Monthly Humanitarian Situation Report SENEGAL
Date: October 2013
UNICEF WASH officer using the handwashing station at the entrance of
a community nutrition site supported by World Vision under the national nutrition reinforcement program
Highlights

More than 15,000 children with SAM have been admitted from January to September 2013.
3,536 admissions took place in September (data from 44% of facilities).

Based on the June 2013 nutritional survey results, UNICEF estimates that the SAM burden for
2014 will be 76,815 children under five and the proposed target considering conditions in the
country is 47,270 children under five.

According to this survey, 17 Departments out of 45 are in nutritional crisis by any or several of
the following crisis thresholds: >15% GAM prevalence; >2% SAM prevalence; and >1% to
<2%SAM prevalence considered critical due to high prevalence of aggravating factors (diarrhea
and respiratory infections >50%).

No additional emergency funding has been received this month. Thus UNICEF Senegal’s
requirements of US$ 3,305,266 in the HAC remain 75% funded.
1
Situation Overview & Humanitarian Needs
The targets for the rehabilitation of children with Severe Acute Malnutrition (SAM) for 2013 in Senegal
are based on the national 2012 nutrition survey using SMART methodology. According to this survey, the
SAM burden for 2013 was estimated at 63,323 under-five children. In 2013, the sectoral group of
partners agreed to an initial target of 38,968 SAM cases (62%1) given funding trends and estimated
geographical coverage of services, then revised to 42,843 at the mid-term review. Based on the same
survey, the Moderate Acute Malnutrition (MAM) caseload is estimated at 255,675 cases for the year
(Table 1). The 2012 survey further identified 16 out of 45 departments as critical. Based on this
geographical breakdown, 11 out of 14 regions were identified as in need of emergency support based on
prevalence of malnutrition and aggravating factors such as diarrhoea and ARIs: Diourbel, Fatick, Kaffrine,
Kedougou, Kolda, Louga, Matam, Saint Louis, Sedhiou, Tambacounda and Thies.
A Food Security and Nutrition survey took place in June 2013 (ENSAN 2013) with broad implication of
concerned government ministries and partners. The nutritional situation in Senegal seems largely
unchanged from 2012 when the emergency nutrition response was launched. This survey includes the
following key findings (see page 3 and annex for details):
Overall national Global Acute Malnutrition (GAM) average prevalence for under-five
children has not reached the WHO 10% threshold but remains precarious at 9.1%2
Four Departments have surpassed the 15% GAM crisis threshold of global acute
malnutrition (Matam 20%, Kanel 18%, Podor 17% and Ranerou 16%)
Twelve Departments have reached the GAM above 10% WHO warning threshold (GAM
>10 % <15 %)
Nine Departments are over the WHO SAM crisis threshold (>2%): Mbour 2,3%, Medina
Yoro Fula 2,2%,Podor 3,9%, Ranérou 4%, Kanel 2,2%, Matam 4,5%, Goudiri 2%,
Bounkiling 4,6%, Bakel 2,7%
Only four Departments have the GAM below 5% (WHO acceptable threshold)
National prevalence of chronic malnutrition is 16.5%
1
2
Taking into account SPHERE standard targets for treatment coverage which are 50% in rural areas and 70% in urban areas.
8,4- 9,8 IC
2
ACCEPTABLE
PRECARIOUS
SERIOUS
CRITICAL
Global Acute Malnutrition
<5%
≥5% to <10%
≥10% to <15%
≥15%
Chronic Malnutrition
<20%
≥ 20% to <30%
≥ 30% to <40%
≥40%
Underweight
<10%
≥10% to <20%
≥20% to <30%
≥30%
SAM
≥2%
Table 1: WHO Classification of Malnutrition Prevalence
2014 estimated SAM caseload3
SAM burden in Senegal
76,815
SAM target caseload
47,270
Prevalence of Global Acute Malnutrition
Global Acute
Malnutrition
2013
Map of Senegal showing GAM by Department based on ENSAN 2013 survey
The food security module of the ENSAN survey found a moderate level of food insecurity at 18.8%; that is
245,000 households or 2.2 million people. There is deterioration in rural food security however as
compared to 2010. Rural households are more affected (25.1%) with the regions of Casamance showing
very high levels (Ziguinchor 68%, Sédhiou 67% and Kolda 50%). The regions of Matam and Kedougou
follow with high prevalence at 48% and 45.6% respectively.
3
Based on the June 2013 ENSAN survey (using SMART methods), the estimations for 2014 were made using the same
methodology than for 2013 estimates (i.e. 1.5 incidence factor for MAM, 1.6 for SAM caseload and 2.6 for the burden).
3
Program response - SAHEL NUTRITION CRISIS
Since the launch of the nutrition response in 2012, UNICEF provides training, anthropometric tools,
Ready to Use Therapeutic Food (RUTF) and therapeutic milks, essential medicine (deworming, vitamin A,
antibiotics, ORS/Zinc), as well as resources for coordination, supervision and monitoring of the response
in all fourteen Health Regions in the country. Following a phased approach, from June 2012 Phase 1
covered Diourbel and Matam regions – with 174 public health facilities to offer nutritional services –
strengthening capacity of district authorities and health providers, both directly and through INGO
partners. Phase 2 effectively started in November 2012, covering Louga, Thies and St. Louis Regions,
which count 367 health facilities. The final stage (or Phase 3) began in January 2013 in six additional
regions, namely Fatick, Kaffrine, Kedougou, Kolda, Sedhiou and Tambacounda which count 400 additional
health facilities making a total of 941 health facilities. In all these regions, UNICEF supports response
plans that integrate Nutrition/Health, WASH and Communication for behavioural change. UNICEF’s
activities in response to the nutritional crisis in Senegal were officially launched in June 2012, and current
targets shown in this report are set until the end of 2013.
UNICEF and partners’ programing
Coordination:
 The WASH sector group continues to meet once a month under UNICEF’s leadership as cluster
lead. The Health and Nutrition Sector group has decided to meet twice a month instead of
monthly given the results of the latest nutritional survey and pressing needs in the sector. The
group continues to be led by WHO and co-led by Action Contre la Faim (Action Against Hunger
Spain) with support from UNICEF. The Refugees and the Food Security groups meet on an asneed basis.

The humanitarian needs analysis exercise was launched by OCHA this month, with analysis
currently taking place within the sector groups. An intersectoral meeting will take place on
October 31st to produce a first draft of Senegal’s Humanitarian Needs Overview. A workshop
with all actors, including government, is planned for the end of November to finalize the
overview document before the planning exercise can be completed.
Response:
 3,536 children with severe acute malnutrition (SAM) were admitted in September, almost
double the number reported in August. According to data shared by medical authorities, more
than 15,000 SAM admissions have taken place between January and September 2013. This data
represents on average 34%4 of nutritional /health facilities expected to report on SAM treatment.
4
(minimum 22% in January and maximum 44% in September)
4

237 deaths of children with SAM have been reported so far in 2013, 72 of them in September. In
addition, 145 children dropped out of the program in September and more than 1,400 were
discharged recovered.

Data on distribution of hygiene kits to mothers of children with SAM has also become available,
showing that almost 6,000 families have benefitted from WASH in Nutrition so far this year.
This intervention aims to reduce the exposure of young children to diarrhea which is among the
underlying causes of malnutrition.

The Cellule de Lutte Contre la Malnutrition (CLM), the government body in charge of prevention
and community management of moderately acute and chronic malnutrition, officially released
the results of the Food Security and Nutrition Survey (ENSAN) conducted in June 2013 with
partner support. (See above for nutrition and food security findings)

The latest nutritional survey of June 2013 confirms a nutritional crisis situation in the three
Departments of Matam Region (Kanel, Ranerou and Matam departments), and in the
Department of Podor (Saint Louis Region). Two UNICEF missions to these areas have taken place
this month to help the local authorities develop emergency response plans to accelerate
interventions until the end of the year. The new C4D specialist will also assist these areas in
producing a better targeted communications strategy to bring about behavioral change. The
response plans are based on a determinant analysis carried out with local actors during the visit.
For Matam key determinants identified included:




Prevalence of morbid factors
Spacing of pregnancies (limited family planning)
Limited access to water and sanitation and poor hygiene practices
Barriers to access to basic services (barriers such as cost and distance)
5


Poor nutrition practices for infants and young children: limited exclusive
breastfeeding, drastic interruption of breastfeeding, and absence of food
diversification for young children
Performance of the malnutrition management system (frequency and coverage
of screening, coverage and effectiveness of outreach, involvement of health
personnel, etc)
Diarrhea
Respiratory Infection
Prevalence of morbid factors by region

The new Nutrition Technical Assistants deployed in the medical Regions to support the
management of SAM were officially confirmed in their functions at the beginning of October.
Completeness of reporting of SAM admissions jumped by more 10 percentage points with the
support of these additional human resources to the regional teams, which also enabled
retroactive data sharing.
6
Sector
SAHEL NUTRITION CRISIS – SENEGAL PERFORMANCE INDICATORS
Nutrition
Estimated # / %
coverage
UNICEF & operational partners
UNICEF
2013
Target
2
42,843
Cumulative
results
2013
3
15,165
11,032
Number of Health
Centers/Posts with
SAM treatment
941
Children <5 with
Severe Acute
Malnutrition with
complications
admitted to
therapeutic care
1,517
Children 0-59 months
with Severe Acute
Malnutrition admitted
for therapeutic care
Children 0-59 months
in therapeutic care
discharged recovered
from SAM
5
Sector / Cluster
% of
Target
Achieved
35%
Cluster
2013
1
Target
2
42,843
Cumulative
results
2013
3
15,165
7,298
66%
11,032
7,298
66%
841
90%
941
841
90%
1,646
109%
1,517
1,646
109%
4
5
% of
Target
Achieved
35%
4
List of UNICEF Operational Partners: Action Against Hunger – Spain, French Red Cross, Ministry of Health,
Childfund (CRS, Plan, Africare, World Vision), Cellule de Lutte Contre la Malnutrition (CLM)
1. UNICEF and Cluster Target for SAM related activities are the same; UNICEF is the supplier of RUTF to all public
health facilities in Senegal
2. Revised target at Senegal Humanitarian Strategy mid-year review after updated context data.
3. Based on available data from government and NGOs covering approximately 34% of nutritional facilities on
average and 44% for the month of August.
4. Recovery data for August admissions is collected in September and is therefore now available in the October
SitRep.
5. WHO in Senegal defines this target as 10% of SAM admissions. This is a rolling target.
WASH
Number of nutrition
centers/posts with the
WASH minimum
2
package
841
420
Number of children
with SAM benefiting
from hygiene kits and
counselling on key
hygiene messages
15,165
5,918
3
50%
841
420
39%
15,165
5,918
50%
3
39%
List of UNICEF Operational Partners: Ministry of Health, Ministry of Water and Sanitation, Local authorities
(Mayor’s office, etc.), CBOs, Senegalese Red Cross
1
This is primarily a UNICEF activity. There is currently no WASH sector-wide reporting on this indicator. Only
UNICEF data is currently provided.
2
“Minimum package” is defined as: availability of drinking water, no open defecation and hygiene promotion.
3
Based on data reported by hygiene brigades
Summary of Sahel Performance Indicators
7
Seasonal Floods and Water Shortage Update


According to data collected by hygiene brigades (Ministry of Health) approximately 25,000
families were affected by flooding during this year’s rainy season. Over 16,000 hygiene kits
provided by UNICEF have been distributed to affected households, with other needs being met
by sector group partners such as the Senegalese Red Cross and World Vision. More than 75 radio
spots, 250 outreach talks and 32,000 home visits were carried out with UNICEF support in order
to improve hygiene practices and water treatment.
On October 18th the UNICEF Representative officially handed over the school kits and disinfection
products to the Ministry of Education in a symbolic ceremony. In September UNICEF distributed
cleaning products to disinfect 150 schools affected by floods, as well as school supplies for
affected children in these schools.

At the end of September and beginning of October the city of Dakar suffered from an important
water shortage. An estimated third of the population of the capital had no access to water for as
long as three weeks. The risk of illness was aggravated by the recent flood season which had led
to the contamination of many water sources being used by the population as a last resort.

UNICEF worked with the Ministry of Health to reduce the risk of epidemics and improve
preparedness for potential epidemic outbreaks, notably cholera. UNICEF supported the hygiene
brigades with additional supplies for water treatment and water quality control. In addition,
UNICEF called for the Direction of Prevention at the Ministry of Health to update its contingency
plan and stock for the eventuality of an epidemic breakout. However, the surveillance system has
so far shown no reason for concern. A new water cut is taking place this week while the pipes are
being repaired.
Nutritional Crisis Funding Update

No additional emergency funding has been received this month. Thus UNICEF Senegal’s
requirements of US$ 3,305,266 in the HAC remain 75% funded.
Revised HAC Requirement USD
(as of June 2013)
3,305,266
Date of next SitRep: 30 November 2013
Funded USD
(August 2013)
2,469,490
Unfunded USD
Gap %
835,776
25
For further information, please contact:
Giovanna Barberis
Edele Thebaud
Representative
Deputy Representative
Tel: +221 33 889 03 00
Tel: +221 33 889 03 00
E-mail: [email protected]
E-mail: [email protected]
8
Annex: Prevalence of Acute Malnutrition by Department
Departments
Matam
Kanel
Podor
Ranérou
Bakel
Linguère
Tambacounda
Médina Yoro
Foulah
Bounkiling
Dagana
Goudiry
Kaffrine
Koungheul
Gossas
Bambey
Saraya
Malem-Hodar
Diourbel
Louga
Goudomp
Birkelane
Salémata
Kolda
Foundiougne
M'bour
NioroduRip
Sedhiou
Vélingara
Saint-Louis
Mbacké
Tivaouane
Fatick
Thiès
Koumpentoum
Guinguinéo
Pikine
Kébémer
Bignona
Kédougou
Guediéwaye
Ziguinchor
Kaolack
Oussouye
Dakar
Rufisque
Prevalence of Wasting (6-59 months old)
Number (n)
Global
Moderate
Severe
337
20.5%
16.0%
4.5%
598
17.90%
15.70%
2.20%
305
16.7%
12.8%
3.9%
400
16.3%
12.3%
4.0%
446
14.3%
11.7%
2.7%
317
12.3%
11.7%
0.6%
353
11.6%
11.3%
0.3%
633
303
253
394
312
376
232
412
283
392
259
287
233
328
188
271
239
216
392
354
270
161
369
239
230
213
321
348
149
210
265
305
116
251
302
228
78
134
11.5%
11.4%
11.1%
10.9%
10.6%
10.4%
10.3%
10.2%
10.2%
9.9%
9.7%
9.60%
9.4%
9.1%
8.5%
8.5%
8.40%
8.3%
8.2%
8.2%
8.1%
8.1%
7.9%
7.90%
7.80%
7.5%
7.5%
7.2%
7.1%
7.1%
6.8%
6.2%
6.0%
5.2%
4.6%
4.4%
3.8%
3.0%
9.3%
9.2%
10.7%
8.9%
9.9%
9.6%
9.5%
9.7%
8.8%
8.2%
9.3%
8.20%
9.0%
8.5%
6.9%
7.7%
7.90%
6.0%
6.6%
8.2%
6.7%
8.1%
7.6%
7.50%
7.40%
6.6%
7.2%
7.2%
6.7%
6.2%
6.8%
6.2%
5.2%
3.6%
4.3%
4.4%
2.6%
3.0%
2.2%
4.6%
0.4%
2.0%
0.6%
0.8%
0.9%
0.5%
1.4%
1.8%
0.4%
1.40%
0.4%
0.6%
1.6%
0.7%
0.40%
2.3%
1.5%
0.0%
1.5%
0.0%
0.3%
0.40%
0.40%
0.9%
0.3%
0.0%
0.7%
1.0%
0.0%
0.0%
0.9%
1.6%
0.3%
0.0%
1.3%
0.0%
9