The Underlying Causes of Malnutrition in South Sudan

Poor health found to be a critical contributing factor to acute malnutrition

Action Against Hunger - USA, (ACF - USA) has carried out an assessment on the underlying causes of malnutrition in Old Fangak Payam of Upper Nile, southern Sudan. Please find the full report attached. While the assessment focused on one specific area of Upper Nile, it is likely that the main findings are applicable to southern Sudan in general: namely, the roots of malnutrition in southern Sudan are structural, and high malnutrition rates are likely to persist after a peace agreement is signed, should that be the case.

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Summary Findings

  • Disease is a prevailing factor leading to malnutrition in this area
  • The high prevalence of disease cases is due to hostile environment, lack of safe drinking water, poor personal and environmental hygiene, poor health seeking and limited health services;
  • The food intake of the under-5 is also questioned, since weaning practices are inappropriate, children only benefit from 2 meals a day and diet is imbalanced;
  • A large part of the underlying causes of malnutrition are related to inadequate childcare practices: breastfeeding, weaning, feeding, hygiene, and health seeking;
  • The heavy women's workload affects the availability of the mothers for childcare and indirectly influence the nutritional status;
  • The lack of support from kinship is an aggravating factor affecting the availability of the mothers and the food security situation at the household level.
  • Food availability at the household level is not a major concern however a prolonged milk and cereals shortage can rapidly deteriorate the nutritional status.
  • While these factors affect similarly all children, including children aged more than 5 years, children aged 6-29 months appear as the most vulnerable since they particularly suffer from inadequate breastfeeding and weaning.


  • To continue and improve the nutritional surveillance
  • To continue promoting adequate breastfeeding and to improve the promotion of adequate weaning
  • To promote balanced diet
  • To continue and to strengthen health education
  • To ensure that people have the means to ensure proper hygiene
  • To assess the possibility to ensure safer water sources
  • To save women's time with the promotion of a collective mill

The findings of the survey on the underlying causes of malnutrition in Old Fangak payam have displayed a large range of factors interacting and leading to malnutrition. These factors are related to different fields: nutrition, health, health and hygiene education, water and sanitation, and food security. Therefore the response to malnutrition has to be multisectoral, with the complementary analysis and intervention of agencies/organisations specialised in the above-mentioned fields.

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