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Nutrition Information in Crisis Situations -
Ethiopia
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| % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Measles immunisation coverage (%)* |
Vitamin A distribution |
Crude Mortality (/10,000/day) |
Under 5 Mortality (/10,000/day) |
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Pastoral areas |
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| 17.6 (15.1-20.0) | 1.7 (0.9-2.6) | 81.0 | 71.2 | 0.65 (0.46-0.85) | 3.22 (2.22-4.22) |
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Agro-pastoral areas |
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| 17.7 (14.8-20.0) | 1.3 (0.7-2.0) | 83.3 | 79.7 | 0.57 (0.23-0.9) | 2.07 (1.08-3.05) |
* According to cards and mothers' statements
Box 1 Food security, public health and child feeding practices, pastoral and agro-pastoral food economy zones, Cherati, Dollo-Ado, Dollo-Bay and West-Emey districts, Afder and Liban zones, Somali region, Ethiopia, October 2004 (SC-UK, 10/04)
| Food security Poor 2004 harvest Poor/very poor condition of livestock: 100%/100%1 Decrease in herd size in the past year: 94.7%/97.6% Lack of pasture/fodder: 60%/99.2% Poor availability of veterinary services Food distribution Water sources Health facilities Child feeding practices |
While the SC's household economy assessment carried out in December 2003 recommended that 30% of the population received a monthly food distribution, only one distribution was carried out in six months.
Two rapid nutrition assessments conducted in two of the worst affected sub-districts of Geladi district and Boh district, Warder zone, Somali region, in November 2004 revealed that about one out of five children measured (weight-height index) were acutely malnourished (ACF, 11/04).
SCF-USA's rapid assessments, measuring all children in two of the worst affected sub-districts of Gode, Adadle, and Ferfer districts of Gode zone and of Hargelle district of Afder zone, Somali region, in November 2004, showed that between 15% and 28% of the children measured (weight-height index and presence of oedema) were acutely malnourished (SC-USA, 11/04). The highest proportion of malnourished children was found in Gode district.
In August 2004, two random-sampled nutrition surveys were conducted in pastoral and agro-pastoral food economy groups in Shinile, Dambal and Erre districts of Shinile zone, Somali region (SC-UK, 08/04). The surveys showed an average nutrition situation with a prevalence of acute malnutrition of 8.1% (6.2-10.0) including 0.3% (0.0-0.7) severe malnutrition and of 9.8% (7.5-12.0) including 0.5% severe acute malnutrition (0.1-1.0) in agro-pastoral and pastoral food economy groups, respectively. The mortality rates were under-control to average: CMR=0.29 deaths/10,000/day and 0.09 deaths/10,000/day and under-five MR=1.19 deaths/10,000/day and 0.37/deaths/10,000/day in agro-pastoral and pastoral areas, respectively.
Measles vaccination was low, around 50%. According to periodical nutrition surveys undertaken by SC-UK in the same area, the nutrition situation has remained stable since September 2003. Shinile zone is not considered as one of the most affected area in Somali region (see above).
Acceptable to average nutrition situation in parts of East Hararghe and West Hararghe zones, Oromia region
According to seven random-sampled nutrition surveys conducted by Care in three districts of East-Hararghe and four districts of West Hararghe in October/November 2004, the nutrition situation was acceptable to average while mortality rates were under control (table 5) (Care, 11/04). These surveys were done during harvest time and seemed to show improvement in the nutrition situation compared to June 2004 (Care, 11/04).
Table 5 Prevalence of acute malnutrition and Mortality rates, East Hararghe and West Hararghe zones, Oromia region, Ethiopia, Oct-Nov 2004, (Care, 11/04)
| % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Crude Mortality (/10,000/day) |
Under 5 Mortality (/10,000/day) |
| East Haraghe Kurfa Chelle | |||
| 4.7 (3.0-7.1) | 0.5 (0.1-1.8) | 0.12 | 0.2 |
| Grawa | |||
| 5.9 (4.0-8.6) | 0.6 (0.2-2.0) | 0.15 | 0.5 |
| Bedeno | |||
| 8.5 (6.2-11.6) | 0.5 (0.1-1.9) | 0.3 | 0.6 |
| West Hararghe Chiro | |||
| 7.2 (5.0-9.6) | 0.4 (0.07-1.7) | 0.11 | 0.3 |
| Miesso | |||
| 9.6 (7.1-12.8) | 1.4 (0.6-3.1) | 0.26 | 0.6 |
| Kunni | |||
| 7.9 (5.7-10.9) | 0.6 (0.2-2.1) | 0.29 | 0.5 |
| Guba Koricha | |||
| 7.1 (4.9-9.9) | 0.9 (0.3-2.4) | 0.34 | 0.6 |
Recommendations
From the SC-UK survey in Fader and Liban zones, Somali region:
The prospect of food security in Ethiopia in 2005 is poor owing to below average rainfall and structural factors. The Belg/Gu season (March-May) was bad in most part of eastern Ethiopia and the Meher/Karma (June-September) rainy season was below average in the eastern crop-dependent areas, and late and erratic in pastoral areas (FEWS, 26/10/04). The Somali region is especially affected and the evolution of the situation will depend on the performance of the Deyr/Hagaya rains (October-December) (FEWS, 29/10/04).
There is a 22% shortfall in pledges towards current cereal needs through October to December 2004. The needs may further increase if the situation deteriorates in pastoral areas (FEWS, 29/10/04). Only 44% of the non-food sector needs have been met so far (FEWS, 29/10/04).
A Productive Safety Net Programme has been designed to respond to the needs of 5.1 million people chronically food insecure and to differentiate them from people requiring emergency assistance. The programme will be cash-oriented rather than food-oriented (DFID, 04/10/04).
A multi-agency assessment estimated that the performance of the Belg/Gu season was poor generally, in both pastoral and agricultural areas (EWS, 07/04). The most severely affected areas are Somali region; Borena, Bale, West and East Haraghe zones of Oromya; and South Omo, Gamu Gofa, Wlayia, Hadiya Konso and Derashe zones of SNNPR.
The coverage of the food distribution was 100% over the last six months. However, a break in cereal stocks is anticipated from September 2004, when it will be the lean season in Ethiopia (figure 1; FEWS, 22/07/04): more food pledges are needed.
Hartisheik refugee camp, eastern Ethiopia, closed at the end of June 2004, after about 250,000 Somali refugees were repatriated or returned on their own to Somaliland (UNHCR, 01/07/04). There are still two Somali refugee camps in Eastern Ethiopia hosting 24,400 refugees.
Figure 1 Emergency food aid stock and deficit (FEWS, 22/07/04)

Although rainfall was good in March-April and mitigated the bad situation due to poor rains at the end of 2003, the rainy season stopped earlier than usual, with no rains in May. The lack of water and pasture will increase and then the food security situation will probably deteriorate until the last rains expected only in October (FEWS, 22/07/04). Fik, Degehabur and Warder zones are considered especially affected. Earlier than normal migration of livestock towards the north of the region has been registered. Around 1.3 million people are in need of food aid, more than was previously considered in the 2004 Inter-Agency Appeal (Addis Tribune, 06/08/04). However, insecurity, such as tensions over resources, hampers the delivery of aid. Eleven food trucks have been attacked and burnt in the last months (IRIN, 13/07/04).
According to several nutrition surveys conducted in Oromya region in March/April 2004, the prevalence of acute malnutrition was between 9% and 13%, depending on the area (DPPC).
Following assessments which showed poor conditions in some resettlement areas (see RNIS 43 and NICS 2), where families are resettled as part of a plan of the government to move families to high-potential agricultural areas (IRIN, 08/06/04), emergency assistance such as supplementary food distribution and therapeutic feeding centres have been established.
A nutrition survey conducted in Chewaka resettlement area in Bedele woreda, Ilibabur zone, Oromya region, showed a precarious nutrition situation: 9.8% (7.1-12.5) of the children surveyed were acutely malnourished, including 1.9% (0.7-3.2) severely malnourished (DPPC, 05/04). The resettlement area counted around 67,000 people who were almost totally dependent on food aid: 99.7% of the families said their main source of food was food distribution and none of the families had been engaged in income-generating activities over the three months previous to the survey. The lands people have been allocated were under preparation for planting, that is cleaned and ploughed, but were not yet ready for cultivation. Mortality rates were of concern: CMR = 0.73 deaths/10,000/day and < 5 MR = 2.65/10,000/day but measles vaccination coverage, according to mothers’ statements, was above 90%.
The situation is still precarious in Ethiopia. Households in Somali region and families in some resettlement areas are especially at risk (category I/II).
Despite an improvement in the food security situation owing to better harvests and rains in 2003 than in 2002, the situation remains precarious. About 7 million people are still in need of food aid in 2004. However, as of April 2004, food aid needs were only 43% funded (ENFS, 04/04). Nutrition programmes have been scaled down and NGOs have handed some facilities over to the Ministry of Health (USAID, 08/04/04).
The Government of Ethiopia started a resettlement programme in 2003, with the aim of addressing food insecurity. In 2003 and 2004, approximately 350,000 people were resettled in Amhara, Oromya, SNNPR and Tigray regions (USAID, 08/04/04). A joint evaluation in some resettlement areas showed that the sites, especially in Oromya region, lacked adequate food, access to water, shelter, health care and agriculture inputs (USAID, 08/04/04). In addition to the cereal ration, a supplementary food distribution of blended food has been started for vulnerable groups (WFP, 21/05/04). A very high number of malnourished children was recorded in October 2003 in resettlement sites in Tigray (see RNIS 43).
Three random-sampled nutrition surveys were conducted during the harvest in November-December in South Wollo (table 4) (Concern, 11/03; DSA, 12/03). The surveys showed average rates of acute malnutrition.
Whilst it was the first survey which was conducted in Tedhudere district, comparison with previous survey results was possible in Dessie Zuria and Kalu districts. In both districts, trends in prevalence of malnutrition showed that the situation in November 2003 was comparable to that in 2000, 2001 and the beginning of 2002. On the other hand, the situation has improved when compared to the second semester of 2002 (which corresponded to the period of drought) when the rates of malnutrition were the highest recorded since 2000.
In the three districts, 50% to 60% of the families received food through the Employment Generation Scheme (EGS) in 2003.
In Dessie Zuria and Kalu districts about 15% of the children also received food through supplementary feeding programmes. In these districts, the current harvest was better than in 2002. The main sources of income were sale of livestock, cash crops and petty trading. EGS was interrupted in September-October 2003 and was intended to restart in April/May 2004 (when the poorest may have exhausted their harvest), targeting a lower proportion of the population than in 2003.
Young children feeding practices seemed poor, with about half of the mothers not being given colostrom within the first three days of their children’s lives. Food was introduced into the children’s diet between 4-6 months of age by only 60% of the mothers.
Table 4 Acute malnutrition and measles vaccination coverage, South Wollo, Amhara region, Ethiopia, Nov-Dec 2003 (Concern, 11/03; DSA, 12/03)
| % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Measles immunisation coverage (%)* |
| Dessie Zuria District, South Wollo zone | ||
| 12.0 (9.6-14.7) | 0.5 (0.1-1.9) | 72.6 |
| Dessie Zuria District, South Wollo zone | ||
| 9.9 (7.6-12.3) | 0.3 (0.3-0.6) | 85.8 |
| Tehuldere district, South Wollo zone | ||
| 7.5 | - | 81.5 |
* According to cards and mothers' statements
Poor rains at the end of last year have significantly affected food security in some parts of Somali region. However, rainfall improved in March and April 2004, mitigating the poor situation (ENFS, 04/04).
Precarious nutrition situation in Ayshia, Shinile, Dembel & Erer districts, Shinile zone
Two random-sampled nutrition surveys were conducted in September 2003, within the agro-pastoral and pastoral population (SC-UK, 09/03). The surveys showed an improvement in the nutrition situation compared to 2002 (figure 1), but the situation remains precarious (table 5). The surveys were conducted during the rainy season but before the harvest. The condition of livestock was reported as being good by almost all the households interviewed. Relief food had been received by most of the population within the month prior to the survey and represented the major source of staple food. The population was using coping mechanisms to get incomes.
Access to health care and safe drinking water was poor as well as the measles vaccination coverage.
Table 5 Acute malnutrition, measles vaccination coverage and mortality rates, Somali region, Ethiopia
| Agency | Date | % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Measles immunisation coverage (%)* |
Crude Mortality (/10,000/day) |
Under 5 Mortality (/10,000/day) |
|
| Gode district, Gode zone |
SCF-US | Feb-04 | 21.4 (18.3-23.7) |
2.8 (1.4-3.4) |
81.4 | 1.23 | 3.76 |
| Patoral areas of Ayshia, Shnile, Dembel & Erer districts, Shinile zone |
SCF-UK | Oct-03 | 11.1 (8.1-14.1) |
0.9 (0.3-1.5) |
4.7 | - | - |
| Agro-pastoral areas of Erer, Shinile & Dembel districts, Shinile zone |
SCF-UK | Sep-03 | 11.2 (8.2-14.3) |
0.8 (0.2-1.4) |
9.4 | - | - |
* According to cards and mothers' statements
Figure 1 Prevalence of acute malnutrition, Pastoral and agro-pastoral population, Shinile zone, Ethiopia (SC-UK, 09/03)
Poor nutrition situation in Gode District
The nutrition situation was poor in Gode district in February 2004 (table 5) and within the same range as in November 2000, according to a random-sampled nutrition survey conducted by SC-US (SC-US, 02/04); the mortality rates were also very high (table 5). The food security situation appeared poor, partly due to the insufficient rains over the end of 2003 (see NICS 1); the general food distribution did not significantly improve the food security level of the population.
Dire situation of internally displaced persons in Somali region
There are several displaced persons camps in Somali region. Fafen and Hartishiek displaced persons camps, situated in Jijiga zone, host between 10,700 to 14,700 people (depending on the estimation) who have been displaced for some years because of drought. Recent dispute on land ownership in Bordode/Mieso areas has led to the displacement of about 14,900 people in Shinille zone (OCHA, 03/2004).
An assessment conducted in March 2004 showed dire conditions in the camps (OCHA, 03/04). Food delivery has been prevented in Fafen since the beginning of the year, because of rivalries between the local population and the IDPs. At the time of the assessment, no general food distribution was implemented in Bordode/Mieso but food had been distributed to vulnerable groups.
Access to safe drinking water was not guaranteed in the camps and cooking and shelter materials were greatly needed.
Nutrition surveys carried out in Fafen and Hartisheikh IDP camps in December 2003 showed appalling rates of malnutrition: 31.8% (27.7-35.9) and 28.5% (24.6-32.7) acute malnutrition, respectively (FSAU-N, 03/04). The malnutrition rates were within the same range as in March 2002 in both camps (see RNIS 38).
According to two random-sampled nutrition surveys carried out in December 2003 and January 2004 (CRS, 01/04; SC-UK, 12/03), the nutrition situation in Meta, Kersa and Golo Oda districts is under control (table 6). These surveys were carried out just after the main harvest and so reflect an optimal situation.
Golo Oda district
Malnutrition rates have dramatically decreased in Golo Oda compared to the rates in 2001 and 2002 (figure 2). However, in 2001 and 2002, the surveys were performed at a less favourable period in regard to the food security situation (not at the harvest time).
Figure 2 Prevalence of malnutrition, Golo Oda, Oromya, Ethiopia
The indicators of the food security situation showed an improvement at the time of the survey, compared to 2001 and 2002; the health situation has also improved, although it was still average (box 1). Mortality rates have decreased over the past years and were average (table 6).
Table 6 Results of nutrition and mortality surveys, Oromya region, Ethiopia
| Agency | Date | % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Measles immunisation coverage (%)* |
Crude Mortality (/10,000/day) |
Under 5 Mortality (/10,000/day) |
|
| Golo Oda district, East Haraghe zone |
SCF-UK | Dec-03 | 6.3 (4.1-8.5) |
0.5 (0.1-1.0) |
43.6 | 0.75 | 1.44 |
| Meta and Kursa districts, East Haraghe zone |
CRS | Jan-04 | 4.1 (2.9-5.7) |
0.8 (0.3-1.7) |
77.6 | 0.82 | 2.04 |
* According to cards and mothers' statements
Box 1 Improved food security and health care in Gola Oda district, East Hararghe zone, Oromya, Ethiopia, December 2003 (SC-UK, 12/03)
| Food security Livelihood More families do possess livestock (94% in 2003 vs 70% in 2001) The harvest was better than the previous years' and rated as average to good Livestock condition was reported as good/medium by 90% of the persons interviewed, compared to 60% in October 2002 Main sources of income were sale of livestock, of own agricultural production and of cash crops, whilst in 2002, the main sources of income was the sale of firewood/charcoal and labour Decrease in migration Lower consumption of wild food in 2003 than in the previous years Food distribution About 80% of the families interviewed during the survey reported having received relief food through EGS or free food distribution in the four months prior to the survey Supplementary and therapeutic feeding programmes were in place Public health |
Meta and Kersa districts
Similarly, the food security in these districts was reported as being satisfactory, with a good harvest and animals in a good condition. However under-five mortality rate was high (table 6), particularly due to malaria and relapsing fever epidemics.
Average to precarious nutrition situation in SNNPR
The nutrition situation was average to precarious according to several surveys conducted in SNNPR (table 7); mortality rates were under-control.
At the end of 2003, the nutrition situation had not improved in Meskan and Mareko districts, Gurahe zone compared to March 2003 (SC-US, 11/03). The food security situation was still precarious owing to an only average rainy season.
In Lanfuro and Darecha district, the malnutrition rates have remained stable since March 2003 (SC-US, 12/03). Most of the households thought they will rely primarily on their crop production within the next three months.
In Offa woreda, Wolaita zone, although the nutrition and food security situation has significantly improved compared to September 2003, it remained precarious in December 2003, despite the harvest (Concern, 12/03). The crop was reported as being worse than in previous years and most of the households were relying on coping mechanisms.
In Shebedino woreda, Sidama zone, the nutrition situation was average in February 2004 and the food security situation was reported as having improved compared to the previous six to 12 months (GOAL/SC-US/ACF, 02/04).
Table 7 Acute malnutrition and measles vaccination coverage, SNNPR, Ethiopia
| Agency | Date | % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Measles Immunisation coverage (%)* |
|
| Offa district, Wolaita zone |
Concern | Dec-03 | 13.4 (10.4-17.0) |
0.4 (0.0-1.8) |
11.8 |
| Dalocha distict, Silti zone |
SCF-US | Dec-03 | 6.1 (4.7-7.9) |
0.2 (0.0-0.9) |
87.1 |
| Lanfuro district, Silti zone |
SCF-US | Dec-03 | 9.7 (7.8-11.7) |
1.2 (0.5-1.9) |
56.3 |
| Meskan district, Gurahe zone |
SCF-US | Nov-03 | 9.1 (7.4-11.2) |
1.0 (0.5-1.9) |
91.2 |
| Mareko district, Gurahe zone |
SCF-US | Nov-03 | 12.8 (10.9-15.4) |
1.0 (0.5-2.0) |
96.7 |
| Shebdino district, Sidama zone |
GOAL/ SCF-US/ ACF |
Feb-04 | 7.8 (6.1-9.9) |
0.3 (0.1-0.9) |
73.2 |
The nutrition and food security situation has improved in most parts of Ethiopia compared to 2002 and 2003. This may be attributed to better weather conditions and to the humanitarian aid which have probably mitigated the situation. Whilst in some areas (such as some districts in Oromya zone), the nutrition situation seems under-control (category III), it is still average to precarious in most parts of Ethiopia (category II). The Somali region is especially at risk (category I), due to poor rainfall and the presence of IDPs.Urgent action is needed in the IDP camps in Somali region where dire living conditions have been reported as well as appalling rates of malnutrition (category I).
Despite an improvement in the food security situation owing to better harvests and rains in 2003 than in 2002, the situation remains precarious. About 7 million people are still in need of food aid in 2004. However, as of April 2004, food aid needs were only 43% funded (ENFS, 04/04). Nutrition programmes have been scaled down and NGOs have handed some facilities over to the Ministry of Health (USAID, 08/04/04).
The Government of Ethiopia started a resettlement programme in 2003, with the aim of addressing food insecurity. In 2003 and 2004, approximately 350,000 people were resettled in Amhara, Oromya, SNNPR and Tigray regions (USAID, 08/04/04). A joint evaluation in some resettlement areas showed that the sites, especially in Oromya region, lacked adequate food, access to water, shelter, health care and agriculture inputs (USAID, 08/04/04). In addition to the cereal ration, a supplementary food distribution of blended food has been started for vulnerable groups (WFP, 21/05/04). A very high number of malnourished children was recorded in October 2003 in resettlement sites in Tigray (see RNIS 43).
Three random-sampled nutrition surveys were conducted during the harvest in November-December in South Wollo (table 4) (Concern, 11/03; DSA, 12/03). The surveys showed average rates of acute malnutrition.
Whilst it was the first survey which was conducted in Tedhudere district, comparison with previous survey results was possible in Dessie Zuria and Kalu districts. In both districts, trends in prevalence of malnutrition showed that the situation in November 2003 was comparable to that in 2000, 2001 and the beginning of 2002. On the other hand, the situation has improved when compared to the second semester of 2002 (which corresponded to the period of drought) when the rates of malnutrition were the highest recorded since 2000.
In the three districts, 50% to 60% of the families received food through the Employment Generation Scheme (EGS) in 2003.
In Dessie Zuria and Kalu districts about 15% of the children also received food through supplementary feeding programmes. In these districts, the current harvest was better than in 2002. The main sources of income were sale of livestock, cash crops and petty trading. EGS was interrupted in September-October 2003 and was intended to restart in April/May 2004 (when the poorest may have exhausted their harvest), targeting a lower proportion of the population than in 2003.
Young children feeding practices seemed poor, with about half of the mothers not being given colostrom within the first three days of their children’s lives. Food was introduced into the children’s diet between 4-6 months of age by only 60% of the mothers.
Table 4 Acute malnutrition and measles vaccination coverage, South Wollo, Amhara region, Ethiopia, Nov-Dec 2003 (Concern, 11/03; DSA, 12/03)
| % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Measles immunisation coverage (%)* |
| Dessie Zuria District, South Wollo zone | ||
| 12.0 (9.6-14.7) | 0.5 (0.1-1.9) | 72.6 |
| Dessie Zuria District, South Wollo zone | ||
| 9.9 (7.6-12.3) | 0.3 (0.3-0.6) | 85.8 |
| Tehuldere district, South Wollo zone | ||
| 7.5 | - | 81.5 |
* According to cards and mothers' statements
Poor rains at the end of last year have significantly affected food security in some parts of Somali region. However, rainfall improved in March and April 2004, mitigating the poor situation (ENFS, 04/04).
Precarious nutrition situation in Ayshia, Shinile, Dembel & Erer districts, Shinile zone
Two random-sampled nutrition surveys were conducted in September 2003, within the agro-pastoral and pastoral population (SC-UK, 09/03). The surveys showed an improvement in the nutrition situation compared to 2002 (figure 1), but the situation remains precarious (table 5). The surveys were conducted during the rainy season but before the harvest. The condition of livestock was reported as being good by almost all the households interviewed. Relief food had been received by most of the population within the month prior to the survey and represented the major source of staple food. The population was using coping mechanisms to get incomes.
Access to health care and safe drinking water was poor as well as the measles vaccination coverage.
Table 5 Acute malnutrition, measles vaccination coverage and mortality rates, Somali region, Ethiopia
| Agency | Date | % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Measles immunisation coverage (%)* |
Crude Mortality (/10,000/day) |
Under 5 Mortality (/10,000/day) |
|
| Gode district, Gode zone |
SCF-US | Feb-04 | 21.4 (18.3-23.7) |
2.8 (1.4-3.4) |
81.4 | 1.23 | 3.76 |
| Patoral areas of Ayshia, Shnile, Dembel & Erer districts, Shinile zone |
SCF-UK | Oct-03 | 11.1 (8.1-14.1) |
0.9 (0.3-1.5) |
4.7 | - | - |
| Agro-pastoral areas of Erer, Shinile & Dembel districts, Shinile zone |
SCF-UK | Sep-03 | 11.2 (8.2-14.3) |
0.8 (0.2-1.4) |
9.4 | - | - |
* According to cards and mothers' statements
Figure 1 Prevalence of acute malnutrition, Pastoral and agro-pastoral population, Shinile zone, Ethiopia (SC-UK, 09/03)
Poor nutrition situation in Gode District
The nutrition situation was poor in Gode district in February 2004 (table 5) and within the same range as in November 2000, according to a random-sampled nutrition survey conducted by SC-US (SC-US, 02/04); the mortality rates were also very high (table 5). The food security situation appeared poor, partly due to the insufficient rains over the end of 2003 (see NICS 1); the general food distribution did not significantly improve the food security level of the population.
Dire situation of internally displaced persons in Somali region
There are several displaced persons camps in Somali region. Fafen and Hartishiek displaced persons camps, situated in Jijiga zone, host between 10,700 to 14,700 people (depending on the estimation) who have been displaced for some years because of drought. Recent dispute on land ownership in Bordode/Mieso areas has led to the displacement of about 14,900 people in Shinille zone (OCHA, 03/2004).
An assessment conducted in March 2004 showed dire conditions in the camps (OCHA, 03/04). Food delivery has been prevented in Fafen since the beginning of the year, because of rivalries between the local population and the IDPs. At the time of the assessment, no general food distribution was implemented in Bordode/Mieso but food had been distributed to vulnerable groups.
Access to safe drinking water was not guaranteed in the camps and cooking and shelter materials were greatly needed.
Nutrition surveys carried out in Fafen and Hartisheikh IDP camps in December 2003 showed appalling rates of malnutrition: 31.8% (27.7-35.9) and 28.5% (24.6-32.7) acute malnutrition, respectively (FSAU-N, 03/04). The malnutrition rates were within the same range as in March 2002 in both camps (see RNIS 38).
According to two random-sampled nutrition surveys carried out in December 2003 and January 2004 (CRS, 01/04; SC-UK, 12/03), the nutrition situation in Meta, Kersa and Golo Oda districts is under control (table 6). These surveys were carried out just after the main harvest and so reflect an optimal situation.
Golo Oda district
Malnutrition rates have dramatically decreased in Golo Oda compared to the rates in 2001 and 2002 (figure 2). However, in 2001 and 2002, the surveys were performed at a less favourable period in regard to the food security situation (not at the harvest time).
Figure 2 Prevalence of malnutrition, Golo Oda, Oromya, Ethiopia
The indicators of the food security situation showed an improvement at the time of the survey, compared to 2001 and 2002; the health situation has also improved, although it was still average (box 1). Mortality rates have decreased over the past years and were average (table 6).
Table 6 Results of nutrition and mortality surveys, Oromya region, Ethiopia
| Agency | Date | % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Measles immunisation coverage (%)* |
Crude Mortality (/10,000/day) |
Under 5 Mortality (/10,000/day) |
|
| Golo Oda district, East Haraghe zone |
SCF-UK | Dec-03 | 6.3 (4.1-8.5) |
0.5 (0.1-1.0) |
43.6 | 0.75 | 1.44 |
| Meta and Kursa districts, East Haraghe zone |
CRS | Jan-04 | 4.1 (2.9-5.7) |
0.8 (0.3-1.7) |
77.6 | 0.82 | 2.04 |
* According to cards and mothers' statements
Box 1 Improved food security and health care in Gola Oda district, East Hararghe zone, Oromya, Ethiopia, December 2003 (SC-UK, 12/03)
| Food security Livelihood More families do possess livestock (94% in 2003 vs 70% in 2001) The harvest was better than the previous years' and rated as average to good Livestock condition was reported as good/medium by 90% of the persons interviewed, compared to 60% in October 2002 Main sources of income were sale of livestock, of own agricultural production and of cash crops, whilst in 2002, the main sources of income was the sale of firewood/charcoal and labour Decrease in migration Lower consumption of wild food in 2003 than in the previous years Food distribution About 80% of the families interviewed during the survey reported having received relief food through EGS or free food distribution in the four months prior to the survey Supplementary and therapeutic feeding programmes were in place Public health |
Meta and Kersa districts
Similarly, the food security in these districts was reported as being satisfactory, with a good harvest and animals in a good condition. However under-five mortality rate was high (table 6), particularly due to malaria and relapsing fever epidemics.
Average to precarious nutrition situation in SNNPR
The nutrition situation was average to precarious according to several surveys conducted in SNNPR (table 7); mortality rates were under-control.
At the end of 2003, the nutrition situation had not improved in Meskan and Mareko districts, Gurahe zone compared to March 2003 (SC-US, 11/03). The food security situation was still precarious owing to an only average rainy season.
In Lanfuro and Darecha district, the malnutrition rates have remained stable since March 2003 (SC-US, 12/03). Most of the households thought they will rely primarily on their crop production within the next three months.
In Offa woreda, Wolaita zone, although the nutrition and food security situation has significantly improved compared to September 2003, it remained precarious in December 2003, despite the harvest (Concern, 12/03). The crop was reported as being worse than in previous years and most of the households were relying on coping mechanisms.
In Shebedino woreda, Sidama zone, the nutrition situation was average in February 2004 and the food security situation was reported as having improved compared to the previous six to 12 months (GOAL/SC-US/ACF, 02/04).
Table 7 Acute malnutrition and measles vaccination coverage, SNNPR, Ethiopia
| Agency | Date | % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Measles Immunisation coverage (%)* |
|
| Offa district, Wolaita zone |
Concern | Dec-03 | 13.4 (10.4-17.0) |
0.4 (0.0-1.8) |
11.8 |
| Dalocha distict, Silti zone |
SCF-US | Dec-03 | 6.1 (4.7-7.9) |
0.2 (0.0-0.9) |
87.1 |
| Lanfuro district, Silti zone |
SCF-US | Dec-03 | 9.7 (7.8-11.7) |
1.2 (0.5-1.9) |
56.3 |
| Meskan district, Gurahe zone |
SCF-US | Nov-03 | 9.1 (7.4-11.2) |
1.0 (0.5-1.9) |
91.2 |
| Mareko district, Gurahe zone |
SCF-US | Nov-03 | 12.8 (10.9-15.4) |
1.0 (0.5-2.0) |
96.7 |
| Shebdino district, Sidama zone |
GOAL/ SCF-US/ ACF |
Feb-04 | 7.8 (6.1-9.9) |
0.3 (0.1-0.9) |
73.2 |
The nutrition and food security situation has improved in most parts of Ethiopia compared to 2002 and 2003. This may be attributed to better weather conditions and to the humanitarian aid which have probably mitigated the situation. Whilst in some areas (such as some districts in Oromya zone), the nutrition situation seems under-control (category III), it is still average to precarious in most parts of Ethiopia (category II). The Somali region is especially at risk (category I), due to poor rainfall and the presence of IDPs.Urgent action is needed in the IDP camps in Somali region where dire living conditions have been reported as well as appalling rates of malnutrition (category I).
The 2003/2004 Meher cereal harvest (the main crop season) is estimated at 13.05 million MTs, which is 46% higher than the 2002/2003 season and 11% above the last five-year average (FAO/WFP, 12/01/04). This good crop performance may partly be attributed to good rainfalls during both crop seasons (the Belg season, from January/February to April/May and the Meher season from June/July to September/October) and higher incentives to invest, because of the rise in cereal prices.
Livestock condition has also improved.
The pastoral areas, such as Somali region, lowland Bale in Oromya and South Omo, are however, facing a severe drought (see below).
At country level, the estimated number of food aid beneficiaries has dropped by 50% in 2004, compared to 2003; at regional level, the number of people in need of food aid has sharply decreased in all regions except Gambella and Somali regions (see map).
Estimated Needy Population Requiring Food Assistance 2004 by Region Compared to 2003 Beneficiaries
Nevertheless, 7.2 million people will still be in need of food aid in 2004; relief food requirements are estimated at about 980,000 MTs.
Among the needy people, 5 million are considered chronically food insecure, as a result of asset erosion due to successive bad years. Among the 300 woreda requiring food assistance, 45% have been receiving food assistance for the past seven-ten years consecutively.
Following the harvest, the situation seemed to have improved in the Southern Nation and Nationalities People's Region (SNPPR). The number of children admitted to TFCs is reported as decreasing in most of the TFCs (OCHA, 09/01/04) and some TFCs have been closed (OCHA, 04/11/03).
Two random -sampled nutrition surveys were carried out in Boricha woreda and Dale woreda, Sidama zone, in October 2003 (ACF-F/ADRA, 10/03; GOAL, 10/03). The surveys showed under control to average nutrition situations and mortality rates (see table 3).
The main cause of deaths in both woreda was fever/malaria.
Table 3 Results of nutrition surveys, Sidama zone, SNNPR, Ethiopia, October 2003
(ACF-F/ADRA, 10/03; GOAL, 10/03)
| % Acute Malnutrition (95% CI) |
% Severe Acute Malnutrition (95% CI) |
Crude Mortality (/10,000/day) |
Under 5 Mortality (/10,000/day) |
Measles immunisation coverage (%)* |
|
Boricha woreda |
||||
| 4.1 (2.5-6.4) | 0.1 (0.0-1.2) | 0.7 | 2.2 | 65.0 |
|
Dale woreda |
||||
| 7.9 (6.3-9.9) | 0.9 (0.4-1.8) | 0.5 | 1.4 | 58.6 |
In Boricha woreda, the nutrition situation seemed to have greatly improved
compared to April 2003, when a DPPC/DPPB's survey showed a malnutrition rate
above 15%.
The number of admissions to therapeutic feeding centres dropped significantly
from 143 in July 2003 to 58 in September 2003. The improvement in the situation
may be partly explained by the harvest and by humanitarian interventions,
especially in terms of food distribution and nutrition.
In Dale woreda, people were mainly relying on their harvest as their sources of
food and income (see box 1). At the time of the survey, people's source of food
was comparable to the situation in a non-drought year.
Box 1 Food security and public health, Dale woreda, Sidama zone, SNNPR,
Ethiopia, October 2003
(GOAL, 10/03)
|
Food security |
The last Deyr rains (October-November) were erratic and were concentrated in very limited areas to which a lot of pastoralists from other parts of Somali region, and even from northern Somalia have migrated. This has resulted in high pressure on pasture and water points (UNCT, 13/01/04). However, unexpected rains in January in six of the nine zones of Somali region have mitigated the situation by improving availability of water and pasture (OCHA, 30/01/03). It is, however, estimated that 1.1 million people will be in need of emergency food aid in 2004, especially until June 2004.
Fik is one of the most affected area (FEWS, 14/01/04). The nutrition situation has gradually deteriorated in Fik zone due to successive droughts, and appalling rates of acute malnutrition (around 30%) were reported in March 2003 (see RNIS 42).
Although the situation has improved in most parts of Ethiopia following a good harvest, several million people are still highly vulnerable due to successive bad years and lack of socio-economic development.
Food assistance has improved over the last months, with close to 100% of requirements delivered in July, August and September (FEWS, 16/10/03). The Meher agricultural production is expected to be average when compared to the years 1994-2001, and 20% higher than in 2002 (FEWS, 06/10/03). Livestock is reported to be in good condition because of the improved access to water and pasture during the rainy season (FEWS, 16/10/03). These good prospects are expected to mitigate the current food security crisis, but food distributions will still be necessary in 2004.
Negative long-term prospects in food security
A survey carried out in Wollo, Amhara Region, showed that destitution has increased over the past ten years, according to the communities and households (IDS/SCF, 04/03). They estimated that destitute and vulnerable households have increased from 5.5% to 14.6% and from 17.4% to 54.9%, respectively, over the past ten years. Most of the households are highly dependent on rain-fed agriculture and the poorest face many resource constraints such as land, livestock, labour, inputs or credits. They are highly vulnerable to shocks such as poor rainfall or loss of work force and recover from them with difficulty.
FEWS estimates that food shortage will increase over the next few years, because of slowly decreasing rainfall and steadily increasing food requirements (FEWS, 06/10/03).
Both reports recommend the development of nonagricultural livelihood activities, and the IDS/SCF report also recommends investment in physical infrastructure and public services and in social protection.
Nutrition situation A nutrition survey carried out in the rural area of Admitulo district, East Shoa, Oromia region, in October 2003, showed an average nutrition situation (MSF-H, 10/03). The prevalence of acute malnutrition was 7.1% (4.9-9.2), including 1% severe malnutrition (0.3-1.3), and had steadily decreased since the last survey done in June 2003 (see figure). Under-five and crude mortality rates were under control (0.48/10,000/ day and 0.83/10,000/day, respectively). Food distributions have been carried out since February 2003, blanket supplementary feeding since May 2003 and therapeutic and supplementary feeding programmes have been intensified since June 2003. Food distributions were, however, irregular, with oil and Famix irregularly distributed. Food distributions stopped in September 2003. The Meher crop was estimated to be generally good in the area and, at the time of the survey, food availability had already improved.
Acute malnutrition, Admitulo district, East Shoa, Oromia, 2003

Following appalling rates of malnutrition and mortality found in April 2003 (see RNIS 42) in Fik zone, Somali region, food distributions have been increased both in terms of number of beneficiaries and of ration scale; a blanket feeding programme has been implemented for under-five year olds; and supplementary and therapeutic feeding programmes have been put in place.
Exhaustive nutrition assessments were carried out in two settlements (Abrihijira and Abdurafi) of the resettlement programme of the Ethiopian government in Western Tigray, in October 2003 (MSF-H, 10/03). The prevalence of acute malnutrition was dramatically high: 36.4% acute malnutrition, including 13.2% severe malnutrition in Abrihijira; 24.7% acute malnutrition, including 6.8% severe malnutrition in Abdurafi.
A nutrition survey was conducted in Offa Woreda, Wolayita zone, Southern Nation and Nationalities People's Region (SNNPR), in September 2003 (Concern, 09/03). The nutrition situation was of concern (see table) and had remained stable since May 2003. The underfive and crude mortality rates were average (see table) and measles immunisation coverage was low.
Prevalence of malnutrition, Offa woreda, Wolayita zone, SNNPR, Ethiopia, September 2003 (Concern, 09/03)
| % Acute Malnutrition (95% CI) | % Severe Acute Malnutrition (95% CI) | Crude Mortality (/10,000/day) | Under 5 Mortality (/10,000/day) |
| 19.4 (16.9-22.2) | 1.3 (0.7-2.4) | 0.5 | 1.6 |
Most of the households interviewed were eating three meals a day (64.4%), whilst 31.1% were eating two meals and 2.2% were eating one meal. The number of meals eaten was reported to have increased when compared to May 2003, especially because of the availability of "temporary food", such as sweet potatoes, green maize and vegetables, during the rainy season. The main source of staple food was own production (82.2% of the families interviewed), followed by purchase (13.3%); 25.3% of the households had received food aid.
Overall - The nutrition situation seemed mixed, with reported improvement in some areas, but still critical rates in some others. The meher agricultural season is expected to improve food security in Ethiopia. However, long-term destitution and heavy reliance on rain-fed agriculture in some areas are key factors of vulnerability. Only long-term strategies will be able to reverse the impoverishment of the population.
As of the beginning of March 2003, pledges covered 56% of cereal food aid needs of 11.3 m drought affected people for 2003. Despite on-going food distributions, it seems that the nutritional status has not improved significantly (FEWS, 14/03/04).
Les promesses de contribution couvrent environ 55% des besoins en aide alimentaire destinée aux populations affectées par la sécheresse.
It becomes more and more apparent that the current drought will have a major impact on some populations. The FAO/WFP crop and food supply assessment, carried out in November 2002, estimated that national cereal and pulse production would be about 25% down from 2001 and 21% down from the average of the previous five years. Some 11.3 m people will be in need of food aid, which will amount to 1.44 m MTs.
Whilst grain prices were very low in the first semester of 2002, they increased sharply thereafter and were 25% to 85% higher (depending on the cereal type) in October 2002 than at the same time the previous year (FAO/WFP, 30/12/02).
In previously identified crisis areas (Afar, eastern parts of Oromoya, several areas of Southern Nations and Nationalities People's Region, and part of Somali region), food aid delivery and harvest have increased food availability. However, other areas of concern have been further identified, such as parts of Arsi zone, Oromoya region (FEWS, 11/11/02). Migrations have already been registered as a result of the drought. Some 20,000 people from East and West Hararghe and Arsi zones have settled in Bale National Park. Their living conditions seem far from adequate (UNDP, 01/11/02). Drought also stimulated ethnic clashes over scarce water resources, particularly in Afar region (OCHA, 08/11/02).
However, unseasonable rains fell in central Ethiopia in December 2002. It seems that the rains were not largely used for cultivation but that they certainly had a positive impact on pasture and water availability (WFP, 03/01/02).
Food aid availability and delivery were inadequate during the first half of 2002; distributions ranged from 12% to 54% of monthly requirements. However, distributions have improved over the past months: 67% of the requirements were covered in June, 97% in August and about 80% in September (FEWS, 11/11/02). Food aid pledges to WFP have been received from several donors and NGOs also received resources for food aid programmes (WFP, 22/11/02).
The current Ethiopian humanitarian crisis appears to be a consequence of structural weaknesses exacerbated by drought. According to some agencies, drought could be better coped with if farming methods were improved, food distribution freed from governmental control and stocks built up during good harvests (Alertnet, 15/11/02).
Land tenure is a highly controversial issue. The current policy is that government-owned lands are allocated to farmers. Plot sizes are too small to enable minimum food production. According to the Ethiopian Economic Association, efforts to increase productivity have largely failed. They advocate a mixture of state, private and communal land holdings, and for increase in plot sizes (OCHA, 07/11/02).
Moreover, the UN's Emergencies Unit for Ethiopia has called for the abolition of collective punishment imposed on farmers who can not repay seed or fertiliser debts. This practice is detrimental to production (OCHA, 30/10/02).
In addition, the two last years grain prices were highly depressed, which led to low producer incentives and therefore reduced the farmers' ability to purchase agricultural inputs (FAO/WFP, 30/12/02). Livestock deaths, poor performance of cash crops such as coffee and khat and low employment opportunities further compound the situation in some areas (FEWS, 13/12/02).
East Harerghe
SCF-UK carried out a nutrition survey in Golo Oda and Meyu Muluke woreda, East Harerghe zone, in October 2002 (SCF-UK, 10/02). The survey showed that 15.0 % of the children were acutely malnourished, including 1.1% with severe malnutrition. The households surveyed were from agro-pastoralist groups (49.3%), agriculturalist groups (43%) and pastoralist groups (7.7%). The region has suffered a four-year rain failure. It is expected that the actual drought will further aggravate the food security situation. At the time of the survey, 70% of the villages were expecting a complete harvest failure. Condition of livestock was reported to be good/medium by 58% of the households and poor/very poor by 42% of the households. Crude Mortality Rate and under-five mortality rate were respectively 0.62/10000/day and 1.81/10000/day.
Measles vaccination coverage, according to mother's statements, was only 4.6%. Health care facilities were also reported to be very limited. Measles vaccination and vitamin A supplementation campaign were implemented in West and East Harerghe in December 2002 (EUE, 27/12/02).
South Wollo
Two surveys were conducted by Concern in Kalu woreda and Dessie Zuria woreda, Sooth Wollo, Amhara region, in November and December 2002 (Concern, 11/02; Concern, 12/02). Belg and Meher rainy seasons have been erratic and led to poor harvests. The results of the surveys are of concern (see table); the percentage of oedematous children was significant in both surveys. The nutrition situation seems to have deteriorated since mid 2002 in both areas (see graph). The current surveys were conducted at the beginning of the Meher harvest but did not show any impact of the harvest on the children's nutritional status.
Acute malnutrition, South Wollo, Ethiopia
Malnutrition and mortality rates, South Wollo, Ethiopia, Nov-Dec 2002 (Concern, 11-12/02)
| Acute Malnutrition (%) | Severe acute malnutrition (%) | Oedema (%) | < 5 mortality rate (/10000/day) | Crude mortality rate (/10000/day) | |
| Kalu woreda | 16.6 | 4.0 | 3.3 | 1.68 | 0.6 |
| Dessie Zuria woreda | 17.2 | 3.1 | 1.8 | 1.67 | 0.56 |
Both woreda have difficult topography, which hampers access to markets and services. In Kalu woreda, the majority of farmers are Meher dependent ( Meher harvest is due in November- December). Although 50,100 out of the 232,000 woreda population should have been receiving food aid from DPPC from March 2002 until October 2002, distribution was interrupted in May and June because of logistical problems. It was planned that only 3,180 beneficiaries were to receive food distribution in the last quarter of 2002. Only 40% of the population reported to have got food from their own production for the previous month, compared to 80% in November 2000. About 25% of the households interviewed reported eating only two meals per day, instead of the normal three, compared to only 7% in January 2002.
The population of Dessie Zuria is chronically food insecure because of long-term problems of degraded grazing and cultivation areas. Most of the farmers are either Belg dependent or Belg Meher mixed dependent. Some 100,000 people have been identified as beneficiaries for food distribution in 2003. At the time of the survey, half of the population relied on their own production for food sources, compared to 70% in August 2002. As a consequence of livestock feed shortage, farmers were selling livestock, which represents one of the farmers' most important assets, at a low price.
Afar region
Following a nutrition assessment, which showed a very precarious situation in seven villages considered as particularly vulnerable in Ayssaita and Afambo woreda in Afar, zone 1, in July 2002, ACF undertook a larger assessment in the area. Some 604 children (75 to 110 cm tall) were screened in five kebele in Ayssaita woreda, two Kebele in Assambo woreda and eight kebele in Dubti area in October 2002 (ACF, 10/02).
The results showed that few children presented a low MUAC (see table); presence of oedema was not assessed. However, the survey also revealed that household food security was precarious, especially because of livestock losses as a consequence of poor rains. In addition health care and water sources were inadequate. Implementation of food distribution and supplementary feeding programmes is planned.
Results of MUAC assessment, Afar region, zone 1, October 2002 (ACF, 10/02)
| Woreda | Number of children | MUAC < 110 mm | MUAC ≥ 110 mm & < 120 mm | MUAC ≥ 120 mm & < 125 mm | MUAC ≥ 125 mm & < 135 mm |
| Ayssaita | 182 | 2 (1.1%) | 7 (3.8%) | 8 (4.4%) | 54 (29%) |
| Afambo | 101 | 1 (1%) | 1 (1%) | 2 (2%) | 19 (18%) |
| Dubti | 321 | 1 (0.3%) | 1 (0.3%) | 2 (0.6%) | 77 (24%) |
Refugees
Repatriation of Somali refugees continues from the camps in Somali region to Somaliland. Six of eight refugee camps have been closed and nearly 30,000 refugees have been repatriated since the beginning of 2002, halving the Somali refugee caseload in Ethiopia (UNHCR, 25/10/02; UNHCR, 05/11/02).
In Western Ethiopia, where 85,000 Sudanese refugees are settled in camps, ethnic clashes erupted between refugee communities in Fugnido camp. Forty-one refugees were killed and several houses were looted (OCHA, 12/12/02).
Overall - The nutrition situation in the areas currently affected by drought is of concern (category II). The food security will not improved in these areas at least until the next belg season which will start in March 2003.
Recommendations and priorities
From the SCF-UK survey in East Harerghe.
Short term:
Long term: