2015 ANNUAL REGIONAL OVERVIEW PUBLIC HEALTH EAST AND HORN OF AFRICA WASH REPRODUC TIVE HEALTH & HIV NUTRITION & FOOD SECURIT Y

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1 ANNUAL REGIONAL OVERVIEW EAST AND HORN OF AFRICA REPRODUC TIVE HEALTH & HIV PUBLIC HEALTH WASH NUTRITION & FOOD SECURIT Y

2 Public Health EAST AND HORN AFRICA Communicable diseases, especially malaria, acute watery diarrhea respiratory infections remained the top causes of morbidity in, Mortality rates were maintained within acceptable standards, contributed to by timely access to quality health care provided by government and NGO partners. Efforts were initiated to firm up integrated management common causes of morbidity at the community level with the strategic objective of reducing overload on health facility based care. Measures included training of community health workers and clinical staff as well as intensified supervision and monitoring. Essential medicines and medical supplies for the refugee programs were supplied in a timely manner including covering emergency operations, thus avoiding stock-outs and shortages. National polio and measles immunization campaigns continued to boost coverage rates in refugee settings in, and. However, regular EPI programme coverage leaves room for improvements. Adjusting EPI programmes with a strong community based approach was the agreed way forward to realize better coverage rates. DISEASE PROFILE U N D E R - F I V E M O R TA L I T Y Proportion of all consultations Deaths/1,/month (lowest-highest country rates) 3,23,18 Total number of consultations in countries of global disease burden among surveyed refugees 1.5 Standard < Communicable diseases (3,24,55) 1.25 Mental Health (4,99) Non-communicable diseases (1,923) Injuries (,) Countr y over view U N DE R - F I V E MO R TA L I T Y D e at hs / 1, / m o nt h ( St and ard < 1. 5 ) H E A LTH U TI L I SATI O N R ATE N e w v i s i t s / p e r s o n/ ye ar ( St and ard 1-4 ) ME A SL E S CO V E R AGE Pro p o r t i o n re c i e ve d m e as le s vacc i nat i o n ( St and ard 9 5 ) S o m e s i te s exce e d e d t he s t and ard fo r und e r- fi ve m o r t ali t y. 98 N R : N o t re li ab le d at a Regional allocation Public Health Data is extracted from UNHCR Global Focus, January

3 Reproductive Health & HIV EAST AND HORN AFRICA Refugee access to reproductive health services improved in. Skilled birth attendants (SBA) assisted with 8 per cent of deliveries in compared to in despite challenges associated with the conflict in the country in. Similar improvement in SBA was reported in all other countries in the region. continued to ensure access to RH services during emergency influx of Yemeni nationals with proportion of eligible rape survivors provided with PEP within 2 hours being 1. While there were country-specific challenges with supply of HIV test kits from national stocks, coordinated efforts were made to ensure continued access to PMTCT with notable improvements in (1 in up from 5) among other countries in the region. R E P R O D U C T I V E H E A LT H & H I V P R O F I L E S K I L L E D B I R T H AT T E N D A N C E Proportion of countries Proportion of all births (lowest-highest proportions) Countries meeting contraceptive prevalence rate standard ( 3) c Countries with access to ART equal to nationals a Countries meeting the coverage standard of 4 ANC visits ( 95) d Countries with access to newborn care b Standard Number of countries included in analysis a,b,d), c) Countr y ove r v ie w SK I L L E D B I R TH AT TE N DA N C E Pro p o r t i o n o f all b i r t hs ( St and ard 1 ) PO ST- E X PO SU R E PR O PHYL AX I S 5 Pro p o r t i o n o f e li gi b le rap e s ur v i vo r s p rov i d e d wi t h P E P wi t hi n 2 ho ur s ( St and ard 1 ) 1 PMTC T CO V E R AGE Pro p o r t i o n cove re d by PMTC T ( St and ard 1 ) 52 CO U N T R I E S W I T H S K I L L E D B I R T HS At te nd ance b e low s t and ard (<1) CO U N T R I E S W I T H Ze ro R ap e Cas e s R e p o r te d i n H I S N R : N o t re li ab le N A : N o t avai lab le Regional Allocation Reproductive Health & HIV* *A part of RH/HIV activities are included under the public health budget Data is extracted from UNHCR Global Focus, January

4 Nutrition EAST AND HORN AFRICA This region has the highest levels of global acute malnutrition and the highest number of sites in which nutrition surveys are conducted. Stunting and anaemia are also persistently high or deteriorating. Amid the many ongoing emergencies (including conflicts, epidemics and natural disasters) and several food cuts and pipeline breaks, some achievement towards reducing prevalence was made in all nutrition indicators in. Investment in, amongst others, infant and young child feeding, intersectoral collaboration and staffing in emergency operations has been partially responsible for these achievements. NUTRITION PROFILE NUTRITION SURVEY TRENDS Proportion of surveyed sites Number of sites with nutrition survey conducted Sites meeting the GAM standard a Sites meeting the anaemia standard c Number of sites with nutrition survey conducted 29 2 Sites meeting the stunting standard b 29 Number of sites included in analyses a-c) 49 Count r y over view STU N TI N G R ange o f p ro p o r t i o ns f ro m s ur ve ye d s i te s St and ard o f < 2 s t unt i ng 1 R ange o f p ro p o r t i o ns f ro m s ur ve ye d s i te s St and ard o f < 1 G AM 1 GLO B A L AC U TE MA L N U TR I TI O N.3 A N A E MI A I N C H I L DR E N R ange o f p ro p o r t i o ns f ro m s ur ve ye d s i te s St and ard o f < 2 anae m i a 1 N U MB E R O F SU R V E YE D SI TE S CO U N T R I E S W I T H S I T E S N OT M E E T I N G S TA N DA R D S N A : N o avai lab le d at a NA NA Regional allocation Nutrition *A part of the nutrition activities are included under the public health budget Data is extracted from UNHCR Global Focus, January

5 Water, Sanitation & Hygiene EAST AND HORN AFRICA With continued emergencies in the region, operations worked hard to maintain the standards in access to water despite geophysical and other constraints. In the national standards of 15 liters per person per day have been met in all sites, including the settlements with new arrivals. Despite the hydrogeological constraints in, an average of 18 liters of water is being provided to refugees. Improvements have been achieved throughout the year in, where a significant progress has been made in achieving the sanitation standards. Water bornediseases continued to be prone in the region, with a cholera outbreak reported in Dadaab at the end of. A multi-sectoral response with strong focus on quality of water and hygiene promotion was set up. New initiatives, such as the solar water pumping in Dadaab, and sustainable sanitation solutions in Kakuma and have started to increase cost effectiveness and sustainability of water and sanitation programmes.' WA S H P R O F I L E WAT E R & S A N I TAT I O N T R E N D S Proportion of sites meeting the stardard Regional coverage (lowest-highest values) 1 Litres/person/day Person/latrine Litres/person/day Person/latrine DJ IBO ER UT I( 2) ITR EA ET (1) HI OP KE IA NY (2 A S. (5) SU DA SU N (9) DA N UG () AN DA 29 (9) ) The figure in brackets represent the number of sites/settlements included in analysis Count r y over view WATE R ACC E SS L i t re s / p e r s o n/ d ay ( St and ard 2 ) 2 SA N I TATI O N ACC E SS Pe r s o ns / lat r i ne ( St and ard 2 ) 24 CO U N T R I E S W I T H S I T E S N OT M E E T I N G S TA N DA R D S 14 CO U N T R I E S W I T H S I T E S B O R D E R L I N E ( WAT E R ACC E S S ; S A N I TAT I O N ACC E S S ) Regional allocation W a t e r, S a n i t a t i o n & H y g i e n e Data is extracted from UNHCR Global Focus, January

6 United Nations High Commissioner for Refugees Public Health Section Division of Programme Support and Management Rue de Montbrillant 94 CH-121 Geneve Switzerland T: F: The boundaries shown on the maps do not imply official endorsement or acceptance by the United Nations. UNHCR 21