TWN Info Service on Health Issues (Apr22/01)
8 April 2022
Third World Network

UN: Africa's Sahel region witnessing high levels of child malnutrition
Published in SUNS #9552 dated 8 April 2022

Geneva, 7 Apr (Kanaga Raja) -  An estimated 6.3 million children aged 6-59 months are expected to suffer from wasting in six Sahel countries in 2022, of which more than 1.4 million will suffer from severe wasting.

This is one of the main findings of a joint report on the nutrition situation in the West and Central Africa (WCA) Region released by the WCA Regional Nutrition Working Group, which comprises of the UN Children's Fund (UNICEF), the World Food Programme (WFP), and the World Health Organization (WHO), as well as non-governmental organization partners including Action Against Hunger and Save the Children.

"As conflicts, insecurity, socio-economic crisis and recurrent extreme climatic events in the region continue to deteriorate and further aggravate the nutrition of children, we need to shift to "business unusual" to address their needs in a sustainable way," said Marie-Pierre Poirier, UNICEF Regional Director for West and Central Africa.

"While treatment remains an imperative to save the lives of children most severely affected, we must shift the paradigm and focus on scaling interventions to prevent malnutrition, especially in the most affected locations," Poirier added.

"The time has come to address the root causes of malnutrition of children in the region with determination and urgency," said the UNICEF official.

"Recurrent crises over the past decade call on us to accelerate efforts and to seize opportunities to re-imagine nutrition with our partners in Governments and with the critical support of donors so that collectively, we put the region on the right trajectory to protect all children against malnutrition," said Poirier.

"And now the Ukraine crisis is leading to an inflation of the food prices, increasing the pressure on the populations already heavily impacted by the crises: a severe food and nutrition insecurity is near if we do not act now in all the hotspots," said Mamadou Diop, Regional Representative of Action Against Hunger for West and Central Africa.

According to the report released on 6 April, in the Sahel G5+1 countries (Burkina Faso, Chad, Mali, Mauritania, Niger and Senegal), results of the nutritional surveys carried out in 2021 show the persistence, even the increase in the prevalence of global acute malnutrition (GAM) among children under 5.

In Mauritania, Niger and Chad, GAM prevalences are above the "alert" threshold of 10%, while in many areas of some countries (Menaka Region of Mali, South Mauritania, Diffa Region of Niger, and East/West Chad), GAM rates exceed the emergency threshold of 15%, said the report.

The report said that the recent IPC (Integrated Food Security Phase Classification) acute malnutrition analysis in Mali shows that between October 2021 and May 2022, 16 administrative sub-divisions will likely be in a Serious nutritional situation (IPC Phase 3) and three other administrative sub-divisions in a Critical situation (IPC Phase 4).

It said between June and August 2022, a progressive deterioration in the nutritional situation is expected, with 37 administrative sub-divisions, out of 51 analysed, in a Serious condition and five administrative sub-divisions likely in a Critical condition.

In Nigeria, both in the North-East and the North-West, the insecurity situation continues to deteriorate which leads to an increase in the number of displaced people, with increased vulnerabilities, said the report.

"As a result, in 2022, it is estimated that 6.3 million children aged 6-59 months in the Sahel G5+1 will suffer from wasting, of which more than 1.4 million children will suffer from severe wasting."

Almost 70% of under-5 (U5) children expected with wasting in the Sahel G5+1 are in the Central-Sahel countries (Burkina Faso, Mali and Niger), said the report.

It said when compared to previous years, the number of expected GAM cases has never been so high, showing an increase of 27% as compared to 2021 estimates and a 62% increase as compared to 2018, reaching for the fifth year in a row a record high level.

In 2021, out of the 1.8 million children under five suffering from severe wasting that were targeted for treatment in the nine Sahel countries (Burkina Faso, Cameroon, Chad, Gambia, Mali, Mauritania, Niger, Nigeria, and Senegal), 1.6 million (89%) were admitted in health facilities.

"Compared to 2020, a slight increase of 2% is recorded in the number of new admissions. As compared to the past 5 years, this represents the highest rate of achievement," said the report.

The situation is even more worrying as the high prevalence of wasting in the region also coincides with a high prevalence of stunting in children under 5, it added.

"This further inhibits their physical and cognitive development, while the concurrent manifestation of wasting and stunting in the same child also increases the risk of mortality."

The results of the national nutrition surveys conducted in 2021 show that in Burkina Faso and Mali, the national prevalence of stunting exceeds the high threshold of 20% (21.9% in Mali and 21.6% in Burkina Faso), while in Chad and Niger, the national prevalence exceeds the very high threshold of 30% (43.5% in Niger and 30.4% in Chad).

The report said that malnutrition is linked to multiple underlying vulnerabilities such as widespread household food insecurity, inadequate dietary and care practices for infants and young children, high incidence of childhood illnesses, widespread poverty, inadequate access to water and sanitation and health services, as well as gender and other social norms.

The results of the national nutrition surveys conducted in 2021 also show that inadequate infant and young child feeding practices persist, it added.

"Among the G5 Sahel countries, the lowest proportion of children having a minimum acceptable diet is found in Mali (9.8%), followed by Chad (11.5%), Niger (19.5%), Mauritania (21.7%) and Burkina Faso (23.9%)."

In the Sahel G5+1 countries, the food security situation is of particular concern, with results from the November 2021 Cadre Harmonise (CH) exercise showing that almost 11.3 million people will be in need of urgent food assistance during the next lean season, said the report.

"Such level has never been reached so far, displaying an increase of 92% when compared to the five-year average (2015-2020)."

Moreover, if the conflict in Ukraine results in a prolonged reduction in food exports from Ukraine and the Russian Federation, simulations from the Food and Agriculture Organization of the United Nations (FAO) suggest that the number of undernourished people in sub-Saharan Africa will increase from 2.6 to 5.1 million, said the report.

"Also, insecurity continues to increase, particularly in the Central-Sahel and Lake Chad Basin regions. This further aggravates an already fragile and precarious situation and leads to massive population displacement," it added.

"As of end 2021, more than 2.5 million people were internally displaced in the Central-Sahel. In Burkina Faso, the number of IDPs grew by 50% last year to over 1.5 million."

In Chad, the number of refugees grew by 17% to 555,787, and the number of IDPs grew by 21% to 406,573 in 2021, said the report.

"Over the past three years, the sharp increase in armed attacks on communities, schools, health centers and other public institutions and infrastructure have disrupted livelihoods and access to social services including education and health care," it added.

Insecurity is worsening chronic vulnerabilities including high levels of malnutrition, childhood illnesses, and poor access to clean water and sanitation as well as health facilities, the report said.

It said the data for the prevention of wasting among children aged 6-23 months and pregnant and lactating women through supplementary feeding in nine countries show that urgent funding is required to ensure efficient and timely response.

The total funding requirement is $93.4 million, with a funding shortfall of $56.2 million, including $26.3 million to cover the needs during the lean season from June to September, said the report.

Nigeria is facing the more serious funding gap ($14.5 million), followed by Cameroon ($8.5 million), Chad ($7.9 million), Niger ($7.2 million) and Central African Republic ($5.9 million), it added.

The funding situation for the treatment of children under 5 with moderate wasting is also alarming, said the report.

"Based on the annual estimated needs, the total funding requirement in 8 countries (Sahel, Lake Chad Basin and Nigeria) is $70.0 million, with a current funding shortfall of $35.5 million (51%)."

The report said Niger ($16.9 million), Burkina Faso ($10.1 million) and Chad ($4 million) are the countries facing the biggest funding shortfalls.

Priority must be given to strengthening the resilience of the most vulnerable communities to break the vicious circle of the increasing levels of wasting, stunting and micro-nutrient deficiencies due to the recurrent and multiple shocks experienced in the region, said the report.

"We need a paradigm shift, prevention first and treatment when prevention fails in all contexts," the report added