Health & nutrition

Our aim is to ensure that children get the best start to life through quality health and nutrition services

Woman holding toddler
UNICEF Sudan/Omer

Challenges

Poor nutrition is a major threat to the survival and development of children under-five in Sudan. Nowadays Sudan have more malnourished girls and boys U5 than 30 years ago, due to an increase in prevalence in the past 2 decades from 20 to 32 per cent  underweight and from 32 to 35 per cent underweight combined with population growth.

Over one in three children U5 (2.3 million) are too short for their age (stunted) with rates above 30 per cent in 128 out of 188 localities, making Sudan one of the 14 countries where 80 per cent of the world’s stunted children live.

One in six U5 girls and boys are too thin for their height (wasted), while nearly 700,000 children per year suffer from severe acute malnutrition in Sudan - about twice the number of severely acutely malnourished (SAM) children in need in Sudan compared to Yemen.

Inadequate dietary intake is one of several immediate causes of undernutrition in Sudan. According to MICS 2014 on average only 15 per cent of young children aged 6-23 months were provided the minimum acceptable diet, primarily due to insufficient diversity of their diets although food frequency is also an issue. These proportions however differ across socioeconomic status and across the country with some states with having less than 5 per cent of 6 - 23 month old infants appropriately fed. 

Across Sudan, maternal, newborn and child health indicators are still far from reaching the SDG targets for 2030, unless accelerated efforts excreted. The maternal mortality ratio remains unacceptably high at 216 per 100,000 live births and the neonatal mortality rate is estimated at 33 per 1,000 live births. 

Young boy in White Nile 2018
UNICEF Sudan/Ahmed Amin Ahmed

Communicable diseases constitute a major cause for morbidity and mortality in Sudan and the country remains prone to measles, meningitis, acute watery diarrhea (AWD) and most recently chikungunya and dengue.

The recent outbreak of measles is a setback to Sudan’s target to eliminate measles by 2020. In 2018 alone, a recorded 4,630 measles cases among children across all states with 11 deaths. This outbreak is still ongoing, and 1077 cases of measles were confirmed thus far in 2019. 

Also, in 2016, only 6,395 cases of AWD were identified, with a peak of cases following in 2017 with more than 30,000 cases. In 2018, 502 cases of AWD were reported in Sudan. While the situation has significantly improved, the risk of future outbreaks remains.

Although Sudan is reported as polio free country since 2009, the country is still considered one of the six countries at risk of polio importation, where about 196,000 girls and boys missed opportunity to vaccination in Nuba mountains and southern Blue Nile, lost their vaccination opportunity for polio.

According to the latest MICS, the coverage of immunization is low with only 42.8 per cent of children under five fully vaccinated. In spite of the gain EPI program witnessed during the period 2002-2018 where marked improvement in the vaccination coverage achieved reaching 94.3 per cent in 2018 from baseline of 64.2 per cent in 2002.

Collectively diarrhea, pneumonia and Malaria cause more than 30 per cent of under-five mortality in Sudan, while the neonatal causes contributed to 40 per cent of the total child mortality. Although 30 per cent of the population in Sudan (12 per cent urban, 39 per cent rural) live more than 5 kilometres from a primary health facility, the coverage with Comprehensive Primary Health care is extremely low, where only 24 per cent of health facilities provide a full package of primary health care services. 

Solutions

UNICEF is supporting the early case finding, referral and treatment of SAM children through the out-patient treatment program (OTP), increasing the target for 2019 by 20 per cent  (from 250,00 to 300,00) in the light of the huge burden faced in the country.

UNICEF is stepping in as the provider of last resort as needed. This include the decision to take over financial and technical support for 11 facilities for the inpatient treatment of SAM with complications 

UNICEF is the agency responsible for the procurement of nutritional products (Ready to Use Therapeutic Food (RUTF), therapeutic milks) and supplies (anthropometric) needed for the treatment of all the severely malnourished children in the country and is trying to build a buffer of the lifesaving nutrition commodities used for the treatment, to ensure sufficient stock to respond to new emergencies and prepositioning particularly in hard to reach areas/areas temporarily cut off during rainy season.

UNICEF is also temporarily taking over the procurement and provision of medicines for the SAM children admitted to OTPs for the remainder of 2019 when the government supply system suffering many gaps, beside ensuring the procurement of drugs for inpatient care of SAM children for the majority of the country.

UNICEF is improving the feeding, caring and hygiene practices of infants and young children through the establishment and support for mother to mother support groups at community level in which women are counselled and share their experiences and best practices and encouraging women to utilize appropriate health services for their children and themselves. 

a woman feeds her daughter plumpy nut paste,
UNICEF/UNI166054/Noorani

UNICEF is also providing key micronutrients including vitamin A supplements for children under 5 and iron folate supplements for pregnant women

To better understand the situation UNICEF together with the Government of Sudan undertook the national level S3M II survey (expected to be released very soon) and is undertaking formative research to understand the nutrition related behaviours and related motives and barriers of adolescents as well as caregivers of young children.

UNICEF supports initiatives towards the achievement of universal health coverage through health system strengthening, to accelerate the reductions in the neonatal and maternal mortality, and prevention of stunting (chronic malnutrition) in children.  

UNICEF is ensuring high immunization coverage through availing vaccines, cold chain equipment’s, and operational support to the hard to reach areas, both through routine and Campaigns.

UNICEF is also supporting the Ministry of Health in its efforts to reduce the prevalence of malaria by procuring the required supplies and supporting the mass distribution campaigns for mosquito nets in the high risk area; UNICEF is also supporting Maternal, new born care and midwifery training.

UNICEF supports increase access to treatment of diarrhea, respiratory tract infections and malaria, through provision of IMCI kits, LLINs, technical support and scale up of the Integrated Community Case Management and newborn care.