ACF Nutrition KIS project Achievements and actual nutrition situation KIS Task Force Meeting Kabul, 08/2013 Clémence Malet, Head of nutrition Department, ACF-Afghanistan

thresholds for emergency situation: Program rational – 2011 SMART nutrition survey in 2011: to define the nutrition situation in KIS Global acute Malnutrition (SAM + MAM): 7.9% (5.6 - 10.9 95% C.I.) Severe acute Malnutrition (SAM): 2.4% (1.5 - 3.9 95% C.I.) thresholds for emergency situation: SAM+MAM 15% and/or SAM 2% ACF strategy: direct implementation if no integration in the health system to answer to a nutrition emergency  ACF KIS nutrition project started in July 2011

Program achievements Since July 2011: Up to 40 KIS covered (+/- depending KIS evolution throughout the time) Community mobilization in all KIS covered: Early detection of acute under-nutrition and referral HE Home visits to the most at risk 9 centers welcoming pregnant and lactating women as well as under 5 children: screening, HE, IYCF, SAM and MAM treatment, referral to TFU (complicated cases including infants) and follow up… 21 November 2006

Program achievements Since July 2011 up to June 2013: SAM: 993 PLW admitted for treatment: 1605 U5 admitted for treatment: SAM: 993 MAM: 2562 21 November 2006

Nutrition situation –end 2012 SMART nutrition survey in KIS, Nov-Dec 2012 Global acute Malnutrition (SAM + MAM): 4,9% (3.3-7.2 95% C.I.) BUT above 10% for 0-11 months children Severe acute Malnutrition (SAM): 1,1% (0.5-2.6 95% C.I.) Action contre la Faim Service - Logistique Mission

Nutrition situation monitoring/seasonality impact Rapid Nutrition Assessment (RNA) Dec 2012 May 2013 GAM (based on MUAC/oedema) 4,6% (95%CI 2,5- 8,5) 5.1% (95%CI 3.0-8.5) Assumption that seasonality may impact acute under-nutrition in KIS No statistical difference between the 2 RNA  The assumption of seasonal impact on the nutritional status of children under 5 in KIS was not confirmed 21 November 2006

Conclusion KIS nutrition situation: not anymore an emergency situation: rationale for ACF CMAM project/exit from KIS at the end of Dec 2013.  Need for CMAM in Kabul to make the treatment available not only for KIS population – integration within the health system + general advocacy for KIS population access. BUT great needs for IYCF interventions – MHCP department of ACF will continue and increase their activities 21 November 2006

For further Details: - SMART nutrition survey report, November-December 2012, KIS, ACF - RNA, November-December 2012, KIS, ACF - RNA, May 2013, KIS, ACF Thanks