The nutrition situation in the BAY states significantly deteriorated in September with increased rates of acute malnutrition attributed to the reduced access to food during the ongoing lean season (increased food prices, low harvest) and disease outbreak. Continued insecurity also generated disruption of health and nutrition services and new population displacements.
The number of severely acutely malnourished children admitted into the nutrition treatment programme continues to be high compared to September 2019. The number of children with severe acute malnutrition admitted into the treatment programs increased by 30% in September compared to August, clearly indicating a seasonal period of high prevalence of malnutrition lasting longer than in previous years.
To address the continued increase in acute malnutrition rates, the Nutrition sector requires additional resources including Ready-to-use Therapeutic Food (RUTF), supplementary foods to expand MAM treatment, and funding to expand the stabilization centres capacities. The sector also requires MUAC tapes to scale-up the family/mother MUAC approach to ensure households are empowered to monitor the nutritional status of their children. The sector will also require resources to strengthen the existing surveillance system and monitor the nutrition situation.
In particular, the sector requires additional resources to establish temporary stabilizations centres and mobile outpatient therapeutic programmes in areas affected by insecurity, including Magumeri, Gubio and Mobbar LGAs.
In September 2020, Nutrition sector partners admitted 28,723 severely malnourished children into the treatment programs. The total number of severely malnourished children admitted up to September 2020 is approximately 70% of the annual target. Over 90 per cent of all children in the outpatient therapeutic programmes and stabilisation centers (SCs) were successful treated and discharged as cured. However, approximately 4% of the children admitted in the SCs died. The major cause of mortality is attributed to caregivers seeking health and nutrition treatment only when their children are presenting advanced poor nutritional status and medical complications. The delay in seeking treatment is often due to use of traditional herbal concoctions and the lack of nutrition services in areas affected by insecurity. Three children have died every day in the BAY states on average since the beginning of the year.
To prevent and treat moderate acute malnutrition (MAM), Sector partners reached approximately 105,000 children between six and 23 months and 55,000 pregnant and breastfeeding women from food insecure households through the blanket supplementary feeding programme (BSFP). In addition, an average of 4,631 children between 24 and 59 months with MAM were also included in the BSFP.
In September, partners reached a monthly average of 8,000 children ages six to 59 months with MAM through the facility-based targeted supplementary feeding programme (TSFP) in selected communities in Jere and Kaga LGAs in Borno State and 10 LGAs in Yobe State. The number of MAM admitted into the TSFP increased by 40% compared to previous months clearly indicating deterioration of the nutritional status of the children in the targeted areas.
To prevent micronutrient deficiencies among children from six to 23 months, Sector partners reached 42,106 children with micronutrient supplementation powders (MNP).
To promote the prevention of acute malnutrition, Nutrition Sector partners provided infant and young child feeding (IYCF) counselling to 77,029 caregivers and 18,799 pregnant women at health facilities. The number of caregivers and pregnant women reached increased compared to the past few months as community members have resumed utilising health and nutrition services that were disrupted by COVID-19 pandemic.
The main challenge facing the Nutrition sector is the lack of capacity to effectively respond to sudden onset emergencies due to escalating insecurity. Insecurity has resulted in disruptions of nutrition services in places including Gubio, Magumeri, Mafa, and Mobbar LGAs in Borno State and in Geidam and Gujba LGAs in Yobe State.
The prolonged lean season had added pressure on the low stabilization centres capacities to cope with the increased rates of SAM cases with medical complications who require intensive medical care and increased mortality rate. The Sector requires additional resources to increase the coverage of SCs in Yobe and Adamawa states and to establish temporary SCs in partially accessible areas like Magumeri and Gubio LGAs.
There is a growing number of under-nourished and separated infants as a result of the COVID-19 pandemic, increased population displacement and armed conflict. Prevention and management of wasting among infants, particularly for the non-breastfed, is a highly technical and resource-demanding initiative which the north-east is lacking at the moment.
The Sector is currently developing the guidance, but significant resources are required to scale-up the identification and treatment of children under 6 months.
The increased malnutrition rates require the Sector to increase its surveillance and early warning mechanism capacity to ensure that the nutritional situation is closely monitored, and effective response put in place to prevent further deterioration.