Post Deyr ’10/11 January 24 th 2011 Integrated Nutrition Situation Analysis Bay &Bakool Regions Information for Better Livelihoods Food Security and Nutrition Analysis Unit Somalia EUROPEAN COMMISSION Swiss Agency for Development and Cooperation SDC

Main Livelihood Groups Bay Region: 2 Agropastoral Livelihoods (Bay Agropastoral High Potential and, Bay-Bakool Agropastoral Low Potential)  Primary sources of income of poor: self- employment, employment, sale of livestock & livestock products and sale of crops.  Primary sources of food of poor: own production and food purchase  Primary livelihood asset of poor: cattle, sheep/goats

Main Livelihood Zones Bakool Region : 1. Pastoral Livelihood (Southern Inland Pastoral)  Primary income sources of poor: sale of livestock & livestock products  Primary food sources of poor: food purchase  Primary livelihood assets of poor: camel, sheep/goat and cattle 2. Agropastoral Livelihoods (Bay-Bakool Agropastoral Low Potential and Bakool Agropastoral)  Bay-Bakool Agropastoral: Main sources of income: the combination of agricultural labour, self- employment (firewood, charcoal and lime) and sale of livestock & livestock products. Main sources of food: own production (crop and livestock products) and purchase.  Bakool Agropastoral is predominantly pastoral. Main sources of income: livestock and livestock product sales, self-employment (bush products) and agricultural labour. Main sources of food: purchase and own production.

Outcome indicators Deyr’09/10 (N=592)Gu’10 (N=1430)Deyr’ 10/ 11 (N=1769) Child Nutrition status o GAM (WHZ<-2 or oedema) 21.7( )NA o SAM (WHZ<-3 or oedema) 6.9( )NA o Oedema 0.5( )NA o MUAC (<12.5 cm or oedema) 4.8( )15.7%18.4% o Severe MUAC (<11.5 cm or oedema) NA3.5%4.4% o Stunting (HAZ<-2) 36.8( )N/ANA o HIS Nutrition Trends High levels and decreasing trendHigh levels (.>30) and stable trends (Jan- Jun’10) High levels (.> 40) and increasing trends (July-Nov’11) o TFPs/SFPs Admission trends High numbers with increasing trend of SFP admissions High numbers with increasing trends of SFP admission Crude death Rate/10,000/day (90days)0.57 ( )NA Under 5 death Rate/10,000/day (90days) 0.68 ( NA OVERALL NUTRITION SITUATIONVery criticalLikely to be Very critical Child Morbidity, Immunization, IYCFNA o Disease Oubreaks: o Morbidity based on 2wk recall No outbreak with seasonal norms Morbidity =28.2 RDT positive=2.1 No outbreak o Immunization status/Vit. A Vitamin A=37.7 Measles 35.3 NA o Children eating from <4 fdgps NA o Children meeting min. feeding freq. 9.3NA Public Health Indicators; GenderN=370NA o Households (HH) hosting IDPs NA o Households (HH) accessing safe water 10.2NA o HH accessing sanitation facilities 15.0NA o HH accessing health facilities o Relation between GAM & child sex o Relation between GAM & sex of hh head Insignificant NA Food Security Phase Proportion of hh consuming <4 fd gps BFI/AFLC X BFI/AFLCBFI OVERALL RISK TO DETERIORATIONPOTENTIAL TO DETERIORATE Bay Agro-pastoral Livelihood Zone, Summary of Findings

Outcome indicators Deyr’09/10, N=251Gu’10, N=1100Deyr’ 10/11, N=1100 Child Nutrition status o GAM (WHZ<-2 or oedema) 13.5 % (Pr=90)21.7 NA o SAM (WHZ<-3 or oedema) 4.0 % (Pr= 0.90 )4.9NA o Oedema 0.2NA o MUAC (<12.5 cm or oedema) 8.1%5.7 ( ) o Severe MUAC (<11.5 cm or oedema) NA4,23.6 o Stunting (HAZ<-2) 19.7( )NA o HIS Nutrition Trends High (>20) & increasing trend (Jul- Dec’09) High level (>20%) and increasing trendsHigh level (>50%) and increasing trends o TFPs/SFPs Admission trends High & increasing trend at OTP (Apr- May) NA Crude death Rate/10,000/day (90days) NA Under 5 death Rate/10,000/day (90days) NA OVERALL NUTRITION SITUATIONSeriousLikely to be Very Critical Child Morbidity, Immunization, IYCF NA o Disease Oubreaks: o Morbidity based on 2wk recall No outbreak Morbidity – 46.3% Whooping cough outbreak in Huddur Rabdure and Tieglow districts and measles cases in Tieglow. Whooping cough and measles in Huddur Rabdure and Tieglow 37% o Immunization status/Vit. A Measles: 44.5; Vit. A: 40.4CHD conducted o Children eating from <4 fdgps XNA o Children meeting min. feeding freq. XNA Public Health Indicators; GenderN=478N=116 o Households hosting IDPs NA o Households access safe water 20.7NA o HH accessing sanitation facilities 48.7NA o HH accessing health facilities 37.1NA o Relation between GAM & child sex o Relation between GAM & sex of hh head Significant Insignificant NA Food Security Phase Proportion of hh consuming <4 fd gps BFI/AFLC 9.2 BFIAFLC OVERALL RISK TO DETERIORATIONPOTENTIAL TO IMPROVEPOTENTIAL TO DETERIORATE Bakool Agropastoral Livelihood Zone, Summary of Findings

Number of morbidity cases in Bakool Agro-pastoral GTZ Deyr’10/11

Outcome indicators Deyr’09/10 (N=247)Gu’10 (N=1100)Deyr’ 10/11 (N= 1100) Child Nutrition status o GAM (WHZ<-2 or oedema) 29.2 (Pr=0.90)NA o SAM (WHZ<-3 or oedema) 4.7 (Pr= 0.90 ) NA o Oedema 0.0 Acceptable NA o MUAC (<12.5 cm or oedema) 14.9 ( ) o Severe MUAC (<11.5 cm or oedema) NA o Stunting (HAZ<-2) 19.7( )NA o HIS Nutrition Trends High (>20) & increasing trend (Jul-Dec’09)High( 20) and increasing trend o TFPs/SFPs Admission trends High & increasing trend at OTP (Apr-May)NA Crude death Rate/10,000/day (90days) NA Under 5 death Rate/10,000/day (90days) NA OVERALL NUTRITION SITUATION Very Critical Likely to be Very Critical Child Morbidity, Immunization, IYCF o Disease Oubreaks: o Morbidity based on 2wk recall No outbreak Morbidity – 46.3% No outbreaks with seasonal norms o Immunization status/Vit. A Measles: 44.5; Vit. A: 40.4 NA o Children eating from <4 fdgps X Poor dietary diversity o Children meeting min. feeding freq. XNA Public Health Indicators; GenderN=478 o Households hosting IDPs NA o Households access safe water 1.0NA o HH accessing sanitation facilities 13.5 NA o HH accessing health facilities NA o Relation between GAM & child sex o Relation between GAM & sex of hh head insignificant Insignificant NA Food Security Phase Proportion of hh consuming <4 fd gps BFI/AFLC 9.2 AFLC/HEHE OVERALL RISK TO DETERIORATION POTENTIAL TO DETERIORATE Bakool Pastoral Livelihood Zone, Summary of findings

Nutrition Key Driving Factors Aggravating factors Low immunization and supplementation status Disease outbreak e.g. whooping cough and measles Lack of income opportunities for poor households Insecurity both Bay and Bakool especially Rabdhure and Elberde district Poor sanitation and clean water and sub-optimal infant feeding practices, Morbidity levels: increased seasonal diseases, intestinal parasite, ARI, suspected malaria and Diarrhoea WHO reported 64 cases of AWD in Baidoa hospital COOPI. In October WHO reported 183 cases suspected measles 18 of them from Bay region SFP/OTP: the number of feeding centres reduced due to insecurity. Reduced humanitarian interventions in health, water, sanitation programs, income generation activities, education and food aid programmes. Food insecurity due to poor Deyr rains. Mitigating Factors Social support Income from charcoal burning in the Jubas (short term benefits) Access to health care service in Dinsor, Huddur and Rabdure in terms of SFP by GTZ; and OTP from ACF

Gu ‘10 Nutrition Situation Deyr’10/11 Nutrition Situation Nutrition Situation Estimates - Bay Bakool Regional Maps

The End