The northwestern part of Afghanistan was severely impacted by drought in 2018. The drought affected nutrition due to reduced access to safe water, health, and food insecurity. It was estimated that 125,000 children under five were malnourished while 32,750 Pregnant and Lactating Women (PLW) needed lifesaving emergency nutrition services across the 20 drought-affected provinces. The nutritional trend analysis showed an increase of Global Acute Malnutrition (GAM) prevalence by Weight for Height Z-Score (from 7.5% to 7.8% in Kunduz, from 11.8% to 14.4% in Kunar, from 9.4% to 11.2% in Zabul and from 6.8% to 7.1% in Logar province). In addition, IYCF practices remain a major problem in Afghanistan. SMART Survey in Ghor province (2016) identified that 99.6% of children 0-23 months were not breastfed and only 65.0% of children 0-5 months were exclusively breastfed. Complementary feeding for children 6-23 months of age was worse due to poverty, drought/natural calamities, lack of diversified food availability and agriculture, poor knowledge & practice of IYCF, and conflict/displacements.
UNICEF requested an IYCF-E TST advisor to provide capacity development in the delivery of the increased coverage and quality of Infant and Young Child Feeding in Emergencies (IYCF-E. The advisor will build on the national IYCF strategy reviewed by consultants.
An analysis of SMART survey data from Afghanistan showed that 15.3% of infants under 6 months were wasted of which 6.2% were severely wasted. Poor maternal malnutrition, with 1 in 5 Pregnant and Lactating Women underweight, was likely a contributing factor. However, other findings showed that the highest prevalence of wasting is observed in infants 5 months of age, and therefore there were likely other factors at play such as poor IYCF practices. A high proportion of inpatient admissions to Stabilisation Centers are infants u6m, highlighting again, a significant burden of malnutrition in this age group in Afghanistan. Outpatient care for infants u6m with acute malnutrition with no complications was included in the Integrated Management of Acute Malnutrition (IMAM) National Guidelines revision of 2018. However, there was a lack of capacity and expertise within the country to implement these guidelines effectively.
The MAMI Adviser was requested to provide guidance on how to integrate MAMI activities into existing services. This would strengthen the overall emergency nutrition response by building the stakeholders' capacity to manage at-risk mothers and infants under 6 months.
Action for Development Afghanistan
Action for Development (AfD) was the lead organization for the SUN Pooled Fund Grant, Afghanistan, ‘Strengthening the SUN Civil Society Alliance in Afghanistan’ (June 2019 – September 2020). Due to COVID, AfD applied for a cost extension of the project and included new activities related to the COVID-19 situation. For example, Family MUAC training for Community Health Workers (CHWs) and caregivers to address the recommendation to increase uptake of SAM and MAM treatment by increasing case detection and sensitization at a household level.
The purpose of the technical support was to enhance the technical capacity of AfD to deliver, monitor, and evaluate CMAM adaptations in response to the COVID-19 pandemic in five provinces of Afghanistan.