1. FINDINGS

2. What is Malnutrition?... Malnutrition is marked by a deficiency of essential proteins, fats, vitamins and minerals in a diet. Without these nutrients, it becomes difficult to achieve optimum health.

3. STUDY BACKGROUND Due to food insecurity brought about by the persistent droughts, nutritious foods are not an option for Turkana residents. The most pressing health problem for Turkana’s children is malnutrition. Assessment reports indicate that the Global Acute Malnutrition level in Turkana is at 28 per cent, which is high considering the WHO threshold is 15 per cent

4. The infant mortality rate in Turkana is 60 in every 1,000. Only 54% of Turkana’s children are fully immunized by the age of five years. Women’s health is not any better, where the maternal mortality rate is 1,500 deaths per 100,000 live births, which is three times the national average.

5. The HIV prevalence in this county is 6.2%, which is higher than the national HIV prevalence of 6.1%. Lack of adequate health personnel is another great challenge in this county, where the doctor: population ratio is 1: 52,434, against the recommended 1: 1,000. This makes it very difficult to provide women with information on family planning, antenatal care, the need to deliver in hospitals, and the importance of immunization.

6. One of the greatest challenges is the encouraging of new mothers to initiate breastfeeding immediately after birth preferably within the first hour. Many mothers in Turkana still practice the long- held tradition of naming a child and which causes them to delay breastfeeding. This encourages malnutrition and discourages proper child development as initiating breastfeeding within the first hour is crucial for the development of a child.

7. Patients awaiting services outside a health center in Turkana. Many take days to get there, having walked for tens of kilometers.

8. CAUSES The major cause of malnutrition in Turkana is persistent droughts which make it almost impossible to cultivate any kinds of food crops for daily consumption. This also their domesticated animals as they are not able to acquire enough food hence produce very little milk or and meat in return. Poverty and low income rates. It is rated as one of the poorest and most marginalized regions in Kenya. This is also contributed to by the polygamous nature of the Turkana culture which results to growth of large families which results to either inadequate food to share among family members or use of all the family income on basic needs like food.

9. Limited knowledge on nutrition which is caused by inadequate personnel to educate on family planning, antenatal care, the need to deliver in hospitals, the importance of immunization and insufficient resources to deliver the same.

10. EFFECTS Death Childhood Disability and Development Delays.

11. CURRENT RESPONSES World Vision Kenya is carrying out Supplementary Feeding Program (SFP), Outpatient Therapeutic Program (OTP), and Infant and Young child feeding in Turkana district, targeting the three worst affected projects of Lodwar, Lokori and Kainuk. It is also providing health outreaches in hard to reach areas. Continuous support for delivery of High Impact Nutrition Interventions (HINI): Currently the sector has three main nutrition partners (Save the children-Turkana North, South- Lokichar, Loima and central, IRC-Turkana West and World vision- Turkana Central, south and East). World Vision and IRC funding will be ending in 2015. Save the Children PCA Contract with UNICEF will end in June 2014.

12. Mapping and re-mapping of the outreach support: currently there are 138 outreaches being supported by all the partners in the county and this can be increased/changed based on need. To address the human resource gaps in the outreach clinics, KRCS-with funding from UNICEF, will be supporting additional human resources for outreaches on Locum basis until the end of June 2014. Continued active case funding: Malnutrition active case finding is done routinely by Community Health Workers (CHWs) and health workers during nutrition service delivery. Supplies: MOH have adequate severe and moderate malnutrition management supplies in the county to cover at least May and June 2014.

13. Contingency plan: The county nutrition technical forum has a contingency nutrition plan in place that will be activated in case of emergency. Mapping of Human Resource support: This is to ensure continued service delivery and referral at all health points