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Book (stand-alone)Twin peaks: the seasonality of acute malnutrition, conflict and environmental factors - Chad, South Sudan and the Sudan
sep/19
2019Also available in:
No results found.To better understand the resilience and vulnerability of the populations in Chad, the Sudan and South Sudan, the Feinstein International Center, Friedman School of Nutrition Science and Policy at Tufts University has drawn on available secondary data on nutrition, environmental factors (rainfall, temperature and vegetation), conflict and emergency events, together with primary qualitative findings from eastern Chad and western Sudan, prioritizing community perspectives. The report findings underscore the importance of environmental variability and the persistence of climate, conflict and other shocks in relation to livelihood resilience and transformation over time. The findings also challenge long-standing assumptions about the seasonality of malnutrition and present new findings on livelihoods in countries struggling with or seeking to recover from climate, conflict and other disasters. Many humanitarian programmes have been in continuous operation in eastern Chad, Darfur and Bahr el Ghazal for over two decades. From a community perspective, the past 50 years have been a series of multiple and overlapping hazardous events, many persisting for years, exacerbating their impact and eroding resilience. At the same time, the region is characterized by environmental variability, including rainfall variability (spatially as well as seasonally, and over years) and ecological diversity. Farming and pastoralist livelihood systems characteristic of the region have co-evolved in response to this environmental variability and have adapted to manage delayed rains and drier spells. However, the long history and protracted nature of many shocks, combined with wider trends, have contributed to pivotal changes and to transformations of these livelihoods, although the dryland farming and pastoralist systems remain central to local livelihoods and the economy. The role of seasonality is further reflected in the observed patterns of different types of conflict. Our data reveal that the region has continued to suffer from high rates of acute malnutrition over the past 25 years, with seasonal peaks regularly exceeding the emergency threshold of 15 percent. Furthermore, contrary to the assumption that in a unimodal rainfall system the peak of acute malnutrition occurs at the end of the lean season, when food insecurity is at its peak, our data show that there are two peaks of acute malnutrition. The first and larger peak occurs at the end of the dry season. It is followed by a slight improvement in acute malnutrition and then a secondary but smaller peak after the lean season. Drawing on the qualitative community perspectives, our analysis points to the seasonality of livelihood systems linked with environmental variability as the crucial determinants of the twin peaks, through its effects on food security, care and health. The analysis also provides insights into the seasonality of different types of conflict, part of which is also related to seasonality of livelihood activities. The findings from this study have direct implications for household recovery, resilience and nutrition, and raise specific considerations for data collection, future research, programming and policy. -
BookletNortheastern Nigeria: Assessing drivers of acute malnutrition relapse in children
Study aiming at enhancing programming, August 2024
2024Also available in:
No results found.The ongoing crisis in northeastern Nigeria, mainly linked to conflict, climate extremes and economic challenges, has significantly impacted agricultural livelihoods, leading to increased levels of acute food insecurity and malnutrition. In 2023, Nigeria recorded the highest number of acutely malnourished children under the age of five and pregnant and breastfeeding women in the African drylands, with over 1.5 million people affected in northeastern Nigeria alone.While outpatient treatment programmes are effective in supporting the initial recovery from severe acute malnutrition, a considerable proportion of children experience relapse, requiring repeated treatments. This indicates a severe shortcoming of current approaches and highlights the need to better understand the determinants of relapse to improve preventative strategies. To this end, FAO carried out a study to provide programme recommendations in order to address these drivers and prevent relapse. -
Book (series)Microbial safety of lipid-based ready-to-use foods for management of moderate acute malnutrition and severe acute malnutrition – Second report 2021
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No results found.Lipid-based ready-to-use foods (RUFs) for the nutritional management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) are provided to children from 6 months to 59 months of age within the context of emergency feeding programmes supervised by governments. Based on the review, the expert committee considered that children with SAM have an increase in susceptibility to bacteraemia and sepsis that is probably between twofold and fivefold compared with children who are not malnourished and are of the same age and live in the same communities. On the basis of its common occurrence as a cause of infections and serious illnesses in children with SAM, and its documented ability to contaminate, survive in, and cause outbreaks of illness associated with low-moisture foods similar to RUFs, the expert committee concluded that Salmonella is the pathogen of most concern in lipid-based RUFs. Many outbreaks of foodborne salmonellosis have been determined to be associated with low-moisture foods that were contaminated at low levels. Therefore, the expert committee carefully considered the qualitative microbiological analyses of RUFs and the contamination levels that could be inferred, and entered into an extended deliberation of dose-response modelling to find a path toward a reasonable approximation of the likely morbidity and mortality in SAM children that could be anticipated from consumption of RUFs contaminated at the estimated levels and observed frequency. The expert committee described three approaches that purchasers of RUFs might use to establish microbiological criteria to assure the safety of RUFs and to communicate to manufacturers their safety expectations. These approaches are: (i) reference to existing standards established for similar low-moisture foods; (ii) determining an acceptable increase in risk over the pre-existing baseline of illness from other sources of exposure; and (iii) process verification sampling using the moving window technique. The microbiological criteria derived by each of these approaches accomplish different purposes, and which is most appropriate is determined by the conditions of manufacture and use.
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