Sudan

Despite the ongoing scale up of treatment and preventive nutrition responses (in-patient, outpatient and targeted supplementary feeding programmes) the prevalence of risk factors (health, WASH, food security, and feeding practices) show no signs of significant improvements. For example, over one-third of acutely malnourished children live in extreme and catastrophic severity scale for WASH and health clusters exposing them to heightened morbidity and mortality risks. These needs have significant impact on physical, mental and well-being of children, pregnant and lactating women, and the community in general. The immediate life-saving nutrition needs include preventive and social protection nutrition services for children under-two, treatment of malnutrition for children under-five and PLWs and emergency supplementary feeding programme (e-BSFP) for underfives and PLWs. Affected people The Nutrition Cluster’s 2023 PiN is 4 million. It remains at the same elevated levels as in 2022. Children underfive years account for over 76 per cent and 23 per cent pregnant and lactating women (PLWs) need life-saving treatment and preventive nutrition responses. With respect to refugees, over 67,000 (of whom 66 per cent are under-five and 34 per cent are PLW) are in urgent need of life-saving nutrition support. Children under-five especially children under the age of two and PLWs are the most vulnerable groups due to their increased physiological and biological needs. Moreover, women, young girls and boys suffer disproportionately. The risk of acute malnutrition increases among children in distressed conditions (IDPs, returnees, refugees etc). Based on the 2022 MSNA results, displaced households reported more severe and moderate malnourished cases than those who were not displaced. Children in such circumstances are likely to miss lifesaving nutrition services exposing them to increased malnutrition, morbidity, and mortality risks. The 2018 S3M II revised results and recent SMART surveys indicate that 64 localities have very high (15 per cent and above) prevalence of GAM, of which five localities have catastrophic levels (GAM 30 per cent and above). 39 per cent of all children under-five years in need of nutrition treatment live in 66 localities (in 16 States) are classified as extreme as per OCHA/Global Nutrition Cluster (GNC) classification. Malnourished children face heightened mortality risk. In countries with relatively similar nutrition situations like Sudan, children under-five years with SAM and stunted are estimated to be 11 times more likely to die than their well-nourished peers, while for those with MAM the rate is four times higher. Among those severely malnourished, one in five children will die if not treated, and the risk increases to 9 out of 10 for SAM cases with complications. Sub-optimal IYCF practices continue to remain low. While exclusive breast-feeding prevalence among children under-six months in Sudan is over 62 per cent age-appropriate dietary diversity is very low at 25.4 per cent. Anemia prevalence in children aged 6-59 months estimated at 48 per cent is among the highest falling into severe levels as per WHO classification.   Children living in refugee camps, IDPs in and outside hosting sites, orphans, abandoned children, single parents mostly below the age of 18 years, patients with chronic and neglected diseases and people with disabilities are likely to have limited access to nutrition services in some locations.

About 6.7 million children under-five were screened for malnutrition.

A total of 462,343 cases of under-five with SAM were admitted and treated for acute malnutrition in over 1978 operational sites representing over 86% of the sector annual target of 539,858 with over 85% reporting rate. Of the SAM cases above 44,593 representing 55% of the annual target of 49,021 where SAM with medical complications were admitted in 128 SCs and provided with specialist care in Stabilization centres with 76% reporting rate as of December 2024.  

Meanwhile, total of 608,605 moderately malnourished under-five children representing about 59% of the 1,037,929 annual targets were admitted and treated in 1078 Targeted supplementary feeding programme (TSFP) sites. The correspond admission of PLW in TSFP was 140,044 representing over 40% of the annual target 345,977).

With Respect to prevention, 600,496 children 6-59 months were reached with vitamin A supplementation, mostly through measles outbreak response campaigns. Ministry of health- supported by UNICEF- piloted routine vitamin A supplementation in Khartoum state, reaching 47,763 children in two localities. This piloting was achieved with support from UNICEF and in collaboration with WFP, which contributed to supporting distribution of MNPs in vitamin A targeted localities.

As result of the declaration of the dry spell in Feb 2022, the sector revised its PIN for acute malnutrition in those localities where additional 31,000 and 122,000 SAM and MAM cases (153,000 in total) were estimated representing 10% increase on the initial caseload.  In view of this, the sector mobilized partners to scale up nutrition responses in dry spell localities where partners expressed commitment to open 303 OTPs, 257 TSFP sites, 21 SCs and 1586 Mother to Mother support groups. By the end of the dry spell in September, a total of 79 (26%); 59 (23%) and 4 (19%) of the partners commitment to open OTP, TSFP and SCs sites above were opened respectively.  In additional, initial analysis of the prioritization of OTP response based on funding availability was prepared in collaboration with UNICEF for 2023 was done. Similar analysis will be done for TSFP and SC in first quarter of 2023.

In terms of capacity building, a total of 5,704 community volunteers and 1,090 frontline nutrition staff were trained on the CMAM package. Meanwhile 3,620 frontline staff were trained on facility-based Infant and Young Child Feeding (IYCF)  and 17,829 volunteers  on community-based IYCF counselling. A total of 52,076 mothers of acutely malnourished children were trained on MUAC screening, bringing the total number of mothers trained on the family MUAC approach to 210,602 from 13 states. Moreover, a total of 87 staff from State MOH and partners were  trained on  nutrition supply chain management. 

 50 SMART survey managers from UN, NGOs and FMOH were trained. As a result, SMART survey resumed to be implemented in Sudan. A total of 10 SMART surveys were conducted of which 9 have been validated by the sector NISTWG. Four of the seven surveys had very high GAM prevalence ranging from 17.2% in Gadeer to 27% in Aroma locality well above WHO 15% emergency threshold.  Two surveys results were classified as high-GAM of 11.5 and 12% and one survey results (Jebel Mara) medium levels- GAM of 6.4%.

The NISTWG of the sector also reviewed and approved 9 SMART survey protocols SMART surveys to be implemented first quarter of 2023 in South, North and Central Darfur States, South Kordofan, Khartoum, Blue and White Nile by various nutrition sector partners.

Sector developed the minimum intervention package with a nutrition lens across WASH, FSL, Health, Education, and protection sectors to be implemented by partners in respective sectors

Improved timeliness of reporting of admissions from quarterly to monthly as well initiated monthly tracking of selected indicators for early warning and early action and supply availability at facility level tracking at site level.  Monthly availability of supplies at national level was tracked and update provided to all nutrition sector partners.

Sudan: Humanitarian Response Plan 2022 (January 2022) [EN/AR] - Sudan 

• Access constraints remain one of the major challenges for the provision of both curative and preventive nutrition interventions.

• Delivery of supplies was hampered due to access and resource constraints, resulting in stockouts for some of the interventions in some of the areas.

• Gaps in geographical coverage of nutrition services in some parts of the country due to access and insecurity.

• Sustained interruption of health workers salaries and limited operation costs for nutrition facilities 

• Delayed approval for SMART survey implementation in some localities of the country.

• Limited funding; only 59.7% of the 2024 annual cluster HRP funding requirement (US$ 350.1M) was received.