1. Post Deyr ’10/11 January 24 th 2011 Integrated Nutrition Situation Analysis Gedo Region Information for Better Livelihoods Food Security and Nutrition Analysis Unit Somalia EUROPEAN COMMISSION Swiss Agency for Development and Cooperation SDC

2. Main Livelihood Groups 2 Agro-pastoral Livelihoods (Southern agro-pastoral and Bay agro-pastoral high potential)  Southern agro-pastoral are more pastoral than agriculturalists. Main sources of income: sale of livestock & livestock products, self-employment (fodder and bush products sales); main sources of food: purchase and own production  Bay bakool agro-pastoral are more agriculturalists than pastoralists. Main sources of income: sale of crops, livestock products and labour; main sources of food: own crop production and purchases. Riverine Livelihood (Juba riverine pump irrigation) are agriculturalists. Main production onion, tobacco, citrus and fruits; main sources of income: sale of crops and labour; main source of food: purchase and own crop production. Livelihood Groups & Main Sources of Food and Income 2 Pastoral Livelihoods  Southern Inland- keep camel, sheep & goat  Dawa – keep cattle, camel & shoat  Primary sources of income of poor: sale of livestock & livestock products  Primary sources of food of poor: purchase and own production  Primary livelihood assets of poor: camel, cattle and sheep/goat

3. Outcome indicatorsGedo Pastoral livelihood Zone, Summary of Findings Deyr’09/10, N=595Gu’10, N=196Deyr’10/11, N=730 Child Nutrition status o GAM (WHZ<-2 or oedema)>20 (pr=90%)>16.3 (pr=90%) 26.4 (22.2-31.1) Mean weight-for-height Z (WHZ) NA -1.07±1.17-1.18±1.14 o SAM (WHZ<-3 or oedema) 3.5 (2.2-5.5)>3.7 (Pro.90%) 4.4 (3.0-6.3) o Oedema00.50 o MUAC (<12.5 cm or oedema)11.4 (8.3—14.6)10.2(5.4- 14.9) 10.8(7.3- 6.3) o MUAC (<11.5 cm or oedema) 1.8(0.6-3.6)2.0(0.0- 4.0)1.6(0.9- 3.0) HIS Nutrition Trends High levels (>30%) and decreasing trends (Jul-Dec’09) High (>30%) and fluctuating trends (Jan-Jun’10) High (>30%) and increasing trends (Sept- Dec.’10 TFPs/OTPPs Admission trendsHigh levels and increasingHigh levels and fluctuating High levels and increasing admission trends in the region Crude death Rate/10,000/day (90days) 0.5 (0.29-1.01)NA0.44 (0.23-0.83) Under 5 death Rate/10,000/day (90days)1.34 (0.60-2.98)NA 1.27 (0.53-3.04) OVERALL NUTRITION SITUATIONLikely Very CriticalCriticalVery Critical Child Morbidity, Immunization, IYCF o Disease Outbreaks: o Morbidity based on 2wk recall Outbreak – None Morbidity – 45.9 Outbreak- suspected measles reported. Morbidity-51.5; RDT=1.4% No out breaks- suspected measles reported; 412 AWD cases reported in Nov.’10 Morbidity=40.8 o Immunization status/Vit. AMeasles: 70.6; Vit. A: 84.0Measles : 75.0; Vit. A: 77.9; Measles 88.4,Vit A :86.0 o Children eating from <4 fdgpsN/A95.495.8 Children meeting min. feeding freq.N/A 727.923.4 Public Health Indicators; GenderN=501N=99N=390 o Households (HH) accessing safe water20.728.310.3 o HH accessing sanitation facilities48.712.117.7 o HH accessing health facilities37.1NAN/A Gender Relation between GAM & child sex Relation between GAM & sex of hh head Insignificant Food Security PhaseAFLC/BFI Proportion of hh consuming <4 fd gpsN/A49.431.0 Overall Risk to Deterioration POTENTIAL TO IMPROVESTABLEUNSTABLE

4. Reduced milk access Weakened livestock body condition and low milk production leave women and children with reduced milk access

6. Outcome indicators Gedo Riverine Livelihood Zone, Summary of Findings Deyr’09/10, N=196 GU’10 N=206Deyr’10/11 N=617 Child Nutrition status GAM (WHZ<-2 or oedema)>16.5 (Pr.90%),>15.9 (pr=90%)26.7 (21.5-32.8) Mean weight-for-height Z (WHZ) -1.13±1.07-1.20±1.21 SAM (WHZ<-3 or oedema)4.2 (Pr.90%) >2.4 (Pro=90%) 6.0(4.1-8.6) Oedema0.100.3 MUAC (<12.5 cm or oedema)20.4 (13.1-26.7)20.318.2(12.9.-23.5) MUAC (<11.5 cm or oedema)6.6(3.0-10.3)2.1(0.1-4.2)2.4(0.7-4.1) HIS Nutrition TrendsHigh levels and decreasing trend High (>15) & decreasing trend (Jan- June’10) High (>20%) and increasing trends TFPs/SFPs Admission trendsHigh and decreasing admission trends Low & fluctuating admission trend at OTP High levels and increasing in the region Crude death Rate/10,000/day (90days)N/ANA0.22 (0.11-0.46) Under 5 death Rate/10,000/day (90days)N/ANA 1.69 (0.78-3.61) OVERALL NUTRITION SITUATIONCritical Very Critical Child Morbidity, Immunization, IYCF o Disease Oubreaks: o Morbidity based on 2wk recall Outbreak -None Morbidity 41.8 No outbreak Morbidity – 32.8%; RDT=1.4% (N=1401) No Outbreak : Suspected measles reported Morbidity=39.8% 412 AWD cases reported in Nov.’10 o Immunization status/Vit. AVitamin A – 82.8, Measles- 85.7Measles: 86.0; Vit. A: 87.1Measles: 91.8; Vit. A :90.7 Children eating from <4 fdgpsN/A73.1N/A o Children meeting min. feeding freq.N/A46.2N/A Public Health Indicators; GenderN=90N=86N=329 o Households (HH) accessing safe water 30.0 20.70 o HH accessing sanitation facilities 42.2 29.914.4 o HH accessing health facilities55.3NAN/A o Relation between GAM & child sex o Relation between GAM & sex of hh head Insignificant Food Security Phase Proportion of hh consuming <4 fd gps AFLC/HE N/A BFI/AFLC 31 AFLC/BFI 35.1 Overall Risk to DeteriorationPOTENTIAL TO DETERIORATE STABLEUNSTABLE

8. Displacement increases nutritional vulnerability

9. Outcome indicatorsGedo AgroPastoral, Summary of Findings Deyr’09/10, N=198Gu’10, N=198Deyr’10/11, N=629 Child Nutrition status o GAM (WHZ<-2 or oedema) >18.2 (pr.90%),>21.7(pr=90%) 25.3(21.5-29.5) o Mean weight-for-height Z (WHZ) -1.22±1.15 -1.14±1.35 o SAM (WHZ<-3 or oedema) >2.6 (pr.91%)>5.6 6.5 (4.6-9.2) o Oedema 01.0 0 MUAC (<12.5 cm or oedema) 18.2 (12.5-23.9)19.2(13.7-24.7) 16.1( 11.9-21.3) MUAC (<11.5 cm or oedema) 4.0 (1.2-7.0)4.0 (0.6-7.5) 1.6 (0.9-2.9) o HIS Nutrition Trends High levels and stable (Jul- Dec’09) High (>15) & fluctuating trend (Jan- June’10 ) High (>20%) and increasing trends (Sept.- Dec.’10) o TFPs/SFPs Admission trends High and stable ( July-Dec’09) High & fluctuating admission trend at OTP (Jan-June’10 ) High levels and increasing in the region Crude death Rate/10,000/day (90days)NA 0.34 (0.16—0.75) Under 5 death Rate/10,000/day (90days)NA 0.85 (0.36—2.02) OVERALL NUTRITION SITUATIONCriticalVery Critical Child Morbidity, Immunization, IYCF o Disease Oubreaks: o Morbidity based on 2wk recall Outbreak – None Morbidity– 27.3 No outbreak Morbidity – 25.3%; RDT=1.4% Outbreak: suspected measles reported; 412 AWD cases reported in Nov.’10 (1 death) Morbidity =40.5 o Immunization status/Vit. A Vitamin A – 58.1 Measles- 64.6 Measles: 74.2; Vit. A: 76.3Measles:88.4,Vit A:86.2 o Children eating from <4 fdgps N/A81.270.6 o Children meeting min. feeding freq. N/A4021.3 Public Health Indicators; GenderN=97N=98N=341 Households (HH) accessing safe water 3.1 20.76.7 HH accessing sanitation facilities 19.6 26.847.7 HH accessing health facilities 12.9NAN/A Gender: Relation between GAM & child sex Relation btn GAM & sex of hh head Insignificant Food Security Phase Proportion of hh consuming <4 fd gps AFLC/HE N/A BFI/AFLC NA AFLC/HE 16.5 (5.1-27.8) Overall Risk to DeteriorationSTABLEPOTENTIAL TO IMPROVEUNSTABLE

11. Driving factors Mitigation factors Rehabilitation of severely malnourished children through the OTP where accessible Humanitarian interventions – health provided where accessible Improved immunization status due to CHD and polio campaign in the region Sale of fodder among riverine communities providing households with income Aggravating factors Impact of the failed Deyr’10/11 rains affecting crop and livestock production, increased cereal prices, subsequently limited milk access and poor diet quality Poor dietary diversity where third of population consume three or fewer food groups, particularly among pastoral and riverine populations Poor access to sanitation facilities and clean water in all livelihoods, exposing the population to water borne diseases Limited access to health facilities among the rural people High morbidity levels and poor health seeking behaviors including AWD and suspected measles Poor infant and young child feeding practices in all livelihoods

12. Nutrition Situation Estimates - Gedo Regional Maps Nutrition Situation Estimates, January 2011 Nutrition Situation Estimates, August 2010

13. The End