Learning from Moyale, Kenya Concern has implemented an integrated set of initiatives designed to enhance resilience among the pastoralist communities in Moyale Dis- trict in northern Kenya since 2006. Past droughts, including those in 2006 and 2009, eroded household assets such as livestock and health and left the pastoralist residents of Moyale with fewer coping options. However, the evaluation of Concern's program revealed that Moyale’s severe acute malnutrition rates fell by 50 percent in early 2011, when those in neighboring areas rose more than threefold (Table 4.2) (Eras- mus, Mpoke, and Yishak 2012). In addition, its global acute malnutri- tion rate increased by a far smaller amount than nearby districts’. Several factors helped reduce Moyale District’s rate of severe
acute malnutrition between 2010 and 2011:
1. The strengthening of resilience at the community level over time through contextually appropriate, multisectoral interventions. These included introduction of dryland farming (alongside pasto- ralism) to grow kale, onions, tomatoes, and fruits; improved irri- gation systems; diversification of livestock; rangeland manage- ment; mitigation of conflict over pasture access; and improved access to water.
2. The strengthening of government capacity to respond to nutrition- al crises. This included technical training for the District Health Management Team staff; the creation of technical protocols and quality-of-care oversight systems; adoption of interventions with the highest impact on mortality; improved budgeting; adoption of
thresholds, strategies, and protocols for scale up and scale down; and monitoring for signs of scale-up triggers.
3. Early scaling up of high-impact nutrition interventions when warn- ings were triggered.
4. Coordinating among Concern, the local Kenyan government services, the World Food Programme, and World Vision (which provided an important protective ration of food targeted at malnourished children).
Designing for Community Resilience in Chad There is much interest in creating systems to build resilience at the community level. Unfortunately rigorous data on the best intervention packages is scarce. To address the evidence gap, Concern is partner- ing with the Feinstein International Center at Tufts University to rigor- ously evaluate its Community Resilience to Acute Malnutrition program in eastern Chad and generate evidence to contribute to international discussions on the concept of resilience. Based on knowledge gained from other programs, in early
2012, Concern designed a three-year program involving water, nutri- tion, disaster risk reduction, livelihoods, and inequality interventions. The program was developed to improve the overall health, nutrition, and livelihood security of the rural population of Dar Sila in eastern Chad while improving their resilience to shocks. Between 2005 and 2010, many people in the Dar Sila region were
displaced due to conflict on both sides of the Chad-Sudan border. While insecurity has decreased, the region remains vulnerable to food insecurity
TABLE 4.2 CHANGES IN CHILD MALNUTRITION RATES IN THREE DISTRICTS OF KENYA, 2010–2011 Global acute malnutrition District Marsabit Wajir North Moyale 2010 rate (%) 13.4 19.8 12.3 Source: Erasmus, Mpoke, and Yishak (2012).
Notes: Global acute malnutrition (GAM) is the proportion of children ages 6–59 months who are severely or moderately wasted according to a standardized weight-to-height ratio and/or have nutritional edema. A GAM prevalence of 15 percent or more among children ages 6–59 months has traditionally been considered a “critical” situation, according to the World Health Organiza- tion. Severe acute malnutrition (SAM) is the proportion of children ages 6–59 months who are severely wasted. The 2010 and 2011 nutrition surveys were conducted between April and June.
2011 rate (%) 27.1 27.9 13.7 % change 102 41 11 2010 rate (%) 1.3 1.4 3.0 Severe acute malnutrition 2011 rate (%) 5.0 6.8 1.5 % change 285 386 -50
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Building Community Resilience to Undernutrition | Chapter 04 | 2013 Global Hunger Index
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