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NUTRITON ANNUAL NUTRITON ANNUAL REPORT 2000REPORT 2000

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1.0. Objectives:1.0. Objectives: To increase exclusive breast feeding rate

from 65 to 75 percent To attain 95% vitamin A supplementation

coverage in children under five To attain universal iodized salt consumption To initiate Iron supplementation for

pregnant women attending antenatal and prenatal care services.

To attain BFHI status in all maternal health services

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2.0. Major Activities 2.0. Major Activities Implemented in Implemented in 20002000 Nutrition Surveillance (Nutrition

monitoring) Commissioning of salt iodization for

private salt producers Vitamin A supplementation Procurement of Iron folate Supplementary feeding for children

under five.

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3.0. Activities and 3.0. Activities and AchievementsAchievements Iodine Five iodizing machines were

commissioned by Ministry of trade and industry (DOT) and handed over to 4 private salt production associations. Training on machine handling and salt iodization was also given. In addition, additional supplies such as Carts, containers, and donkey are in the process of procurement.

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Iron: Iron foliate was procured and distributed to all Zones.

Vitamin A : Vitamin A supplementation was given to children between the ages of 6 months and 12 years in the drought affected areas & IDP camps together with integrated measles vaccination campaign in all Zones:

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Vitamin A con...Vitamin A con...– 13,371 children under five in the IDP camps of Gash Barka– 15,000 children under five in the IDP camps of Debub– 25,000 children in elementary schools of zoba Debub– 3,249 children age 6 – 11 months in zoba Maekel– 47,761 children age 12 – 59 months in zoba Maekel– 21,740 children under five in zoba NRS– 826 postpartum mothers in zoba Maekel

– 340 postpartum mothers in zoba NRS received Vit. A capsules. – 25,000 children in Elementary schools in Zoba Debub received

vitamin A Capsules– Hence, a total of 151,121 children were supplemented with Vit.

A – Supplementary food:

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3.2. Breastfeeding3.2. BreastfeedingThis year Breastfeeding Week was taken up as an This year Breastfeeding Week was taken up as an

important theme to Protect, Promote and Support important theme to Protect, Promote and Support breastfeeding. The week focused on breastfeeding breastfeeding. The week focused on breastfeeding as a human right, as a right of mothers to as a human right, as a right of mothers to breastfeed their children and a fundamental breastfeed their children and a fundamental component in assuring a child's right to food, component in assuring a child's right to food, health and care .The goal of this year was to go to health and care .The goal of this year was to go to all IDP camps and drought affected with women's all IDP camps and drought affected with women's association of MOH and to raise awareness on the association of MOH and to raise awareness on the first week of August. Based on these the following first week of August. Based on these the following achievements were gained: achievements were gained:

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Anseba Zone: All health facilities Anseba Zone: All health facilities celebrated the breast-feeding week. Beside celebrated the breast-feeding week. Beside that there were contest on breastfeeding that there were contest on breastfeeding and weaning issues in Keren. There were and weaning issues in Keren. There were 15,000 women who attended the contest. 15,000 women who attended the contest.

Debub: two days training /sensitization on breast-feeding was given to the friends of BFHI mainly mothers, TBAs (traditional birth attendants)

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Maekel Out Reach Health Facility Women's AssociationCommunity Mothers Association

Gala Nefhi 878 mothers were trained 212 390Serejega 563 304 140Bereik 2,998 2,538Asmara 17,903 3,503

6557 530Total 29,795 mothers were trained

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Mai Haabar 900Alba 839Adi-Keshi 1672Afabet 1309Gaala Nefhi 878Total 5598Total 49,514 mothers were trained/sensitised

Camps

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3.3. Supplementary feeding3.3. Supplementary feeding

Zoba Debub/ Host and IDP Zoba Debub/ Host and IDP population population

A target supplementary feeding and health education program for malnourished children and pregnant /lactating women started in November in Zoba debub in IDPs and host populations in 15 health centres. Endaghergis, Shekaeyamo, and Adi Quala.

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Areza, May Dema, Adi Gulti, Zban Debri, Adi Guorto, Mai Sagala, Adi Jhoni, May Mine, Dabre, Adi Quala and Bet Gabriel.Due. For those who live in fur distances three outreach sites serving remote villages at certain days of the month is set up .The objective of the program is to increase the caloric intake of the targeted group and nutritional knowledge of the population. Beneficiaries included children < 5 years of age as well as pregnant and lactating mothers. These activities, however, started late due to shortage of DMK.

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Harena Camp Harena Camp Supplementary feeding program (SFP) run in

Harena camp for 3-4 months after measuring a global malnutrition rate of 15%. The operation included a supplementary feeding centre (SFC) and therapeutic feeding centre (TFC) between 200-240 children and 200-280 pregnant / lactating women attending each week .The SFC distributes weekly supply of BP5 (940 Kcal/child/day) and HPB (940 Kcal/woman /day). Children also got weekly dose of Vitamin C and Iron /Folic Acid. Nutritional screening done on November showed a Global Malnutrition Rate of 4.2%.

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Therapeutic feeding Therapeutic feeding centrecentre Day care therapeutic feeding centre has treated

approximately 130 severely malnourished patients since it was opens in September 2000 in Harena Camp, admission criteria included children less than 5 year of age and whose Wt/Ht < 70 % of median or Bilateral Odema. Patient s are discharged from SFC once the W/t / H/t reaches > 80 %. There has been a relatively high defaulter rate of 30%, mostly among patients who had reached > 70% in Wt/ Ht and were qualified to SFC. There have been no reported deaths due to alnutrition since the camp was opened. Currently there are fewer than 10 patients in the TFC.

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Buya IDP camp /NRSZ/ Galallo sub Zone

400 people from Buya IDP who came from Endeli surrounding Gelaelo Sub –Zone were displaced in May 2000 And in November. Most of th4e severely malnourished children were transferred to Massawa Hospital and to therapeutic feeding centre in Harena camp. In December, about 300 IDPs from Buya were transferred to Ghinda camp. Food, tents and none food items were distributed after their arrival to the camp. Mass vaccination against measles and polio was given to all children and other routine vaccination continued in all children < 5 of age.

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Gash - BarkaGash - Barka Mekete camp (Afabet) Targeted dry supplementary feeding and wet feeding is

running in this camp The average length of stay in the wet feeding programme is The average length of stay in the wet feeding programme is

about 10 weeks. The number of malnourished children about 10 weeks. The number of malnourished children participating in the programme is dropping significantly. participating in the programme is dropping significantly. However, the number of lactating mothers attending the However, the number of lactating mothers attending the programmes continue to rise regarding the wet ration. Full programmes continue to rise regarding the wet ration. Full milk mixed with sugar, oil, and biscuit to reach an amount of milk mixed with sugar, oil, and biscuit to reach an amount of about 400 Kcal per day is given. . A daily ration to children about 400 Kcal per day is given. . A daily ration to children above 2 years and have .the small children below 2.5 year's above 2 years and have .the small children below 2.5 year's old received twice daily /ration for a total daily Kcal 778 the old received twice daily /ration for a total daily Kcal 778 the beneficiary of the program have been divided in two shift, in beneficiary of the program have been divided in two shift, in the morning and after noon about 3000 children and mothers the morning and after noon about 3000 children and mothers are benefit The severely malnourished children are treated in are benefit The severely malnourished children are treated in the health facility. the health facility.

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Cont...Cont... Korokon, Tole Gamja and

Kotobia (KTK) Targeted supplementary feeding

continues in these three sites. This is only for children less than five.

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Adi KeshiAdi Keshi There are targeted supplementary feeding programmes

and therapeutic feeding centres in the health facility. A 12 –hour therapeutic feeding centre was opened in Adi- Keshi in November. Children are admitted when they are < 70 % W/H or have bilateral oedema. During phase one, they are given F75 135 ml/kg/day in two –hourly feeds .In phase 2 F100 is given at the rate of 150-200 ml/kg/day .At the moment, children are given one milk meal to take at 8pm, and one BP5 biscuit to be taken during the night. Enriched CSB(corn Soya blend) porridge are given to children as their appetite improves and they gain weight. When the children reach 75% W/H for one week they discharge to the SFC. The physician from the health centre provides a medical care.

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Nutrition Survey in IDPNutrition Survey in IDP Nutrition Survey were conducted in IDP Nutrition Survey were conducted in IDP

– a) Afabet Camp the malnutrition rate was found to be 7.7%

– b) Korokon ,Kotobia and Teleggimja :- Total Malnutrition rate 6.6%

– c) in Guluj Subzone in three villages (Goluj, Gergef, and Tebeldia) Total malnutrition rate 11.1%

– d) Tessanei town. The global malnutrition rates 14.6.

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Drought affectedDrought affected Rapid Nutrition Assessments in drought affected area in Anseba Zone, Northern Red sea zone and Southern red sea Zone was conducted .The aim of this assessment was to assess the nutritional impact of the drought affected population.

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Anseba Zone: Among the most affected communities of the most

drought affected sub-Zobas in Anseba Zone in (7 community) the level of malnutrition in Habero and Hagas are significantly high 16.1% respectively as compared only to 8.3% in Geleb. (Seven sub-Zoba out of 11 were affected by drought in Anseba region for the last two three year these are Habero, Geleb, Asmat, Hagaz,Kerkebet ,Halhal and Sela .Out of the total population of 335,462, about 193,258 was reported affected by drought ,which are about 58% of the total population of the region However ,it is only 161,789 who are eligible for WFP's food

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Northern Red sea Zone: 4 subzoba ,Nakfa ,Karora, sheab and Ginda

were assessed for their drought severity (15 community ) and the total malnutrition rate was found 12% however the level of malnutrition in some community such as Nakfa ,Karora, Maihimey , Wekiro and Demas are in serious nutritional situation with above 15% WFH.

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Southern Red sea zone: 3 sub Zone ,Debub sub Zone (4 villages),

Maekel sub Zone (3 villages) and Araeta sub Zone (5 villages) were assessed for their drought severity and the total malnutrition rate was : 13.9% however the level of malnutrition in some villages such as:

Sub Zoba Debub (Kiloma, Abo) 21.2% and Sub Zoba Debub (Kiloma, Abo) 21.2% and 14.2% 14.2% zoba Maekel (Edl, Afambo, Behbuy village) 16.4% 14.4% and 13 % and Sub zoba Araeta (Alati, Tio) 19.4% and 13.3%

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Main constrains in Main constrains in ImplementationImplementation

Disruption of nutrition monitoring and Disruption of nutrition monitoring and delay in the nutrition monitoring delay in the nutrition monitoring supplies (measuring board, table….) supplies (measuring board, table….) Due to conflict Due to conflict

Displacement of staff Displacement of staff Irregularity of the distribution of Irregularity of the distribution of supplementary food And storage supplementary food And storage

Limited production capacity of DMK Limited production capacity of DMK factory factory

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Recommendation Host and other vulnerable groups

living outside of IDP camps often do not receive attention when it comes to their nutritional needs. IDP camps are often better served with general rations and supplementary feeding programs. More attention should be paid to groups living outside of a camp setting.