According to the July 2020 Zimbabwe Vulnerability Assessment Committee (ZIMVAC) rural assessment, global acute malnutrition (GAM) prevalence has increased from 3.6 per cent to 3.8 per cent (based on MUAC assessment).
The nutrition status of children in Zimbabwe has shown deterioration with the minimum acceptable diet in young children having gone down to a record low at 2.1 per cent, which was a decline from 6.9 per cent recorded in 2019 according to the latest ZimVAC assessment.
Nationally, there was a decrease in households consuming diets with acceptable dietary diversity. Matabeleland North (35 per cent) and Masvingo (27.5 per cent) had the highest proportion of households that were consuming diets with low dietary diversity.
According to the latest ZimVAC, at least 56.2 per cent of the rural households are food (cereal) insecure, whilst there was a signiﬁcant drop in the proportion of women of childbearing age consuming minimum dietary diversity (43 per cent in 2019 to 19 per cent in 2020). Food insecure households were more susceptible to COVID-19 shocks as a result of reduced incomes brought about by the depressed economic activity. The report also shows low proportions of women of childbearing age consuming iron-rich food. Bulilima (3 per cent), Masvingo (5 per cent) and Bindura (5 per cent) had the least proportion of women consuming iron-rich foods.
The number of pellagra cases reported has continue to be higher than in the previous year. As per routine data, the number of pellagra cases was 195 in October, down from 342 in September 2020. A total of 2,007 pellagra cases were recorded between January and October 2020, compared to the 1,250 cases over the same period last year (DHIS2, Oct 2020). The numbers of pellagra cases are likely to continue to increase as food insecurity in the country deepens and household income for accessing diversiﬁed diets continues to be depleted by the impact of COVID-19 lockdown and economic crisis.
Completing its needs analysis for the 2021 Humanitarian Response Plan (HRP) the Nutrition Cluster estimates that approximately 74,267 children under age 5 years are affected by wasting or global acute malnutrition (GAM) with at least 38,425 of these being affected by severe acute malnutrition (SAM).
The Nutrition Cluster is working on its cluster response plan for the 2021 HRP whilst continuing with treatment of child wasting as the most critical life-saving intervention for the nutrition humanitarian response. Active screening of children under age 5 for wasting has continued in the current COVID-19 lockdown following adoption of family and mother-led mid-upper arm circumference (MUAC) screeening which aims at limiting the risk of infection by community health workers involved in screening and yet providing the much needed early identiﬁcation and referral of children with wasting to health facilities to access treatment for acute malnutrition.
In the 25 priority districts, 88,056 children were screened for acute malnutrition at health facilities from 26 October to 22 November, with a total of 367 being admitted for SAM during the same period. At total of 439,706 children were screened in the community by village health workers and caregivers/mothers during the same period. Nationally, 16,127 children were admitted for treatment of SAM between January and October 2020.
A total of 25,145 village health workers are actively reporting.
Promotion of appropriate IYCF and care practices in the context of the COVID-19 emergency is ongoing with support of nutrition partners, namely ADRA, GOAL, Save the Children, Nutrition Action Zimbabwe (NAZ), Organization for Public Health Interventions & Development (OPHID) and World Vision with a total of 253,241 mothers and caregivers of children under age 2 supported with IYCF messages at the community level whilst 73,993 were reached at health facility level during the month.
A total of 67,060 children received Vitamin A supplementation during the reporting period.
UNICEF supported procurement of nicotinamide for the treatment of pellagra which is in-country. Health workers are currently being sensitized to identify pellagra cases for treatment, particularly in the peri-urban areas
The Nutrition Cluster funding for the 2020 HRP response activities has remained at $3.6 million against the $24.6 million required.
A higher number of health facilities reported stock outs of Ready-to-Use Therapeutic Food (RUTF) during the week 16-22 November compared to previous week, with 52 health facilities reporting stock outs of RUTF.
Generally lower numbers of children have been reached with vitamin A supplementation (VAS) in 2020 compared to the past two years, partly due to the disrupted health delivery system due to COVID-19 .
High integrated management of acute malnutrition (IMAM) defaulter rates are affecting treatment outcomes, compounded by the food insecurity situation, with some of the children that are being discharged as cured relapsing back into the program within a short period.
The routine health management information systems (HMIS) weekly reporting and verification of RapidPro data needs to be strengthened to improve quality of data and reduce variations in figures reported by routine systems.
Network challenges are affecting completeness of RapidPro reporting.
Data collection and reporting in urban and peri-urban areas is inconsistent with mostly incomplete malnutrition data, hence masking the real situation on the ground. However, due to deteriorating economic status and poor water and sanitation, data shows that there are likely to be many malnourished children. Nutrition programming in the urban and peri-urban areas is limited, yet there are highly vulnerable population groups due to the deteriorating socio-economic situation compounded by COVID-19 related movement restrictions and economic activity lockdowns.