The annual performance review summarizes the nutrition unit's activities and outcomes in Nabdam District for 2021. Key priorities included building staff capacity, improving data quality, and increasing vitamin A supplementation coverage. Major activities carried out were training staff and lobbying for nutrition support. Growth monitoring showed most children were normal weight but some were underweight or stunted. Anaemia rates among pregnant women decreased from 2021. Vitamin A supplementation and CMAM program coverage improved. Challenges remained around staffing and funding but ways forward focused on continued capacity building and community nutrition programs.

1. 2021 ANNUAL PERFORMANCE REVIEW
NABDAM DISTRICT
NUTRITION
PRESENTED
BY
Baba Yahaya Mohammed
(HEALTH INFORMATION OFFICER)

2. PRESENTATION OUTLINE
• Introduction
• Broad Goal/mission of the Nutrition Unit
• Concerns at the beginning of the year
• Priorities for the year under review
• Background of nutrition programmes
• Activities carried out
• GMP(CWC)
• Anaemia Control & Birth Outcomes
• Micro Nutrient Deficiency Control(Vit. A)
• Nutrition programs
• CMAM (Nutrition Rehabilitation)
• GIFTS
• Combined minerals powder
• Challenges
• Way forward

3. HEALTH INFRASTRUCTURE
FACILITY NUMBER
Total Health facilities 24
Hospitals (Private) 1
CHAG Facilities 1
Health Centers 3
Number of Electoral areas 13
POPULATION INDICES
DESCRIPTION 2021
Total Population 42632
Expected Pregnancy (4%) 1705
WIFA (24%) 10232
Children 0-23 months(8%) 3411
Children
0 – 59 months
8526
Number of communities 85
DISTRICT PROFILE

4. NANGODI
PELUNGU
SAKOTE
AYAMFOYA CLINIC
KOTINTABIG CHIPS
SAKOTE CHIPS
NANGODI HEALTH
CENTER
YAKOTE CHIPS
NYORBOK
CHIPS
DISTRICT SUB-DISTRICT MAP

5. INTRODUCTION
Malnutrition is still a major problem especially among pregnant women and
hildren <5yrs. According to the 2020 Global Nutrition Report, one in every
hree persons is either over weight or obese whiles one in every nine
ersons is underweight. Yet, little attention is paid to nutrition in most
ountries. Malnutrition is now becoming a global pandemic with hypertension,
iabetes and several other non communicable diseases taking many lives.
Recent studies indicate poor/inadequate maternal and child care
ractices/behaviors coupled with under nutrition contributes greatly to the
tagnating infant mortalities.

6. VISSION AND MISSION
VISSION
A HEALTHY POPULATION FOR NABDAM DEVELOPMENT
MISSION
WORK TOWARDS ACHIEVING HEALTHY LIFSTYLE FOR ALL
PEOPLE LIVING IN NABDAM AND BEYOUND THROUGH A
NUTRITION AND HEALTH FRIENDLY APPROACHE THAT
PRIORITISES CUSTOMER VALUES AND ALL
STAKEHOLDERS IN A COORDINATED MANNER

7. CONCERNS AT THE BEGINNING OF THE YEAR
 Many staff not trained on the new Combined MCHRB
 No food commodities for targeted supplementary feeding
 Poor documentation amongst some staff
 Low capacity in nutrition counselling(C-IYCF), CMAM program and data sets
 Apathy towards nutrition activities
 Staff Attrition/Movements
 Inadequate funds or support for nutrition activities
 Higher prevalence of anaemia in pregnancy
 Vitamin A low coverage

8. PRIORITIES
 Build capacity of staff on nutrition
programs and data sets
 On the job coaching on Nutrition
counseling
 Wellness clinic
 Improving nutrition data quality in
DHIMS
 Carry out Vitamin A mop up to improve
coverages
 Lobbying for alternative support for
nutrition (CMAM and HIV/AIDS clients)

9. MAJOR ACTIVITIES CARRIED OUT
 Trained selected GES and GHS staff on the
nutrition friendly/ SMART school
initiative.
 Trained selected GES and GHS staff on
the reforms on GIFTS implementation
 Lobbied for support from Marilyn of
Yakoti Women Farmers for local plumpy nut
for CMAM clients.
 Carried out on the job coaching on
nutrition counselling using the MCHRB

10. BACKGROUND ON NUTRITION
PROGRAMMES
NUTRITION PROGRAMMES/INTERVENTIONS IMPLEMENTED AT THE DISTRICT
LEVELC-
TARGET
The Smart School Program Five JHS
GIFTS
Aneamia control
Adolescents 10-19 years
and women in reproductive age
C-IYCF Pregnant women and Children up to
2 years
CMAM Children 6-59 months
Vitamin A Supplementation Children 6-59 months
Growth monitoring and promotion Children 0-59mmonths
Promotion of iodized salt consumption All communities/ General population
Nutrition counselling using CARDS and MCHRB Pregnant women and targeted adults

11. GROWTH MONITORING AND PROMOTION
• Is a periodic weighing of a child and
classification of the child’s progress
and uses it for decision regarding
care at home or the need for medical
attention and also to stimulate
community, district programs to
improve the child’s growth .
• Activities carried out include:
• Immunization
• Vit. A supplementation
• Referrals
• Counseling
• Deworming
• Growth pattern
• etc.

12. Nutritional Status of CWC Registrants
Sub-Districts KONGO NANGODI PELUNGU SAKOTE ZALERIGU
Period 2019 2020 2021 2019 2020 2021 2019 2020 2021 2019 2020 2021 2019 2020 2021
Registrants 737 827 370 332 385 176 567 523 330 523 609 325 651 627 217
Severe
underweight
(< -3SD)
1 4 32 0 1 0 1 2 2 0 3 12 4 3 1
%
0.1%
0.5% 9% 0% 0.3% 0% 0.2% 0.4% 0.6% 0% 0.5% 3.7% 0.6% 0.5% 0.5%
Moderate
underw’ght
(-3SD to -2SD)
30 63 8 12 3 12 5 10 17 39 33 1 20 6 22
% 4% 7.6% 2% 3.6% 0.8%
6.8
%
0.9
%
1.9% 5% 7.5 5.4 0.3% 3.0% 1.0% 10%
Normal
(-2SD to +2SD)
713 763 334 323 381 164 561 513 311 484 569 313 627 618 194
% 96.7
%
92.3% 89%
97.3
%
99.1
%
93.2
%
98.9
%
98.1
%
89.5%
92.5
%
93.4% 96%
96.3
%
98.6%
89.5
%

13. Trend of Underweight at registration - District
96% 96% 98%
4% 4% 2%
0%
20%
40%
60%
80%
100%
120%
2019 2020 2021
Normal Underweight

14. Nutritional Status of Children 0-59 at CWC Registration
DISTRICT YEARS
Period 2019 2020 2021
Registrants 2810 2968 1418
Severe underweight (< -3SD) 6 13 15
%
0.2%
0.4% 1.1%
Moderate underw’ght (-3SD to -2SD) 106 115 12
% 3.8% 3.9% 0.8%
Normal (-2SD to +2SD) 2708 2844 1391
% 96.4% 95.8% 98.1%

15. STUNTING
93%
7%
0.2%
98%
1%
0.6
98%
1.5% 0.3%
0%
20%
40%
60%
80%
100%
120%
NORMAL MODERATE TUNTING SEVERED STUNTING
stunting coverages
2019 2020 2021

16. ANAEMIA CONTROL
It is estimated that
41.8% pregnant women
worldwide are Anaemic.
Therefore Routine iron
supplementation will
help reduce the risk of
maternal Anaemia & its
consequences; iron
deficiency and LBW.

17. ANAEMIA AMONG PREGNANT WOMEN
SUB-
DISTRICT
KONGO NANGODI PELUNGU SAKOTE ZANLERIGU DISTRICT
YEAR 2019 2020 2021 2019 2020 20212019 2020 2021 20192020 2021 2019 2020 2018 2019 2020 2021
New
Registrant
408 386 533 150 178 247 241 272 304 230 239 363 150 208 247 1179 1350 1694
Hb
Checked
@Reg
308 356 522 141 161 232 166 243 256 175 238 337 133 189 238 1003 1251 1585
Anaemia 189 117 200 81 98 113 44 71 85 77 105 131 68 93 96 459 513 624
% 61%
32.9
%
38% 57%
60.9
%
48.7
%
27% 29.2 33% 44% 44% 38.9% 51%
49.2
%
40.3% 46% 41% 39%
HB
Checked
at 36
weeks
275 186 293 81 95 147 75 108 163 106 173 205 67 92 153 604 678 961
Anaemia 128 70 127 57 54 99 17 38 74 74 95 84 36 52 74 312 325 458
% 47%
37.6
43% 70%
56.8
67% 23% 35.2 45% 70%
54.9
41% 54%
56.5
48.4% 52% 48%
47.7

18. TREND OF ANEMIA AT 36 WEEKS OF PREGNANCY
47%
70%
23%
70%
54%
46%
38%
57%
35%
55%
57%
48%
43%
67%
45%
41%
48% 48%
0%
10%
20%
30%
40%
50%
60%
70%
80%
KONGO PITANGA NANGODI PELUNGU SAKOTI ZANLERIGU DISTRICT
2019 2020 2021

19. GRAPHICAL PRESENTATION OF ANAEMIA
46%
41%
39%
52%
48%
48%
0%
10%
20%
30%
40%
50%
60%
2019 2020 2021
Anaemia@REG Anaemia@36wks

20. Birth outcome
Sub-districts Kongo-pitanga Nangodi Pelungu Sakote Zanlerigu District
Period 19 20 21 19 20 21 19 20 21 19 20 21 19 20 21 19 20 21
Total Live Births 402 325 418 131 111 146 185 182 209 201 206 281 112 99 165 1031 973 1219
# With Birth Wght
< 2.5kg
55 50 46 15 12 5 23 23 11 18 20 34 15 3 14 126 114 110
%With Birth Wght
< 2.5kg
13.7
%
15.4
%
11%
11.5
%
10.8
%
3%
12.4
%
12.6
%
5% 9% 9.5% 18.8%
10.7
%
3% 8.5%
12.2
%
11.7
%
9.0%
Babies put to
breastfeed within
30mins)
395 323 408 129 110 133 185 182 220 195 205 282 112 99 165 1016 963 1208
% EARLY
Initiation(within
30mins)
98% 99% 97%
98.5
%
99.1
%
91% 100
100
%
105
%
97
99.5
%
100% 100
100
%
100% 98.5 99%
99.1
%

21. BIRTH WEIGHT AGAINST ANAEMIA AMONG PREGNANT WOMEN(@ 36 WEEKS)
12%
12%
9%
52%
48%
48%
0%
10%
20%
30%
40%
50%
60%
2019 2020 2021
BIRTH WGHT <2.5 ANAEMIA RATES AMONG PREGNANT WOMEN AT 36WKS

22. Trend of Infant Feeding – District
2019 2020 2021
Early Initiation 98% 99% 99%
EBF @ Discharge 98% 100% 100%
EBF @ 3months 100% 105% 76%
98% 99% 99%
98%
100% 100%
100%
105%
76%

23. VITAMIN A
SUPPLEMENTATION IS
RECOMMENDED IN INFANTS
6-59MONTHS TO REDUCE
CHILD MORBIDITY AND
MORTALITY.

24. First Sem (6-59 months)
Nangodi Kon-Pitanga Pelungu Sakote Zanlerigu Nabdam
20192 28% 13% 18% 2% 16% 14%
20202 34% 29% 29% 23% 31% 29%
2021 34% 29% 29% 23% 31% 39%
28%
13%
18%
2%
16%
14%
34%
29% 29%
23%
31%
29%
34%
29% 29%
23%
31%
39%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%

25. Second Sem (6-59 months)
Nangodi Kon-Pitanga Pelungu Sakote Zanlerigu Nabdam
2019 34% 37% 46% 31% 30% 49%
2020 26% 27% 31% 21% 16% 26%
2021 26% 27% 31% 21% 16% 48%
34%
37%
46%
31%
30%
49%
26%
27%
31%
21%
16%
26%
26% 27%
31%
21%
16%
48%
0%
10%
20%
30%
40%
50%
60%
AXIS
TITLE

26. Vitamin A coverage for 2021 (6-59 months)
Nangodi Kon-Pitanga Pelungu Sakote Zanlerigu Nabdam
2019 62% 50% 64% 33% 45% 49%
2020 60% 56% 60% 43% 57% 54%
2021 60% 56% 60% 43% 57% 87%
62%
50%
64%
33%
45%
49%
60%
56%
60%
43%
57%
54%
60%
56%
60%
43%
57%
87%

27. The Community-Based Approach Involves Timely Detection of Sever Acute
Malnutrition in the Community and Provision of Treatment for those Without
Medical Complication with Ready –To-use Therapeutic Foods(RUTF) at
Home and Regular Medical Monitoring at a Health Facility.
IT COMES WITH THE BENEFITS:
• EASY TO ACCESS SAM
• TIMELY DETECTION
• INCREASE COVERAGE
• REDUCES INFECTIONS
IT SAVES TIME
• LESS COST
• REDUCES CASE FATALITY

28. CMAM QUALITY
District
Period 2019 2020 2021
ADMISSIONS 30 75 120
DISCHARGED 30 59 104
# CURED 29 51 94
CURE RATE 96.7% 84.4% 90.4%
# DEFAULTERED 1 1 2
DEFAULTER RATE 3.3% 1.7% 1.9%
# DIED 1 1 1
DEATH RATE 3.3% 1.7% 1%

29. Cure Rate
2019 97%
2020 84%
2021 90%
97%
84%
90%
75%
80%
85%
90%
95%
100%
Trend of Cure Rate
3%
2% 2%
2019 2020 2021

30. COMMUNITY INFANT AND YOUNG CHILD
FEEDING (C-IYCF)
YEAR 2019 2020 2021
Total number in
register(old and new)
659 444 607
New Registrants 381 132 129
Number visited at
least once at home
374 305 275
% Visited at home 57% 68.7% 45%
Number discharged
from Home visits
293 97 46

31. GIFTS IMPLEMENTATION

32. GIFTS IMPLEMENTATION, IN- SCHOOL
SUB
DISTRICTS
SCHOOL
IMPLEMEN
TING
TOTAL NO.
OF GIRLS
REGISTERE
D ON GIFTS
TOTAL
NO.OF IFA
RECEIVED
TOTAL
NO.OF IFA
USED
NO.OF IFA
WASTED
BALANCE
OF IFA
NANGODI SUB 3 98 1034 803 55 224
KONGO-
PITANGA SUB 12 780 7823 7194 15 813
PELUNGU SUB 5 339 3121 2671 389 59
SAKOTI SUB 4 280 3407 2584 19 804
ZANLERIGU 4 283 2100 1495 18 598
DISTRICT 28 1780 17485 14747 496 2498

33. GIFTS IMPLEMENTATION, OUT OF SCHOOL
SUB
DISTRICTS
FACILITIES
IMPLEMENT
ING
TOTAL NO.
OF GIRLS
REGISTERE
D ON GIFTS
TOTAL
NO.OF IFA
RECEIVED
TOTAL
NO.OF IFA
USED
NO.OF IFA
WASTED
BALANCE OF
IFA
NANGODI SUB 3 36 2376 112 0 2264
KONGO-
PITANGA SUB 6 222 5585 1433 21 4131
PELUNGU SUB 3 217 6103 1944 42 4117
SAKOTI SUB 3 65 5294 476 0 4818
ZANLERIGU 3 109 6411 1984 0 4427
DISTRICT 18 649 25769 5969 63 19757

34. IFA PERCENTAGE COVERAGE BY SUB-DISTRICTS 2021
74%
53%
43%
58%
54% 54%
18%
32%
24%
17% 14%
9.40%
17.60%
75%
72%
57%
29%
51%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Nangodi sub Pelungu sub Kongo/Pit sub Zanlerigu sub Sakoti Sub District
2019 2020 2021

35. PICTURE GALARY

37. SUPPORT VISIT TO A PREGNANCYPREGNANCY
SCHOOL

38. MEETING WITH ZANLERIGU STAFF AND
COMMUNITY MEMBERS

39. OREINTATION OF NANGODI HEALTH CEBTRE
STAFF ON WELLNESS CLINIC

40. Visits to CMAM clients

41. PREGNANCY SCHOOL IN PELUNGU

42. Orientation on nutrition data sets at Zanlerigu

43. In-School GIFTS Orientation

44. CMAM Clients

45. Challenges
• Poor documentation amongst staff/low capacity on some nutrition
programs and data sets
• Many staff still not trained in CMAM, C-IYCF and the MCHRB
• Staff Attrition/Movements
• Inadequate collaboration
• Apathy towards some nutrition activities
• Inadequate supervision/monitoring due to inadequate logistics eg fue

46. WAYFORWARD FOR 2021
• Monitor and supervise outreach session
• Implement the formation of pregrancy school at facilities levels for
nutritional education
• Build capacity of staff on nutrition programs and data sets
• Carry monthly monitoring & data validation
• Ensure that all primary schools are enrolled on the GIFTS Program

47. ACKNOWLEDGEMENT
• RHD
• PARTNERS
• ALL STAFF
• VOLUNTEERS AND
COMMUNITIES

48. THE END
THANK YOU