Overview of the area

 

Mandera central sub county is one of the five sub counties in the larger Mandera County in North Eastern region of Kenya. It is composed of approximately 17,162 households according to the 2009 census and an estimated population of 275,8041. The Garre (who speak Borana) clan are the predominant ethnic group inhabiting, they are mainly nomadic and their settlements and density are mainly influenced by water and pasture. Parts of the district are covered by a range of low lying hills starting from Wargadud stretching to Gari hills towards the North. The rest is low-lying plains which rise to around 400m above sea level. The communities are pastoralist and agro pastoralist with limited access to irrigation who continue to face food insecurity from re-occurring drought and subsequent livestock losses.

 

The district experiences chronic food insecurity and high incidences of malnutrition. The rainy and dry seasons can no longer be counted upon to provide season grazing and water for the pastoral population, whose resilience is increasingly eroded by broader economic factors in the region.

The sub county borders Ethiopia to the North, Mandera East to the North East and Eastern side, and Somali to South East, Wajir East district to the South and Mandera West district to the West

 

The district has a total area of 6148 Km. 2Temperatures are relatively high throughout the year. They range from a minimum of 27 degree Celsius in July to a maximum 38 degree Celsius in February. The district gets scanty rainfall averaging 255mm, which peaks in the month of April and May. Short rains are received in the month of October & November. Drought has been common phenomenon lately with adverse impact to livestock and crop production.

 

1.1.2. Nutritional situation

 

Regarding the nutritional situation, Save the Children has been conducting nutritional SMART surveys2 in Mandera Central Sub County since 2008 to date. Figure 2 shows the results of these

 

nutritional surveys. Global acute malnutrition (GAM) rates have surpassed the WHO alert threshold for a state of emergency (>15%) since 2009 though there is a remarkable improvement over the years.

In Country, malnutrition rates have been chronically at emergency levels. These high rates of malnutrition can be attributed to poor health conditions, sub-optimal maternal and child feeding, care practices, and food insecurity. This has been compounded by high rates of poverty and illiteracy, marginalization, recurrent environmental shocks (floods and droughts) and displaced populations adding an additional strain to already weak health systems and communities3.

 

1.1.3. Health access in Mandera central Sub County

 

Mandera central has one district hospital (Elwak District Hospital) and a total of 6 health centres & Dispensaries (some closed due to lack of personnel) which are closer to community level and deliver primary health care unity and nutrition services as for those who are not near the facilities, they get health and nutrition at the outreach sites.

 

1.1.4. Nutrition services

 

In Mandera central, the nutrition services are delivered by the Ministry of Health (MOH) supported by Save the Children International (SCI).

 

Currently there is one Stabilization Centre (SC) at the district hospital, 7 static Health Facilities (HF) and 14 Outpatient Therapeutic Programme (OTP) sites functioning in the district except from one that is not due to the insecurity issues hence people have not resumed fully.

 

Since August 2012, the MOH started to integrate the in-patient and out-patient management of severe acute malnutrition into hospital and health Centre. The ministry of health through community health workers and nurses are involved in screening and doing active case findings of the children under 5 years and pregnant and lactating mothers in the community for early detection and refer malnutrition cases, if any to the nearest health centres.



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