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