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Nutrition in Crisis SituationsVol 6, May 2005 Summary of the nutrition survey results Notes on the survey methodologies Indicators and risk categories HighlightsDjibouti—Drought alert—The last three rainy seasons were poor and this was compounded by the migration of pastoralists from Somalia, Ethiopia and Eritrea in search of pasture and resulted in the deterioration of the food security situation. At the beginning of April 2005, the government of Djibouti asked for support from the international community for the provision of the humanitarian assistance to 28,650 persons affected by the drought and the provision of animal feed, water and emergency veterinary care for 50,000 heads of livestock. A further assessment carried out at the end of April estimated that the number of people in need of emergency food assistance had increased from 28,650 to 47,500 due to additional migration of pastoralists. Food is currently distributed, but is only sufficient to cover the needs until the end of May. Further pledges towards the appeal are urgently needed. Ethiopia—Number of affected population increased — A flash appeal, released at the beginning of May 2005, reconsidered the number of affected people from the estimated 3.1 m at the beginning of the year to 3.8 m. This increase is due to new evidence gathered through assessments and to a delay in the delivery of food assistance. Another concern is that the safety net, which should cater for 5m chronically food-insecure people, who were therefore removed from the emergency relief programme, was not yet implemented as of February 2005, leaving them without assistance. Kenya –Appalling rates of malnutrition in Northern Kenya- Following a poor short-rainy season in parts of Kenya, the delay in the onset of the long-rains season is a cause of concern. A significant number of districts are considered as being in the alert phase regarding food security. The drought-affected pastoral and marginal agricultural areas are the most at risk. Beside weather hazards, the problem of chronic poverty seems to be also related to minorities' issues in some districts. Random-sampled nutrition surveys, which were conducted in the worst affected areas of Wajir and Mandera districts, revealed very high rates of acute malnutrition while crude mortality rates were under control. Sudan—Precarious situation— Following the peace agreement signed in January 2005 between the government of Khartoum and the SPLM/A, donors have pledged US$ 4.5 billion for reconstruction in South Sudan for the period of 2005-2007, exceeding by US$ 2 billion the estimated minimum requirements. Displaced and refugee populations continue to return to the South, although their number is impossible to estimate because of problems of registration and tracking. Several random-sampled nutrition surveys conducted in South Sudan showed average to critical nutrition situations. The security situation saw no improvement in Darfur. As of February 2005, it was estimated that 58% and 80% of the affected population were covered in regard with provision of drinking water and non-food items, respectively, while sanitary interventions covered 70% of the needs. Primary health coverage was still far from sufficient. Recent random-sampled nutrition surveys showed average to precarious nutrition situations. Guinea—Worsening of the situation—The prevalence of malnutrition seems higher in Gueckedou prefecture since 2002 than in 1999-2000. This might be partly explained by the fact that since the refugees who were hosted in Gueckedou prefecture were relocated in 2001 the dynamic of the region has changed and the humanitarian assistance has decreased. The current economic and political instability probably also plays a major role. Niger—Food crisis looming—Last year’s weather conditions were bad with drought and locust invasion. According to MSF, more than 3,000 children were admitted to their therapeutic feeding centre in Maradi, southern Niger, in the first four months of 2005, which is three times higher than for the same period in previous years. A UN appeal was launched on 19 May 2005, requesting US$ 16.2 million to, amongst other things, provide food aid to 3.6 m people and cater for malnourished children. Uganda—Average situation—The situation has remained tense in Northern Uganda over the last months . Several nutrition surveys conducted in IDP camps in Gulu, Lira, Appac and Pader districts showed acceptable to average nutrition situations. Haiti—Nutrition situation not critical—The security situation is still highly volatile, especially in Port au Prince. A number of nutrition surveys conducted over the last months do not show a critical situation, even in Gonaives, which was hard hit by hurricane Jeanne in September 2004. Risk Factors affecting Nutrition in Selected SituationsIn the table below are classed into five categories relating to prevalence and or risk of malnutrition (I—very high risk/prevalence, II—high risk/prevalence, III—moderate risk/prevalence, IV—not at elevated risk/prevalence, V-unknown risk/prevalence; for further explanation see section "Indicators and classification" at the end of the report). The prevalence/risk is indirectly affected by both the underlying causes of malnutrition, relating to food security, public health environment and social environment, and the constraints limiting humanitarian response. These categories are summations of the causes of malnutrition and the humanitarian response, but should not be used in isolation to prescribe the necessary response.
J Adequate K Mixed L Inadequate Greater Horn of AfricaDjiboutiDjibouti is a small country of about 500,000 inhabitants. Because only 3% of the land is arable, most of the inhabitants were nomadic pastoralists. However, due to adverse climatic conditions and national border limitations, most of the population (an estimated 85%) have shifted to an urban way of life. They mostly rely on the activity of the port of Djibouti. The last three rainy seasons were poor and this was compounded by the migration of pastoralists from Somalia, Ethiopia and Eritrea in search of pasture and resulted in the deterioration of the food security situation (OCHA, 21/04/05). At the beginning of April 2005, the government of Djibouti asked for support from the international community for the provision of the humanitarian assistance to 28,650 persons affected by the drought (OCHA, 21/04/05). A flash appeal was then launched by the international agencies for providing emergency assistance such as food to 28,650 people, water to 18,000 people, implementing nutrition programmes for malnourished children, and animal feed, water and emergency veterinary care for 50,000 heads of livestock (OCHA, 2005). A further assessment carried out at the end of April estimated that the number of people in need of emergency food assistance had increased from 28,650 to 47,500 due to additional migration of pastoralists (WFP, 13/05/05). Food deficits of between 17% and 50% are expected to start in June and to last for at least six months in pastoral areas (FEWS, 13/05/05). The most affected areas are the Southeast pastoral zone, the Roadside sub-zone and the Northwest pastoral zones (see map). NICS is not aware of any nutrition survey recently conducted in Djibouti.
The government of Djibouti has started to provide water to the population of the Roadside pastoral zone. Food is currently distributed, but is only sufficient to cover the needs until the end of May. Further pledges towards the appeal are urgently needed. RecommendationsRequirements for international assistance to the needs of the government of Djibouti:
EritreaOwing to the poor crop in 2004, 2.3 m vulnerable people require food aid in 2005 (see NICS 5). Nutrition situation remains precarious in Anseba and Northern Red SeaNutrition surveys conducted in Anseba and Northern Red Sea in January 2005 showed a precarious nutrition situation with a prevalence of acute malnutrition of 12.6% in Anseba and 14.2% in Northern Red Sea (DPPC, 01/05). This is comparable to the rate of acute malnutrition found in the same season in 2004 and is lower than the prevalence of acute malnutrition found during the lean season in summer 2004 in Anseba, while the prevalence of malnutrition remains stable in Northern Red Sea (figure 1). On the other hand, chronic energy deficiency among women has slightly decreased when compared to December 2003 in Anseba, but has not changed in Northern Red Sea (figure 2). As in previous surveys, most families (98% in Anseba and 94% in Northern Red Sea) had received food aid in the four months prior to the survey. On average, they had received 8 kg of cereals per person per month in Anseba, but only 6.3 kg in Northern Red Sea, which is slightly less than in June 2004 when families received an average of 7.9 kg of cereals. The coverage of the supplementary feeding programme was about 69% in Anseba, which was slightly lower than in June 2004. In Anseba, ninety-three percent of children less than one year old were breastfeeding as well as 68% of the 12 to 23 month-olds. Only 6% and 12.1% of the families interviewed had access to sufficient safe drinking water in Anseba and Northern Red Sea, respectively. This has remained stable when compared to the previous surveys. In Anseba, it seems that Selea area was the most at risk according to the different factors measured in the survey while Gheleb area was the "better-off". RecommendationsFrom the N-NSS survey in Anseba for Selea area:
Figure 1 Prevalence of wasting, Anseba and Northern Red Sea, Eritrea
Figure 2 Prevalence of Chronic energy deficiency, Anseba and Northern Red Sea, Eritrea
EthiopiaA flash appeal, released at the beginning of May 2005, reconsidered the number of affected people from the estimated 3.1 m at the beginning of the year to 3.8 m (OCHA, 04/05/05). This increase is due to new evidence gathered through assessments and to a delay in the delivery of food assistance. The affected populations are those who have not benefited from the bumper harvest of 2004, estimated 24% above the 2003 harvest (FAO, 28/01/05). These comprise the populations of agricultural areas which have received little rain, and of pastoral areas (see map). Another concern is that the safety net, which should cater for 5m chronically food-insecure people, who were therefore removed from the emergency relief programme, was not yet implemented as of February 2005, leaving them without assistance (OCHA, 21/02/05).
Somali region, which has been hard-hit by the drought, has recently suffered from severe flooding. An estimated 150 people have been killed and 250,000 displaced (AFP, 03/05/05). Affected populations are difficult to reach (IRIN, 10/05/05). Critical to precarious prevalence of acute malnutrition have been reported in Hartishek and Fanfan IDP camps, Jijiga area, Somali region. The under-five mortality rates were also well above emergency thresholds (OCHA, 11/04/05). The situation has been dire in those camps for years (see NICS 2). According to two random-sampled nutrition surveys conducted in Afar region at the beginning of the year, the nutrition situation was precarious (table 1) (GOAL, 02/05; WV, 01/05). While the mortality rates were below the alert threshold in Abala district, zone 2, they were of concern in Assayita district, zone 1 (table 1). Measles vaccination and vitamin A distribution coverage was low (table 1). In Abala, almost all the families interviewed reported a fall in livestock-holding size compared to last year, and poor condition of livestock. Households were reliant on coping strategies such as reduced food consumption, unusual migration and sale of livestock. In Assayita, the food security was also precarious and the nutrition situation has not improved compared to November 2003, despite the distribution of food to targeted families. Table 1 Results of surveys in Zones 1 and 2 , Afar region, Ethiopia (GOAL, 02/05; WV, 01/05)
KenyaFollowing a poor short-rainy season in parts of Kenya, the delay in the onset of the long-rains season is a cause of concern (FEWS, 14/04/05). A significant number of districts are considered as being in the alert phase regarding food security. The drought-affected pastoral and marginal agricultural areas are the most at risk. Moreover, inter-clan clashes have been reported in Turkana, West Pokor, Garissa, Marsabit and Mandera districts (IRIN, 16/03/05, FEWS, 14/04/05). Food distributions have been disrupted in March due to logistical problems (FEWS, 14/04/05). Beside weather hazards, the problem of chronic poverty seems to be also related to minorities' issues in some districts. A report highlights that some minorities are the frequent victims of development policies (MRG, 13/04/05). For example, the total development budget for the district of Turkana, which is one of the poorest districts in Kenya and is regularly hard hit by drought, was less than one sixth of the budget for the relatively prosperous Nyeri district, in 2004-2005. The report warns that excluding minorities from development can result in conflict. Appalling rates of malnutrition in North Eastern KenyaWajir and Mandera districts are part of the arid lands. They are mainly populated by Somali ethnic pastoralists. The areas suffer political, social and economic marginalisation and have poor infrastructure and very limited employment opportunities. They were also hard hit by the drought which began in 2003. Random-sampled nutrition surveys were conducted in the worst affected areas of the districts: Wajir South and Wajir West in October 2004 (OXFAM, 10/04), and Mandera Central and Khalalio divisions in Mandera district in March 2005 (AAH-US, 03/05). The surveys revealed very high rates of acute malnutrition while crude mortality rates were under control (table 2). The under-five mortality rate was above alert threshold in Wajir West. When compared with the results of nutrition surveys carried out in September 2001, the nutrition situation in Wajir South seems to have remained stable while it has significantly worsened in the Western zone. A food distribution is implemented in the district, targeting 22% of the households. This is clearly not enough to guarantee an adequate nutritional status. Table 2 Results of surveys in Mandera and Wajir districts, North-Eastern province, Kenya (OXFAM, 10/04; AAH-US, 03/05)
In Mandera district, the comparison with previous surveys conducted in Mandera Central division showed that the nutrition situation is within the same range as in March 2002, but has significantly deteriorated when compared to March 2001. Despite the implementation of a targeted food distribution and of supplementary and therapeutic feeding programmes, the nutrition situation is still highly precarious. RecommendationsFrom the Oxfam nutrition survey in Wajir:
SomaliaThere is still no formal plan for the relocation of Somalia political authorities into Somalia (AFP, 21/04/05). Good Deyr season in most parts of the countryThe Deyr season was exceptionally good in most parts of the country. In southern Somalia, cereal production is estimated at 122,400 MT, which is 121% above post-war average (FSAU, 02/05). While the sorghum harvest was very good, heavy rains and floods along the Shabelle and Juba rivers have hampered maize production, which, consequently, is less than half of the post-war average. In Northern Somalia, the above normal rains have ended a three-year drought and have renewed pasture and water sources. Livestock productivity and livestock prices have increased (FEWS, 21/04/05). It is expected that the situation will improve in the drought hit areas of Sool plateau and Nugal valley, although full recovery will need time to be achieved. One million people still in need of assistanceDespite the relief which has been brought by the Deyr season, 240,000 people are still experiencing livelihood crises and 260,000 people require emergency assistance (table 3). In the North, these are people who have experienced multiple shocks over a number of years (drought, flooding and tsunami). In the Central area, insecurity is the main negative factor affecting population, while in Southern Somalia, populations of the Juba and Shabelle valleys who have experienced floods are the most affected, and people from Gedo region are most affected because of insecurity. Around 400,000 displaced people also require assistance as well as 100,000 urban chronically poor (FEWS, 21/04/05). In March 2005, food aid was provided to about 320,000 beneficiaries. Nutrition situation has improved or stabilised in Northern SomaliaA new round of sentinel sites surveillance was conducted in February 2005 in Lower Nugal valley and Sool plateau (FSAU/N, 03/05). The nutrition situation has remained stable in Sool plateau (table 4) and has improved in Nugal valley: the prevalence of acute malnutrition was 17.2% in February 2005, including 3.7% severe acute malnutrition, compared to 33.9%, including 6.6% severe acute malnutrition in November 2004. Table 3 People in need of assistance, Somalia (FSAU, 02/05)
Table 4 Nutrition situation in Sool plateau, screening in sentinel sites (FSAU-N, 03/05)
Nutrition situation still precarious in Juba riverine areasA random-sampled nutrition survey was conducted along the Juba River 20 km north and 20 km south of Marere in November 2004 (MSF-H, 11/04). The nutrition situation was precarious: 10.9% (8.1-12.8) acute malnutrition, including 2.3% (1.1-3.2) severe acute malnutrition), but was better than that recorded in Jilib riverine area in May 2004 (see NICS 3). Measles immunisation coverage was only 24%. The survey was done after the Gu harvest and although some families had had a bad harvest, others were doing well. Moreover, families had put in place coping mechanisms and it was also believed that distribution of supplementary food and family food rations had helped to mitigate the situation. OverallDespite an exceptionally good Deyr season in most part of Somalia, a significant number of people still remain in need of assistance either because they have not yet completely recovered from the previous poor seasons, or because of chronic food insecurity due to displacement or insecurity. SudanSouth SudanFollowing the peace agreement signed in January 2005 between the government of Khartoum and the SPLM/A (Sudan People's Liberation Movement/Army) (see NICS 5), donors have pledged US$ 4.5 billion for reconstruction in South Sudan for the period of 2005-2007, exceeding by US$ 2 billion the estimated minimum requirements (UNNews, 12/04/05). During a reconciliation conference held in Kenya in April 2005, factions operating in Southern Sudan agreed to support the peace deal (AFP, 21/04/05). However, this meeting was not attended by the Khartoum-backed militia which controls oil-rich areas in Upper Nile. On the ground, it seems that the population are still subjected to arbitrary taxations by the different factions (IRIN, 12/04/05). Displaced and refugee populations continue to return to the South, although their number is impossible to estimate because of problems of registration and tracking (FEWS, 31/03/05). It seems that the influx is more significant in Northern Bhar-el- Ghazal. Urgent funding is needed to help the re-integration of the returnees, while host populations are already only surviving on meagre resources and will not be able to provide help for the returnees, especially in Bhar-el-Gahzal where the food security situation is fragile (FEWS, 04/05). In Khartoum, arbitrary demolition of IDP settlements continues, compromising IDP livelihood (IRIN, 22/03/05). UNICEF, together with WHO, will develop the Expanded Programme of Immunisation and implement a mass measles vaccination coverage, targeting children from six months to 15 years (UNICEF, 02/05). Vaccination coverage is generally very low in South Sudan. Several random-sampled nutrition surveys conducted in South Sudan showed average to precarious nutrition situations. The nutrition situation was critical in Twic and Abeyi counties, Bhar el Ghazal (table 5), mainly due to poor food security (AAH-US/GOAL, 04/05). Cereal stocks were depleted and the last food distribution took place in July 2004. Moreover, the security situation was still volatile. On the other hand, the nutrition situation was average in Bunagok district, Awerial county, Bhar el Ghazal (table 5) (AAH-US, 01/05). The food security situation in the area was considered satisfactory as the last harvest was good. The area seems to have benefited from a calm situation since 2000. In Luakini county, Upper Nile, the nutrition situation was precarious mainly because of poor rains in 2004 (table 5) (AAH-US, 03/05). Table 5 Results of surveys in Southern Sudan (AAH-US, 01/05; AAH-US, 03/05; AAH, US/GOAL, 04/05; GOAL, 02/05)
Crude mortality was under control in the three above mentioned locations (table 5). The prevalence of acute malnutrition has significantly decreased in Kapoeta South county, when compared to January 2004 (figure 3) (AAH-US, 01/05). This might be explained by a good rainy season, leading to a better harvest than in the previous year and to the negotiation of a truce with neighbours, which has allowed access to the nearby valley for grazing pasture and to the route to Uganda for trading. However, measles vaccination coverage was very low and crude mortality rate was at the alert level. Figure 3 acute malnutrition and mortality, Kapoeta county, Southern Sudan
In Kurmuk district, Southern Blue Nile, the nutrition situation was average (table 5) (GOAL, 02/05). Food security, health and access to water were also average (box 1). However, the mortality rates were above alert thresholds. The main cause of mortality was bloody diarrhoea. Box 1 Food security, public health and child feeding practices, Kurmuk County, Southern Blue Nile, February 2005 (GOAL, 02/05)
It is worth noticing that these surveys were done after the rainy season, a favourable period in regard to food security. DarfurThe security situation saw no improvement in Darfur (BBC, 11/04/05; UNNews, 18/04/05). Attacks on civilians seem to have decreased only marginally, while attacks against humanitarian personnel and convoys are on the rise. A new round of African-Union sponsored peace talks are due to begin in Nigeria in May 2005 (AFP, 26/04/05). WFP food deliveries increased by 34% in February 2005 compared to January (UNNews, 15/03/05). New routes have been opened for food transportation from Abeche in Chad and from Libya (WFP, 09/05/05). However, as of April 2005, WFP was facing a funding shortfall of 40% of the total requirement (WFP, 06/05/05). As of February 2005, it was estimated that 58% and 80% of the affected population were covered in regard with provision of drinking water and non-food items, respectively, while sanitary interventions covered 70% of the needs (UNSC, 12/04/05). Primary health coverage was still far from sufficient. Access to several remote areas has recently been gained (UNSC, 12/04/05). A recent report describes the effects of the conflict and humanitarian crisis on the livelihoods of the communities in Darfur (FIFC, 02/05). The main livelihoods in Darfur are crop cultivation and livestock rearing and trading, supplemented by migration and remittances, collection of natural resources (firewood, fodder and wild foods) and trade. The figure below attempts to summarise the main findings regarding the disruption to livelihood in Darfur (figure 4). Figure 4 Disruption to livelihood, Darfur, Sudan (FIFC, 02/05)
Recent random-sampled nutrition surveys showed average to precarious nutrition situations (table 6). Table 6 Results of surveys in Darfur region, Sudan
In the IDP camp of Kalma, South Darfur, the nutrition situation and the mortality rates have improved when compared to September 2004 (figure 5) (MSF-H, 02/05). Figure 5 Malnutrition and mortality, Kalma IDP camp, South Darfur, Sudan
However, a rise in the number of admissions to the feeding centres has been reported from March 2005. Measles vaccination was low and despite the fact that the great majority of the population had access to a protected source of water, diarrhoea was widespread. There was a fear that some of the bladders might be contaminated. Latrine coverage has improved from 44.3% in September 2004 to 74.3% in February 2005. However, only 20% of the households surveyed reported having soap at home. Eighty-four percent of the families interviewed stated they had a ration card. Among them, 12% reported not having received a food distribution in the month prior to the survey. In Gereida camp, South Darfur, the nutrition situation was precarious and the under-five mortality was above emergency threshold (however, mortality was recorded over the month prior to the survey and confidence intervals are probably very large) (table 6) (ACF-F, 01/05). Diarrhoea was the main cause of death. Ninety six percent of the families were benefiting from the general food distributions. The nutrition situation was also precarious in Jebel Mara area, West Darfur and under- five mortality was of concern (table 6) (GOAL, 03/05). The area, which was the bread basket of Darfur, has been affected by food insecurity due to the conflict and poor rainfall. Only one food distribution had taken place in the five months prior to the survey (03/05). OverallDespite some improvements, the situation is still grim in both Southern Sudan and Darfur. Both regions suffer funding gaps (see map). Funding gaps, Sudan (Humanitarian Information centre, Darfur, 02/05)
West Africa
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| AAH-US | Action Against Hunger USA |
| ACF-F | Action Contre la Faim France |
| ACH-S | Action Contra El Hambre Spain |
| AFP | Agence France Presse |
| BMI | Body Mass Index |
| CI | Courrier International |
| CMR | Crude Mortality Rate |
| < 5 MR | Under-five Mortality Rate |
| FAO | Food & Agricultural Organization of the United Nations |
| FEWS | Famine Early Warning System |
| FIFC | Feinstein International Famine Center, Tufts University |
| FSAU | Food Security Analysis Unit for Somalia |
| HKI | Helen Keller International |
| IOM | International Organisation on Migration |
| IRIN | International Regional Information Network |
| MOH | Ministry of Health |
| MONUC | United Nation Organisation Mission in the DRC |
| MRG | Minority Rights Group International |
| MSF | Médecins Sans Frontières |
| MSF-H | Médecins sans frontières - Holland |
| MUAC | Mid-upper arm circumference |
| NGO | Non-governmental Organisation |
| N-NSS | National Nutrition Surveillance System, Eritrea |
| OCHA | Office for the Co-ordination of Humanitarian Assistance |
| RI | Refugees International |
| SC-US | Save the Children-United States |
| UNDP | United Nations Development Programme |
| UNHCR | United Nations High Commission on Refugees |
| UNICEF | United Nations International Children’s Emergency Fund |
| UNSC | United Nations Security Council |
| USAID | US Agency for International Development |
| VAM | Vulnerability Analysis Mapping |
| WFP | World Food Programme |
| WHO | World Health Organization |
| WV | World Vision |
FEWS 13/05/05 Fews Djibouti food security warning 13 May 2005– Pledges below appeal requirements
OCHA 21/04/05 Djibouti: drought OCHA situation report No 1
OCHA 2005 Djibouti drought, 2005 flash appeal
WFP 13/05/05 WFP Emergency Report No 20 of 2005
N-NSS 01/05 Nutrition survey report, Anseba
N-NSS 01/05 Nutrition survey report, Northern Red Sea
AFP 03/05/05 At least 146 killed, more than 250,000 displaced in Ethiopian floods
FAO 28/01/05 FAO/WFP crop and food supply assessment mission to Ethiopia
GOAL 02/05 Preliminary results of Abala nutritional survey
IRIN 10/05/05 Ethiopia: floods ravage remote Somali region
OCHA 21/02/05 Relief bulletin: weekly humanitarian highlights in Ethiopia 21 Feb 2005
OCHA 11/04/05 Relief bulletin: weekly humanitarian highlights in Ethiopia 11 April 2005
OCHA 04/05/05 Flash update: The 2005 joint humanitarian appeal for Ethiopia
SC-USA 11/04 Rapid assessments in 4 drought-affected woredas of Somali region
WV 01/05 Summary report, Nutrition surveys conducted in Assayita woreda, zone 1, Afar regional state
AAH-US 03/05 Nutritional anthropometric survey, children under five years, Mandera Central and Khalalio divisions
IRIN 16/03/05 1,500 families flee from inter-clan violence in Mandera
FEWS 14/04/05 FEWS Kenya food security update Apr 2005—Concerns over late long-rains season
MRG 13/04/05 Risk of conflict increasing
OXFAM 10/04 Nutritional survey in the Western and Southern zones of Wajir district–North Eastern province
AFP 21/04/05 Somali president urges bickering MPs, ministers to return to Kenya
FEWS 21/04/05 FEWS Somalia: food security emergency 21 Apr 2005: significant needs remain
FSAU 02/05 Food security and nutrition, February monthly brief
FSAU 03/05 Food security and nutrition, March monthly brief
FSAU/N 03/05 Monthly nutrition update
MSF-H 10/04 Nutritional survey report, Lower and Middle Juba, Somalia
ACF-F 01/05 Nutritional anthropometric survey, children under five years old, Gereida camp, South Darfur state
AFP 21/04/05 Southern Sudanese factions, minus militias, agree to support peace deal
AFP 16/04/05 Sudan to take part in Nigeria peace talks with Darfur rebels
AAH-US/GOAL 04/05 Nutritional anthropometric survey, children under five years old, results summary, Twic/Abyei counties, Bhar GOAL el Ghazal
AAH-US 01/05 Nutritional anthropometric survey, children under 5 years old, Bunagok district, Awerial county– Bhar el Ghazal
AAH-US 01/05 Nutritional anthropometric survey, children under 5 years old, Kapoeta South county, Eastern Equatoria
AAH-US 03/05 Nutritional anthropometric survey, children under 5 years old, Kiechkuon, Kier districts, Luakipinyi county– Upper Nile region
BBC 11/04/05 Darfur village rampage shocks UN
FEWS 31/03/05 Population returns continue
FEWS 04/05 Southern Sudan, food security update
FIFC 17/02/05 Darfur 2005, livelihood under siege
GOAL 02/05 Findings of a nutrition survey, Kurmuk county, Southern Blue Nile
GOAL 03/05 Preliminary findings of a nutrition survey, Jebel Mara, West Darfur
IRIN 22/03/05 Sudan: IDPs forced to move as Khartoum settlement is demolished
IRIN 12/04/05 Sudan: NGO says armed groups still active in the south
MSF-H 02/05 Nutrition and health assessment, Kalma camp, South Darfur state, Sudan
UNICEF 02/05 Monthly report, February 2005, Southern Sudan
UNNews 15/03/05 Despite attacks, UN food deliveries rise in Sudan’s war-torn Darfur region
UNNews 12/04/05 After Annan’s call for generosity, donors pledges $4.5 billion for Sudan
UNNews 18/04/05 UN reports no security improvement in Sudan’s strife-torn Darfur region
UNSC 12/04/05 Sudan: Monthly report of the Secretary-General on Darfur
WFP 06/05/05 WFP Emergency report No 19 of 2005
WFP 09/05/05 Sudan: WFP opens new air route via Libya to increase food flow to Darfur
WHO 15/04/05 Sudan: Primary health coverage in Darfur IDP camps
IRIN 11/01/05 Côte D’Ivoire: Mbeki gets more time to mediate but runs into trouble
IRIN 27/04/05 Côte d’Ivvoire: Gbagbo agrees to let rival stand in election, rebels give cautious Welcome
IRIN 27/04/05 Côte d’Ivoire: Une ratonnade à Guiglo fait au moins un mort et plusieurs blessés
OCHA 21/04/05 Crisis in Cote d’Ivoire situation report No 39
UNICEF/MOH 2004 Assessment of nutritional status of the populations of Côte d’Ivoire
UNICEF/MOH 11/04 Assessment of the fight against iodine deficiency disorders in Cote d’Ivoire
ACF-F 02/05 Food security report, Internally displaced persons, Montserrado, Margibi and Bong IDP camps/Bomi and Grand Cape Mount communities
AFP 24/04/05 Food rations for Sierra Leone refugees to be cut
Global IDP project 15/04/05 Liberia’s displaced people face rushed and poorly planned return process
IOM 19/04/05 Liberia– IOM begins returns to Lofa county
IRIN 19/04/05 Liberia: Ex-fighters making money from latex refuse to leave rubber plantation
OCHA 28/02/05 Rapport de situation humanitaire en Guinée—Février 2005
WFP 02/05 Lofa county, food security and nutrition assessment
WFP 03/05 Grand Gedeh county, food security and nutrition assessment
WFP 15/04/06 WFP Emergency Report No 16 of 2005
ACH-S 02/05 Enquête nutritionnelle, prefecture de Gueckedou, Guinée
OCHA 28/02/05 Rapport de situation humanitaire en Guinée– Février 2005
ACF-F 09/04 Nutrition survey, Freetown, Sierra Leone
CI 31/03/05 Une révolte justifiée
FEWS 16/03/05 Niger: Food security warning 16 March 2005—Growing food insecurity conditions
FAO/WFP 21/12/04 FAO/WFP crop and food supply assessment mission to Niger
MSF 26/04/05 Nutritional emergency in Niger
MSF 28/04/05 Alarming increase in malnutrition in Niger
OCHA 19/05/05 UN appeals for $ 16 million for Niger food crises
WFP 22/04/05 WFP Emergency Report No 17 of 2005
WFP 20/05/05 WFP Emergency Report No 21 of 2005
AFP 16/02/05 Army says 18,000 ex-rebels disarmed in Burundi
AFP 16/05/05 Burundi rebel group, president sign deal to end hostilities
IRIN 07/03/05 Burundi: court to endorse final result of constitutional referendum, official says
MINAGRI/FAO, WFP, UNICEF 2005 Evaluation des récoltes, des approvisionnements alimentaires et de la situation nutritionnelle
MSF-H 01/05 Nutritional survey, Kirundo province, Burundi
OCHA 12/05/05 Burundi situation report, 2-8 May 2005
VAM 12/04 Analyse de la sécurité alimentaire et de la vulnérabilité effectuée en juillet-août
WFP 16/03/05 Burundi: food shortages deepen as country embraces peace
AAH-US 11/05 Rapport d’enquête nutritionnelle, zone de santé de Shabunda, province du Sud Kivu
AAH-US 12/05 Rapport d’enquête nutritionnelle, zone de santé de Lubutu, province du Maniema
OCHA 06/05/05 Monitoring de la situation humanitaire en RDC du 30 avril au 6 mai 2005
USAID 30/04/05 USAID field report DR Congo Apr 2005
AAH-US 02/05 Nutritional anthropometric survey, children under five years old, Minakulung/Ngai/Otwal, Northern Appac
AAH-US 03/05 Nutritional anthropometric survey, children under five years old, results summary, Lira, Northern Uganda
FEWS 05/05 Uganda, food security update
GOAL 03/05 Findings of a nutrition survey, Parabongo, Wol & Paimol sub-counties, Agago county, Pader district, Northern Uganda
SC district director 10/04 Summary results of the nutrition survey conducted by Save the Children in Ugandain partnership with the office of the health service– Gulu
USAID 13/04/05 Uganda complex emergency situation report #2 (FY05)
WFP/MOH/UNICEF 10/04 Summary of nutrition and health assessment in the internally displaced persons camps in Gulu district
AAH-US 01/05 Rapport final d’enquête nutritionnelle, districts sanitaires d’Adre, de Bahai et de Guereda, Décembre 2004-Janvier 2005
FEWS 25/04/05 Rapport mensuel de sécurité alimentaire au Tchad: 25 avril 2005—Accès des céréales limité par des prix élevés
IRIN 08/02/05 Chad-Sudan: Vaccination completed following meningitis outbreak in refugee camps
IRIN 26/04/05 Chad: water supplies run dry in desert refugee camps
MSF-H 01/05 Nutritional survey, Farchana and Bredging camps, Eastern Chad
RI 05/04/05 Sudanese refugees in Chad: situation stabilises but challenges remain
UNHCR 03/05/05 12th camp opened in eastern Chad
UNHCR 12/05/05 UNHCR press release, Chad, 12 May 2005
WFP 13/05/05 WFP emergency report No 20
AFP 04/05/05 Sri Lanka’s president vows Tsunami deal with rebels
BBCNews 18/04/05 Aceh talks end constructively
FAO/WFP 05/05/05 FAO/WFP food supply and demand assessment for Aceh province and Nias island (Indonesia)
HKI 01/01/05 Operations update
MOH/joint 20/04/05 Rapid nutrition assessment in Nanggroe Aceh Darusslam, February-March 2005, Executive summary
OCHA 29/04/05 Indonesia, Sri Lanka, Maldives, Thailand and Seychelles: earthquake and Tsunami OHA situation report No 38
OCHA 11/05/05 Indonesia situation report: natural disasters in Nanggore Aceh Darussalam and North Sumatra 11 May 2005
OCHA 05/05 Post-Tsunami update
OCHA 24/05/05 Humanitarian situation report– Sri Lanka: 20-24 May 2005
Reuters 24/05/05 S.Lanka tsunami aid stuck on the ground-World Bank Foundation
UNDP 17/04/05 UNDP’s initial response to the tsunami in Indonesia (end of mission report: Jan-Marc 2005)
USAID 30/04/05 USAID field report Sri Lanka Apr 2005
WFP 01/05 Impact of the Tsunami on the lives and livelihhod of people in Myanmar with special focus on Labutta township, Ayeyarwaddy division
WHO 11/03/05 Tsunami and health, situation report # 41
ACF-F 09/04 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Section communale de Soussaille, Commune de Kenscoff, Département de l’Ouest, Haiti
ACF-F 10/04 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Ouanaminthe (section I), Département du Nord Est, Haiti
ACF-F 10/04 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Saint Jean du Sud, Département du Sud, Haiti
ACF-F 11/04 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune du Mole Saint Nicolas, Département du Nord Ouest, Haiti
ACF-F 11/04 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune du Saint Michel de l’Attaye, Département de l’Artibonite, Haiti
ACF-F 12/04 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Pilate, Département du Nord, Haiti
ACF-F 01/05 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Ville de Gonaives, Département de l’Artibonite, Haiti
ACF-F 01/05 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Anse Rouge, Département de l’Artibonite, Haiti
ACF-F 01/05 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Corail, Département de la Grande Anse, Haiti
ACF-F 01/05 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Bonbon, Département de la Grande Anse, Haiti
ACF-F 02/05 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Fonds Verrettes, Département du Sud Est, Haiti
ACF-F 02/05 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Cerca Cavajal, Département du Centre, Haiti
ACF-F 03/05 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Belle Anse, Département du Sud Est, Haiti
ACF-F 03/05 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Commune de Bianet, Département du Sud Est, Haiti
ACF-F 04/05 Enquête nutritionnelle anthropométrique et de mortalité rétrospective, Communes de Petit Trou de Nippes et de Plaisance du Sud, Département de Nippes, Haiti
AFP 19/03/05 Haitian PM slams slow pace of international aid
FEWS 23/02/05 Fews Haiti food security watch Feb 2005
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Anseba - The survey was conducted in January 2005 by the N-NSS. The sample was a stratified multi-stage random sample. 1125 children were measured. BMI was measured among non-pregnant women aged 18 to 60 years. The survey also estimated morbidity and various food security indicators.
Northern Red Sea - The survey was conducted in January 2005 by the N-NSS. The sample was a stratified multi-stage random sample. 829 children were measured. BMI was measured among non-pregnant women aged 18 to 60 years. The survey also estimated morbidity and various food security indicators.
Assayita district, Zone 1, Afar region - The survey was conducted by WV in January 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 910 children between 6-59 months. The survey also estimated measles vaccination coverage, retrospective mortality rates over the 3 months prior to the survey and various food security and public health indicators.
Abala woreda, zone 2, Afar region - The survey was conducted by Goal in February 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 966 children between 6-59 months. The survey also estimated measles vaccination and vitamin A coverage, retrospective mortality rates and various food security and public health indicators.
Wajir, North-Eastern region - Two surveys were conducted in Wajir South & Wajir West by OXFAM in October 2004. Two-stage cluster sampling methodologies of 30 clusters were used to measure 956 children and 948 between 6-59 months, respectively. The surveys also estimated measles vaccination and vitamin A coverage, crude and under-five mortality rates over the 3 months prior to the survey and various food security and public health indicators.
Mandrea Central & Khalalio divisions, North-Eastern region - The survey was conducted by AAH-US in March 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 921 children between 6-59 months. The survey also estimated measles vaccination and vitamin A coverage, retrospective mortality rates over the 3 months prior to the survey and various food security and public health indicators.
Lower & Middle Juba - A random-sampled nutrition survey was conducted along the Juba River 20 km North and 20 km South of Marere by MSF-H in November 2004. A two-stage 30-by-30 cluster sampling methodology was used to measure 894 children between 6-59 months. The survey also estimated measles vaccination coverage.
Gereida camp, South Darfur -The survey was conducted by ACF-F in January 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 956 children between 6-59 months. The survey also estimated measles vaccination coverage and retrospective mortality rate over one month prior to the survey.
Kalma camp, South Darfur - The survey was conducted by Epicentre/MSF in February 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 900 children between 6-59 months. The survey also estimated measles vaccination coverage, retrospective mortality rate over three and a half months prior to the survey and various food security and public health indicators.
Goldo, Gildu & Rokero, Jebel Mara, West Darfur - The survey was conducted by GOAL in March 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 921children between 6-59 months. The survey also estimated measles vaccination and vitamin A distribution coverage and retrospective mortality rate over three months prior to the survey.
Kurmuk county, Southern Blue Nile - The survey was conducted by GOAL in February 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 956 children between 6-59 months. The survey also estimated measles vaccination coverage, retrospective mortality rate over three months prior to the survey and various food security and public health indicators.
Kapoeta South county, Eastern Equatoria - The survey was conducted by AAH-US in January 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 769 children between 6-59 months, respectively. The survey also estimated measles vaccination and retrospective mortality rate over three months prior to the survey.
Turalei, Ajac-Kuac & Akoc districts, Twic county & Alal & Rum-Amer district, Abyei county - The survey was conducted by AAH-US in April 2005. A two-stage cluster sampling methodology of 30 clusters was used. The survey also estimated measles vaccination and crude mortality rate over the three months prior to the survey.
Bunagok district, Awerial county, Bahr el Ghazal - The survey was conducted by AAH-US in January 2005. An exhaustive survey was conducted, 424 children were measured. The survey only included villages situated within a 3 hour walk radius from Bunagok. The survey also estimated measles vaccination and crude mortality rate over the three months prior to the survey.
Kiechkong & Kier districts, Luakipiny county, Upper Nile - The survey was conducted by AAH-US in March 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 922 children. The survey also estimated measles vaccination and crude mortality rate over the three months prior to the survey.
Gueckedou prefecture - The survey was conducted by ACH-S in February 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 908 children. The survey also estimated measles vaccination coverage and retrospective mortality over the previous 3 months.
Abidjan - The survey was conducted by UNICEF/MOH at the end of 2004. The sample was a stratified multi-stage random sample. The survey also estimated various food security and public health indicators.
Nation-wide Idd survey - The survey was conducted by UNICEF/MOH in August 2004. The sample was a stratified multi-stage random sample. The survey estimated various indicators of iodine deficiency disorders.
Lofa county - The survey was conducted by WFP/joint in February 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 950 children. Vahun district was excluded from the sampling frame because of inaccessibility. The survey also estimated measles vaccination and vitamin A distribution coverage, retrospective mortality over the previous 6 months and various indicators of food security and public health.
Grand Gedeh county - The survey was conducted by WFP/joint in March 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 916 children. The survey also estimated measles vaccination and vitamin A distribution coverage, retrospective mortality over the previous 6 months and various indicators of food security and public health.
Freetown - The survey was conducted by ACF-F in September 2004. A two-stage cluster sampling methodology of 30 clusters was used to measure 957 children. The survey also estimated measles vaccination.
Bugabira, Kirundo & Busoni communes - The survey was conducted by MSF-H in January 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 924 children. The survey also estimated measles vaccination coverage, retrospective mortality over the previous 3 months and various indicators of food security and public health.
Lubutu and Obokote health zones, Maniema province - The survey was conducted by AAH-US in December 2004. A two-stage cluster sampling methodology of 30 clusters was used to measure 910 children. The survey also estimated measles vaccination and vitamin A coverage, retrospective mortality over the previous 3 months and nutritional status of adults and infants.
Shabunda health zone, South Kivu - The survey was conducted by AAH-US in November 2004. A two-stage cluster sampling methodology of 30 clusters was used to measure 957 children. The survey also estimated measles vaccination and vitamin A coverage, retrospective mortality over the previous 3 months and nutritional status of adults and infants.
33 IDP camps, Gulu district - The surveys were conducted by WFP/MOH/UNICEF in October 2004. Random systematic sampled surveys were conducted in each camp. The surveys also estimated retrospective mortality and women’s nutritional status.
13 newly gazetted IDP camps, Gulu district - The surveys were conducted by SC in November 2004. Random systematic sampled surveys were conducted in each camp. The surveys also estimated retrospective mortality.
IDP camps, Minakulu, NGAI & Otwal, Northern Apac - The survey was conducted by AAH-US in February 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 956 children. The surveys also estimated measles vaccination coverage and retrospective mortality over the previous 3 months.
25 IDP camps, Lira district - The survey was conducted by AAH-US in March 2005. A two-stage cluster sampling methodology of 30 clusters was used. The survey also estimated measles vaccination coverage and retrospective mortality over the previous 3 months.
Kalongo town and 3 surrounding IDP camps, Agago county, Pader district - The surveys were conducted by GOAL in March 2005. Two-stage cluster sampling methodology of 30 clusters were used to measure 894, 273, 270 and 272 children in Kalongo town, Wol, Paimol and Miya Pacwa IDP camps, respectively. The surveys also estimated measles vaccination coverage, retrospective mortality over the previous 3 months and various public health and food security indicators.
Farchana & Bredging refugee camps - The survey was conducted by MSF-H in January 2005. A two-stage cluster sampling methodology of 30 clusters was used to measure 995 children. The survey also estimated measles vaccination and retrospective mortality over the previous 3 months.
Treguine, Mile & OureCassoni refugee camps & host populations - The surveys were conducted by AAH-US in January 2005. A two-stage cluster sampling methodology of 30 x 30 was used to measure approximately 900 children in all locations, except in Ourecassoni & Mile surrounding local populations where exhaustive surveys were conducted. The surveys also estimated measles vaccination coverage and retrospective mortality over the previous 3 months.
West Coast, North Coast & East Coast, Aceh province - The survey was conducted by MOH/joint in February 2005. A cluster sampling methodology of 255 clusters was used to measure 4,030 children between 6-59 months and 4,024 women aged 18-45 years. The survey also estimated vitamin A distribution and measles vaccination coverage, anaemia and various indicators of food security and public health.
Belladère, Centre department - The surveys were conducted by ACF-F between September 2004 and April 2005. A two-stage cluster sampling methodology of 30 clusters was used in each survey. The number of children surveyed in each survey is given in the table below. The surveys also estimated measles vaccination coverage and mortality rates over the previous three months.
The methodology and analysis of nutrition and mortality surveys are checked for compliance with internationally agreed standards (SMART, 2002; MSF, 2002; ACF, 2002).
Most of the surveys included in the Reports on Nutrition Information in Crisis Situations are random sampled surveys, which are representative of the population of the targeted area. The Reports may also include results of rapid nutrition assessments, which are not representative of the target population but rather give a rough idea of the nutrition situation. In that case, the limitations of this type of assessments are mentioned.
Most of the nutrition survey results included in the Reports target children between 6-59 months but may also include information on other age groups, if available.
Detailed information on the methodology of the surveys which have been reported on in each issue, is to be found at the end of the publication.
Unless specified, the Reports on Nutrition Information in Crisis Situations use the following internationally agreed criteria:
No international consensus on a definitive method or cut-off to assess adult under-nutrition has been reached (SCN, 2000). Different indicators, such as Body Mass Index (BMI, weight/height2), MUAC and oedema, as well as different cut-offs are used. When reporting on adult malnutrition, the Reports always mention indicators and cut-offs used by the agency providing the survey.
In emergency situations, crude mortality rates and under-five mortality rates are usually expressed as number of deaths/10,000 people/day.
Prevalence of malnutrition and mortality rates are late indicators of a crisis. Low levels of malnutrition or mortality will not indicate if there is an impending crisis. Contextual analysis of health, hygiene, water availability, food security, and access to the populations, is key to interpret prevalence of malnutrition and mortality rates.
Thresholds have been proposed to guide interpretation of anthropometric and mortality results.
A prevalence of acute malnutrition between 5-8% indicates a worrying nutritional situation, and a prevalence greater than 10% corresponds to a serious nutrition situation (SCN, 1995). The Crude Mortality Rate and under-five mortality rate trigger levels for alert are set at 1/10,000/day and 2/10,000/day respectively. CMR and under-five mortality levels of 2/10,000/day and 4/10,000/day respectively indicate a severe situation (SCN, 1995).
Those thresholds have to be used with caution and in relation to contextual analysis. Trend analysis is also recommended to follow a situation: if nutrition and/or mortality indicators are deteriorating over time, even if not above threshold, this indicates a worsening situation.
In the Reports, situations are classed into five categories relating to risk
and/or prevalence of malnutrition.
The prevalence/risk is indirectly affected by both the underlying causes of
malnutrition, relating to food, health and care, and the constraints limiting
humanitarian response. These categories are summations of the causes of
malnutrition and the humanitarian response:
The Reports on Nutrition Information in Crisis Situations have a strong public
nutrition focus, which assumes that nutritional status is a result of a variety
of inter-related physiological, socio-economic and public health factors (see
figure). As far as possible, nutrition situations are interpreted in line with
potential underlying determinants of malnutrition.
Action contre la Faim (2002) Assessment and treatment of malnutrition in
emergency situation. Paris : Action contre la Faim.
Médecins sans Frontières (2002) Nutritional guidelines.
SCN (2000) Adults, assessment of nutritional status in emergency affected
population.
Geneva: SCN.
University of Nairobi (1995) Report of a workshop on the improvement of the
nutrition of refugees and displaced people in Africa. Geneva : SCN.
SMART (2002) www.smartindicators.org
Young (1998) Food security assessment in emergencies, theory and practice of a
livelihoods approach.
The UN Standing Committee on Nutrition, which is the focal point for harmonizing nutrition policies in the UN system, issues these Reports on Nutrition Information in Crisis Situations with the intention of raising awareness and facilitating action. The Reports are designed to provide information over time on key outcome indicators from emergency- affected populations, play an advocacy role in bringing the plight of emergency affected populations to the attention of donors and humanitarian agencies, and to identify recurrent problems in international response capacity.
The Reports on Nutrition Information in Crisis Situations are aimed to cover populations affected by a crisis, such as refugees, internally displaced populations and resident populations.
This system was started on the recommendation of the SCN's working group on Nutrition of Refugees and Displaced People, by the SCN in February 1993. Based on suggestions made by the working group and the results of a survey of the readers, the Reports on Nutrition Information in Crisis Situations are published every three months.
Information is obtained from a wide range of collaborating agencies, both UN and NGOs. The Reports on Nutrition Information in Crisis Situations are put together primarily from agency technical reports on nutrition, mortality rates, health and food security.
The Reports provide a brief summary on the background of a given situation, including who is involved, and what the general situation is. This is followed by details of the humanitarian situation, with a focus on public nutrition and mortality rates. The key point of the Reports is to interpret anthropometric data and to judge the various risks and threats to nutrition in both the long and short term.
This report is issued on the general responsibility of the Secretariat of the UN System/Standing Committee on Nutrition; the material it contains should not be regarded as necessarily endorsed by, or reflecting the official positions of the UNS/SCN and its UN member agencies. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the UNS/SCN or its UN member agencies, concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
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This report was compiled by Dr Claudine Prudhon of the UNS/SCN Secretariat
Sarah Philpot assisted in the editing.
Design concept: Marie Arnaud Snakkers
The chairman of the UNS/SCN is Catherine Bertini
___________________________________________
The SCN Secretariat and the NICS Coordinator extend most sincere thanks to all those individuals and agencies who have provided information and time for this issue, and hope to continue to develop the excellent collaboration which has been forged over the years.
___________________________________________
If you have information to contribute to forthcoming reports, or would like
to request back issues of the report, please contact:
Claudine Prudhon, NICS Coordinator,
UNS/Standing Committee on Nutrition
20, avenue Appia, 1211 Geneva 27, SWITZERLAND
Tel: +(41-22) 791.04.56, Fax: +(41-22) 798.88.91,
Email: scn@who.int
Web: http://www.unsystem.org/scn
___________________________________________
Funding support is gratefully acknowledged from the Canadian International Development Agency, the Department of Foreign Affairs, Ireland, the Royal Ministry of Foreign Affairs, Norway and UNHCR..
This report was made possible through the support provided to the Food and
Nutrition Assistance (FANTA) Project by the Office of Program, Policy and
Management at the Bureau for Democracy, Conflict and Humanitarian Assistance and
the Office of Health, Infectious Diseases and Nutrition at the Bureau for Global
Health at the U.S. Agency for International Development, under the terms of
Cooperative Agreement No. HRN-A-00-98-00046-00 awarded to the Academy for
Educational Development (AED). The opinions expressed herein are those of the
authors and do not necessarily reflect the views of the US Agency for
International Development.
ISSN 1564-376X
United Nations System 
