Background of the crisis

The armed conflict in the north and central zone of Cabo Delgado since the end of 2017 has had a major impact on food security and the nutritional situation of households, especially in areas with limited humanitarian access. It has resulted in people’s homes and fields being abandoned and massive evictions from districts in the north and center to districts in the south of Cabo Delgado, neighboring provinces and Tanzania. As of April 14, 2021, 646,802 displaced persons were registered. In addition to the destruction of the livelihoods of internally displaced persons and those left behind, this also led to the destruction of the health infrastructure and the dysfunction of health systems. Persistent insecurity prevents the provision of health and nutritional services, both customary and as part of humanitarian aid to those still living in these areas. Conflict, along with other factors such as infrequent rainfall and poor water and sanitation infrastructure, have created a worrying situation of food insecurity and malnutrition. The acute food insecurity (AFI) and acute malnutrition (AMN) analyzes for the province were carried out at the same time, however, AFI only analyzed internally displaced persons and households with internally displaced persons, while AMN analyzed all children under the age of five.

Acute food insecurity

During the acute food insecurity analysis, two specific groups were assessed: 1) internally displaced persons (in resettlement and transit centers and at inns) in five districts – Metuge, Ancuabe, Chiúre, Namuno and Balama; and 2) households with internally displaced persons in seven districts – Pemba City, Montepuez, Metuge, Ancuabe,
Chiure, Namuno and Balama. For the period from April to September 2021, an estimated 128,000 internally displaced persons and 101,000 people from inns will have high levels of acute food insecurity (IPC phase 3 or higher) and require immediate action. All IDP groups and inn groups are classified as crisis situations (IPC phase 3), with the exception of the Balama IDP group, which is classified as stressed (IPC phase 2). Between October 2021 and February 2022, the number of internally displaced persons and innkeepers in IPC phase 3 or higher is estimated to increase in all seven districts analyzed, and is expected to reach around 197,000 internally displaced persons and 166,000 innkeepers. 44,000 IDPs are expected to be in distress in Metuge District (IPC Phase 4) if food aid is not provided, while the remaining IDP groups and inn groups in other districts (Pemba City, Namuno, Montepuez, Balama, Ancuabe and Chiure) is still classified in crisis (IPC phase 3). It is important to note that this is a time of food shortage, characterized by depleted grain reserves and rising prices, and households are likely to employ crisis or emergency strategies.

Acute malnutrition situation

In the 16 areas analyzed in Cabo Delgado Province, it is estimated that around 75,000 children under the age of five are likely to suffer from acute malnutrition and consequently require treatment over the next 12 months. Between October 2020 and March 2021, eight districts and two IDPs had Warning Levels of Acute Malnutrition (IPC Phase 2), while five districts and one IDC reported Acceptable Acute Malnutrition (IPC Phase 1).
The forecast analysis of the situation shows that between April and September 2021 the situation in districts with limited or no humanitarian access is likely to deteriorate from critical (IPC phase 4) to serious (IPC phase 3) in one district. in three districts and an alert (IPC phase 2) in four districts. The remaining four counties and three internally displaced persons reception centers will remain in the same situation despite the likely deterioration. Between October 2021 and January 2022, the situation is expected to deteriorate further, with two districts with limited or no humanitarian access likely to move into critical phase, six new districts likely to move into serious phase, and one IDP center likely to move into warning phase. The remaining units of analysis are likely to remain in the same phases even if the situation might worsen.

Recommendations for immediate action

Priority should be given to ensuring that all children who are or may be suffering from acute malnutrition have access to treatment. Estimates of access to acute malnutrition treatment at the community level in these counties show that coverage is very poor and therefore urgent and coordinated attention is needed to prevent deaths from severe acute malnutrition. As soon as access is possible, it should be in the district of Palma in particular, but also in the districts of Macomia, Quisseria, Nampula in Macomia, Quissanga, Mueda, Muidumbe and Nangade. Humanitarian aid (food, health and nutrition, water and sanitation) is provided to districts so that it can protect against the expected deterioration, especially when new internally displaced persons arrive in the last two districts. Ongoing humanitarian aid to internally displaced persons in transit centers and inns, with priority given to the most vulnerable in the resettlement centers, should continue. Households hosting internally displaced persons should also be supported. or continue to be supported if applicable. Capacities for basic services are to be created and strengthened not only in centers, but also in communities near resettlement centers. It is also crucial to monitor the evolution of food insecurity and malnutrition in this rapidly evolving scenario and to continue data collection for a thorough analysis of the acute food insecurity of all households, including those not hosting internally displaced persons and districts not from the acute food insecurity are recorded analysis.