Prevalence of Acute and Moderate Malnutrition among Under Five Children in Three Counties of Western Lakes State, South Sudan

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DOI: 10.21522/TIJNR.2015.04.02.Art004

Authors : Nebiyu Lera Alaro


The prevalence of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) of under-five children, in South Sudan is considerably high and is being aggravated by various internal conflicts and food insecurity ravaging the country. The situation has attracted the attention of various international organizations like World Food Programme (WFP), United Nations Children Emergency Fund (UNICEF), and other international Non-governmental Organizations (INGOs), for possible interventions. However, the success of the nutrition therapy programme in reducing the prevalence of SAM and MAM among under-five children, as implemented by these humanitarian organizations is hinged on many factors.

A retrospective cohort study was conducted by collecting reported data from District Health Information Software (DHIS) of SAM and MAM prevalence of under-five children across three years; 2015, 2006 and 2007 for three counties, and was analysed using SPSS. Findings revealed significant differences in SAM and MAM within counties and among counties across the three years. It was further revealed that there was rising prevalence of SAM and MAM (poor impact) among the counties as the nutrition therapy programme progressed across the three years in the three counties. It was suggested, among others, that training and re-training of health and nutrition workers, timely availability of food supplements, ensuring food security, unwavering adherence to the principle of neutrality and impartiality on the part of INGOs and government, and conduct of pre and post-intervention surveys for feedbacks, may serve as the panacea towards the present unsatisfying state of the nutrition therapy programme in the war-torn Lakes State of South Sudan.

Keywords: Nutrition therapy, Prevalence, Malnutrition, SAM, MAM, and South Sudan.


[1].Abdalla MA, Saad A, Abdullahi HE, Abdul Gader H (2009). Socio-economic aspects influencing food consumption patterns among children under age of five in rural area of Sudan. Pak. J. Nutr. 8:653-659.

[2].Adair, L. S., Fall, C. H., Osmond, C., Stein, A. D., Martorell, R., Ramirez-Zea, M., Sachdev, H. S., Dahly, D. L., Bas, I., Norris, S. A., Micklesfield, L., Hallal, P. & Victora, C. G. (2013): Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies. Lancet, 382, 525-34.

[3].Agozie C Ubesie, N. S. ( 2012). Malnutrition Admitted at the University of In Nigeria Teaching HOSPITAL, Enugu: 10years retrospective review. . NutritionJournal, 1.

[4].Ahmed, F. .. (2014). Effects of malnutrition under five years of age and its complications. Carechallenge .

[5].Ahmed, T., Auble, D., Berkley, J.A., Black, R., Ahern, P.P., Hossain, M., Hsieh, A., Ireen, S., Arabi, M., Gordon, J.I. (2014). An evolving perspective about the origins of childhood undernutrition and nutritional interventions that includes the gut microbiome. Annals of the New York Academy of Sciences. 1749-6632. http: // 1111/nya s.12487

[6].Amy L. Rice, L. S. (2000). Malnutrition asa aan underlying cause of childhood deaths associated with infectious diseases in developing countries. Bulletin of the World Health Organisatioon.

[7].Ashworth, A.; Ferguson, E. (2009). “Dietary Counselling in the Management of Moderate Malnourishment in Children.” Food and Nutrition Bulletin.2009, 30(Suppl. 3): S405–S433Bachmann.

[8].Black RE, Allen LH, Bhutta ZA, Caulfield LE, Onis M, Ezzati M, Mathers C, Rivera J (2008). Maternal and child under nutrition: global and regional exposures and health consequences. Lancet 371:243-260.

[9].Checchi, F. & Robinson, W. C. (2013). Mortality among populations of southern and central Somalia affected by severe food insecurity and famine during 2010-2012. Rome, Washington.

[10]. De-Onis M, Blössner M, Borghi E, Morris R, Frongillo E (2004a). Methodology for estimating regional and global trends of child malnutrition. International Journal of Epidemiology (in press).

[11]. Lehmann A.B. (1991). Nutrition in old age: an update and questions for future research: part I. Reviews in Clinical Gerontology 1, 135-145.

[12]. Mwanza, K.M, Okop J, Puoane T (2016): Evaluation of outpatient therapeutic programme for management of severe acute malnutrition in three districts of the eastern province, Zambia

[13]. Neitzel J (2011). The targeted supplementary feeding programme

[14]. Stephan LS, Lathum MC, Ohesen EA (2000). Global malnutrition. Parasitology 121:55-22.

[15]. UNICEF (2014). Chief of Strategic Communication, UNICEF South Sudan.

[16]. UNICEF, WHO & World-Bank (2012). UNICEF-WHO-World Bank Joint Child Malnutrition Estimates. (UNICEF, New York; WHO, Geneva; The world Bank, Washington, DC).

[17]. VOA (2016). Child malnutrition crisis deepens in South Sudan

[18]. WFP (2015). UNICEF And WFP resolve to defeat malnutrition in South Sudan

[19]. WHO (2000) World Health Organization, Dept of Nutrition for Health and Development. Nutrition for health and development: A global agenda for combating malnutrition. WHO

[20]. WHO, (2003) “The Management of Nutrition in Major Emergencies”.

[21]. WHO 2013: Guideline update: Technical aspects of the management of severe acute malnutrition in infants and children. Geneva: World Health Organization; 2013.

[22]. WHO and UNICEF. 2009. WHO child growth standards and the identification of severe acute malnutrition in infants and children: A Joint Statement by the World Health Organization and the United Nations Children’s Fund. Geneva: WHO.

[23]. WHO, (2003) “The Management of Nutrition in Major Emergencies”

[24]. WHO, WFP, UN/SCN, UNICEF. (2007). Community-Based Management of Severe Acute Malnutrition. AJoint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children’s Fund (UNICEF). New York: UNICEF. May 2007.

[25]. WHO. (2012). Technical Note: Supplementary Foods for the Management of Moderate Acute Malnutrition in Infants and Children 6–59 Months of Age. Geneva: WHO.