2015 ANNUAL REGIONAL OVERVIEW PUBLIC HEALTH GREAT LAKES AND SOUTHERN AFRICA WASH REPRODUC TIVE HEALTH & HIV NUTRITION & FOOD SECURIT Y

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1 ANNUAL REGIONAL OVERVIEW GREAT LAKES AND SOUTHERN AFRICA REPRODUC TIVE HEALTH & HIV PUBLIC HEALTH WASH NUTRITION & FOOD SECURIT Y

2 Public Health GREAT LAKES AND SOUTHERN AFRICA UNHCR s efforts to meet the health care needs of refugees in emergency and protracted situations remained an operational priority. Malaria, respiratory tract infection and diarrhoea were top causes of morbidity. UNHCR and partners rapidly responded to influxes of Burundi refugees to, and Democratic republic of Congo (DRC) where new camps had to be built and health services rapidly scaled up. To supplement coordinated efforts to control a cholera outbreak in among refugees and host communities, an oral cholera vaccination (OCV) campaign was conducted in coordination with MOH, UN and NGO partners. In Southern Africa, UNHCR worked closely with respective countries line ministries to provide support towards integration of refugee health services into national systems. Healthcare to refugees in the region is either fully or partially integrated into national health systems with service delivery modalities varying from free access to services to reimbursement schemes. In 16 UNHCR will further explore opportunities for integration into national health and social security services. 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) 1,8,35 Total number of consultations in 6 countries..9 of global disease burden among surveyed refugees 1.75 Standard < Communicable diseases (969,917) 1.5 Mental Health (1,848) Non-communicable diseases (19,58).5 9 Injuries (16,94) Countr y over view Congo (Rep) 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 ) NR DRC 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 ) 84 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. N R : N o t re li ab le d at a Burundi NR Regional allocation Public Health Zambia Data is extracted from UNHCR Global Focus, January

3 Reproductive Health & HIV GREAT LAKES AND SOUTHERN AFRICA Despite ongoing emergencies in the region, partners efforts ensured continued and improved access to reproductive health services. In Congo Republic, 1 (1) deliveries in were performed by a skilled birth attendant. This represents a significant improvement compared to 85 in. faced the additional complexity of an emergency influx of Burundians in, which required rapid expansion RH services. Partners in ensured 9 of eligible rape survivors received post exposure prophylaxis (PEP) within 7 hours to prevent HIV infection. UNHCR and partners continued to ensure refugees are integrated in national RH and HIV treatment programs including in Southern Africa countries where some programs are fully integrated in the national system. Zambia showed improvement in skilled birth deliveries at 85 up from 7 in. 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 Standard Countries meeting the coverage standard of 4 ANC visits ( 95) d Countries with access to newborn care b 4 9 Number of countries included in analysis a,b,d) 5, c) 4 Countr y ove r v ie w Congo (Rep) 1 NA SK I L L E D B I R TH AT TE N DA N C E 54 DRC 94 8 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 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 7 ho ur s ( St and ard 1 ) 96 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 ) 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 Burundi Regional Allocation Reproductive Health & HIV* Zambia *A part of RH/HIV activities are included under the public health budget Data is extracted from UNHCR Global Focus, January

4 Nutrition GREAT LAKES AND SOUTHERN AFRICA Surveys were only conducted in two countries in the Southern Africa and the Great Lakes region in. Despite the emergencies in the region, global acute malnutrition remains low. However, persistent stunting and anaemia are of concern in both emergency and protracted contexts. Several food cuts have affected the region in, making improvements in nutritional outcomes more difficult. Nutrition sensitive programming in the protracted Congolese refugee camps in, for example rabbit rearing and homestead gardening activities combined with enhanced public health, WASH and improved nutrition products, have resulted in positive decreasing trends in the longer term nutritional outcomes of stunting and anaemia. 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 Sites meeting the stunting standard b 9 Number of sites included in analyses a-c) 9 Count r y over view GLO B A L AC U TE MA L N U TR I TI O 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 < 1 G AM 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 < s t unt i ng 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 < anae m i a 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 Mozambique Regional allocation Nutrition <.1 *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 GREAT LAKES AND SOUTHERN AFRICA The Burundi refugee influx in and, greatly impacted the availability of water and latrines. To ensure that sufficient water is available, expert geo-hydrological assessments have been conducted in both countries to support decisions on water availability and water system development. During the first phase of the emergencies, water and sanitation standards were hard to achieve in especially, however the situation improved with the relocation of refugees to new refugee camps. In Southern Africa, multi-year WASH strategies, have been developed for Mozamibique, Zambia and Zimbabwe to support the further integration into national services and ensure increased community ownership. 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 DR C( 4) RW AN TA DA (5) NZ AN ZA IA () MB IA 9 () The figure in brackets represent the number of sites/settlements included in analysis Count r y over view WATE R ACC E SS DRC 16 L i t re s / p e r s o n/ d ay ( St and ard ) 16 SA N I TATI O N ACC E SS Pe r s o ns / lat r i ne ( St and ard ) 31 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 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 1-5 ) 5 Regional allocation W a t e r, S a n i t a t i o n & H y g i e n e Zambia 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-11 Geneve Switzerland T: F: The boundaries shown on the maps do not imply official endorsement or acceptance by the United Nations. UNHCR 16