1. Food Security and Nutrition Analysis Unit Somalia
Post Deyr 2012/2013
Food Security and Nutrition Analysis Unit Somalia
Information for Better Livelihoods
January 2013
Southeast Regions
EUROPEAN COMMISSION
Swiss Agency for Development and Cooperation SDC

2. SE Regions Livelihood Zones

3. Nutrition Trends at Health Facilities
HIS Malnutrition Trends in Shabelle Agropastoral MCHs (Source: COSV/MSF-S)
High (>30%) and stable trend

4. Lower Shabelle Riverine Livelihood Zone, Summary of Findings
Outcome indicators
Lower Shabelle Riverine Livelihood Zone, Summary of Findings
Deyr 2011/2012
Gu 2012
Deyr 12/13
Child Nutrition status
Afgoye Town and environs (N=966; December 2012)
GAM (WHZ<-2 or oedema)
No survey due to lack of access
8.7 ( )
2.1 ( )
SAM (WHZ<-3 or oedema)
-0.43 ±1.09
Mean weight-for-height
Oedema
0.1
6.4 ( )
MUAC (<12.5 cm or oedema)
Severe MUAC (<11.5cm)
1.2 ( )
HIS Nutrition Trends
High (>10%) and declining trend
Low (<10%) and stable trends
Crude death Rate/10,000/day
N/A
0.74 ( )
Under 5 death Rate/10,000/day
1.43 ( )
OVERALL NUTRITION SITUATION
Likely Very Critical
Insufficient data to estimate the nutrition situation
Alert (in Afgoye town)
Insufficient data to estimate the nutrition situation of the rural LZ
Child Morbidity, Immunization, IYCF
Morbidity-24.6 ( ) in Afgoye town
Disease Outbreaks:
Morbidity based on 2wk recall
Outbreaks of measles and AWD continue
No outbreaks but incidences of diarrhoea and measles reported
Food Security Phase
Stressed
Overall Risk to Deterioration
Potential to Improve -

5. Nutrition Trends at Health Facilities
HIS Malnutrition Trends in Shabelle Riverine MCHs (Source: COSV/MSF-S)
Low (<10%) and stable trend

6. Driving Factors Shabelle regions
Aggravating factors
High morbidity observed in all MCHs in the regions
Reduced access to humanitarian interventions due to civil insecurity
Inappropriate child feeding and care practices persist in all regions
Poor access to sanitation facilities and safe water in rural LHZs
Coastal areas of Middle Shabelle have experienced poor rainfall, poor harvests are expected to affect the HH income/dietary diversity
Lack of adequate immunization coverage
Mitigating factors
Average crop production in Middle Shabelle region
Milk availability is average across all livelihoods
Good livestock prices, TOT and labor opportunities from agricultural activities are increasing HH income and DD
Control/ reduction of disease outbreaks

7. Likely to improve with HA
Outcome indicators
Mogadishu Town Livelihood Zone, Summary of Findings
October 2011
(N=645)
December 2011
(N= 630)
April 2012
(N=959)
July 2012
(N=676)
December 2012
(N=635)
Child Nutrition status
GAM (WHZ<-2 or oedema)
Unchanged 15-20%
21.1 ( )
10.3 ( )
10.8 ( )
9.7 ( )
SAM (WHZ<-3 or oedema)
6.4 ( )
5.6 ( )
1.7 ( )
1.5 ( )
1.6 ( )
Mean weight-for-height
-0.86
-1.01
-0.57
-0.44 ±1.16
-0.45 ±1.18
Oedema
0.3
0.2
0.0
0.4
MUAC (<12.5 cm or oedema)
13.3 ( )
13.4 ( )
6.6 ( )
5.4 ( )
11.3 ( )
Severe MUAC (<11.5cm)
2.3 ( )
3.5 ( )
1.2 ( )
1.2 ( )
3.5 ( )
HIS Nutrition Trends -
High (>20%) and fluctuating,
Low (>10%) and decreasing trend
Low (>10%) and stable trend
High (>20%) and stable trend
TFPs/SFPs Admission trends
High number of admission in charge (in ACF managed centers in Hodan, and Forlanini
Reduced number of admissions to feeding programmes (ACF, CONCERN)
Reduced number of admissions to SFPs (ACF, CONCERN & OXFAM)
Reduced number of admissions to SFPs (ACF, CONCERN & OXFAM
Crude death Rate/10,000/day (90days)
2.81 ( )
1.33( )
1.06 ( )
1.23 ( )
0.65 ( )
Under 5 death Rate/10,000/day (90days)
7.49 ( )
4.12 ( )
1.22 (
1.54 ( )
0.92 ( )
Non Pregnant MUAC < 18.5
Pregnant and Lactating with MUAC <21
2.3 ( )
2.3 ( )
6.4 ( )
1.4 ( )
1.3 ( )
Pregnant and Lactating with MUAC <23
6.7 ( )
12.5 ( )
17.3 ( )
7.5 ( )
3.2 ( )
OVERALL NUTRITION SITUATION
Critical
Very Critical
Serious
Alert
Child Morbidity, Immunization, IYCF
Disease Outbreaks:
Morbidity based on 2wk recall
Measles and AWD
Morbidity -50.9
Measles and AWD outbreak
Morbidity
Morbidity – 26.3
Morbidity – 45.9
Suspected cholera reported in Banadir
Morbidity – 38.4
Immunization status/Vit. A
Measles 60.1
Vit A 59.9
Measles Vac- 61.3
Vitamin A – 59.9
Measles Vac- 67.2
Vitamin A
Measles Vac- 43.6
Vitamin A
Relation between GAM & child sex
Statistically Insignificant
Food Security Phase
Famine
Emergency
Overall Risk to Deterioration
Likely to improve with HA
Stable- With HA

8. Likely to improve with HA
Outcome indicators
Mogadishu IDPs, Summary of Findings
August (N=544)
October 2011 (N=870
December (N=808)
April 2012
(N= 929)
July 2012
(N=675)
December 2012
(N=990)
Child Nutrition status
GAM (WHZ<-2 or oedema)
45.6 ( )
~30.0%
20.5 ( )
16.1 ( )
9.6 ( )
16.0 (
SAM (WHZ<-3 or oedema)
23.0 ( )
~10%
5.6 ( )
3.7 ( )
1.8( )
3.6 ( )
Mean weight-for-height
-1.90
-1.33
-1.04
-0.86
-0.57
-0.75 ±1.17
Oedema
0.4
0.1
MUAC (<12.5 cm/ oedema)
36.8 ( )
19.4 ( )
14.6 ( )
10.6 ( )
8.4 ( )
8.5 ( )
Severe MUAC (<11.5cm)
12.1 ( )
3.9 ( )
3.9 ( )
1.9 ( )
2.6 ( )
1.7 ( )
HIS Nutrition Trends
High (30%) and increasing trend -
High (>20%) and fluctuating, peaks in Aug and Oct
Low (>10%) and decreasing trend
Low (>10%) and stable trend
High (>20%) and stable
TFPs/SFPs Admission trends
High and increasing admission trend
High and increasing number of admission
Reduced number of admissions
Crude death Rate/10,000/day
5.68 ( )
1.78 ( )
2.06 ( )
1.42 ( )
1.41 ( )
0.9 ( )
Under 5 death Rate/10,000/day
15.43 ( )
5.0 ( )
5.46 ( )
2.80 ( )
2.81 ( )
2.0 ( )
Non Pregnant MUAC < 18.5
0.0
1.4 ( )
0.5 ( )
0.6 ( )
0.1 ( )
Pregnant and Lactating MUAC <21
5.3 ( )
5.0 ( )
5.1 ( )
3.9 ( )
5.2 ( )
2.2 ( )
Pregnant and Lactating MUAC <23
12.2 ( )
13.5 ( )
38.2 ( )
14.1 ( )
19.1 ( )
9.7 ( )
OVERALL NUTRITION SITUATION
Very Critical
Critical
Serious
Child Morbidity, Immunization, IYCF
Disease Outbreaks:
Morbidity based on 2wk recall
Measles and AWD outbreak
Morbidity
Measles and AWD
Morbidity
Measles and AWD continue
Morbidity
Morbidity – 26.3
Morbidity
Suspected cholera in Banadir
Morbidity
Immunization status/Vit. A
Measles 28.0 and Vit A 26.2
Measles 60.1 and Vit A 59.9
Measles Vac- 61.3
Vitamin A – 59.9
Measles Vac- 67.2
Vitamin A
Measles Vac-
Vitamin A-
Relation between GAM & child sex
Statistically Insignificant
Food Security Phase
Famine
Emergency
Overall Risk to Deterioration
Uncertain
Likely to improve with HA
Stable- With HA

9. Nutrition Trends Mogadishu Health Facilities
HIS Malnutrition Trends in Mogadishu MCHs
High (>20%) and stable trend

10. ACF Feeding data Jan – Dec 2012
High numbers and decreasing trends

11. Driving Factors Banadir region
Aggravating factors
High morbidity still persists in the region
Inappropriate child feeding and care practices
Limited access to sanitation facilities and safe water especially among the urban poor and IDPS
Reduced Humanitarian Intervention
Mitigating factors
Humanitarian programmes in Banadir region
Control/ reduction of disease outbreaks
Improved food security indicators in the town

12. Likely to improve with +ve FS indicators
Outcome indicators
Beletweyne District , Summary of Findings
Gu 2012 (N=628)
July 2012
Deyr 12/13 (N=539)
December 2012
Child Nutrition status
GAM (WHZ<-2 or oedema)
16.6 ( )
24.9 ( )
[20.4% using SD of 1]
SAM (WHZ<-3 or oedema)
3.3 ( )
11.1 ( )
Oedema
0.0
0.7
Mean Weight-for Height Z (WHZ scores)
-0.86
-1.17 ±1.24
MUAC (<12.5 cm or oedema)
20.1 ( )
23.0 ( )
Severe MUAC (<11.5cm)
6.4 ( )
6.0 ( )
HIS Nutrition Trends
High (>20%) and increasing trend
TFPs/SFPs Admission trends
Crude death Rate/10,000/day (90days)
0.80 ( )
0.20 ( )
Under 5 death Rate/10,000/day (90days)
2.32 ( )
0.83 ( )
Non Pregnant women with MUAC < 18.5
0.6 ( )
0.2 ( )
Pregnant and Lactating women with MUAC <21
5.1 ( )
4.0 ( )
Pregnant and Lactating women with MUAC <23
22.7 ( )
20.0 ( )
OVERALL NUTRITION SITUATION
Critical
Likely Very Critical
Child Morbidity, Immunization, IYCF
Disease Outbreaks:
Morbidity based on 2wk recall
No disease outbreaks reported
Morbidity
Morbidity
Immunization status/Vit. A
Measles
Vitamin A
Measles
Vitamin A- 11.2
Public Health Indicators; Gender
Relation between GAM & child sex
Statistically Insignificant
Food Security Phase
Stressed/ Crisis
Stressed
Overall Risk to Deterioration
Stable with HA
Likely to improve with +ve FS indicators

13. Mataban District Summary of Findings
Outcome indicators
Mataban District Summary of Findings
Gu 2012 (N=480)
July 2012
Deyr 12/13 (N=558)
December 2012
Child Nutrition status
GAM (WHZ<-2 or oedema)
16.7 ( )
24.6 ( )
[23.2% using SD of 1)
SAM (WHZ<-3 or oedema)
4.2 ( )
7.1 ( )
Oedema
0.4
0.0
Mean Weight-for Height Z (WHZ scores)
-0.91
-1.27 ±1.14
MUAC (<12.5 cm or oedema)
19.3 ( )
20.8 ( )
Severe MUAC (<11.5cm)
2.6 ( )
4.0 ( )
HIS Nutrition Trends
Not available due to closed health facilities
TFPs/SFPs Admission trends
N/A
Crude death Rate/10,000/day (90days)
0.99 ( )
0.99 ( )
Under 5 death Rate/10,000/day (90days)
4.50 ( )
1.44 ( )
Non Pregnant women with MUAC < 18.5
0.7 ( )
0.3 ( )
Pregnant and Lactating women with MUAC <21
16.5 ( )
18.2 ( )
Pregnant and Lactating women with MUAC <23
37.8 ( )
36.6 ( )
OVERALL NUTRITION SITUATION
Critical
Very Critical
Child Morbidity, Immunization, IYCF
Disease Outbreaks:
Morbidity based on 2wk recall
No disease outbreaks reported
Morbidity – 28.2
Morbidity
Immunization status/Vit. A
Measles Vac
Vitamin A
Measles Vac
Vitamin A – 15.1
Public Health Indicators; Gender
Relation between GAM & child sex
Statistically Insignificant
Food Security Phase
Stressed
Overall Risk to Deterioration
Stable
Likely to improve with +ve FS indicators

14. Insufficient data to estimate the nutrition situation
Outcome indicators
Hiran Agro-pastoral Livelihood Zone, Summary of Findings
Deyr 2011/2012
Gu 2012
Deyr 12/13
Child Nutrition status
No survey due to lack of access
GAM (WHZ<-2 or oedema)
SAM (WHZ<-3 or oedema)
Oedema
Mean Weight-for Height Z (WHZ scores)
MUAC (<12.5 cm or oedema)
Severe MUAC (<11.5cm)
HIS Nutrition Trends
High (>20%) and increasing trend, with a decrease in the month of Oct 2011
High (10-15%) & stable trend (Jan-Mar 2012)
No data since April 2012 due to withdrawal of humanitarian agencies from the region
TFPs/SFPs Admission trends -
N/A
Crude death Rate/10,000/day (90days)
Under 5 death Rate/10,000/day (90days)
OVERALL NUTRITION SITUATION
Likely Very Critical
Insufficient data to estimate the nutrition situation
Child Morbidity, Immunization, IYCF
Disease Outbreaks:
Morbidity based on 2wk recall
Outbreaks of measles
Diarrhoea incidences reported
Food Security Phase
Emergency
Crisis
Overall Risk to Deterioration
Potential to Improve
Stable

15. Hiran Riverine Livelihood Zone, Summary of Findings Deyr 2011/2012
Outcome indicators
Hiran Riverine Livelihood Zone, Summary of Findings
Deyr 2011/2012
Gu 2012
Deyr 12/13
Child Nutrition status
GAM (WHZ<-2 or oedema)
No survey due to lack of access
SAM (WHZ<-3 or oedema)
Oedema
Mean Weight-for Height Z (WHZ scores)
MUAC (<12.5 cm or oedema)
Severe MUAC (<11.5cm)
HIS Nutrition Trends
High (>15%) and a stable trend of acutely malnourished children
High (>15%) and increasing trend
No data since June 2012 due to withdrawal of humanitarian agencies from the region
TFPs/SFPs Admission trends
N/A -
Crude death Rate/10,000/day (90days)
Under 5 death Rate/10,000/day (90days)
OVERALL NUTRITION SITUATION
Likely Very Critical
Insufficient data to estimate the nutrition situation
Child Morbidity, Immunization, IYCF
Disease Outbreaks:
Morbidity based on 2wk recall
Outbreaks of measles
Diarrhoea incidences reported
Food Security Phase
Stressed
Stressed/ Crisis
Overall Risk to Deterioration
Potential to Improve
Stable

16. Driving Factors Hiran region
Aggravating factors
High morbidity observed in all areas surveyed
Reduced access to humanitarian interventions due to civil insecurity (withdrawal of humanitarian agencies from the region)
Inappropriate child feeding and care practices persist in all regions
Poor access to health and sanitation facilities and safe water
Mitigating factors
Limited Humanitarian programmes in Hiran region
Milk availability is average across all livelihoods
Good crop production will likely improve dietary diversity among the Hiran riverine and agro-pastoral populations
Good livestock prices, TOT increasing HH income and DD

17. Nutrition Situation Estimates
Shabelle
Nutrition Situation Estimates
Nutrition Situation Estimates,
August 2012
Nutrition Situation Estimates,
January 2013
Nutrition Situation Estimates, February- April, 2013
Nutrition situation in Banadir (Mogadishu) IDPs has deteriorated from Serious in Gu ‘12 to Critical . The nutrition situation in Mogadishu town has improved from Serious to Alert, and the situation in Afgoye town is also Alert. No nutrition surveys were conducted in the Shabelle livelihoods due to lack of access, therefore there was insufficient data to make an overall nutrition statement.
Nutrition Outlook, February – April 2013
The nutrition situation is projected to be in a Serious phase across all of Shabelle regions in the coming three months, with the improving food security situation and prospects of improved security that will boost humanitarian access.