1. Nutrition Sector NiESWG Borno
Nutrition in Emergency Sector Working Group
3rd OCT 2017

2. 1. Overview of needs: Nutrition sector key issues and needs?
Serious nutrition situation with GAM between % rates in northern Borno and parts of central Borno among other aggravating factors.
Possible outbreak of water borne and diarrhoea diseases with negative impact on nutrition situation.
Inadequate facilities for addressing malnutrition cases with medical complications.
MUAC Screening of every child 6-59 months.
Low coverage of MAM cases
Slow achievement of set targets in Biu, Damboa, Gwoza, Kalabarge, Kukawa,Mobbar, Ngala and Nganzai

4. Changes in context 3: CH analysis (II) Food Security and Nutrition situation
In the projected period (June – August 2017), a total of about 8.9 million people may fall into the three combined critical food insecurity situations (crisis, emergency and famine) in the 16 states; including 5.2 million people in Adamawa, Borno and Yobe states with about 50,000 people in famine situation, if no adequate remedial measures are provided on time. Table below shows projected situation in Borno

5. Changes in Context 4: Progress of nutrition interventions 2017
Fields in red have at least gap of 70%. Source of information is the NiESWG 5Ws (January-August, 2017)

6. 3. People affected by Malnutrition
The cohort of population during crises vulnerable to malnutrition in a community are children under 5 years and pregnant and breastfeeding women. They constitute the people in need of nutrition intervention. Children under 5 years of age whom are estimated to be 20% of a population as well as
Pregnant and breastfeeding women between 15 and 49 years whom are estimated to be 8% of the population.
The Sector specific people in need number is the sum of number of children (6-59m) and women (15-49years) to be reached with any one intervention respectively.

7. Populations in the six North east states
People in Need
SAM without medical complication (6-59m)
20% * SAM (WHZ)% * 9
SAM with Medical complication (6-59m)
Estimated at 10% of SAM
MAM < 5
20% * MAM (WHZ)% * 2.6
MAM PLW
????
BSFP <5
??????
BSFP PLW
?????
VIT A <5
20% of the population
Deworming (12-59m)
90% of the population eligible for Vit A
Pregnant _ Iron
8% of the population*0.375
MNP (6-23m)
6% of total population*.3335
IYCF -PLW
8% of the population

8. Formula for estimating SAM/MAM Burden Burden = N x P x K
Specific nutrition Activities estimation of Burden
Formula for estimating SAM/MAM Burden
Burden = N x P x K
Estimated 2018 SAM and MAM caseload burden:
For N estimation : proportion of 20% for children 6-59 months
For P estimation : use of prevalence from the NFSS July 2017 (Borno & Yobe) NFSS Oct 2016 (Adamawa)
For K estimation: 9 for SAM and 2.6 for MAM.
Indicators
Adamawa
Bauchi
Borno
Gombe
Taraba
Yobe
Total
PiN
Target
SAM without medical complication
34025
23818
154083
107858
217695
152386
61739
43217
42459
29722
199841
139888
709,842
496,889
SAM with Medical complication
3781
2646
17120
11984
24188
16932
6860
4802
4718
3302
22205
15543
78,871
55,210
MAM < 5
95018
66513
213278
149295
278511
194958
58351
40846
85643
59950
199465
139626
930,266
651,186
MAM PLW -
VIT A <5
717139
573712
950916
959388
423315
338652
748342
598673
819539
655631
5,096,215
4,076,972
Pregnant _ Iron
86057
142637
143908
50798
89801
98345
611,546
Deworming PiN
MNP 6-23 months
167416
277489
279962
98823
174700
191321
1,189,711
IYCF
286856
475458
479694
169326
299337
327815
2,038,486
BSFP 6-23 months
BSFP PLW
To avoid double counting the PIN is calculated = Highest category of under five beneficiary (Vit A) + highest category of PLW beneficiary (IYCF)

9. 7.1 million 6.7 million Nutrition Sector 6.1 million 0.0 million
IN 2017
IN 2018
2018 NEEDS SEVERITY
7.1 million
6.7 million
PEOPLE IN NEED
PEOPLE IN NEED
6.1 million
0.0 million
In Host Community
In Host Community
0.49 million
IDPs
0.0 million
IDPs
0.35 million
IDPs - Returnees
0.11 million
0.0 million
Refugees - Returnees
Returnees
0.06 million
In inaccessible LGAs

10. 2018 PEOPLE IN NEED PER CATEGORY PER STATE
2018 PEOPLE IN NEED PER SEX AND AGE PER STATE

11. 5. Nutrition sector Severity MAP
The nutrition Severity Map is based WHO crisis classification on Global acute malnutrition (GAM) six point scale from 1 (no nutrition problem) to 6 (catastrophic problem) with Weighting against other aggravating factors including Food security situation, presence of IDP in Host communities and access.
Severity
Presence of GAM
Indicator Score
Weight 1
Normal 2
Acceptable
1-5%
Minimal 3
Poor
5-9%
Stressed 4
Serious
10-14%
Crisis 5
Critical
15-30% 7
Emergency 6
catastrophic
> 30% 11
Catastrophe

12. 6. Discussions
As the nutrition activities on supplementation are conducted as routine government intervention through the MCHW Camping bi-annually they don’t really qualify as humanitarian response. If this is agreeable then we should use the core interventions such as SAM, MAM treatment IYCF and BSFP to estimate the people in need for the emergency nutrition interventions. This will leave the PIN constituted of all U5 requiring BSFP (0-23 months) + PLW requiring IFE (IYCF-E)  and this will lower the no of PIN
Options
The states with minimal data (Gombe, Taraba, and Bauchi) use the 2015 NNHS survey prevalence to estimate the number of malnourished children and PLW and use this as PIN.
The states with current humanitarian response (Yobe Adamawa and Borno) use the all children 0-23 m eligible for BSFP and PLW  eligible for IYCF-E