According to the IPC Acute Malnutrition (IPC AMN) analysis conducted by the Nutrition Sector in February 2020, the nutrition situation in Yobe and Borno states for the period between January and April 2020 is at phase 3 (serious). This marks a deterioration in the nutrition situation as compared to the period between September and December 2019 which was in phase 2 (alert). The nutrition situation in Adamawa State is expected to remain stable in phase 2 (alert). The deterioration is attributed to increased food insecurity due to poor harvest and poor infant and young child feeding practices including exclusive breastfeeding.
In the months of March and April, the nutritional situation in Adamawa, Borno and Yobe states remained poor but stable compared to the previous months. During the reporting period, the provision of nutrition services was disrupted due to the COVID-19 pandemic, especially due to the movement restrictions imposed. The Nutrition Sector partners focused on adapting the nutrition interventions to the context of COVID-19 to ensure both the service providers and beneficiaries are protected.
In March, the Nutrition Sector finalized the development of its three-year “Strategy and Response Plan” and its operational plan. In response to the COVID-19 pandemic, the Nutrition Sector partners adapted the “Mother Mid-Upper Arm Circumference (MUAC)” approach, in which mothers or caregivers screen their own children for acute malnutrition by measuring their mid-upper arm circumference. To support the scale-up of this approach, partners distributed over 300,000 MUAC measuring tapes to households, and trained over 2,500 community health workers on the approach to roll out in their villages and communities.
In March and April, Nutrition Sector partners collectively screened over one million children, pregnant and breastfeeding women for acute malnutrition. A total of 30,714 severely malnourished children were admitted for treatment into the outpatient therapeutic programme (OTP) and 1,593 into the stabilization centres for inpatient intensive care. The number of admissions in April was slightly lower than expected due to COVID-19 movement restrictions in Maiduguri, Jere, Mafa and Konduga LGAs (Borno State). In 2020, a total of 61,326 severely malnourished children have been admitted for treatment, representing approximately 31 per cent of the annual target, well within the expected trend.
Between January and April, Nutrition Sector partners admitted a total of 819 children under six months with acute malnutrition and/or having difficulties breastfeeding into stabilization centres for re-lactation and rehabilitation. Over 96 per cent of all severely malnourished children have been successfully treated and discharged as cured.
In March and April, partners provided specialized supplementary foods to 180,341 children between the ages of six and 23 months and 6,012 children between 24 and 59 months with moderate acute malnutrition through the blanket supplementary feeding programme (BSFP) to prevent and treat moderate acute malnutrition. The BSFP aims to improve generic food rations, particularly for households who rely on general food assistance.
In selected LGAs in Yobe and Borno a total of 5,017 children of ages six to 59 months with moderate acute malnutrition received intensive care through the targeted supplementary feeding programme (TSFP) by providing specialized supplementary foods (super cereal) or locally formulated supplementary foods (Tom Brown). Over 98 per cent of those in the programme were discharged cured in the month of April.
To prevent acute malnutrition among the pregnant and breastfeeding women, Nutrition Sector partners reached 82,109 in March and April mainly in IDP camps, but also in communities with returnees and host populations who are directly affected by conflict.
To prevent overall malnutrition, the Nutrition Sector partners promoted appropriate infant and young child feeding and caring practices (IYCF) through various channels including counselling at health facilities and care support groups. In March and April 2020, a total of 234,412 caregivers of children ages six to 23 months and pregnant women received counselling in IYCF at health facilities. At the community level, a total of 10,000 mother-to-mother care groups met reaching over 285,080 women and 2,000 father-to-father support groups reaching over 10,000 fathers and other men with IYCF messages. In April, the Care Support Groups activity level reduced as a result of the COVID-19 requirement to maintain physical distance and avoiding group gatherings.
To prevent micronutrient deficiencies in the community, a total of 35,695 children between ages six to 23 months received multi-micronutrient supplement powder either for the first time or during repeated visits.
The main challenges and gaps facing Nutrition Sector partners are related to the disruption of services due to insecurity especially in Gubio, Mafa and Magumeri LGAs (Borno State) and the emerging threat of the COVID-19 pandemic. COVID-19 related challenges include inadequate supply of personal protective equipment (PPE) and disinfectant supplies, a reduced number of health workers at health facilities, and inadequate MUAC measuring tapes to optimally scale-up Mother MUAC approach.
In response to the COVID-19 pandemic, the Nutrition Sector will continue adapting nutrition interventions to COVID-19 and implementing mitigation measures to reduce exposure to and spread of the disease. This will include development of the Nutrition Sector’s COVID-19 Strategy and Response Plan and developing guidelines for adaptation of nutrition programmes in the context of COVID, as well as incorporating the lessons learned and best practices. The Sector will also establish a COVID-19 Nutrition technical working group in June to guide the implementation and monitoring of programmatic measures to reduce nutrition-related mortality and morbidity as a result of the COVID-19 impact on public health, economy and social aspects.
The Nutrition Sector will continue to work closely with the Health, Food Security, Child Protection and WASH sectors to ensure that the needs of children, as well as pregnant and breastfeeding mothers - especially those in temporary isolation centres - are comprehensively addressed. The Sector will also continue to lobby for more funds allocated to the Mother MUAC approach, to ensure that all households have the capacity to monitor the nutrition status of children under five during the pandemic period.
The Nutrition sector partners will increasingly preposition essential supplies in anticipation of a higher number of malnutrition cases as a result of the socio-economic impact of COVID-19 and the looming rainy season during which cases of severe acute malnutrition are highest.