There is need for continued provision of PPEs for health workers and community volunteers for service delivery at facility level and to strengthen community outreach services.
Nationally, the Severe Acute Malnutrition (SAM) Programme coverage is still low at 43 per cent compared to 70 per cent national target. The cure rate still at 65 per cent compared to the 75 per cent national target.
National estimated SAM prevalence is 1.5 per cent, with an estimated SAM burden of 133,902 children under age 5. Estimated SAM cases are 60,783 and 131,962 expected moderate acute malnutrition (MAM) cases. SAM patients are nine times more likely to die than well-nourished children.
There is need to increase health worker and volunteers capacity to provide SAM management and IYCF counselling on prevention and treatment interventions at facility and community levels. Currently, less than 50 per cent are trained against a target of 80 per cent.
There is need to scale up promotion and protection of the key recommendations for infant feeding and protecting breastfeeding in the context of COVID-19.
Support to Ministry of Health in rolling out IMAM programme in drought and COVID-19-affected districts.
NGOs coordinating with MoH supported the distribution of RUTF from district level to various health facilities that needed replenishment and pre-positioning ahead of the rainy season.
Of the 24,871 children targeted, 8,521 children aged 6 to 59 months with severe acute malnutrition were treated with a cure rate of 64 per cent, mortality rate of 6 per cent and defaulter rate of 12 per cent. A total of 4,153 children with moderate acute malnutrition were also admitted and treated.
Orientation on monitoring and evaluation was conducted in central province targeting 20 MoH data staff. Support on data quality was offered to Lusaka district for nutrition data management to increase reporting rate and quality.
Infant and Young Child Feeding (IYCF) capacity building was conducted for 486 community health workers (198 females and 288 males in Chilombo, Chisamba, Kaphiri and Serenje Districts of Central Province, Nyimba, Katete, Petauke, and Mambwe districts of Eastern Province
IYCF sessions(messages) and cooking demonstrations were conducted, reaching out to 20 OTP sites in Eastern Province (5 in Katete, 5 in Nyimba, 5 in Petauke and 5 in Mambwe ). Total number of participants reached were: 78 men, 450 women, 102 boys and 153 girls, bringing the total reach to 783. One cooking demonstration was conducted at Chibombo Rural Health Centre reaching a total of 26 mothers in Chibombo district of Central province. IYCF counseling and cooking demonstrations benefited pregnant and lactating women and care givers in Samfya reaching a total of 140 (79 females and 10 males, Chiengi 48 females and 3 males). COVID19 awareness sessions were included during the IYCF and cooking demonstration sessions.
Monthly nutrition programme review meetings with community health workers held in Central and Eastern provinces reaching out to 196 males and 131 females’ with a total reach 327.
About 245 community health workers were oriented in active case finding in three districts; Chiengi, Lunga and Samfya districts of Luapula Province.
Six districts (Mongu, Kalabo, Limulunga, Sikongo, Nalolo and Senanga) in Western Province were supported by MoH and People in Need (PIN) NGO and provided IMAM services and SAM treatment in 74 health facilities and 3 other facilities were supported by Kalabo DHO.
The Sector facilitated trainings on Integrated Management of Acute Malnutrition (IMAM) and Infant and Young Child Feeding (IYCF) in 14 districts from the provinces of Southern, Eastern, Western, Lusaka, where 330 health facility workers were trained in. 808 community health volunteers were trained in Integrated IMAM and IYCF.
Sector partners delivered 908 boxes of RUTF across the 14 districts to the IMAM program. The response also supported the distribution and preposition of RUTF in the various health facilities that needed replenishment.
The Sector delivered COVID-19 PPEs to various districts and the districts have allocated and distributed the items to health facilities. The COVID-19 PPEs delivered to the health facilities include: 2,810 face shield, 843 hand sanitizers, 843 liquid soap, 281,000 gloves, 112,400 non-medical masks, 2,810 aprons and 1,405 protective gowns. The items procured but to be delivered in November include 281 handwashing stations and 281 thermometers.
Only 58 districts have consistent stocks of RUTF with the rest of the country without RUTF to manage SAM children. Nationally, more than 50 per cent of facilities are without therapeutic feeds due to funding constraints.
In the context of COVID-19, inaccessibility due to bad terrain and roads and low community outreach services, not all beneficiaries can be reached. There is need to consider programme adaptations e.g Family MUAC for early identification and self-referrals of wasted children if funds are availed.
Most of the 58 drought-prone districts have poor network and accessibility to some facilities affecting efficient distribution of supplies and timeliness of report submission. Poor terrain, areas in islands and long distances pose a significant challenge especially in Western province increasing the costs of the programme.
Very few or no livelihood, WASH or school feeding activities taking place in the catchment areas of health facilities, which would complement the IMAM programme.
The current nutrition project budget is limited and not enough to cover 100 per cent capacity building for health workers and volunteers in the target districts and only 55 per cent coverage of health facilities in six districts in western province targeted by People in Need. There is need to increase to 100 per cent coverage to reach all health facilities and communities in target districts.
Lack of new SOPs for COVID-19 at health facility level, leading to non-implementation of the new COVID-19 SOPs at health facility level.