According to Integrated Phase Classification for Acute Malnutrition (IPC AMN) conducted in August 2020, nutrition situation largely remained within the same phase across counties compared to the 2019 short rain assessment conducted in February 2020, with major improvement observed compared to the same period last year. The stable nutrition situation is mainly attributed to a stable food security situation characterized by improved milk availability and access as livestock largely remained within the counties and near the households. This is due to favourable forage condition and availability of water for livestock and availability of food stock at household level in the cropping areas, following good rainfall performance .
Despite the seeming stable nutrition situation, malnutrition levels remain unacceptably high in the arid counties with serious to critical levels of malnutrition reported. Approximately 531,005 children (boys and girls) with acute malnutrition; 98,390 pregnant and lactating women and 84,000 older persons need services related to treatment of acute malnutrition. This is attributed to poor infant and young child feeding practices, stock-out of essential supplies for management of acute malnutrition and morbidities, coupled with multiple shocks, which have slowed down recovery from the 2019 drought such as floods reported during the 2019 short rains and the 2020 long rains leading to loss of lives and livelihoods, resource based conflict and locusts invasion reported since December 2019. The nutrition situation is projected to remain in the same phase between September and November 2020.
The sector has continued to work to provide access to integrated health and nutrition services. To this end, as at close of August 2020, a total of 36,497 and 68,056 children requiring treatment of acute malnutrition had been admitted to the Therapeutic Feeding Program and Supplementary Feeding Programs respectively.
On the maternal infant and young child nutrition programme, a total of 1,031,071 primary caregivers of children aged 0-23 months have received IYCF counselling from January to August 2020. While the trends indicate a decline compared to 2019 and previous years, there is a slight improvement in the number of clients seeking care that is attributed to improved availability of supplies (therapeutic supplies) at the facility level as well as sustained communication and social mobilization to counter COVID-19 related fears.
Stock outs of ready-to-use therapeutic food (RUTF) significantly reduced with the rates in August 2020 recorded as 1 per cent compared to 20 per cent in February 2020 or Vitamin A supplementation (VAS), a reduction was noted in the numbers reached in the month of August which is attributed to the decreased intensity of the community strategy approach which was accelerated in the months of June and July as part of the VAS catch up following and also in alignment with the bi annual Malezi bora annual campaign.
A deep dive into the Integrated management of acute malnutrition (IMAM) was done with a section of county teams in a bid to understand the trends and factors contributing to low admissions. The key drivers identified include significant scale down or suspension of outreaches attributed to funding gap and COVID-19 infection prevention control (IPC) measures, improved nutrition situation across the ASAL counties, stock out of Ready-to-Use Therapeutic Foods (RUTF) of above 14 per cent from January to June 2020 and COVID-19 related fears (based on qualitative data from interviews in LRA 2020) there is still continuous analysis to ensure the sector responses are able to address the fundamental challenges to access in addition to reviewing success of programme adaptations like the use of Family MUAC.
In the month, a total of 6,734 care givers from the counties of Turkana, Marsabit, Kilifi, Isiolo, Tana River & Kisumu and from the NDMA Sentinel sites were reached through the approach and are considered capable to screen and refer their own children based on the screening outcomes.
The sector has supported the development of Information, education and communication materials inclusive of posters, fliers, guidance notes and animation on breastfeeding, complementary feeding, maternal nutrition, health diets and physical activities as part of COVID-19 response. A total of 7,450 maternal, infant and young child nutrition (MIYCN) counselling cards were distributed to the counties. As part of marking the world breastfeeding week, 47-county nutrition and public health coordinators were engaged in promoting, protection and support for breastfeeding during the COVID-19 pandemic and beyond.
Over the reporting period, a scoping mission was undertaken in Mombasa to explore possibility of extending MAM programming in Mombasa County. Mombasa is being considered since it is one of the COVID-19 affected counties, necessitating need to target high risk groups who include malnourished children aged between 6-59 months, pregnant and lactating women with a child less than six months, and the elderly. Support to the Nairobi Metropolitan Service, for the MAM programme is in its second month of actual distribution to the eligible clients.
The sector continued with efforts to integrate nutrition education in fisheries and aquaculture programmes. The nutrition sensitive programme focused on promoting consumption of fish, safe fish handling, preservation and preparation. The efforts targeted Government staff, traders and fish farmers from Kirinyaga, Nyeri, Meru, Homabay, Migori, Vihiga and Kakamega counties.
All patients in isolation facilities and those in quarantine centres are provided with meals.
Inadequate PPE to cover nutrition workforce in the counties as well as the community health volunteers.
Seeming reduction in COVID-19 cases “flattening of the curve” that could result in increased spread if IPC measures are not adhered to further. An increase would potentially overwhelm health facilities and trigger a second round of effects.
Increasing threat to service provision through health workers industrial action. In Nairobi, a strike by health workers paralyzed facilities for a week which further affected access to the lifesaving services.
Inadequate funds and commodities to facilitate the scale up of IMAM especially in the non ASAL counties and to cover refugee operations fully remains a challenge.