Results and impact:
WFP provided food ration was able to meet energy requirement of 94% (maximum) in November and 62% (minimum) in July of the recommended level (2,100 Kcal). On an average, a refugee received about 78% and 64% of intended kcal and protein respectively. Micronutrients remained inadequate throughout the year distributed at an average of 0% for vitamin C, 13% for Riboflavin, 21% for Vit A and Iron at 41% of the daily recommended allowance. Therefore, the prevalence of micronutrient deficient diseases remained high.
Nutritional screening to children under-five continued through routine measurement of mid upper arm circumference (MUAC) in the community and health facilities and was referred to camp clinic and to referral hospital (severe acute malnutrition with medical complications). A total of 428 new cases of acute malnutrition were registered in the feeding programme. Performance indicators showed an average recovery rate of 95%, death rate 0.1% and default rate of 0.7% for supplementary feeding (SFP) while recovery rate for Outpatient care (OTP) was 95%, 0.8% death rate and 1.6% defaulter rate. When compared to UNHCR/WFP standards (recovery rate >75%, defaulter rate15% for SFP; death rate 3% and death rate10% for SFP and OTP respectively) both SFP and OTP performance was within acceptable level. Children recovered from SFP seemed to stay longer (>12 weeks) while those recovered from OTP stayed within the recommended period (60days). Programme coverage was below the recommended level of >90%; (67% SFP and 43% OTP).
Nutributter was provided to the children aged 6-23 months who were targeted for Blanket Supplementary Feeding Program (BSFP). A total of 47 health and nutrition staff and community volunteers were trained before implementing BSFP. To enable monitoring of performance of the program, 8,400 pcs of microcuvettes and lancets were procured and used for routine checking heamoglobin of the children enrolled in the program. At the end of the year, reports from respective camps indicated improvement of haemoglobin in at least 60% of children enrolled in the programme. WFP in collaboration with UNHCR was also supporting BSFP for pregnant and lactating women by providing super-cereal plus. The programme was operational for five months from January 2014 and discontinued due lack of resources from WFP.
Unmet needs:
Funding limitation could not allow procurement of micronutrient powder (MNP) to address critical anaemia and stunting among children aged 24 – 59 months as per SENS 2013 recommendations. Fund for procurement of nutributter for children aged 6 – 23 months could only cover six months as opposed to one year recommended in the two consecutive UNHCR nutrition surveys conducted. In the absence of supercereal plus in the general food ration, refugee will continue consuming imbalanced diet which lacks essential micronutrients. In the absence of urgent interventions the rise in the level of anaemia among children will increase mortality and morbidity in children under 5 severely.
Blanket supplementary feeding programs for pregnant and lactating women aimed to address additional nutritional needs which has resulted in physiological changes was discontinued due to lack of resources. Home backyard gardening coverage at household level to provide the needs to this vulnerable group is still low. Micronutrient deficiencies such as calcium, iron, vitamin A and iodine can lead to poor maternal health outcomes and pregnancy complications which put the mother and baby at risk.
Annual nutrition survey could not be conducted in 2014for the purpose of monitoring the program due to limitation of resources and the outbreak of the EVD.