1. Puntland Nutritional Situation Ministry Of Health 9th September 2015

2. Classification for assessing severity of malnutrition by prevalence ranges among children under 5 years of age
Indicator
Severity of malnutrition by prevalence ranges (%
Low
Medium
High
Very high
Acute Malnutrition (Wasting) 5
5 to 9
10 to 15
>=15

3. Puntland Livelihood Map

4. Nutrition Situation in different IDPs across Puntland
Area/Location
Global Acute Malnutrition (GAM)
Gu'2015
Dayr2014
Gu'2014
Dayr2013
Bossaso IDP
12.5 
17.2
13.2
13.5
Qardho IDPs
14.0 
11.1
12.2
18.5
Garowe IDPs
15.7 
19.0
21.0
15.8
Galkayo IDPs
20.2 
15.1
16.5
15.0
Median for Puntland
14.9
16.2
15.4
Prevalence Rate >15 = Very High

5. Nutrition Situation in different IDPs across Puntland
Area/Location
Severe Acute Malnutrition (SAM)
Gu'2015
Dayr2014
Gu'2014
Dayr2013
Bossaso IDP
1.5
3.1
2.9
2.8
Qardho IDPs
2.2
1.8
1.7
4.9
Garowe IDPs
1.9
3.9
4.4
4.1
Galkayo IDPs
4.7
2.6
2.5
Median for Puntland
2.1
2.7
3.5
Prevalence Rate >2 = Very High

6. Nutrition Situation of Non IDPs in Puntland
 Area/Location
Gu’ (May-July)14
Gu'15 (May –July )15
GAM
SAM
Addun
9.7
2.4
12.5 
1.9 
Hawd
17.3
4.6
14.3 
2.8 
East Golis
15.8
2.8
14.6 
1.7 
Coastal D.
12.7
2.1
13.1 
2.1 

7. Total Admission( Jan-June) For 2014= 3,764

8. Category of public health significance Prevalence of anemia (%)
Proposed classification of public health significance of anemia in populations the basis of prevalence estimated from blood levels of hemoglobin or hematocrit
Category of public health significance
Prevalence of anemia (%)
Severe
>or = 40
Moderate
20.0 to 39.9
Mild
Normal
<or = 4.9
Prevalence of low serum Vitamin A (0.70 μ mol/l or below) to define a public health problem and its level of importance among children 6-71 months of age
Degree of public health problem
20% or more
10 to19 %
2 to 9 %

9. Prevalence of Anemia & Vitamin A Deficiency (Puntland )
Micronutrient Deficiency ( U 5 children)
Anemia is quite high at 56.4%
Vitamin A deficiency at %,
Micronutrient Deficiency ( Women )
Prevalence of Anemia (non PW) 52.8%
Vitamin A deficiency women %,
(source 2009 MDD survey)
(Vit A Def. >20% = Emergency / Anaemia >50% = Emergeny)

10. Infant & young child feeding indicators (Puntland )
IYCF practices ( U 2 children)
Early initiation of BF (1hr) %
Exclusive BF (0-6 ms) % (4.8%)
Continue BF at 12 months 45%
Continue BF at 24 months 8.3%
introduction of solid/soft food (6-8m) 11.6%
(source 2009 MDD survey)

11. Inadequate Food Intake Disease
Malnutrition
Immediate Causes
Inadequate Food Intake
Disease
Underlying Causes
Poor social & care environment
Inadequate infant young child & maternal feeding, care & hygiene practices
Poor access to public health service and healthy environment
Limited access to & use of health facilities
Poor water and sanitation situation
Household Food Insecurity
Conflict, recurrent drought & floods
Loss of livelihoods
Poor quality and quantity of food
The persistently high rates of both acute and chronic malnutrition, even when production is good point to the important role for other underlying causes. The UNICEF Conceptual model of causes of malnutrition provides useful framework for the highlighting the underlying causes of persistent malnutrition in Somalia. Basic causes are beyond the control of this sector. But the model highlights the cross cutting and overlapping causes that require a more holistic multi sectoral approach, a shift away from focusing on programmes for the management of acute malnutrition towards more integrated interventions aimed towards prevention.
Strategy to provide agreed upon framework for action to respond to this need for a shift in approach whilst continuing to improve the quality of emergency nutrition interventions.
Basic Causes
Volatile political situation & civil unrest
Lack of formal & informal infrastructure
Limited resources

12. Key Strategic Frameworks Informing Nutrition Support in Puntland
Somali Nutrition Strategy 2011
Puntland Infant and Young Child Feeding Strategy & Plan of Action – 2016
Puntland Micronutrient Strategy ( )
Basic Nutrition Services Package (BNSP)

13. Challenges
Inadequate scale up of interventions addressing underlying causes of malnutrition ( WASH, health and livelihood support) contributing to continued deterioration of nutrition situation in Puntland
limiting case coverage for nutrition services in remote areas
Minimal capacity for implementation of nutrition programmes
Miss information from mass media - hindering efforts to promote some messages e.g. Exclusive breastfeeding and Complementary feeding .
Unavailability of Breast Milk Substitutes (BMS) policy or act and Commercial advertisement of BMS.

14. Management Of Acute Malnutrition (Bossaso Stabilization centre )

15. Thank You