlt-3 or oedema) -
Oedema 0.1 (0.08 -1.02) 0.2
MUAC (lt12.5 cm or oedema) 8.7 (8.3-9.1) gt 15 but poor quality data - R3
MUAC (lt11.5 cm or oedema gt 3 but poor quality data - R3
Stunting (HAZlt-2) -
HIS Nutrition Trends Low (lt10) declining trend (Jul-Dec09) High (gt20) increasing trend (July-Dec10) higher than 09 trends
TFPs/SFPs Admission trends N/A
Crude death Rate/10,000/day (90days) N/A
Under 5 death Rate/10,000/day (90days) N/A
OVERALL NUTRITION SITUATION Serious deterioration
Child Morbidity, Immunization, IYCF
Disease Oubreaks Morbidity based on 2wk recall Outbreak localized AWD Morbidity Outbreak AWD, measles and whooping cough in all the livelihood
Immunization status/Vit. A Measles
Children eating from lt4 fdgps
Children meeting min. feeding freq.
Public Health Indicators Gender N
Households (HH) accessing safe water -
HH accessing sanitation facilities -
HH accessing health facilities -
Relation between GAM child sex Relation between GAM sex of hh head Insignificant Insignificant

Food Security Phase Proportion of hh consuming lt4 fd gps BFI BFI
Overall Risk to Deterioration STABLE POTENTIAL TO DETERIORATE
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Outcome indicators Lower Shabelle Riverine Livelihood Zone, Summary of Findings Lower Shabelle Riverine Livelihood Zone, Summary of Findings
Outcome indicators Gu 10 (N2200) Deyr 10/11 (N2200)
Child Nutrition status - -
GAM (WHZlt-2 or oedema) - -
Mean WHZ - -
SAM (WHZlt-3 or oedema) - -
Oedema 0.05 (0.04 -0.06) 0.3
MUAC (lt12.5 cm or oedema) 9.4 (9.2-9.6) gt 15 but poor quality data - R3
MUAC (lt11.5 cm or oedema gt 3 but poor quality data - R3
Stunting (HAZlt-2) -
HIS Nutrition Trends High (gt20) stable trend (Jan-Jun10) higher than 09 trends High (gt15) stable trend July-Dec10) consistent with 09 trends
TFPs/SFPs Admission trends N/A
Crude death Rate/10,000/day (90days) N/A
Under 5 death Rate/10,000/day (90days) N/A
OVERALL NUTRITION SITUATION Serious deterioration
Child Morbidity, Immunization, IYCF
Disease Oubreaks Morbidity based on 2wk recall Outbreak AWD, measles and whooping cough Morbidity Outbreak AWD, measles and whooping cough
Immunization status/Vit. A Measles

Food Security Phase Proportion of hh consuming lt4 fd gps BFI BFI
Overall Risk to Deterioration POTENTIAL TO IMPROVE POTENTIAL TO DETERIORATE
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Outcome indicators Hiran Pastoral Livelihood Zone, Summary of Findings Hiran Pastoral Livelihood Zone, Summary of Findings Hiran Pastoral Livelihood Zone, Summary of Findings
Outcome indicators Deyr09/10 (N695) Gu10 (N1100) Deyr 10/11 (N1100)
Child Nutrition status
GAM (WHZlt-2 or oedema) 21.2 (16.5-25.8) - -
SAM (WHZlt-3 or oedema) 5.3 (3.1-7.6) - -
Oedema 0.1 (0.0-0.4) 0.0 0
MUAC (lt12.5 cm or oedema) 5.1 (3.1-7.6) 15.4 (15.1-15.8) 14.7
MUAC (lt11.5 cm or Oedema) 3.7 (3.5 -3.9) 2.5
Stunting (HAZlt-2) 22.0(16.9-27.0) -
HIS Nutrition Trends High (gt15) stable trend (Jul-Dec09) High (gt10) stable trend (Jan-Jun10) lower than 09 trends Low(lt10) and stable due to closure of HFs in June10 therefore reduced numbers of children
TFPs/SFPs Admission trends High and increasing numbers High and increasing numbers in Mahas (upto 400) in Apr-Jun10
Crude death Rate/10,000/day (90days) 0.50 (0.27-0.95) N/A N/A
Under 5 death Rate/10,000/day (90days) 0.82 (0.40-0.67) N/A N/A
OVERALL NUTRITION SITUATION Very Critical Likely Very Critical Likely Critical
Child Morbidity, Immunization, IYCF
Disease Oubreaks Morbidity based on 2wk recall No outbreak Morbidity 51.4 RDT 4.9 Outbreak whooping cough in Mahas (30 cases with 4 deaths) and Mataban (40 cases) in Apr-Jun10 Morbidity Out breaks whooping cough in B/burti (Nov Dec)
Immunization status/Vit. A Measles 32.7 Vit. A 31.7 Measles ------- VitA ---------
Children eating from lt4 fdgps
Children meeting min. feeding freq.
Public Health Indicators Gender N403 N
Households (HH) accessing safe water 20.0 -
HH accessing sanitation facilities 18.1 -
HH accessing health facilities 47.7 -
Relation between GAM child sex Relation between GAM sex of hh head Insignificant Insignificant Insignificant Insignificant

Food Security Phase Proportion of hh consuming lt4 fd gps HE/AFLC 47.5 HE/AFLC HE/AFLC
Overall Risk to Deterioration STABLE STABLE POTENTIAL TO DETERIORATE
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Outcome indicators Hiran Agropastoral Livelihood Zone, Summary of Findings Hiran Agropastoral Livelihood Zone, Summary of Findings Hiran Agropastoral Livelihood Zone, Summary of Findings
Outcome indicators Deyr09/10 (N795) Gu10 (N1100) Deyr 10/11 (N1100)
Child Nutrition status
GAM (WHZlt-2 or oedema) 23.4 (19.0-27.8) - -
SAM (WHZlt-3 or oedema) 7.4 (3.9-10.9) - -
Oedema 0.0 0.1 0.1
MUAC (lt12.5 cm or oedema) 5.4 (2.5-8.3) 16.7 (16.4-17.0) 17.1
MUAC (lt11.5 cm or Oedema) 3.2 (3.0 -3.4) 2.9
Stunting (HAZlt-2) 21.7(17.1-26.4) -
HIS Nutrition Trends High (gt15) increasing trend (Jul-Dec09) High (gt10) stable trend (Jan-Jun10) High (gt10) stable trend (July -Dece10)
TFPs/SFPs Admission trends High and increasing numbers of admissions High and increasing numbers in the 3 districts (upto 1800) in Apr-Jun10
Crude death Rate/10,000/day (90days) 0.54 (0.36-0.82) N/A N/A
Under 5 death Rate/10,000/day (90days) 0.84 (0.32-2.17) N/A N/A
OVERALL NUTRITION SITUATION Very Critical Likely Very Critical Likely Very Critical
Child Morbidity, Immunization, IYCF
Disease Outbreaks Morbidity based on 2wk recall No outbreak Morbidity 51.4 RDT 4.9 Outbreak whooping cough in the three districts (604 cases) in Apr-Jun10 Morbidity Outbreak whooping cough in the three districts in Nov Dec 10
Immunization status/Vit. A Measles 32.7 Vit. A 31.7 Measles ------- VitA ---------
Children eating from lt4 fdgps
Children meeting min. feeding freq.
Public Health Indicators Gender N478 N
Households (HH) accessing safe water 18.3 -
HH accessing sanitation facilities 30.9 -
HH accessing health facilities - -
Relation between GAM child sex Relation between GAM sex of hh head Insignificant Insignificant Insignificant Insignificant

Food Security Phase Proportion of hh consuming lt4 fd gps HE/AFLC 52.6 HE/AFLC HE/AFLC
Overall Risk to Deterioration STABLE STABLE POTENTIAL TO DETERIORATE
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Outcome indicators Hiran Riverine Livelihood Zone, Summary of Findings Hiran Riverine Livelihood Zone, Summary of Findings Hiran Riverine Livelihood Zone, Summary of Findings
Outcome indicators Deyr09/10 (N197) Gu10 (N1760) Deyr 10/11 (N1100)
Child Nutrition status
GAM (WHZlt-2 or oedema) gt18.8 (pr 0.90) - -
SAM (WHZlt-3 or oedema) gt2.6 (pr 0.09) - -
Oedema 0.5 0.4 0
MUAC (lt12.5 cm or oedema) 10.1 (4.8-15.4 18.5 (18.2-18.8) 17.7
MUAC (lt11.5 cm or Oedema) 4.6 (4.4-4.8) 3.5
Stunting (HAZlt-2) 21.7(17.1-26.4) -
HIS Nutrition Trends High stable trend (Jul-Dec09) High (gt10) but declining trends in the last 3-4months trend (Jan-Jun10) High (gt10) but declining trends in the last 3-4months trend (July - Dece10
TFPs/SFPs Admission trends High and increasing numbers of admissions High and increasing numbers in the 3 districts (upto 1800) in Jan-Jun10
Crude death Rate/10,000/day (90days) N/A N/A N/A
Under 5 death Rate/10,000/day (90days) N/A N/A N/A
OVERALL NUTRITION SITUATION Critical Likely Very Critical Likely Very Critical
Child Morbidity, Immunization, IYCF
Disease Oubreaks Morbidity based on 2wk recall No outbreak Morbidity 60.9 RDT Outbreak whooping cough in the three districts (604 cases) in Apr-Jun10 Morbidity Outbreak whooping cough in the B/Burti districts in Nov Dec 10
Immunization status/Vit. A Measles 63.5 Vit. A 63.4 Measles ------- VitA ---------
Children eating from lt4 fdgps
Children meeting min. feeding freq.
Public Health Indicators Gender N434 N
Households (HH) accessing safe water 31.6 -
HH accessing sanitation facilities 43.5 -
HH accessing health facilities - -
Relation between GAM child sex Relation between GAM sex of hh head Insignificant Insignificant Insignificant Insignificant

Food Security Phase Proportion of hh consuming lt4 fd gps HE/ AFLC 43.0 HE HE
Overall Risk to Deterioration STABLE STABLE Potential to deteriorate
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Outcome indicators Mogadishu/ Banadir Region, Summary of Findings Mogadishu/ Banadir Region, Summary of Findings Mogadishu/ Banadir Region, Summary of Findings
Outcome indicators Deyr09/10 (N) Gu10 (N660) Deyr 10/11 (N1320)
Child Nutrition status
GAM (WHZlt-2 or oedema) - - -
SAM (WHZlt-3 or oedema) - - -
Oedema - 0.0
MUAC (lt12.5 cm or oedema) - 11.7 (6.7-16.6) gt 15 (29.2 R3)
MUAC (lt11.5 cm or Oedema) 0.3 (0.0-0.7) gt 3 (12.0 R3)
Stunting (HAZlt-2) - -
HIS Nutrition Trends Very high numbers (gt20) and stable in at least 6 months period in three MCHs Medina, Harmar Janjab and Hamar weyne (Source HIS data, Jul Dec09). Very high (gt20) and fluctuating trends in the last 6 months in Medina, Waberi, Hamar weyne and hamar Jabjab. Low levels (lt5) and stable trends in Zam zam (Jan-Jul10). Very high (gt20) and fluctuating trends in the last 6 months in Medina, Waberi, Hamar weyne and hamar Jabjab. Low levels (lt5) and stable trends in Zam zam (July-Dec10).
TFPs/SFPs Admission trends High and increasing numbers of admissions (in charge) in ACF managed centers (Hodan and Forlanini). Source ACF, Mogadishu Nov 2009) 1,200 new admissions reported in Mogadishu high SAM (34) and MAM (19.5) among the screened children increased death rates among U5s High and increasing numbers of admissions (in charge) in ACF managed centers (Hodan and Forlanini). Source Jul 2010) High and increasing numbers of admissions (in charge) in ACF managed centers (Hodan and Forlanini). Source Jul Dec 2010)
Crude death Rate/10,000/day (90days) N/A N/A
Under 5 death Rate/10,000/day (90days) N/A N/A
OVERALL NUTRITION SITUATION Likely Very Critical Likely Critical Likely Very Critical
Child Morbidity, Immunization, IYCF
Disease Oubreaks Morbidity based on 2wk recall No outbreak No outbreak Morbidity 17.9 (12.9-22.9) Out break AWD, cholera
Immunization status/Vit. A Measles ------- Vit A --------- Measles 80.2 VitA 88.0
Children eating from lt4 fdgps
Children meeting min. feeding freq.

Food Security Phase Proportion of hh consuming lt4 fd gps HE/ AFLC 43.0 HE HE
Overall Risk to Deterioration UNCERTAIN UNCERTAIN UNCERTAIN
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Key Driving Factors

• Aggravating factors
• Civil Insecurity
• Shabelle and Hiran are the most affected
  Mogadishu remains the epicentre.
• Limited humanitarian space
• - displacement associated with civil
  insecurity
• Disease Outbreaks AWD, cholera, malaria
• Taxation
• Limited access to health centres
• Limited medical supply in the area
• New IDPs
• Outbreak of AWD, Measles and malaria in M. L.
  Shabelle and Whooping cough /AWD in Hiran
• Mitigating Factors
• Limited access to SF programs
• Income from sale of fodder and some labour
  opportunities among the riverine
• Social support

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Nutrition Situation Estimates
Nutrition Situation Estimates, January 2011
Nutrition Situation Estimates, July 2010