Monthly Humanitarian Situation Report SENEGAL Date: September 2013

Transcription

1 Monthly Humanitarian Situation Report SENEGAL Date: September 2013 Mothers receiving advice on nutrition good practices from outreach workers in a community nutritional site in Fatick region Highlights Based on available data more than 11,000 SAM admissions have been reported in Senegal between January and August August reports (available for 32% of facilities) show 1,617 new SAM admissions. The region of Diourbel has already reached 141% of its annual SAM target. The region admits more than double the monthly SAM cases than any other region. The June 2013 nutritional survey shows that overall national Global Acute Malnutrition (GAM) average prevalence for under-five children has not reached the 10% threshold but remains precarious at 9.1%. However, four Departments have surpassed the 15% crisis threshold of global acute malnutrition (Matam 20%, Kanel 18%, Podor 17% and Ranerou 16%). Sixteen Departments are areas of concern, with ten Regions concerned. Nine Departments have surpassed the 2% SAM threshold. UNICEF Senegal s requirements of US$3,305,266 in the HAC for 2013 are 60% funded. 1

2 Situation Overview & Humanitarian Needs The targets for the rehabilitation of children with Severe Acute Malnutrition (SAM) for 2013 in Senegal are based on the national 2012 nutrition survey using SMART methodology. According to this survey, the SAM burden for 2013 was estimated at 63,323 under-five children. In 2013, the sectoral group of partners agreed to an initial target of 38,968 SAM cases (62% 1 ) given funding trends and estimated geographical coverage of services, then revised to 42,843 at the mid-term review. Based on the same survey, the Moderate Acute Malnutrition (MAM) caseload is estimated at 255,675 cases for the year (Table 1). The 2012 survey further identified 16 out of 45 departments as critical. Based on this geographical breakdown, 11 out of 14 regions were identified as in need of emergency support based on prevalence of malnutrition and aggravating factors such as diarrhoea and ARIs: Diourbel, Fatick, Kaffrine, Kedougou, Kolda, Louga, Matam, Saint Louis, Sedhiou, Tambacounda and Thies. A Food Security and Nutrition survey took place in June 2013 (ENSAN 2013) with broad implication of concerned government ministries and partners. The nutritional situation in Senegal seems largely unchanged from 2012 when the emergency nutrition response was launched. This survey includes the following key findings (see page 3 and annex for details): Overall national Global Acute Malnutrition (GAM) average prevalence for under-five children has not reached the 10% threshold but remains precarious at 9.1% 2. Four Departments have surpassed the 15% crisis threshold of global acute malnutrition (Matam 20%, Kanel 18%, Podor 17% and Ranerou 16%) Twelve additional Departments have reached the 10% GAM warning threshold Nine Departments are over the 2% Severe Acute Malnutrition crisis threshold: Mbour 2,3%, Medina Yoro Fula 2,2%,Podor 3,9%, Ranérou 4%, Kanel 2,2%, Matam 4,5%, Goudiri 2%, Bounkiling 4,6%, Bakel 2,7% National prevalence of chronic malnutrition is 16.5% Based on the June 2013 ENSAN survey (using SMART methods), the estimations for 2014 were made using the same methodology than for 2013 estimates (i.e. 1.5 incidence factor for MAM, 1.6 for SAM caseload and 2.6 for the burden). Thus the estimated under-five SAM caseload for 2014 is of 47,271 cases and the overall SAM burden is 76,817 cases. MAM caseload is estimated as just over 250,000 under-five children. 1 Taking into account SPHERE standard targets for treatment coverage which are 50% in rural areas and 70% in urban areas. 2 8,4-9,8 IC 2

3 Regions Global acute malnutrition in Senegal Global Acute Malnutrition (SMART 2011) Global Acute Malnutrition (SMART 2012) Global Acute Malnutrition (ENSAN 2013) Dakar Diourbel Fatick Kaffrine Kaolack Kédougou Kolda Louga Matam Saint-Louis Sedhiou Tambacounda Thiès Ziguinchor National 8,8 9.1 Table 1: Comparative GAM 2011, 2012, 2013 by Region Prevalence of Global Acute Malnutrition Global Acute Malnutrition 2013 Figure 2: Map of Senegal showing GAM by Department based on ENSAN 2013 survey 3

4 The food security module of the ENSAN survey found a moderate level of food insecurity at 18.8%; that is 245,000 households or 2.2 million people. There is deterioration in rural food security however as compared to Rural households are more affected (25.1%) with the regions of Casamance showing very high levels (Ziguinchor 68%, Sédhiou 67% and Kolda 50%). The regions of Matam and Kedougou follow high prevalence at 48% and 45.6% respectively. Program response - SAHEL NUTRITION CRISIS Since the launch of the nutrition response in 2012, UNICEF provides training, anthropometric tools, Ready to Use Therapeutic Food (RUTF) and therapeutic milks, essential medicine (deworming, vitamin A, antibiotics, ORS/Zinc), as well as resources for coordination, supervision and monitoring of the response in all fourteen Health Regions in the country. Following a phased approach, from June 2012 Phase 1 covered Diourbel and Matam regions with 174 public health facilities to offer nutritional services strengthening capacity of district authorities and health providers, both directly and through INGO partners. Phase 2 effectively started in November 2012, covering Louga, Thies and St. Louis Regions, which count 367 health facilities. The final stage (or Phase 3) began in January 2013 in six additional regions, namely Fatick, Kaffrine, Kedougou, Kolda, Sedhiou and Tambacounda. In all these regions, UNICEF supports response plans that integrate Nutrition/Health, WASH and Communication for behavioural change. UNICEF s activities in response to the nutritional crisis in Senegal were officially launched in June 2012, and current targets are set until the end of UNICEF and partners programing Based on available data more than 11,000 SAM admissions have been reported in Senegal between January and August The five regions for which August data is available have reported 1,617 new SAM admissions. This number represents 306 nutritional facilities which have reported in August (32% of total facilities). Reports are still awaited from five additional Regions. The region of Diourbel has already reached 141% of its annual SAM target. The region admits more than double the monthly SAM cases than any other region. The CLM has provided community level nutrition surveillance to 1,399,776 children under five in its screening of the second quarter. UNICEF and its partners contributed to setting up the mechanism that allows for this kind of community surveillance for malnutrition. UNICEF delivered 1,500 cartons of Plumpynut to health facilities in the month of August and an additional 1,000 in September. 4

5 UNICEF has supported the Ministry of Health to recruit and train five additional local Nutrition Technical Assistants to be placed within Health Regions nutrition teams in Louga, Thies, Saint Louis, Podor, Sedhiou. This approach is already successfully used in the Health Regions for which UNICEF received CERF funding 3 to accelerate the emergency response and provide nutrition management support to capacity of Regions. Two more technical assistants will be recruited for Tambacounda and Matam. In all, UNICEF is providing 13 nutrition technical assistants to the government of Senegal countrywide as an approach favored by the Ministry of Health. In light of persistent Severe Acute Malnutrition in the country as evidenced by the latest nutrition data, UNICEF believes there is need to strengthen the community level work conducted by the CLM and its partners. Additional resources are needed to support outreach for good practices as well as to increase the coverage and frequency of active screening so that children are identified and treated early on. 11.2% of SAM cases reported suffer of complications such as diarrhea, acute respiratory infections or oedema. 26 deaths occurred in August, more than half of which in the Region of Diourbel. A joint supervision mission by UNICEF, French Red Cross and the Ministry of Health to Diourbel is awaiting confirmation by the Ministry and is expected to help shed light on the reasons for this. Figure 3: Deafaulters by month. The number of defaulters 4 has increased with the agricultural season linked to the August rains. Thus 236 defaulters have been reported in August, totalling 631 this year. Mothers are less likely to take the time to bring children to nutrition facilities while having to spend time in the fields. 3 Fatick, Kaffrine, Kedougou (shared with Tambacounda), Kolda, Sedhiou (shared with Kolda), Tambacounda 4 Defaulter is defined as missing two consecutive doctor s appointments 5

6 SAHEL NUTRITION CRISIS SENEGAL PERFORMANCE INDICATORS Sector Estimated # / % coverage Nutrition Children 0-59 months with Severe Acute Malnutrition admitted for therapeutic care Children 0-59 months in therapeutic care discharged recovered from SAM Number of Health Centers/Posts with SAM treatment Children <5 with Severe Acute Malnutrition with complications admitted to therapeutic care UNICEF & operational partners UNICEF 2013 Target Cumulative results 2013 % of Target Achieved Cluster 2013 Target 1 Sector / Cluster Cumulative results 2013 % of Target Achieved 42, , % 42, , % 9,341 5, % 9,341 5, % % % 1, , % 1, , % List of UNICEF Operational Partners: Action Against Hunger Spain, French Red Cross, Ministry of Health, Childfund (CRS, Plan, Africare, World Vision), Cellule de Lutte Contre la Malnutrition (CLM) WASH 1. UNICEF and Cluster Target for SAM related activities are the same; UNICEF is the supplier of RUTF to all public health facilities in Senegal 2. Revised target at Senegal Humanitarian Strategy mid-year review after updated context data. 3. Based on available data from government and NGOs covering approximately 36% of nutritional facilities in the month of August. 4. Recovery data for July admissions is collected in August and is therefore now available in the September SitRep. 5. WHO in Senegal defines this target as 10% of SAM admissions. This is a fluctuating target. Number of nutrition centers/posts with the WASH minimum package 2 Number of children with SAM benefiting from hygiene kits and counselling on key hygiene messages % % 11.,032 1, % 11,032 1, % List of UNICEF Operational Partners: Ministry of Health, Ministry of Water and Sanitation, Local authorities (Mayor s office, etc.), CBOs, Senegalese Red Cross 1 This is primarily a UNICEF activity. There is currently no WASH sector-wide reporting on this indicator. Only UNICEF data is currently provided. 2 Minimum package is defined as: availability of drinking water, no open defecation and hygiene promotion. 3 Based on partial data Table 4: Summary of Sahel Performance Indicators 6

7 Seasonal Floods Update Part of a road washed away by flood waters Child in flooded house along an inlet in Joal, Thies region The Ministry of Education has identified 107 flooded schools, 4 occupied by families displaced from their homes and 11 otherwise damaged by the rains in Dakar, Saint Louis, Fatick, Kaffrine. Kaolack and Ziguinchor. UNICEF is supporting these schools with supplies to disinfect the facilities before the beginning of the school year in October and with school supplies. In a recent WASH rapid assessment, an additional 23 schools were found to be occupied by displaced families and will be disinfected by the WASH sector when the facilities are vacated. The Department of Mbour (Thies Region) declared an emergency after a road was washed away by flood waters and several neighborhoods were affected by flooding. Two joint mission of UNICEF and the National Hygiene Service (MoH) to visit the floods affecting the regions of Dakar, Fatick, Kaffrine, Kaolack and Thies have found a situation under control by authorities. More than 5,000 floodaffected families have received hygiene kits provided by UNICEF to hygiene brigades, with a reinforcement of 5,500 kits to the most affected areas to be delivered by the end of the month. UNICEF has also provided the funding needed for sensitization of the population on good hygiene practices and the treatment of water for drinking. According to WHO and the Ministry of Health, epidemiological surveillance shows that despite the floods the situation remains normal for the season in terms of suspected cases of malaria and diarrhea stating no reason for concern at this time. 7

8 Suspect Cases Weeks Figure 5: Suspected cases of bloody diarrhea by week, comparative Source: WHO Senegal Funding Update UNICEF Senegal has received an additional $500,000 from the ECHO regional pool. With this new funding UNICEF Senegal s requirements of US$ 3,305,266 in the HAC are currently 60% funded. Revised HAC Requirement USD (as of June 2013) Funded USD (August 2013) Unfunded USD Gap % 3,305,266 2,469, , Date of next SitRep: 30 October 2013 For further information, please contact: Giovanna Barberis Representative Tel: gbarberis@unicef.org Edele Thebaud Deputy Representative Tel: ethebaud@unicef.org 8

9 Annex: Prevalence of Acute Malnutrition by Department Departments Prevalence of Wasting (6-59 months old) Number (n) Global Moderate Severe Matam % 16.0% 4.5% Kanel % 15.70% 2.20% Podor % 12.8% 3.9% Ranérou % 12.3% 4.0% Bakel % 11.7% 2.7% Linguère % 11.7% 0.6% Tambacounda % 11.3% 0.3% Médina Yoro Foulah % 9.3% 2.2% Bounkiling % 9.2% 4.6% Dagana % 10.7% 0.4% Goudiry % 8.9% 2.0% Kaffrine % 9.9% 0.6% Koungheul % 9.6% 0.8% Gossas % 9.5% 0.9% Bambey % 9.7% 0.5% Saraya % 8.8% 1.4% Malem-Hodar % 8.2% 1.8% Diourbel % 9.3% 0.4% Louga % 8.20% 1.40% Goudomp % 9.0% 0.4% Birkelane % 8.5% 0.6% Salémata % 6.9% 1.6% Kolda % 7.7% 0.7% Foundiougne % 7.90% 0.40% M'bour % 6.0% 2.3% NioroduRip % 6.6% 1.5% Sedhiou % 8.2% 0.0% Vélingara % 6.7% 1.5% Saint-Louis % 8.1% 0.0% Mbacké % 7.6% 0.3% Tivaouane % 7.50% 0.40% Fatick % 7.40% 0.40% Thiès % 6.6% 0.9% Koumpentoum % 7.2% 0.3% Guinguinéo % 7.2% 0.0% Pikine % 6.7% 0.7% Kébémer % 6.2% 1.0% Bignona % 6.8% 0.0% Kédougou % 6.2% 0.0% Guediéwaye % 5.2% 0.9% Ziguinchor % 3.6% 1.6% Kaolack % 4.3% 0.3% Oussouye % 4.4% 0.0% Dakar % 2.6% 1.3% Rufisque % 3.0% 0.0% 9