Approximately 95,000 children under age 5 are suffering from acute malnutrition, with a national global acute malnutrition (GAM) prevalence at 3.6 per cent (ZimVAC rural 2019). Eight districts recorded GAM prevalence of over 5 per cent. Since early April and the beginning of the harvesting season, the country overall has not experienced a nationwide increase in malnutrition. However, pockets of increased cases of malnutrition particularly in Epworth and Gutu and Mutare districts remain a concern and are closely monitored. Further cases of acute malnutrition are expected to start increasing from the month of June onwards. A major concern is the potential impact of disruption of services due to COVID-19 on malnutrition which would translate into a 10 to 50 per cent increase of acute malnutrition in the worst-case scenario (equivalent to 9,500 to 47,500 children).
The nutrition status of children in Zimbabwe is further compounded by 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 has continued to increase in Zimbabwe. As per routine data, 747 pellagra cases were recorded between January to April 2020, which is doubled when compared to the 336 over the same time last year.
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 the general community. Already nationally 56 per cent of women consume less than ﬁve groups of foods recommended.
Treatment of acute malnutrition, a very critical life-saving activity, has been prioritized by the Nutrition Cluster. Screening of acute malnutrition has continued in the current COVID-19 lockdown following adoption of mother led mid-upper arm circumference (MUAC) aiming at limiting the risk of infection by community health workers involved in screening. In the first week of June 2020, 82,391 children were screened for acute malnutrition with 93 per cent being screened at community level in 25 nutrition priority districts. Of those screened between 1-7June, 40 were admitted for treatment of moderate acute malnutrition (MAM) and 32 were admitted for treatment of severe acute malnutrition (SAM). Nationally, 7,982 children were admitted for treatment of SAM between January and May 2020. An unexpected decrease of admission of children for treatment of acute malnutrition that was recorded in April has sustained into May with 1,227 children being admitted in May compared to 1,842 in March. This can be explained by the disruption in services due to the COVID-19crisis and seasonal variation due to the recent harvest.
The Nutrition Cluster is prioritizing the improvement of the quality of care provided in the Outpatient Therapeutic Programme (OTP) and in stabilization centres. Continuous capacity building of health workers is being done. 4,960 village health workers were capacitated on active screening and 1,135 health care workers were trained on integrated management of acute malnutrition (IMAM) in April and May 2020. Implementation modalities adjustment are progressively rolled-out to ensure infection prevention and control. Speciﬁcally, the Paediatric Association of Zimbabwe (PAZ) is developing remote training materials aiming at strengthening the capacity of health workers and clinicians through the e-learning platform.
Promotion of appropriate infant and young child feeding (IYCF) and care practices in the emergency context is ongoing with support of nutrition partners ADRA, GOAL, Save the Children, Nutrition Action Zimbabwe (NAZ), Organization for Public Health Interventions & Development (OPHID, Plan International and World Vision. Since early May, 287,787 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 362,263 children from 6-59 months (36 per cent of the cluster target on Vitamin A supplementation). Vitamin A coverage dropped by about 50 per cent due to the disruption is services delivery following the lockdown as a response to the COVID-19. In April, 52,379 children received vitamin A compared to the preceding months (107,491 in March 100,120 in February and 102,273 in January).
The RapidPro SMS reporting, an innovation of UNICEF in conjunction with the MoHCC, is operational with 24 districts reporting on weekly basis on nine high frequency nutrition indicators.
Elaboration of the ZIMVAC seasonal assessment is at planning stage for collection and analysis of data across both urban and rural settings with the aim of measuring food and nutrition security situation and the socio-economic impact of COVID-19.
Partners have supported the MoHCC on the movement of nutrition commodities and distribution of MUAC tapes for the mother-led screening for acute malnutrition changed approach in the context of COVID-19, which has been realized along with the COVID-19 sensitization sessions.
The Ministry of Health and Child Care, together with partners WFP, UNICEF, UNAIDS and ILO, is planning a better integration and dissemination of health and nutrition messaging to the general public using a coordinated approach. WFP in collaboration with the Ministry of Health, UNICEF and ILO is developing and disseminating social and behavioural change communication (SBCC) messaging on HIV and COVID-19 through platforms such as jingles, radio talk shows and social media campaigns. This activity is a collaborative effort among the UN joint team on HIV.
WFP in collaboration with UNICEF and MoHCC continued providing the emergency response for screening, SBCC and provision of preventive rations into June in order to deter the detrimental effects of COVID-19 on the nutritional status of beneﬁciaries. As the number of highly food insecure districts under the lean season assistance (LSA) program into June was decreased to 19 districts, the number of nutrition priority districts targeted decreased from 29 districts in March and April to 15 districts in May. In April 3,557 children below five and 334,655 pregnant and lactating women (PLWs) were reached with preventative food rations, versus 43,010 children under age 5 and 316,700 in March.
Limited funding to meet the needs of the response remains the main challenge for the emergency nutrition projects. 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.