Zimbabwe

Situation Report

Cluster Status

Nutrition

606K
people targeted
544,143
children screened in 25 districts in July

Needs

  • An estimated 95,000 children under age 5 are at risk of wasting. According to the February 2020 Zimbabwe Vulnerability Assessment Committee (ZIMVAC) rapid assessment, global acute malnutrition (GAM) prevalence has increased from the 3.6 per cent (ZimVAC rural 2019) to 3.7 per cent at national level with the drought prone provinces of Masvingo and Matabeleland North and South most affected.. The country has seen pockets of increased cases of malnutrition particularly in Epworth ,Gutu , Binga, Hwange and Mutare urban and rural districts. The hot spots remain a concern and are closely monitored. Of particular concern is an expected increase in child malnutrition, including wasting, due to steep declines in household incomes, changes in the availability and affordability of nutritious foods, and interruptions to health, nutrition, and social protection services resulting from the impact of the COVID-19 lockdown. According to recent global estimates, the current situation would lead to an additional 14,250 children being malnourished in Zimbabwe due to increased food insecurity.

  • The nutrition status of children in Zimbabwe is further compounded by already existing sub-optimal infant and young child feeding practices including very poor dietary diversity at 15 per cent and with only 7 per cent having attained the minimum acceptable diet.

  • The number of pellagra cases reported has continued to increase in Zimbabwe. As per routine data, 1,258 pellagra cases were recorded between January to July 2020, which is double compared to the 667 cases over the same period last year (DHIS2, Aug 2020). Following increases from 88 pellagra cases in March to 141 cases in April, 224 in May and 248 in June, 169 cases were reported for July 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.

  • Due to the drought-induced food insecurity, the majority of the households in the country require food assistance to facilitate adequate dietary intake and prevent deterioration of the nutrition status of children, women and other vulnerable groups like the disabled. Already nationally 56 per cent of women consume less than five groups of recommended foods

Response

  • The Nutrition Cluster has recommended 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) 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 too health facilities to access treatment of acute malnutrition. In the first 2 weeks of August 2020, 233,688 children were screened for acute malnutrition with 88 per cent of the children being screened at community level in the 25 nutrition priority districts. Of the children screened in the first 2 weeks of August, 281 were admitted for treatment of moderate acute malnutrition (MAM) and 121 were admitted for treatment of severe acute malnutrition (SAM). Nationally, 11,697 children were admitted for treatment of SAM between January and July 2020. The decline in numbers of children admitted for treatment of acute malnutrition that was recorded in April has since improved with 1,643 children being admitted in May compared to 1,168 the previous month of April. In June and July, the numbers of children admitted were 1,556 and 1,302 consecutively showing a similar trend to what was seen in the past 3 years which is experienced after the harvest season. The Nutrition Cluster is prioritizing the improvement of the quality of care provided in the Outpatient Therapeutic Programme (OTP) and inpatient stabilization centres owing to the continuous mentorship and capacity building of health workers.

  • Approximately 5,175 village health workers were trained on active screening and this has resulted in increased admission and treatment of children with acute malnutrition. Additionally, 1,247 health-care workers have been trained on integrated management of acute malnutrition (IMAM) in April, May and June 2020 resulting in improved quality of care for malnourished children. Also, 217 lead mothers were trained on infant and young child feeding (IYCF) in Chiredzi increasing the number of community volunteers leading mother care groups. More health care workers and community health workers are still being capacitated to support the emergency response. ,The Pediatric Association of Zimbabwe (PAZ) is developing remote training materials aiming at strengthening the capacity of health workers and clinicians working in hard to reach areas through the e-learning platform.

  • 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. In the first 2 weeks of August 2020, 133,580 pregnant and lactating women and caregivers of children under age 2 were reached with counselling support and an estimated 2 million people have been reached through the nine episodes of the radio show “Live Well: The Health and Nutrition Show” on topics related to nutrition, health and HIV in the context of COVID-19.

  • The micronutrient supplementation of Vitamin A reached 640,445 children from 6-59 months (65 per cent of the cluster target on Vitamin A supplementation) for 2020. Vitamin A coverage had dropped by 50 per cent in April due to the disruption is services delivery following the COVID-19 lockdown which restricted movement of mothers and children and most were not able to go to health facilities for fear of COVID19 infections. In May, June and July however with the relaxing of lockdown conditions, a continuous improvement was noticed with 97,067 children having received Vitamin A in June and 88,403 children in July. Vitamin A supplementation continues both at health facility and community levels through village health workers.

  • The RapidPro SMS reporting, an innovation of UNICEF in conjunction with the MoHCC was initiated in April 2020 and is operational in 25 targeted districts and two acute malnutrition hotspots with districts reporting on weekly basis on seven high frequency nutrition indicators.

  • Following, the ZIMVAC 2020 seasonal assessment, with field data collection across both urban and rural settings conducted during the period 10 to 21 July, with the aim of measuring food and nutrition security situation and the socio- economic impact of COVID-19. Data analysis and report writing will be completed by end of September and the report shared with all stakeholders.

  • The Ministry of Health and Child Care, together with partners WFP, UNICEF, UNAIDS and ILO, continues strengthening integration and dissemination of health and nutrition messages to the general public using a coordinated approach.

  • WFP in collaboration with UNICEF and MoHCC continued providing the emergency response for screening.The Preventive rations will be discontinued from July 2020 until next lean season.

Gaps

  • The Nutrition cluster HRP 2020 response activities have only been funded with $3.5 million against the $18.8 million required.

  • There is a knowledge gap in the context of COVID-19 pandemic and in nutritional messages or information to the community and health workers and partners continue to support capacity building.

  • Lack of personal protective equipment (PPE) for the community volunteers and supervisors implementing nutrition in emergencies life-saving activities is still posing a challenge for the implementation of the nutrition lifesaving interventions. The market demand for PPE is much more than the supply and UNICEF continues to follow-up on supplies ordered.

  • Due to the high demand of MUAC tapes for family-led MUAC, some mothers have not yet received MUAC tapes which is hindering the progress of the programme. More MUAC tapes have been ordered. General lack of transport, travel and movement restrictions, fear of contracting COVID-19 infections, and prioritization of emergency life- saving interventions over routine critical nutrition services have increased the risk of eroding the gains made over the years.

  • The Nutrition cluster HRP 2020 response activities have only been funded with $3.5 million against the $18.8 million required. There is a knowledge gap in the context of COVID-19 pandemic and in nutritional messages or information to the community and health workers.

  • Lack of personal protective equipment (PPE) for the community volunteers and supervisors implementing nutrition in emergencies life-saving activities is still posing a challenge for the implementation of the nutrition lifesaving interventions.

  • Due to the high demand of MUAC tapes for family-led MUAC, some mothers have not yet received MUAC tapes which is hindering the progress of the programme.

  • General lack of transport, travel and movement restrictions, fear of contracting COVID-19 infections, and prioritization of emergency life- saving interventions over routine critical nutrition services have increased the risk of eroding the gains made over the years.

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