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This study is the first component of a multi-pronged research study on breaking the cycle of food insecurity in Malawi. Results from other components are to follow, including promoting nutritious value chains and understanding the drivers of food security and resilience. This study examines the impact of a food-based social transfers (MVAC) on household food security, diets, and nutrition status of young children during the lean season in Malawi. This was a quasi-experimental prospective study based on two rounds of a mixed methods surveys study in Zomba district in southern Malawi. Study outcomes include household expenditures and food consumption (7-day recall), child level dietary diversity (24-hour recall) and nutritional status (anthropometric measurements). We follow a mixed methods approach and undertake child and household surveys and assessments as well as in-depth interviews with household members. We estimate program impact by combining propensity score matching (PSM) and difference-in-difference (DID) methods. Qualitative data provides insights into community norms on targeting and sharing that may impact the effectiveness of the transfers.
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This presentation and discussion was led by Noora-Lisa Aberman (IFPRI) along with virtual input from co-authors, Aulo Gelli (IFPRI), Jason Donovan (ICRAF), and Amy Margolies (JHU), on February 13, 2017 at IFPRI-Malawi.
Impact of food transfers in zomba abermanIFPRIMaSSP
This study is the first component of a multi-pronged research study on breaking the cycle of food insecurity in Malawi. Results from other components are to follow, including promoting nutritious value chains and understanding the drivers of food security and resilience. This study examines the impact of a food-based social transfers (MVAC) on household food security, diets, and nutrition status of young children during the lean season in Malawi. This was a quasi-experimental prospective study based on two rounds of a mixed methods surveys study in Zomba district in southern Malawi. Study outcomes include household expenditures and food consumption (7-day recall), child level dietary diversity (24-hour recall) and nutritional status (anthropometric measurements). We follow a mixed methods approach and undertake child and household surveys and assessments as well as in-depth interviews with household members. We estimate program impact by combining propensity score matching (PSM) and difference-in-difference (DID) methods. Qualitative data provides insights into community norms on targeting and sharing that may impact the effectiveness of the transfers.
Food transfers appear to have a protective effect on food security, diets and nutrition status of young children. There was suggestion of a positive effect on micronutrient availability in diets, particularly for iron. At child level, highly significant positive effects were found on dietary diversity and food variety scores, corresponding to increases of 15% and 12% respectively, as well as a positive effect on stunting. But targeting did not appear to be progressive or aligned to MVAC criteria. Furthermore, the coverage of food transfers is extremely low compared to extent of food insecurity. Community norms about targeting and sharing may explain the targeting errors and also may be seen as a response to low coverage.
Harnessing markets for improved nutrition: A Case Study of ZombaIFPRIMaSSP
Hunger and undernutrition are intractable problems in Malawi. This study takes a Value Chains for Nutrition (VCN) approach, which examines the potential for harnessing markets for improved nutrition and food security. This case study from the Zomba District of southern Malawi applies data from household surveys, in-depth individual interviews, and market surveys to examine opportunities for improved diets through leveraging demand and supply of nutritious foods, and enhancing value chain performance with a nutrition lens. Preliminary results on bottlenecks and opportunities provide insights for policy and programs.
This presentation and discussion was led by Noora-Lisa Aberman (IFPRI) along with virtual input from co-authors, Aulo Gelli (IFPRI), Jason Donovan (ICRAF), and Amy Margolies (JHU), on February 13, 2017 at IFPRI-Malawi.
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more closely to disaster relief efforts could substantially
improve welfare outcomes during and after a natural
disaster. Finally, risk-coping strategies, including financial
account ownership, access to off-farm income sources,
and adult children living away from home, were generally
ineffective in mitigating the negative impacts of the floods.
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Shelter from the Storm? Household-Level Impacts of, and Responses to, the 201...IFPRIMaSSP
As extreme weather events intensify due to climate change,
it becomes ever more critical to understand how vulnerable
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two-period panel data set. The results show that while yields
were dramatically lower for households severely affected
by the floods, drops in food consumption expenditures
and calories per capita were less dramatic. However, dietary
quality, as captured by the food consumption score, was
significantly lower for flood-affected households. Although
access to social safety nets increased food consumption outcomes,particularly for those in moderately-affected areas,
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net programs was lower in 2015 compared with 2013.
The latter finding suggests that linking these programs
more closely to disaster relief efforts could substantially
improve welfare outcomes during and after a natural
disaster. Finally, risk-coping strategies, including financial
account ownership, access to off-farm income sources,
and adult children living away from home, were generally
ineffective in mitigating the negative impacts of the floods.
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3. 3
1. SITUATION OVERVEIW
Due to the war and natural disasters:
5,620,469 population in emergency need
609,541 IDPs
77500 (13%) in the camp
532041 in Host community
5. Rapid Nutrition
Assessment findings
=>The ENCU with some
partners conducted RNA in 4
Hotspot woredas
• 3 Zone: Waghimera and North
Gondar and North Wollo
• 4 woredas: Raya Kobo, Ziquala,
Sekota Zuriya and Adirkay
• 12 selected kebeles
• The presentation will be compiled
for Sekota Zuria & Raya Kobo
woredas
5
6. General Objective
• to assess the nutrition situation,
particularly to overview the prevalence of
malnutrition on children 6-59 months of
age and PLWs
Specific Objectives
• To examine the current nutritional status of children
6-59 months of age and PLW
• To assess whether there is a need to undertake
standard emergency nutrition assessment
• To trigger an immediate response where acute
needs are identified in specific areas or population
groups;
• To make appropriate recommendation based on the
key finding of the assessment.
Objective of
RNA
7. ASSESSMENT METHODOLOGY
7
• kebeles in the woreda were purposely categorized by
the woreda administration in to 3 sub-groups as
• worst affected, close monitoring and normal
• Purposive sampling method was used to select
woredas & kebeles for the assessment parallel to
MUAC and oedema measurement
• Six kebeles /three in each woreda/ were selected for
the assessment
8. Methodology...
8
• Both Qualitative and Quantitative approaches have
been used in conducting the assessment
• Quantitative MUAC Measurement
• Qualitative FGD & KII at woreda & kebele level
d
• Children aged between 6-59 months in each “gots” of
each kebeles were measured
• Three teams of five - seven members each were
deployed in each kebele
• Zone & woreda EW officers, woreda health officer, WASH
officer, ENOs, health extension workers
• and members from NGOs (SCI, GOAL, AAH)
9. Assessed woredas and kebeles
9
Woreda Selected kebele
Assessment
date
Activities
Sekota Zuria
Double
Mariyam,
Bagmila and
Tsemera December
01-12/022
Focus group
discussion,
Transact walk,
MUAC
Measurement
Raya Kobo
Dino, Ramma &
Workie
10. Nutritional Assessment result of Sekota Zuria woreda_Debele Mariyam Kebele
0
Debele Mariyam Kebele
Under 5 children Screened147
(female =70 & male =77)
• GAM prevalence 24.5%
• SAM prevalence 1.40%
Age category
Nutritional
status
Males Females Total
N % N % N %
6mo - <2 Years Old
Oedema 0 0.00% 0 0.00% 0 0.00%
<115 mm 0 0.00% 0 0.00% 0 0.00%
115-124 mm 8 25.00% 9 52.90% 17 34.70%
≥125 mm 24 75.00% 8 47.10% 32 65.30%
Total 32 100.00% 17 100.00% 49 100.00%
≥ 2-5 Years Old
Oedema 0 0.00% 0 0.00% 0 0.00%
<115 mm 1 2.20% 1 1.90% 2 2.00%
115-124 mm 5 11.10% 12 22.60% 17 17.30%
≥125 mm 39 86.70% 40 75.50% 79 80.60%
Total 45 100.00% 53 100.00% 98 100.00%
Total
Oedema 0 0.00% 0 0.00% 0 0.00%
<115 mm 1 1.30% 1 1.40% 2 1.40%
115-124 mm 13 16.90% 21 30.00% 34 23.10%
≥125 mm 63 81.80% 48 68.60% 111 75.50%
Total 77 100.00% 70 100.00% 147 100.00%
Indicator
Nutritional
Status
Number Percentage
MUAC <23 CM
Moderate
Malnourished
66 66%
MUAC >23 CM Normal 34 34%
PLW Result
11. Nutritional Assessment result of Sekota Zuria woreda_Bagimila Kebele
Age category
Nutritional
status
Males Females Total
N % N % N %
6mo - <2 Years Old
Oedema 0 0.00% 0 0.00% 0 0.00%
<115 mm 0 0.00% 0 0.00% 0 0.00%
115-124 mm 28 59.60% 41 77.40% 69 69.00%
≥125 mm 19 40.40% 12 22.60% 31 31.00%
Total 47 100.00% 53 100.00% 100 100.00%
≥ 2-5 Years Old
Oedema 0 0.00% 0 0.00% 0 0.00%
<115 mm 0 0.00% 0 0.00% 0 0.00%
115-124 mm 15 31.90% 15 28.30% 30 30.00%
≥125 mm 32 68.10% 38 71.70% 70 70.00%
Total 47 100.00% 53 100.00% 100 100.00%
Total
Oedema 0 0.00% 0 0.00% 0 0.00%
<115 mm 0 0.00% 0 0.00% 0 0.00%
115-124 mm 43 45.70% 56 52.80% 99 49.50%
≥125 mm 51 54.30% 50 47.20% 101 50.50%
Total 94 100.00% 106 100.00% 200 100.00%
Bagimila Kebele
Under 5 children Screened 200
(female =106 & male =94)
• GAM prevalence 49.5%
Indicator Nutritional Status Number Percentage
MUAC <23 CM
Moderate
Malnourished
52 73.20%
MUAC >23 CM Normal 18 26.80%
PLW Result
12. Nutritional Assessment result of Sekota Zuria woreda_Tsemera Kebele
Age category
Nutritional
status
Males Females Total
N % N % N %
6mo - <2 Years
Old
Oedema 0 0.00% 0 0.00% 0 0.00%
<115 mm 3 5.40% 9 15.30% 12 10.40%
115-124 mm 21 37.50% 23 39.00% 44 38.30%
≥125 mm 32 57.10% 27 45.80% 59 51.30%
Total 56 100.00% 59 100.00% 115 100.00%
≥ 2-5 Years Old
Oedema 0 0.00% 0 0.00% 0 0.00%
<115 mm 0 0.00% 2 2.30% 2 1.00%
115-124 mm 12 10.60% 10 11.50% 22 11.00%
≥125 mm 101 89.40% 75 86.20% 176 88.00%
Total 113 100.00% 87 100.00% 200 100.00%
Total
Oedema 0 0.00% 0 0.00% 0 0.00%
<115 mm 3 1.80% 11 7.50% 14 4.40%
115-124 mm 33 19.50% 33 22.60% 66 21.00%
≥125 mm 133 78.70% 102 69.90% 235 74.60%
Total 169 100.00% 146 100.00% 315 100.00%
Tsemera Kebele
Under 5 children Screened 315
(female =146 & male =169)
• GAM prevalence 25.40%
• SAM prevalence 4.40%
Indicator Nutritional Status Number Percentage
MUAC <23 CM
Moderate
Malnourished
44 74.50%
MUAC >23 CM Normal 15 25.50%
PLW Result
13. Nutritional Assessment result of Raya Kobo woreda_3 Kebeles (6-59 months children & PLW)
3
Age group
Nutritional
status
Males Females Total
N % N % N %
< 2 Years
Old
Oedema 0 0% 0 0.0% 0 0%
<115 mm 10 6.6% 6 3.8% 16 5.2%
115-124 mm 76 50% 89 56.3% 165 53.2%
≥125 mm 66 43.4% 63 39.9% 129 41.6%
Total 152 100% 158 100% 310 100%
≥ 2 Years
Old
Oedema 0 0% 0 0% 0 0%
<115 mm 3 2.1% 1 0.8% 4 1.4%
115-124 mm 32 22.1% 21 16% 53 19.2%
≥125 mm 110 75.9% 109 83.2% 219 79.3%
Total 145 100% 131 100% 276 100%
Total
Oedema 0 0% 0 0% 0 0%
<115 mm 13 4.4% 7 2.4% 20 3.4%
115-124 mm 108 36.4% 110 38.1% 218 37.2%
≥125 mm 176 59.3% 172 59.5% 348 59.4%
Total 297 100% 289 100% 586 100%
Three Kebele
Under 5 children Screened 586(female
=289 & male =297)
• GAM prevalence 40.60%
• SAM prevalence 3.40 %
Indicator Nutritional Status Number Percentage
MUAC <23 CM MAM 230 79.30%
MUAC >23 CM Normal 60 20.70%
Total 290 100%
PLW Result of three kebeles
14. WASH situations in
Raya Kobo
woreda
• Problems of access to clean potable water have
been the bottlenecks of households in different
kebeles of the woreda for the last months
• The water points were damaged and out of
service
• Most of the kebeles populations in the woredas
have been consuming water from open sources.
• As per the Raya Kobo woreda water and energy
office, the major sources of drinking water are
streams (298 streams) of which 190 (63.7%) are
still functioning.
• Absences of electricity and absence of predictable
budget for fuel purchase are the main challenges.
14
15. Agriculture and
Livelihoods
Situation..
• The displacement of people from their areas
was happened starting from the second of
August 2022.
• Proper agricultural practices such as, planting,
weeding and harvesting was not done
• Based Woreda KII and kebele FGD in the
assessed woredas indicated that farmers were
collected stalks of sorghum just for the sake of
the biomass for their cattle.
• The livestock herd size especially shoats
extremely reduced as they are looted and
slaughtered.
• Generally, the overall livelihood system were
interrupted by the conflict.
16. Protection
and
Education
Concerns
• Children including the disables have been living
without appropriate care arrangements and access
to basic social services including education
• As per the Key informant and focus group
discussion findings, the education system has not
yet fully functioned.
• A number of schools are also damaged and their
equipment's like chairs, tables, blackboards were
looted
• There are still a number of people who were
affected by psychological trauma.
16
17. CONCLUSION
• The level of malnutrition with the observed
aggravating factors like;
• poor meher crop production
• poor household food access and availability,
• damage of infrastructures,
• increased prices of major staples food may
lead to the alert malnutrition stage of
“serious”
• Most of the basic services in the woredas have
been impaired for the last years
• Schools, health and WASH infrastructures were
damaged & may take longer time to rehabilitate
18. CONCLUSION
• several lives and livelihoods were lost, looted and
damaged
• The psychosocial trauma of the war was very high
that caused anxiety and hopelessness
• Coordinated efforts and support should be exerted to
recover and rehabilitate the damaged facilities.
• Assessed woredas have ample amount of irrigable
land and able to cover the food needs if the damaged
and looted services maintained and work properly
• Agricultural farm tools and improved emergency
seed supply for the poor farmers is mandatory to
recover from the trauma.
19. Response
• Emergency food has been distributed to 5,620,469 beneficiaries by different
actors
• EDRMC: for 2,933,541 beneficiaries /17%/
• CRS /JEOP/ 1,763,305 beneficiaries 31%
• WFP:- 923,623 beneficiaries /52%
More than 186 FDPs were opened for emergency food distribution
TSFP support in 32 IMAM woredas in November 2022
55,475 U5 Children
63,464 PLW
20. • 72,519 children and 25,605 PLW were screened for
malnutrition;
• 1,042 SAM and 8,566 MAM children were identified
(proxy GAM of 13%)
• 4,738 (19%) MAM PLW were found.
Screening for
Malnutrition
• 999 children suffering from SAM admitted to TFP (440 OTP & 45
SC).
• 6,144 children and 3,477 PLW were admitted to TSFP/BSFP
• 10,020 children 6-59 months supplemented Vitamin A.
• 7,606 children 24-59 months dewormed.
• 2,647 mothers received IFA, and 14,126 caretakers of
children 0-23 received IYCF counseling.
• 1,032 children and 514 PLW received High energy biscuits.
Treatment of Acute
malnutrition and
micronutrient
supplementation; a total
of 46,565 children and
mothers reached during
these two weeks (24,889)
are children).
21. Monthly SAM Management Report
10663
11539
8288
7099
7864 8293
6679
7866
9021
10379
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Amhara Region TFP Admission Trend (2020-2022)
Admission - 2020 Admissions 2021 Admissions 2022
23. CHALLENGES
• Long delays and an incomplete general food program
package led to an unequal distribution among zones and
the implementing agency.
• Lack of Budget for recovery & Rehabilitation
• Absence of data both at zonal, woreda and kebele levels
• Lack of office materials and equipments
• Destruction of anthropometric and other nutrition
supplies at health facilities of war affected areas and
recently liberated areas.
• Less partner involvement in recently liberated areas
North Wollo, North Gondar and Waghimera zone.
24. RECOMMENDATIONS
• Timely & adequate emergency food assistance
• Regular monitoring of the nutrition situation and
timely response for malnourished children
• Health extension workers should work on improving
hygiene and sanitation
• Psychosocial support (therapy) should be provided
broadly to treat people from Psychosocial trauma
• Livelihoods support in different like IGAs, restocking
program … etc for the most affected ones
• Regular follow up and verification of the
malnutrition prevalence using SMART Nutrition
Survey is highly advisable
• Rehabilitation and recovery interventions
Facilitator Notes
- Brief scheme of the main points to talk about during the session
In the month of Oct 2022, Children suffering from severe acute malnutrition admissions increased by 15% compared with the previous month i.e., from 9,021 cases in Sep 2022 with RR of 60.35% to cases 10,379 in Oct 2022 with a reporting rate of 59.78%. Similarly, the admission is more than triple as compared to the similar period of Oct 2021.
From January to Oct 2022, 87,691 SAM children were treated, which constituted 72% of the region's HRP Annual 2022 target of 121,749.
The proportion of SAM admissions with medical complications (required inpatient care) was 9.74%, which is high compared with other previous months, and it is equal with the national average of 10% of total admissions.
