PostDeyr2016
19thJanuary2017
Bay/Bakool RegionsNutrition Situation
Information for Better Livelihoods
Donors
Livelihood Zone/
Population assessed
Type of survey # Clusters # HH # Children # Boys # Girls
IDPs
Baidoa IDPs Comprehensive Smart 30 448 658 344 314
Bay
AP
Bay A- Pastoral Comprehensive Smart
30 383 649 335 314
Bak
ool
Past
oral
Bakool Pastoral Comprehensive Smart
28 305 467 231 233
Total
Comprehensive Smart
88 1136 1774 910 833
Survey Details
BayAgro-pastoral(SummaryofFindings)
Outcome Indicator Deyr15
(n=1109)Gu16
(n=680)Deyr16(n=649)
Plausibility 22%Acceptable 16%Acceptable 12%goodGAM (WHZ<-2 or oedema) - WHO/
UNICEF 17.3(15.2-19.7) 18.1(14.1-22.9) 20.0(15.6-25.3)
SAM (WHZ<-3 or oedema) 5.0(3.9-6.5) 4.1(2.6-6.5) 4.5(2.5-7.9)Oedema 0.4 0.4% 0.2
Mean of WHZ ±SD -1.13±0.91 -1.10±1.00 -1.09±1.06DEFF 1 2.47 2.3
MUAC (<12.5 cm or oedema) 13.2(11.3-15.3) 11.5(8.3-15.7) 11.9(8.9-15.7)Severe MUAC (<11.5cm) 2.5(1.7-3.6) 1.8(0.8-4.3) 3.0(1.8-4.9)
Stunting (HAZ-2) 13.6(11.7-15.8) 32.6(26.4-39.4) 31.7(26.0-38.1)
Under weight (WAZ-2) 20.4(18.1-22.8) 35.3(29.2-41.895CI) 32.0(26.4-38.1)
Screening data (HIS) - FSNAU High(>40%)levelincreasing
trendsHighnumbers>40with
increasingtrendsHighnumbers>40with
increasingtrends
Crude death Rate 0.45(0.21-0.98) 0.35(0.19-0.64) 0.73(0.43-1.24)Under 5 death Rate 0.40(0.09-1.80) 0.37(0.14-0.96) 0.46(0.10-1.98)
NUTRITION SITUATION - WHO/UNICEF
CriScal CriScal CriScal
Morbidity based on 2wk recall 20.4 23.3 9.4
Vitamin A Measles Vac
3.60.7
0.80.5
6.58.5
Mean CSI 3% 1.6FCS 10.3% 5(poorandborderline)HHS 2 2%(severe&moderate)
Food Security Phase - IPC Minimal Minimal Stress
19.3
23.921.7
58.3
3020.4
18.7
22.619.6
17.1
14
1917.3
18.1 20
2.15.2 6.9
22.1
76.4
26 5.1 3.7
2.8
5.5 5 4.1 4.5
0
10
20
30
40
50
60
70
Deyr'07 Gu09 Deyr'09 GU'11 Oct'11 GU'12 Deyr'12 GU'13 Deyr'13 Gu'14 Deyr14 Gu'15 Deyr15 Gu'16 Deyr16
TrendsinAcuteMalnutritioninBayagro-pastoral,Somalia
GAM SAM
0 1 2 3 4 5 6 7
Gu11July
Gu11Aug
Deyr11
Gu12
Deyr12
Gu13
Deyr13
Gu14
Deyr14
Gu15
Deyr15
Gu'16
Deyr16
BayagropastoralCDRandU5DRtrendGu2011-Deyr2016
U5DR CDR
61.8
68.3
32.8
29.123.9
25.6
32.3
19.3
29.1
20.4
23.3
29.4
0
10
20
30
40
50
60
70
80
Gu11July
Gu11Aug
Deyr11 Gu12 Deyr12 Gu13 Deyr13 Gu14 Deyr14 Gu15 Deyr15 Gu'16 Deyr16
BayagropastoralMorbiditytrendGu2011-Deyr2016
0
10
20
30
40
50
60
Gu11Aug
Deyr11
Gu12 Deyr12
Gu13 Deyr13
Gu14 Deyr14
Gu15 Deyr15
Gu'16 Deyr16
MeaslesandVitaminA
VitA Measles
5
55
105
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
No
of a
dmis
sion
s
SC New monthly Admissions Bay Agro-pastoral 2015/2016 : Source BRH
2015 2016 2 per. Mov. Avg. (2015) 2 per. Mov. Avg. (2016)
Baidoa IDPs
OutcomeIndicatorBaidoaIDPs,SummaryFindings
Deyr‘2015/2016n=743
Gu2016n=760
Deyr2016n=658
PLAUSIBILITY 15% 15% 13%
GAM(WHZ<-2oroedema)-WHO/UNICEF 14.5(11.3-18.6) 18(15.2-21.1)
13.4(10.8-16.5)
SAM(WHZ<-3oroedema)-FSNAU 4.4(2.7-7.2) 4.3(2.9-6.4) 3(1.6-5.6)
Oedema 1.7 1.2 0.8
MeanWHZ±SD -0.70±1.09 -1.00±1.07 -0.73±1.08
DEFFWHZ 1.00 1.25 1.22
MUAC(<12.5cmoroedema)-FSNAU 11.3(8.5-14.5) 13.7(11.3-16.6) 9.2(7.1-11.9)
SevereMUAC(<11.5cm)-FSNAU 4.7(3.2-6.9) 2.7(1.6-4.5) 2.4(1.4-3.9)
CrudedeathRate-Sphere 0.28(0.14-0.59) 0.25(0.11-0.57) 0.21(0.07-0.59)Under5deathRate-Sphere 0.10(0.02-0.47) 0.37(0.12-1.15) 0.30(0.07-1.24)
OVERALLNUTRITIONSITUATION-WHO/UNICEF Serious CriEcal Serious
Morbidity 24.2 37.4 28.2
VitaminAMeaslesPolio
48.341.676.1
49.847.583.1
61.755.277.6
CSI TBD 48% 33
FCS TBD 35% 57%poorandborderlineHHS 59(severe&moderate)
FoodSecurityPhase-IPC stressed Crisis TBD
Trends of GAM & SAM –Baidoa IDPs
15.5
12.8
15.814.3
12.9
15.3 15.314.5
18
13.5
5.13.5 3.4
2.5 2.43.3
4.1 4.4 4.43
0
2
4
6
8
10
12
14
16
18
20
2012Gu 2012Deyr 2013Gu 2013Deyr 2014Gu 2014Deyr 2015Gu 2015Deyr15
2016Gu 2016Deyr
TrendsinGAMandSAMprevalenceamongBaidoaIDPs GAMSAM
0 50 100 150 200
Week1
Week2
Week3
AWDnewcasesinBaidoa HospitalJan2017
>5y <5y
0 0.5 1 1.5 2 2.5 3 3.5 4
Week1
Week2
Week3
AWDDeathsinBaidoaHospitalJan2017
>5y <5y
AccordingtoWHOtheCFRisameasureoftheseverityofadiseaseandisdefinedastheproporEonofreportedcasesofaspecifieddiseaseorcondiEonwhicharefatalwithinaspecifiedEme.WithproperandEmelytreatment,thecasefatalityrateshouldremainbelow1%.HowevertheCFRinBaidoathefirstepidemiologicalweekwas1.03,thesecondwas1.37.andthethirdepidemiologicalweekwas1.47.
OutcomeIndicatorPostDeyr15/16
(n=672)Gu2016(n=561)
Deyr2016(n=467)
PLAUSIBILITY 10%Good 13%Good 14%good
GAM(WHZ<-2oroedema)-WHO/UNICEF 11.2(9.0-13.8) 19.1(14.3-24.9) 27.4(23.5-31.6)
SAM(WHZ<-3oroedema)-FSNAU 1.5(0.8-2.7)2.4 5.0(3.1-8.0) 1.9(1.0-3.6)Oedema 0 0.4 0
MeanWHZ±SD,P-value -1.03±0.91 -1.17±1.02 -1.37±0.97
DEFFWHZ 1 2.47 1MUAC(<12.5cmoroedema)-FSNAU 7.4(5.7-9.7) 7.1(5.5-9.1) 7.5(5.4-10.2)SevereMUAC(<11.5cm)-FSNAU 0.7(0.3-1.7) 1.2(0.5-2.7) 0.4(0.1-1.5)
StunSng(HAZ-2)-WHO/UNICEF 7.4(5.7-9.7) 2.8(1.4-5.4) 6.7(4.8-9.3)
Underweight(WAZ-2)-WHO/UNICEF 14.3(11.8-17.1) 13.2(9.5-18.1) 17.8(14.6-21.5)
Screening data (HIS) - FSNAU >20%HighandStable >20%Highand
Stable>20%HighandStable
CrudedeathRate-Sphere0.14(0.05-0.41) 0.0 0.24(0.09-0.68)
Under5deathRate-Sphere0.16(0.02-1.24) 0.0 0.64(0.14-2.93)
OVERALLNUTRITIONSITUATION-WHO/UNICEF Serious CriEcal CriEcal
Morbidity 10.5 19.2 19.9VitaminAMeasles
46.50
5.25.1
019.2
CSI 1.67 34FCS 34 92%(poorandborderline)HHS 20(severe&moderate)
FoodSecurityPhase Stressed Stressed ?
BakoolPastoralLivelihoodZone
25.2
29.2
55.9
26.224.5
27.4
18.5
24.8
12.3 9.811.2
19.1
27.4
1.24.7
20.4
5.72 5.4
2.66.2
1.6 1 1.55
1.9
0
10
20
30
40
50
60 TrendinAcuteMalnutrtioninBakoolpastoral,Somalia
GAM
SAM
0 1 2 3 4 5 6 7 8
Gu'09
Gu'11
Deyr'12
Deyr'13
Deyr14
Deyr2015
Deyr16
CrudeandUnderfivedeathrate
U5DR CDR
38 35.6
0
46.9
29.7
24
30.4
25
31.7
25.9
10.5
19.2
19.9
05101520253035404550
Morbidity
0
10
20
30
40
50
60
70
80
90
Gu'09 Deyr'09 Gu'11 Gu'12 Deyr'12 Gu'13 Deyr'13 Gu'14 Deyr14 Gu2015 Deyr2015 Gu'2016 Deyr16
Vit AandMeaslesvaccination
VitA Measles
SC Admissions in – Agropastoral LH area 2015/2016
HIS Malnutrition trends in Bakool Agro-pastoral
HIS malnutrition trends in Bakool Pastoral
KeyDrivingFactorsAggravaSng MiSgaSng
BakoolPastoralLH • Lowcoverageofhealthprograms(VitaminA=0)andMeaslesvaccinaEon19.2
• LimitedtransportmovementwithindistrictsinBakoolregions
• Morbidity(19.2%)inBakoolPastoral• PopulaEonmovementduetoinsecurity• Watershortage,/watertrucking• HugelivestockoutmigraEon(abnormal)• Increasedlivestockoaake,• IncreasedcerealpricewithdecreaseofTOT• Familysplibngduetofoodshortage
• OperaEonalFeedingclinics• ExisEngNarrowHumanitariansupport,• SocialSupport
BayLHZzones, • Civilinsecurity-displacementassociatedwithcivilinsecurityacrossthelivelihoods,Morbidity=9.4(5.6-13.2)inBayAP.
SocialSupport.• Remifances• Casuallabour• Withnarrowhumanitarianaccess
BaidoaIDPs • Highmorbidity=24.2• ReporteddiarrheaoutbreakinBaidoa• LowVitaAandMeaslescoverage• PoorShelteringcondiEon
• SocialSupport.• Withnarrowhumanitarianaccess
BakoolAP • ProlongedCivilinsecurity• Foodinsecurity• PoorwatersanitaEon,• PoorchildcarepracEces• VeryrecentpopulaEonmovementduetoinsecurity,
• Foodaidthroughpartnersinlimitedareas,• SocialSupport• NarrowHumanitariansupport,Cash
distribuEons,inHuddurbyeACF,• LimitedHealth/NutriEonprogramsinAP
areas.
NutriSonSituaSonEsSmates,Jan2016Dery15/16
NutriSonSituaSonEsSmates,AugustGu16
CurrentDeyr2016/17NutriSonsituaSon
NutriSonOutlook:April2017.Thefoodsecurityoutlookislikelytodeteriorateinthecoming3months,Nevertheless,thenutriEonsituaEoninBakoolPastoralislikelytodeteriorate-CriEcalphaseduetodecreasingTOT,decreasedinanimalproductconsumpEon,(meatandmilk)increasedcerealprice,livestockoutmigraEon,seasonalmorbidity,deterioraEngaccesstohumanitarianhealthandnutriEonassistanceandtheinsecurity.TheBayagro-pastoralwilllikelytoremainCriEcalduetoLimitedhealthservice,PoorCropharvestPoormilkaccess,presenceofAWDoutbreak,andseasonalmorbidityexpectedtoincreaseinJiilaal,lowincomefromlabouropportunity,andcompromisedWASHduetowatershortagesandhumanoutmigraEoninpartsofBayAP.
BakoolPastoralSustainedCri0calnutri0onsitua0on
NutriEonphaseProjecEonFeb-April2017
PartnersinvolvedBayandBakoolNutriSonAssessment`
Partners/Stakeholdersinvolved
• Government :MinistryofHealth–SouthWestFederal• MOPIC(MinistryofplaningaditeraEonalrelaEons)• UnOCHA• LocalNGOs :EPHCO,BMO,DMO,DHO,URO,BTSCEDAO• PublicInsEtuEons :BaidoaReferralHospital• Localcommunity :CommunityElders,villagechiefs,Surveyguides• WomenInvolvement :Primaryrespondents,womenleaders/IDP/Rural
villages/Femalesurveyguide• YouthGroups :involvedenumeratorsfromcommunalyouthsector
Acknowledgment
END
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