COMMUNICATION BRIEF: KENYA NUTRITION SITUATION ARID AND SEMI-ARID AREAS LONG RAINS ASSESSMENT JULY 2017

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1 COMMUNICATION BRIEF: KENYA NUTRITION SITUATION ARID AND SEMI-ARID AREAS LONG RAINS ASSESSMENT JULY Key Findings The IPC for Acute Malnutrition conducted in July 2017 has reported a Very Critical nutrition situation (Phase 5; GAM WHZ 30 percent) in Central, North, South, and North Horr in Marsabit. The rates of acute malnutrition in are very alarming and are comparable with the rates recorded in 2011 Horn of Africa Crisis with the highest Global Acute Malnutrition (GAM) of 37% recoded in South. A Critical nutrition situation (Phase 4; GAM WHZ percent) was reported in East Pokot (Baringo), Samburu, West Pokot, West, Garissa, Wajir, and Mandera, while Laikipia reported a Serious nutrition situation (Phase 3; GAM WHZ percent). Moyale and Saku were classified as Alert (Phase 2; GAM WHZ 5 to 9.9 percent), while Narok, Kajiado, Makueni, Mbeere, Kwale, and Kilifi were Acceptable (Phase 1; GAM WHZ <5%) (Figure 1). Compared to February 2017, the overall nutrition situation continues to remains of great concern, including deterioration recorded in some counties. Furthermore, the situation is at risk of further deterioration in most counties in the coming due to the anticipated worsening of the food security situation (Figure 2). Currently, 420,674 children 6 to 59 and 39,068 pregnant and lactating women require treatment for acute malnutrition across the ASAL and Urban counties. The main contributing factor to the increased malnutrition is household food insecurity resulting from reduced milk availability at household level, reduced household food stocks and increased food prices. Other contributing factors include: common illnesses such as diarrhea, poor child feeding practices and poor water and hygiene practices. Pre-existing factors such as high poverty rates, low literacy, poor access to health facilities and frequent shocks aggravate the situation. Figure 1. Current nutrition situation map Figure 2. Projected nutrition situation map

2 2.0. Methods, Process and Key Issues The analysis applied the global protocols for Integrated Phase Classification for Acute Malnutrition released (November 2016). The IPC for Acute Malnutrition classified the severity of acute malnutrition into five Phases which was done based on the prevalence of GAM by WHZ. The phases are Acceptable (GAM< 5%), Alert (GAM of ), Serious (GAM of %), Critical (GAM of %) and extremely critical (GAM of 30% or more).

3 3.0. Prevalence of Acute Malnutrition in Selected Counties Survey Area (County or Sub County) Laikipia Survey date June/ July 2017 GAM WHZ SAM WHZ children 6-59 GAM MUAC SAM MUAC Under-five Mortality Rate (U5MR) Crude Mortality Rate (CMR) 11.4 ( ) 2.2 ( ) 5.2 ( ) 0.6 ( ) not done not done 7% Anthropometric Plausibility Garissa July ( ) 1.5 ( ) 3.5 ( ) 0.4 ( ) % Mandera July ( ) 5.2( ) 7.4 ( ) 0.8 ( ) not done not done 1% Central June ( ) 8.0 ( ) 12.3 ( ) 1.7 ( ) 0.6 ( ) 0.48 ( ) 5% South North June ( ) 12.0 ( ) 13.2 ( ) June ( ) 8.6 ( ) 15.1 ( ) 1.9 ( ) 0.17 ( ) 0.45 ( ) 10% 2.5 ( ) 0.42 ( ) 1.18 ( ) 4% West June ( ) 6.4 ( ) 12.2 ( ) 3.4 ( ) 0.39 ( ) 0.73 ( ) 7% Samburu June ( ) 3.8 ( ) 5.1 ( ) 0.6 ( ) not done not done 6% West Pokot June ( ) 3.2 ( ) 5.7 ( ) 0.6 ( not done not done 5% Marsabit - Laisamis Marsabit North Horr July ( ) 5.3 ( ) 8.3 ( ) 2.0 ( ) not done not done 0% July ( ) 5.0 ( ) 7.4 ( ) 1.5 ( ) not done not done 4%

4 Survey Area (County or Sub County) Marsabit Moyale Marsabit Saku Survey date GAM WHZ SAM WHZ children 6-59 GAM MUAC SAM MUAC Under-five Mortality Rate (U5MR) Crude Mortality Rate (CMR) July ( ) 0.3 ( ( ) 0.3 ( ) not done not done 7% July ( ) 0.0 ( ) 2.7 ( ) 0.8 ( ) not done not done 3% Anthropometric Plausibility Wajir pastoral July ( ) 2.5 ( ) not done not done 8% Wajir agro pastoral ) July ( ) 2.5 ( ) not done not done 3% Nairobi May ( ) 0.1 ( ) 2.6 ( ) 0.3 ( ) not done not done 10% Baringo (East Pokot) Rapid SMART) July ( ) 5.8( ) 10.8( ) 2.7( ) Not done Not done 0%

5 3.1. Summary of Caseloads County/Sub County Caseloads GAM Children 6 to 59 Months Caseload MAM Children 6 to 59 Months Caseload SAM Children 6 to 59 Pregnant and Lactating women caseloads Baringo County 17,396 13,850 3,546 1,260 Mbeere 1,363 1, Garissa 26,324 23,902 2,422 3,665 Isiolo 9,327 7,130 2, Kajiado 5,911 4,335 1,576 1,572 Kilifi 22,564 18,119 4,444 1,651 Kitui 6,608 3,735 2, Kwale 9,537 8, Laikipia 11,872 9,581 2,291 1,503 Yatta Makueni 12,389 11, Mandera 63,391 49,991 13,400 4,725 Laisamis 4,695 3,691 1,003 1,042 Moyale 1,616 1, North Horr 6,394 5,363 1, Saku 1, Meru North 10,626 8,694 1, Narok 7,154 5,067 2,087 1,987 Kieni Samburu 13,775 10,914 2,860 1,088 Taita Taveta 3,764 3, Tana River 11,737 9,167 2, Tharaka 1,509 1, Central 11,618 8,658 2,960 1,268 North 15,625 11,684 3,941 1,846 South 13,816 9,335 4,481 1,146 West 13,313 9,672 3,641 1,388 Wajir 27,618 23,508 4,110 5,173 West Pokot 35,390 29,838 5,551 1,371 Lamu 1,342 1, Kisumu 3,240 2,208 1, Mombasa 3,648 1,267 2,381 1,102 Nairobi 44,509 37,444 7, Total 420, ,563 83,109 39,068

6 Summary of Contributing Factors Coastal Marginal (Kwale, Kilifi, Lamu and Taita Taveta Counties) SUMMARY CONTRIBUTING FACTORS BY AREA Major contributing factor Minor contributing factor Not a contributing factor KILIFI T/TAVETA KWALE LAMU Inadequate dietary intake Diseases Inadequate access to food Inadequate care for children Insufficient health services & unhealthy environment Basic causes Other nutrition issues Minimum Dietary Diversity (MDD) Minimum Meal Frequency (MMF) Minimum Acceptable Diet (MAD) Minimum Dietary Diversity Women (MDD-W) Diarrhoea Dysentery Malaria HIV/AIDS prevalence Acute Respiratory Infection Disease outbreak Outcome of the IPC for Acute Food Insecurity analysis Exclusive breastfeeding under 6 Continued breastfeeding at 1 year Continued breastfeeding at 2 years Introduction of solid, semi-solid or soft foods Measles vaccination Polo vaccination Vitamin A supplementation Skilled birth attendance Health seeking behaviour Coverage of outreach programmes CMAM programme coverage (SAM, MAM, or both) Access to a sufficient quantity of water Access to sanitation facilities Access to a source of safe drinking water Human capital Physical capital Financial capital Natural capital Social capital Policies, Institutions and Processes Usual/Normal Shocks Recurrent Crises due to Unusual Shocks Other basic causes Anaemia among children 6-59 Anaemia among pregnant women Anaemia among non-pregnant women Vitamin A deficiency among children 6-59 Low birth weight Fertility rate

7 Pastoral Northwest (, Marsabit, Samburu) SUMMARY OF CONTRIBUTING FACTORS Major contributing Factor Minor Contributing Factor Not a contributing Factor Inadequate Minimum Dietary Diversity (MDD) dietary intake Minimum Meal Frequency (MMF) Minimum Acceptable Diet (MAD) Moyale North Horr SAKU LAISAMIS North Central West South Samburu Minimum Dietary Diversity Women (MDD-W) Diseases Inadequate access to food Inadequate care for children Insufficient health services & unhealthy environme nt Diarrhoea Dysentery Malaria HIV/AIDS prevalence Acute Respiratory Infection Disease outbreak Outcome of the IPC for Acute Food Insecurity analysis Exclusive breastfeeding under 6 Continued breastfeeding at 1 year Continued breastfeeding at 2 years Introduction of solid, semi-solid or soft foods Measles vaccination Polo vaccination Vitamin A supplementation Skilled birth attendance Health seeking behaviour Coverage of outreach programmes CMAM programme coverage (SAM, MAM, or both) Access to a sufficient quantity of water Access to sanitation facilities Access to an improved source of drinking water Basic causes Other nutrition issues Human capital Physical capital Financial capital Natural capital Social capital Policies, Institutions and Processes Usual/Normal Shocks Recurrent Crises due to Unusual Shocks Other basic causes Anaemia among children 6-59 Anaemia among pregnant women Anaemia among non-pregnant women Vitamin A deficiency among children 6-59 Low birth weight Fertility rate

8 SUMMARY CONTRIBUTING FACTORS BY AREA Inadequate dietary intake Diseases Major contributing factor Inadequate access to food Inadequate care for children Insufficient health services & unhealthy environment Basic causes Other nutrition issues Minor contributing factor Minimum Dietary Diversity (MDD) Minimum Meal Frequency (MMF) Minimum Acceptable Diet (MAD) Minimum Dietary Diversity Women (MDD-W) Diarrhoea Dysentery Malaria HIV/AIDS prevalence Acute Respiratory Infection Disease outbreak Outcome of the IPC for Acute Food Insecurity analysis Exclusive breastfeeding under 6 Continued breastfeeding at 1 year Continued breastfeeding at 2 years Introduction of solid, semi-solid or soft foods Measles vaccination Polo vaccination Vitamin A supplementation Skilled birth attendance Not a contributing factor Health seeking behaviour Coverage of outreach programmes CMAM programme coverage (SAM, MAM, or both) Access to a sufficient quantity of water Access to sanitation facilities Access to a source of safe drinking water Human capital Physical capital Financial capital Natural capital Social capital Policies, Institutions and Processes Usual/Normal Shocks Recurrent Crises due to Unusual Shocks Other basic causes Anaemia among children 6-59 Anaemia among pregnant women Anaemia among non-pregnant women Vitamin A deficiency among children 6-59 Low birth weight Fertility rate MBEER THARAKA KITUI MAKUENI MERU/N

9 Pastoral North East (Tana River, Garissa, Wajir, Mandera and Isiolo) SUMMARY CONTRIBUTING FACTORS BY AREA Inadequate dietary intake Major contributing factor Minor contributing factor Minimum Dietary Diversity (MDD) Not a contributing factor WAJIR EAST WAJIR NORTH MANDER A GARISSA ISIOLO T/RIVER Diseases Inadequate access to food Inadequate care for children Insufficient health services & unhealthy environment Basic causes Minimum Meal Frequency (MMF) Minimum Acceptable Diet (MAD) Minimum Dietary Diversity Women (MDD-W) Diarrhoea Dysentery Malaria HIV/AIDS prevalence Acute Respiratory Infection Disease outbreak Outcome of the IPC for Acute Food Insecurity analysis Exclusive breastfeeding under 6 Continued breastfeeding at 1 year Continued breastfeeding at 2 years Introduction of solid, semi-solid or soft foods Measles vaccination Polo vaccination Vitamin A supplementation Skilled birth attendance Health seeking behaviour Coverage of outreach programmes CMAM programme coverage (SAM, MAM, or both) Access to a sufficient quantity of water Access to sanitation facilities Access to a source of safe drinking water Human capital Physical capital Financial capital Natural capital Social capital Policies, Institutions and Processes Usual/Normal Shocks Recurrent Crises due to Unusual Shocks Other basic causes Other nutrition issues Anaemia among children 6-59 Anaemia among pregnant women Anaemia among non-pregnant women Vitamin A deficiency among children 6-59 Low birth weight Fertility rate

10 Agro pastoral livelihood Zone (West Pokot, East Pokot, Laikipia, Kajiado and Narok) SUMMARY CONTRIBUTING FACTORS BY AREA Inadequate dietary intake Diseases Major contributing factor Inadequate access to food Inadequate care for children Insufficient health services & unhealthy environment Basic causes Other nutrition issues Minor contributing factor Minimum Dietary Diversity (MDD) Minimum Meal Frequency (MMF) Minimum Acceptable Diet (MAD) Minimum Dietary Diversity Women (MDD-W) Diarrhoea Dysentery Malaria HIV/AIDS prevalence Acute Respiratory Infection Disease outbreak Outcome of the IPC for Acute Food Insecurity analysis Exclusive breastfeeding under 6 Continued breastfeeding at 1 year Continued breastfeeding at 2 years Introduction of solid, semi-solid or soft foods Measles vaccination Polo vaccination Vitamin A supplementation Skilled birth attendance Not a contributing factor Health seeking behaviour Coverage of outreach programmes CMAM programme coverage (SAM, MAM, or both) Access to a sufficient quantity of water Access to sanitation facilities Access to a source of safe drinking water Human capital Physical capital Financial capital Natural capital Social capital Policies, Institutions and Processes Usual/Normal Shocks Recurrent Crises due to Unusual Shocks Other basic causes Anaemia among children 6-59 Anaemia among pregnant women Anaemia among non-pregnant women Vitamin A deficiency among children 6-59 Low birth weight Fertility rate NYERI /N LAIKIPIA BARINGO W/POKOT AKAJIADO NAROK