What do the health indicators tell us about humanitarian crises in 2009?

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Last year, in the 8th issue of the CE-DAT Scene, we presented a summary of the 2008 trends in malnutrition and mortality. We received a lot of positive feedback on this and it lead to an upsurge of new surveys that were sent to us. We therefore decided to redo a similar analysis for the 2009 figures.

Note: the tables below should be interpreted with some caution. Mortality and nutrition indicators are known to vary depending on the season. Therefore, the comparison of surveys from different years and different seasons could be biased by a seasonality effect.

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Out of 99 settings in Africa and Asia for which data from both 2008 and 2009 were available, 48 (48%) showed an increase in global acute malnutrition (GAM) and 41 (42%) a decrease. Kenya and Sudan in particular were countries where the nutritional situation worsened considerably. The Mandera district in the Kenyan North Eastern province had the highest reported levels of GAM (31.9% and 31.3%). Compared to last year’s figures, this represents an increase in value of 5 to 10%. More east in the district, at the border with Ethiopia and Somalia, the situation improved with GAM levels decreasing from 26-27% to 20%.

In Sudan, the nutritional deterioration was less substantial than in Kenya, with an increase in GAM that was generally less than 5% in value. An exception was Aweil East county in North Bahr-El-Ghazal, where GAM almost doubled compared to 2007 going from 16% to 29.5%. Balliet county in Upper Nile on the other hand, experienced a considerable decrease from 28.8% in 2008 to 22% in 2009.

Two refugee camps in Bangladesh had GAM values that were at their highest levels since 2005. Compared to 2008, there was a doubling from 8.5% and 9.2% for Kutupalong and Nayapara, respectively, to 17.9% in 2009 in both camps. This is the 2nd highest figure reported for these camps since 1998.

A more positive evolution was seen in Somalia, with Somaliland regions of Awdal, Togdheer and Woqooyi Galbeed halving the levels of malnutrition from around 20% to about 10%. In general, the situation in Puntland also improved, though with the exception of its capital city Garowe where GAM among IDPs increased from 21.2% in 2008 to 24% in 2009. Regions south of Mogadishu reported a slight increase in malnutrition.

Surveys conducted in the north of Côte d’Ivoire showed a decrease in GAM from around 17% to values between 6.8% and 8.5%.

Crude Mortality

Of the 48 locations for which crude mortality rates (CMR) from both 2008 and 2009 were available, 21 (44%) had higher rates in 2009 than 2008, 19 (40%) had lower rates and 8 (17%) remained unchanged.

Similarly to malnutrition, the North Eastern province of Kenya was the area with the most deteriorating trend in CMR. Overall, rates in 2009 were about twice as high as the rates of 2008. Although all rates were below the emergency threshold of 1 death/10,000/year, the trend is nevertheless alarming.

Sudan also showed some alarming CMR patterns, especially in the Kurmuk area, Blue Nile state. The CMR in 2009 was 1.3/10,000/day, compared to 0.9 in 2008. The situation has been alarming for several years and is mainly due to the high number of diarrhoea-related deaths, indicating a need for more Water, Sanitation and Hygiene assistance projects.

Surveys from North Bahr-El-Ghazal also reported increasing CMRs from 0.2/10,000/day in 2008 to 0.7 in 2009, the highest rates since 2003. Finally, Twic area in Warab state had a 2009 CMR of 0.9/10,000/day, 0.3 higher than in 2008 and just below the emergency threshold.

Positive trends were reported in Somalia. Most of the locations had lower CMRs in 2009 compared to 2008. Noteworthy are the improvements in the Awdal region (0.5 vs 1.1), Bossaso city (0.4 vs 1) and Togdheer (0.6 vs 1.1). The Shabelle and Juba regions around Mogadishu, however, remain of concern with often increasing mortality rates, almost all of which are above the emergency threshold.

Under 5 Mortality

Fifty-one percent (28/55) of the locations reporting under 5 mortality rates (U5MR) in 2008 and 2009 had lower U5MRs in 2009 compared to 2008. The other locations had higher figures in 2009, except for 3 where 2009 rates were equal to those of 2008.

Unlike CMR, Kenya did not show a particularly alarming trend. Areas where U5MR was elevated in 2008 had lower rates in 2009 and those areas where U5MR increased in 2009 remained within an acceptable range. The highest reported value was 1.5/10,000/day in the northern part of Mandera district, North Eastern province.

In Sudan, U5MR patterns followed the CMR trends. Main areas of concern are Kurmuk area, Blue Nile state (2.8) and Twic area, Warab state (2.3), as well as Aweil north and Aweil West in North Bahr-El-Ghazal, where U5MR increased from 0.3 in 2008 to 1.2/10,000/day in 2009.

The biggest improvement is again in Somalia, where, except for Gedo, Jubaland and Lower Shabelle, all locations had U5MRs below the emergency threshold. Gedo had the highest U5MR with 2.7/10,000/day, a doubling compared to 2008. Finally, a survey conducted among displaced people in Garowe city in Nugaal region reported an important increase from 0.3 in 2008 to 1.3/10,000/day in 2009.

Bangladesh Cote d'Ivoire Democratic Republic of the Congo Ethiopia Haiti Kenya Liberia Mauritania Nepal Niger Occupied Palestinian Territories Sierra Leone Somalia Sudan Yemen


Bangladesh⇒Chittagong⇒Kutupalong camp
Bangladesh⇒Chittagong⇒Nayapara camp

Cote d'Ivoire



Democratic Republic of the Congo⇒Bandundu⇒Djuma Health Zone area
Democratic Republic of the Congo⇒Bandundu⇒Masi⇒Manimba Health Zone area
Democratic Republic of the Congo⇒Bandundu⇒Pay⇒Kongila Health Zone area
Democratic Republic of the Congo⇒Bandundu⇒Yasa⇒Bonga Health Zone area
Democratic Republic of the Congo⇒Kasai⇒Oriental⇒Katako⇒Kombe Health Zone area
Democratic Republic of the Congo⇒Katanga⇒Ankoro Health Zone area
Democratic Republic of the Congo⇒Province⇒Orientale⇒Bafwasende Health Zone area
Democratic Republic of the Congo⇒Province⇒Orientale⇒Irumu area
Democratic Republic of the Congo⇒Province⇒Orientale⇒Lubunga Health Zone area
Democratic Republic of the Congo⇒South⇒Kivu⇒Bunyakiri Health Zone area


Ethiopia⇒Amhara⇒Dessie Zuria area
Ethiopia⇒Oromia⇒Darolebu area
Ethiopia⇒Oromia⇒Deder area
Ethiopia⇒Oromia⇒Kersa area
Ethiopia⇒Oromia⇒Kombolcha area
Ethiopia⇒Oromia⇒Kuni area
Ethiopia⇒SNNP⇒Boricha area
Ethiopia⇒SNNP⇒Damot Gale area
Ethiopia⇒SNNP⇒Damot Pulassa area
Ethiopia⇒SNNP⇒Soro area


Haiti⇒Ouest⇒Port au Prince city


Kenya⇒Nairobi⇒Nairobi city
Kenya⇒North Eastern⇒Banisa area
Kenya⇒North Eastern⇒Central Mandera area
Kenya⇒North Eastern⇒Dandu area
Kenya⇒North Eastern⇒Garissa area
Kenya⇒North Eastern⇒Hareri area
Kenya⇒North Eastern⇒Khalalio area
Kenya⇒North Eastern⇒Libehia area
Kenya⇒North Eastern⇒Malkamari area
Kenya⇒North Eastern⇒Mandera area
Kenya⇒North Eastern⇒Rhamu Dimtu area
Kenya⇒North Eastern⇒Takaba area
Kenya⇒Rift Valley⇒Samburu area






Nepal⇒Eastern⇒Beldangi⇒I camp
Nepal⇒Eastern⇒Beldangi⇒II camp
Nepal⇒Eastern⇒Beldangi⇒II⇒Ext camp
Nepal⇒Eastern⇒Goldhap camp
Nepal⇒Eastern⇒Khudunabari camp
Nepal⇒Eastern⇒Sanischare camp
Nepal⇒Eastern⇒Timai camp


Niger⇒Tahoua⇒Illela area
Niger⇒Tahoua⇒Tahoua area

Occupied Palestinian Territories

Occupied Palestinian Territories⇒West Bank

Sierra Leone

Sierra Leone⇒Southern⇒Bo area
Sierra Leone⇒Southern⇒Pujehun area


Somalia⇒Bari⇒Bossaso city
Somalia⇒Lower Shabelle⇒Afgoye area
Somalia⇒Lower Shabelle
Somalia⇒Lower Shabelle⇒Merka area
Somalia⇒Middle Juba
Somalia⇒Middle Shabelle
Somalia⇒Mudug⇒Galcayo city
Somalia⇒Nugaal⇒Garowe city
Somalia⇒Togdheer⇒Burao town camp
Somalia⇒Woqooyi Galbeed⇒Berbera camp
Somalia⇒Woqooyi Galbeed⇒Hargeisa area
Somalia⇒Woqooyi Galbeed⇒Hargeisa camp
Somalia⇒Woqooyi Galbeed


Sudan⇒Blue Nile⇒Kurmuk area
Sudan⇒North Bahr El Ghazal⇒Aweil East area
Sudan⇒North Bahr El Ghazal⇒Aweil North area
Sudan⇒North Bahr El Ghazal⇒Aweil West area
Sudan⇒North Darfur⇒El Fasher city
Sudan⇒North Darfur⇒Kabkabiya city
Sudan⇒Upper Nile⇒Balliet area
Sudan⇒Upper Nile⇒Ulang area
Sudan⇒Warab⇒Gogrial⇒West area
Sudan⇒Warab⇒Twic area
Sudan⇒West Darfur⇒Beida area


Yemen⇒Lahij⇒Kharaz camp
Yemen⇒Lahij⇒Kharaz city

Document: CE-DAT Scene - May 2010.pdf - (382.86 Kb.)