Key Findings from the Post Deyr Seasonal Food Security and Nutrition Assessment in Somalia

Transcription

1 Information for Better Livelihoods Key Findings from the Post Deyr Seasonal Food Security and Nutrition Assessment in Somalia 3 February 2014, Nairobi

2 FSNAU Post Deyr 2013/14 Seasonal Assessment Timeline : November-December (for Field work) Coverage: All parts of Somalia; however, assessment methodology adapted depending on the security condition: teleconference with key informants (pink areas on the map) use of partners and rapid assessment techniques for nutrition surveys; and assessment in urban areas was done using analyses of secondary data due to funding constraints. Scope: Food security and nutrition assessment of rural livelihoods, urban livelihoods and Internally Displaced Persons Process: (1)FSNAU-led assessment with the participation of Technical staff of other UN agencies, partners and government institutions (2) Regional analysis workshops in Garowe & Hargeisa (3) All team analysis workshop in Hargeisa (4) Technical vetting in Nairobi (with partners) With partners and government focal persons (5) Presentation to Government authorities (Mogadishu, Garowe and Hargeisa) (6) Presentation to other stakeholders in Nairobi and technical release (today) (7) Public dissemination (technical release, food security and nutrition outlook; comprehensive technical reports)

3 Key Message Highlights Nearly 860, 000 people remain acutely food insecure and require urgent humanitarian assistance over the next six month period a majority of them are IDPs (75%) ( 000s) Over 2 million additional people beyond those requiring urgent assistance are classified as Stressed (IPC Phase 2); their food security remains fragile and vulnerable to any major shock that could push them back to Crisis or Emergency (IPC Phases 3 and 4) 203,000 children under 5 years of age are acutely malnourished of which 51,000 are severely malnourished and face a higher risk of death; a majority of the malnourished are found among non-idp populations in South-Central Somalia Multi-sectoral efforts to address the underlying and basic causes of malnutrition are critical and must be supported by continued humanitarian action Lifesaving humanitarian assistance and livelihood support remain vitally important between now and June 2014 to help food insecure populations meet their immediate food needs. Areas of major concern are: IDPs; mostly rural and some urban populations experiencing food security crisis in Sanaag, Sool, Bari, Nugaal, North and South Mudug, Galgaduud, Hiran, and Middle Shabelle as well as Middle and Lower Juba regions. Other areas (mostly in South and Central Somalia) that have in the past experienced repeated food security crises and persistently high levels of acute malnutrition also remain a major concern.

4 Presentation Outline Sectoral Analysis Abdullahi Khalif, National Technical Manager, FEWS NET Somalia Nutrition Analysis Nina Dodd, Nutrition Technical Manager, FSNAU Integrated Food Security Analysis Tamara Nanitashvili, Food Security Technical Manager, FSNAU Summary Results and Key Messages - Daniel Molla, Chief Technical Advisor, FSNAU

5 SECTORAL ANALYSIS Civil Insecurity Markets Agriculture Climate Livestock

6 Civil Insecurity Conflict in most part of the southern regions of the country remained active: Suicide attacks, hand grenades, Rocket Propelled grenades, mortar attacks, targeted attacks on prominent individuals mainly in Mogadishu In the Jubas and Shabelles, many forms of conflict have increased since July 2013 In Bay and Bakool, armed confrontations between insurgent and government forces backed by troops from the African Union Mission to Somalia (AMISOM) emerged in November. In Hiraan, conflict and trade restrictions have affected market access Conflict in North of Jowhar town between two clans Continued insecurity poses a major challenge to food security, especially in South-Central Somalia Assumptions Insecurity will likely continue through June. Clan conflicts in the Shabelle will likely continue with likely adverse impact on trade, labor migration, and normal movement of people and livestock. Conflict between insurgent and government forces supported by troops from AMISOM are unlikely to decrease between now and June with potential adverse impact on trader movements and humanitarian access in some areas. All forms of conflict in southern and central Somalia may lead to additional displacement of populations between now and June and requires close and continuous monitoring.

7 Climate Performances/Outlook Oct Dec 2013 Seasonal Cumulative Rainfall estimates (Source: NOAA/FEWS NET) Statement: Deyr 2013 rainfall exhibited a mixed trend in terms of amount, temporal and spatial coverage across the country. The rains were normal to above normal in most of the country with the exception of most of Juba, some parts of Gedo, Lower Shabelle, Central, Hiran and Sanaag regions where rains were below to near normal. In the North, Tropical Cyclone 3 led to flash floods in the eastern sector of Bari and Nugal regions of Northeast Somalia. The December to January Xays rains over Guban Pastoral of northwestern Somalia and East-Golis Rains ended earlier than normal (3rd dekad of November 2013) across the country except parts of Lower and Middle Juba, Bay and Middle Shabelle regions which received localized light to moderate rains. From October to December, the upper catchments in Ethiopia received unusually high amounts of rain. This led to river flooding on arable land in the Juba and Shabelle Valleys.

8 2014 Gu (Apr-Jun) Season Rainfall Outlook ECMWF Seasonal (Jan to June) Statement: ENSO neutral conditions are expected to continue through June, therefore, near normal seasonal rainfall performance is forecast for the April June period, across Somalia. However, long-term forecasts have very low reliability skills and will require close monitoring and updates. An updated and more reliable forecast is expected at the end of February when the 36 th Greater Horn of Africa Climate Outlook Forum (GHACOF 36) concludes its session.

9 Market Trend Analysis Trend since January 2013: mostly stable Exchange Rates: Somali Shilling: Stable/slightly depreciation in July-Dec. However, its slightly stronger than Dec Somaliland Shilling: Stable in since July and in Dec 12-Dec 13 period Imported commodities: In most Sosh markets, prices of imported commodities were generally stable or declined from July They are modestly lower than In SlSh zone commodity prices are relatively stable due to steady supply through Berbera Port and stable Shilling Cross-border trade: reduced trade activity in reexports of imported food items due to restrictions related to seasonal rains and security related restrictions in Ethiopia (Nov 2013) Consumer Price Index (CPI): Slight increase In CPI in most regions related to seasonal peaks in staple cereals. CPI generally stable since a year a go. Expected trend to June 2014 Exchange rates likely to remain stable through June Imported commodity: prices will likely remain stable through April. Following the normal, seasonal trend, prices will likely start to rise slightly in May as shipping is curtailed from May to August during the monsoon winds off the coast Livestock imports and exports expected to follow seasonal trend of decrease Below average cereal production likely to affect the cost of minimum expenditure basket (MEB)

10 Livestock Performances Improved rangeland conditions across pastoral areas except pockets in central, Sanaag, Coastal deeh of central regions and Juba resulting in typical livestock migration Deyr 2013/14 Livestock reproduction: medium to low kidding and lambing (small ruminants), low to medium calving for cattle and camel across the country Livestock body condition (PET 3-4) is average to above average across the country Milk production: generally improved in all pastoral livelihoods across the country. Average to good in the North, average to near average in Central (Camel) and average to near average in the South (all species) No epidemic diseases reported Outlook through June 2014: Medium kidding/calving (North/South). Medium kidding/low calving (Central). In the North: increased in herd size (camel = above baseline; goat/sheep near baseline). In Central: camel at baseline, goat/sheep at baseline. In the South: Increased trend in herd size but still below baseline except SIP.

11 Livestock Prices Price per Head of Goat (SOSH) 1,600,000 1,400,000 1,200,000 1,000, , , , ,000 Regional Trends in Local Quality Goat Prices (SOSH) SorghumBelt Shabelle Valley Juba Valley Increasing livestock prices from July to October and decreasing trend from November, consistent with seasonal trends 0 Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Sep-11 Dec-11 Mar-12 Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Sep-13 Dec-13 Month Regional Trends in Local Quality Goat Prices (SOSH/SLSH) 1,800, ,000 1,600, ,000 Price per Head of Goat (SOSH) 1,400,000 1,200,000 1,000, , , , ,000 NE Central NW (SLSH) 350, , , , , ,000 50,000 Price per Head of Goat (SLSH) Livestock price are expected to follow seasonal trend of decreasing through March Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Sep-11 Dec-11 Mar-12 Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Sep-13 Dec-13 Month

12 Livestock Export Performance 6,000,000 5,000,000 July-Dec Livestock Exports Jan-June Livestock Exports 5-year Average ( ) Number of Heads 4,000,000 3,000,000 2,000,000 1,000, Livestock exports in 2013 remain among the highest in recent years and 18% higher than the five-year average but slightly lower than in 2012 (by 4%).

13 Agriculture Deyr 2013 Cereal (Maize and Sorghum) Production in Somalia Deyr 2013/14 cereal production in the south is below average (by about 20%) and significantly lower than 2012 Deyr production (by 43%) The decline in cereal production is mainly due to a reduced contribution from Middle Shabelle (flooding/conflict); Juba (floods/ poor rains); and a switch to sesame (cash crop) cultivation in Lower Shabelle The Gu/Karan 2013 production in the North is also 38% below the three year average for Regions Deyr 2013 Production in MT Maize Sorghum Total Cereal Deyr 2013 Deyr 2013 as % of Deyr as % of PWA Deyr 2012 ( ) Deyr 2013 as % of 5 year average ( ) Bakool 300 2,500 2,800 32% 101% 55% Bay 2,100 30,000 32,100 56% 93% 74% Gedo 2,200 3,600 5, % 107% 139% Hiran 1,100 2,500 3,600 50% 60% 90% Juba Dhexe (Middle) ,100 14% 23% 21% Juba Hoose (Lower) 1, ,200 49% 80% 101% Shabelle Dhexe (Middle) 4,200 5,900 10,100 61% 84% 83% Shabelle Hoose (Lower) 13,800 10,700 24,500 65% 73% 83% Deyr 2013 Total 25,100 56,100 81,200 57% 81% 78% Regions Gu - Karan 2013 Production Estimate in MT Maize Sorghum Total Cereal Gu-Karan 2013 as % of Gu- Karan 2012 Gu-Karan 2013 as % PET average ( ) Awdal (Gu/Karan 13 harvest) 2,800 11,750 14,550 88% 70% Waqooyi-Galbeed (Gu/Karan 13 harvest) 5,500 23,000 28,500 55% 58% Togdheer (Gu 13 harvest) 50 1,000 1,050 24% 32% Total (Harvest) 8,350 35,750 44,100 60% 62%

14 Agriculture: Cereal Prices Sorghum Belt-Trends in Red Sorghum/White Sorghum Prices Price per Kg (SOSH) 30,000 25,000 20,000 15,000 10,000 Bardera (Red Sorghum 1 kg) Baidoa ( Red Sorghum 1 kg) Huddur ( Red Sorghum 1 kg) Betetweyne (White Sorghum 1kg) Shabelle & Juba Riverine-Trends in White Maize Prices Price per Kg (SOSH) 25,000 Jamame (White Maize 1kg) Jilib (White Maize 1kg) Qorioley (White Maize 1kg) 20,000 Jowhar (White Maize 1kg) 15,000 10,000 5,000 5,000 Price per Kg (SLSH) 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1, Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Sep-11 North West -Trend in White Sorghum Prices Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Sep-11 Month Dec-11 Month Dec-11 Mar-12 Mar-12 Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Hargeisa (White Sorghum 1kg) Borama (White Sorghum 1kg) Togwajale (White Sorghum 1kg) Burao (White Sorghum 1kg) Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Sep-13 Sep-13 Dec-13 Dec-13 0 Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Local cereal prices generally showed a mixed trend, largely increasing during lean season consistent with seasonal trends. Main cereal producing districts in Bay (Baidoa), Lower Shabelle (Qoryoley), Middle Juba (Jilib) and Gedo (Bardhere) still showing atypical cereal price increases in December Sep-11 Dec-11 Month Mar-12 Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Sep-13 Dec-13

15 NUTRITION ANALYSIS

16 Acute Malnutrition Rates of acute malnutrition improved slightly or remained stable since Gu 2013 exception being Qardho IDPs and Berbera IDPs There have been no changes in the rates of malnutrition compared to Deyr 2012/13 for most livelihoods (except a deterioration in Garowe IDP) Positive correlation of Global (GAM) and Severe (SAM) Acute Malnutrition=0.73 Median GAM rates for Somalia are 14.2% in Dec 2013 compared to 14.4% in August 2013

17 Morbidity and Mortality Morbidity is more than 50% in Beletweyne and Mataban Districts and among IDPs in Dollow Serious levels of Crude Death Rates (CDR) are reported in Beletweyne District, Kismayo IDPs and Middle Shabelle Riverine U5DR-Acceptable except Beletweyne District where Serious levels are seen

18 Stunting and Wasting Stunting and underweight are often used as proxy indicators for poverty and food insecurity The highest rates of stunting and underweight are also reported primarily among IDP and non-idp populations in South-central Somalia

19 The geographic extent of areas with Critical (>15% GAM) rates of malnutrition has been declining since 2011; however hundreds of thousands of children are malnourished every year Critical levels of acute malnutrition tend to persist in South and Central Somalia; this includes parts of Bay, Bokool, Hiran and Gedo regions for Deyr 2013/14 Concerted effort and support interventions that address Underlying and Basic causes of malnutrition are necessary in order to make the gains made thus far more sustainable Trends in Malnutrition in Somalia

20 Number of Malnourished Children (based on Prevalence) Deyr 2013/14 nutrition surveys indicate an estimated 203,000 children under-5 as being acutely malnourished (compared to 206,000 in Gu 2013 and 215,000 in Deyr 2012/13 The largest proportion of acutely malnourished children (68%) are located in Southcentral Somalia Number of severely malnourished children under-5: 51,000 for Deyr 2013/14 (compared to 41,000 in Gu 2013 and 51,000 in Deyr 2012/13 The number of severely malnourished children as a proportion of total number of acutely malnourished children is slightly higher in Deyr 2013 (25%) compared to Gu 2013 (20%) and Deyr 2012/13 (21%)

21 INTEGRATED FOOD SECURITY ANALYSIS Rural Livelihoods Urban Livelihoods Internally Displaced Persons (IDPs)

22 Rural Livelihoods (Mostly Livestock Dependent) There are an estimated 2.7 million pastoralists and mainly livestock-dependent agropastoralists across Somalia Milk availability (source of income/ food): o Average in most livelihoods, apart from cyclone affected areas in Northeast (Eyl, Bandarbayle and Dangorayo districts) Livestock holding (main asset): o Increasing trend in livestock herd size among the Poor except the cyclone affected areas (drastic reduction); o Despite the increase, livestock herd size among the poor still remains below baseline levels in most livelihoods apart from Juba camel pastoralists (SIP), which is above baseline. Kg per Head Regional Trend in Terms of Trade: Cereal to Goat Dec-09 Mar-10 Jun-10 Sep-10 Central (Red Rice) NE(Red Rice) NW (Red Rice) Dec-10 Mar-11 Jun-11 Sep-11 Dec-11 Regional Trend in Terms of Trade: Cereal to Goat Mar-12 Month Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Sep-13 Dec-13 Terms of Trade (ToT): o High ToT across pastoral livelihoods due to high livestock prices and relatively low cereal prices; o ToT declined over the past one year in most regions although still higher than 5yr average ( ) across the country Kg per Head SorghumBelt (Red Sorghum) Juba Valley (White Maize) Shabelle Valley(White Maize) Food consumption: o Protection and survival (food & water) deficits found among populations in cyclone (Northeast) and flood-affected areas (Jowhar), respectively Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Sep-11 Dec-11 Month Mar-12 Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Sep-13 Dec-13

23 Rural Livelihoods (Mainly Crop-Dependent) There are an estimated 1.8 million mainly crop-dependent agropastoralists and riverine people across Somalia Cereal stock availability among poor households: o Average cereal stock availability (3-4 months) at household level in major cereal-producing areas (Shabelle, Bay); o Lack of cereal stocks due to poor harvest in agropastoral areas of Beletweyne (Hiran), Jowhar (Middle Shabelle) Riverine (flood/conflict affected areas) and Middle Juba Agropastoral & Riverine Farm Labour: o High farm labour wages (> 5yr avg) in most areas apart from agropastoral of Middle Juba and Jowhar; o Normal access to labour opportunities in the coming Gu rainy season (projected as near normal) and offseason opportunities (riverines of L. Shabelle, Jubas) Terms of Trade (ToT): o Higher ToT compared to 5yr average in most areas apart from Middle Juba Agropastoral and Jowhar (< 5yr avg); Kg per Labour Wage Terms of Trade Agriculture Labour Wage to Cereal 25 M Shabelle L Shabelle Jubas Kg per Labour Wage Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Sep-11 Dec-11 Mar-12 Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Sep-13 Month Terms of Trade Agriculture Labour Wage to Cereal 40 Hiraan Bay Bakool Gedo Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Jun-11 Sep-11 Dec-11 Mar-12 Jun-12 Sep-12 Dec-12 Mar-13 Jun-13 Sep-13 Month Dec-13 Dec-13

24 Urban Livelihoods Kg per Daily Labor Wage TOT Labor Wage to Cereals Dec-12 Jul-13 Dec-13 5-Year average (Dec 13) Market purchase represents main source of food or urban households; Terms of Trade Casual Labour Wage to Cereals: Terms of trade (casual labour/ cereals) have either improved or remained stable in Dec-Jul 2013 in most urban markets (10 out of 18 regions); ToT is higher than 5yr average in most urban areas of the country 30% 20% 10% 0% -10% -20% % CMB change from July 13, Dec 12 & 5 YA Cost of the Minimum Basket (CMB) Trend: Relatively stable or decreased CMB over the past one year in most regions; lower than 5yr average across urban areas due to the decline in prices of cereals and imported commodities -30% -40% -50% 6 months 1 year 5YA

25 Urban Livelihoods Vulnerability: % of Food Spending Households in most urban areas of Somalia spend more than 75 percent of their income on food alone, which signifies a high degree of vulnerability to market food price fluctuations Nutrition situation varied from Acceptable to Serious in most urban areas (Jul 13) No major shocks in rural areas in the past 6months to affect urban population through increased competition for labour/ social support in urban areas; Exceptions Middle Shabelle (flood &clan conflict), Middle Juba (poor harvest), Bari and Nugaal (cyclone) regions

26 Internally Displaced Persons (IDPs) There are an estimated 1.1 million internally displaced persons (IDPs) across Somalia of which 635,000 live in the assessed (13) major settlements; ~60% of the assessed IDPs are concentrated in Banadir/ Mogadishu % 120.0% 100.0% 80.0% 60.0% 40.0% 20.0% 0.0% Duration of Residency in the IDP Settlement 1-3 months 4-12 months 1-3 years >3 years High proportion (> 20%) of newly arrived IDPs (within past one year): Dobley (32.7%), Mogadishu (27.5%) and Baidoa (24%) mostly from within or neighboring regions; > 50% are long-term IDPs (>3 years) in most settlements in the North 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% HH Dietary Diversity Relatively diverse diet among the majority of IDPs in most settlements apart from Kismayo where 50% of IDPs have inadequate diet; WDHs are majority of HHs consuming less than 4 food groups 4 food groups and more less than 4 food groups

27 Access to Food Among IDPs Qardo Kismayo Garowe Dusamareb Dobley Bossaso Baidoa 0% 20% 40% 60% 80% 100% none 1-2 assets 3 assets or more Majority of IDPs (60% or above) have a very low level of productive asset ownership (0-2), which indicates at a reduced income generation and coping capacity; MDHs dominate in ownership of land and shoats. 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Expenditure pattern Food accounts for over 75% of IDP Households expenditures for all settlements. This signifies a high degree of vulnerability in times of high food prices and/or reduced income; no stat. significant difference between WDH and MDH % Expenditures (food) % Expenditures (non-food)

28 Integrated Phase Classification Maps Behind the predominantly yellow IPC Phase 2 (Stress) map, there are pockets of population groups that are experiencing a food security Crisis (IPC Phase 3) or Emergency (IPC Phase 4). They are listed below. Current: Jan 2014 Most Likely Scenario: Feb-Jun 2014 Populations experiencing acute food security crisis (IPC Phases 3 &4) are concentrated across the 13 main IDP settlements as well as rural and some urban areas in Sanaag, Sool, Bari, Nugaal, North and South Mudug, Galgaduud, Hiran, and Middle Shabelle as well as Middle and Lower Juba regions.

29 Summary Results and Key Messages

30 Acute Food Insecurity Situation Population in Crisis and Emergency Current (Jan 2014) Number of people affected 603, 000 people are currently experiencing a food security crisis across Somalia; IDPs represent approximately 60 percent of the total. Projected (Feb-Jun 2014) % Share Assessed Urban population in Crisis 32,000 5% Assessed Rural population in Crisis and Emergency 204,000 34% Assessed IDP population in settlements in Crisis 367,000 61% Estimated Total Population in Crisis and Emergency 603, % Estimated Total Population in Stress 2,355,000 Population in Crisis and Emergency Number of people affected % Share Assessed Urban population in Crisis 32,000 4% Assessed Rural population in Crisis and Emergency 190,000 22% Assessed IDP population in settlements in Crisis 635,000 74% Estimated Total Population in crisis and Emergency 857, % Estimated Total Population in Stress 2,048, , 000 people are projected to experience food security crisis through June 2014 with IDPs representing nearly 75 percent of the total.

31 Food Insecurity Projection: Feb-Jun 2014 Nearly 860, 000 people remain acutely food insecure across Somalia. The number of people facing acute food security crisis has shown very little improvement since August The positive impact of increased livestock prices, increasing livestock herd sizes, improved milk availability, low prices of both local and imported staple food commodities, higher purchasing power from labor income and livestock sales as well as sustained humanitarian interventions over the last six months was undermined by a nearly 20 percent decline in the Deyr 2013 cereal harvest compared to the long-term and five-year averages, exacerbated by rainfall deficit, conflict, floods and cyclone. Recovery remains fragile and acute malnutrition persists. Over 2 million additional people beyond those requiring urgent assistance are classified as Stressed (IPC Phase 2); their food security remains fragile and vulnerable to any major shock that could push them back to Crisis or Emergency (IPC Phases 3 and 4)

32 Food Insecurity Trends in Somalia There has been a steady decline in the severity of acute food security crisis in Somalia in recent years (an increasingly lower number of people in Emergency relative to the numbers in Stressed). However, this improvement remains fragile, with an average of over 2 million people remain in food security Stress (IPC=2) since February 2013; Nutrition support should be provided to the 203,000 malnourished children, a majority of which are found among rural populations in South and Central Somalia Measures aimed at addressing underlying and root causes of malnutrition are important to reduce levels of acute malnutrition on a sustainable basis with a focus on areas that have persistent high levels of acute malnutrition (south central Somalia) In order to ensure sustainability of the gains made thus far, it would be important to invest in interventions aimed at protecting livelihoods, and building the resilience of the 2 million people that will be experiencing a food security Stress (IPC Phase=2) a major shock can push them back to a food security Crisis or Emergency (IPC Phases 3 and 4)

33 Malnutrition in Somalia Somalia is a country with unacceptably high rates of acute malnutrition. One in nearly eight children under 5 suffers from acute malnutrition at the time of the assessments. The situation among IDPs is worse (about one in six) Currently 203,000 children <5 yrs are estimated to be acutely malnourished ( approximately the same number as in Gu 2013). Sixty eight percent of these children are in South-central Somalia 51,000 children under 5 are suffering from severe acute malnutrition and are at higher risk of death and disease, a slightly higher proportion (25 %) in Deyr 2013/4 compared to 20 % in Gu 2013 or 21% in Deyr 2012/13 Acute malnutrition in Somalia, particularly in South-Central and among IDP populations is also exacerbated by chronic malnutrition Treatment of Severe and Moderate Acute Malnutrition (SAM and MAM) must become more central to the health care and health sector agendas Multi-sectoral efforts to address the underlying and basic causes of malnutrition are critical and must be supported by continued humanitarian action