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Despite ongoing humanitarian assistance, levels of acute malnutrition and mortality remain high

  • Food Security Outlook Update
  • Ethiopia
  • December 2022
Despite ongoing humanitarian assistance, levels of acute malnutrition and mortality remain high

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  • Key Messages
  • Key Messages
    • Ethiopia is facing two extreme crises simultaneously: five consecutive seasons of drought in the south and southeast and the aftermath of the two-year conflict in northern Ethiopia, both of which have significantly eroded local livelihoods. In southern and southeastern Ethiopia, Emergency! (IPC Phase 4!) and Crisis! (IPC Phase 3!) outcomes are widespread, and FEWS NET assesses some households are likely in Catastrophe (IPC Phase 5). In northern Ethiopia, humanitarian assistance will likely mitigate the size of food consumption deficits among recipient households, but Emergency (IPC Phase 4) outcomes are still expected amid low crop production and significantly below-average purchasing power.

    • In southern and southeastern pastoral areas, households are expected to face immense difficulty accessing food and income even with ongoing and planned food assistance.  A sixth below-average rainy season is forecast in March to May 2023, raising the likelihood that this protracted humanitarian crisis will likely persist well into 2023. Humanitarians are prioritizing food aid distributions to drought-affected locations, reaching 2.3 million people in Somali Region by December; in the absence of aid, worse outcomes than Emergency (IPC Phase 4) would be expected. Levels of acute malnutrition and mortality are still high, and a large, sustained scale-up of humanitarian aid is needed to save lives and livelihoods.

    • In early November, the Cessation of Hostilities Agreement led to a significant decline in conflict in northern Ethiopia. While levels of conflict have significantly decreased in Tigray since then, access to both typical food sources and humanitarian assistance has yet to improve considerably. Improvements in market and economic functioning have been limited, and households still face extreme difficulty accessing food. In Tigray, about 2.27 million people received assistance between mid-November and late December. Emergency (IPC Phase 4) and Crisis (IPC Phase 3) outcomes will likely persist through at least May.

    • Nutrition outcomes among children under five remain of high concern across the worst drought- and conflict-affected areas with elevated proxy global acute malnutrition (GAM) rates. Acute malnutrition levels are within the “Critical” and “Extremely Critical” ranges in woredas of Wag Hamra and North Wollo Zone in Amhara Region, according to the December Rapid Nutrition Assessment (RNA). Similarly, nutrition data collected in November and December in the Somali Region found proxy levels of acute malnutrition within the “Critical” and “Extremely Critical” thresholds. 


    Conflict: While conflict in northern Ethiopia has been minimal following the Cessation of Hostilities Agreement in early November, political tension and violence have increased elsewhere in the country, with the largest concentration of conflict recorded in Oromia (Figure 1). According to ACLED, in December, the violence within Oromia is spreading geographically and intensifying. Additionally, inter-communal conflict continues along areas of the Somali border with Oromia and Afar. In November, conflict between the Somali and Oromo clans occurred along the Oromia and Somali borders in the areas of Gura Damole woreda and East Bale Zone; however, relative calm returned in this area in December.

    In northern Ethiopia, access to basic services – including banking and electricity – has improved but remains restricted, and the internet is still generally unavailable. Humanitarian assistance convoys into Tigray have increased through three corridors, including the Semera-Abala, Woldiya-Alamata, and Gonder-Shire routes. Despite this progress, market functioning, the movement of goods, and population movement remain limited in part due to the presence of landmines, especially along the Tigray-Afar border.

    Rainfall: Overall, rainfall performed slightly better than anticipated during the October to December 2022 deyr/hageya season; however, FEWS NET climate scientists estimate total cumulative rainfall was only about 127 mm, which is still well below the requirement for healthy crops and rangelands. At the sub-regional level, rainfall performance was mixed, with the most significant deficits observed in southern Oromia and Somali regions (Figure 2). In these areas, rainfall deficits were 40 percent or greater compared to the long-term average, based on remote sensing data. Additionally, the rains started late, were erratic throughout the season, and ended early. Even in the localized areas where rainfall was favorable, the precipitation has not alleviated drought conditions due to dry soils and low total rainfall in 2022.

    Displacement: According to the most recent International Organization for Migration (IOM) assessment in August and September, more than 2.7 million[1] people are displaced across Ethiopia, primarily due to conflict and drought, a finding similar to that of IOM’s June/July assessment. In Somali Region, 911,000 internally displaced people (IDP) are scattered across more than 488 sites and 74 woredas in the 11 zones of the region, most of whom have been displaced by drought. Due to humanitarian access challenges, levels of displacement are likely higher, specifically in Afar, Oromia, and Somali regions.

    In Tigray, anecdotal reports indicate that households are yet to return to their homesteads in areas still occupied by parties to the conflict. In conflict-affected areas of Afar and Amhara, IDPs are continuing to return to their area of origin, including but not limited to Wag Hamra and North Wello zones. Based on the - meher seasonal assessment that took place in late November/early December, over 614,000 people remain displaced in Amhara. The assessment also found that more than 150,000 people have been displaced in Zones 1 and 3 of Afar by conflict along the Somali Region border and by flooding during the July to September 2022 karma/karan season. Intercommunal conflict in the Somali Region along the border with Oromia and Afar regions has also caused some displacement.

    Crop production: National meher production is below average despite favorable production in western surplus-producing areas of the country due to poor rainfall, flooding, conflict, and the impact of low purchasing power on household access to agricultural inputs. Field assessments carried out in Tigray and Amhara in October and November indicate that while meher 2022 production is near average in Amhara, it is well below average in areas covered by the Joint Emergency Operation Program (JEOP) in Tigray Region. A below-average harvest is also expected in lowland areas of West Arsi, Arsi, Bale, West Guji, and East and West Hararghe and in the lowland woredas of Sidama and Southern Nations, Nationalities, and People's Region (SNNPR).

    In southern areas that depend on deyr/hageya rainfall, production either failed or was significantly below average across most areas due to the poor rains. In rainfed areas, little to no production occurred because rainfall was not sufficient for crop growth. According to the meher seasonal assessment, in riverine areas along the Shebelle River and farming areas in Fafan and Sitti zones, production was not as poor as in rain-fed areas but was still around half of normal.  

    Pasture and water availability: In a normal year, pasture and water are generally available in December in southern and southeastern pastoral areas due to rainfall. However, due to the ongoing drought and poor late 2022 rainfall, these resources remain atypically dry in these areas (Figure 3). Meanwhile, pasture and water are generally available in northern pastoral areas. In contrast, most parts of SNNPR, central and western Oromia, Amhara, Tigray, Gambella, and Benishangul Gumuz regions have average to above-average pasture and water availability due to the good seasonal rainfall during the recent kiremt season.

    Livestock conditions and productivity: In southern and southeastern pastoral areas, livestock production and productivity are very poor due to the historic five-season drought, which has caused large-scale and widespread livestock deaths. As of late November 2022, regional government estimates of total livestock deaths in southern and southeastern pastoral areas are over 4.5 million (Figure 4). In addition to livestock deaths, consecutive seasons of pasture and water shortages have resulted in a fifth season of low kidding/calving and low milk productivity. Household livestock holdings have consequently declined. In northern pastoral areas in Afar, livestock body conditions in most parts of the region are near normal due to the improved karma rains from July to September; however, herds and livestock productivity are below normal due to the impacts of conflict.

    Macroeconomy: Annual inflation remains high, reflecting continued poor macroeconomic conditions. According to the Central Statistical Agency (CSA), annual inflation reached 33.8 percent in December, a slight decline from November when inflation was at 35.1 percent. The decline is primarily driven by reductions in food inflation, which eased due to decreases in the price of edible oil, meat, and dairy. However, the Ethiopian Bir (ETB) continues to depreciate despite the government’s continued market interventions. In December, the National Bank of Ethiopia indicated that the ETB was trading on the official market at 53.16 ETB/USD, which is nearly 10 percent higher than at the same time in 2021.

    Market supply and functioning: The movement of food and non-food goods into and within Tigray and some neighboring areas of Amhara and Afar has moderately improved following the peace agreement. Furthermore, the re-opening of banks and increased cash flow in some towns have stimulated the local market functioning, leading to increases in market supplies. Despite these relative improvements, the movement of goods and level of market supplies remain disrupted and well below normal, especially in rural areas of Tigray, most notably in the Eastern and Central zones. Checkpoints and high transportation costs remain a significant constraint, and the Semara-Adama Road is increasingly unsafe for traders due to banditry.

     In southern and southeastern pastoral areas, market supplies of both imported and local foods remain below average, mainly in areas of Afder and Shabelle zones bordering Somalia, where Al-Shabaab disrupts the movement of goods from Somalia and Kenya. Conflict in Liban Zone also limits trade flows, resulting in lower market supply to these areas.

    Staple food prices: According to WFP and JEOP, staple food prices in many markets in Tigray declined in November 2022 compared to the last six months due to the increased flow of both commercial and humanitarian supplies. However, prices remain significantly above average. According to WFP, teff and wheat prices in Mekele were 16 to 25 percent lower in November compared to the June to October average (Figure 5). However, several areas have yet to see notable improvement in staple food prices, such as Eastern and Central Tigray and Zones 2 and 4 of Afar region, where market functioning remains poor. In most of northeastern Amhara and parts of Afar regions, staple food prices also remained elevated while following seasonal trends.

    The prices of most staple foods in southern and southeastern pastoral areas increased compared to previous months and remain well above average, mainly driven by below-average annual production from the neighboring crop-producing areas, a reduction in food grain imports, the impact of insecurity, and increased transportation costs from the country's western surplus-producing areas. In Chereti market in the Somali Region, maize prices increased by 73 percent in November compared to the same time in 2021 and are over 200 percent higher than the five-year average.

    Livestock prices: Livestock prices remain above average due to annual inflation, even though poor livestock conditions persist in southern and southeastern pastoral areas and livestock are generally unsalable. In November, prices for salable livestock ranged from 15 to 30 percent higher than the same time in 2022 across key reference markets in Somali Region. While livestock prices are high, food prices are increasing at an even higher rate. The livestock-to-maize terms of trade (ToT) in most pastoral and agropastoral markets continue to decline. In Chereti market, the goat-to-maize ToT in December are significantly below that of 2021 and two-year average (Figure 6). In Chereti market, money earned from the sale of one goat can only purchase 36 kg of maize compared to around 65 kg normally. For a household of seven, this equates to about nine days of maize.

    The relative peace in Tigray and the bordering areas of Amhara and Afar has resulted in a slight increase in livestock prices in these areas. In Mekele, goat prices in November 2022 were 14 percent higher than the five-month average. Meanwhile, in Sekota market in Amhara, goat prices in November were over 200 percent higher than in 2021. The prices in Sekota are much higher than last year because of inactivity in the market due to conflict.

    Labor income and self-employment: Due to the ongoing harvest, self-employment and agricultural labor opportunities are generally available in most crop-producing areas, mainly for harvesting and threshing. According to the meher seasonal assessment, the daily wage rate in Oromia, SNNPR, and Sidama regions ranges from 15 to 25 percent higher than last year; however, the availability of labor is lower than normal due to higher-than-normal labor supply, which counter-acts the benefit of higher wages. Meanwhile, in conflict-affected areas of Tigray and adjacent areas of Afar and Amhara, the availability of income from labor and self-employment activities has only somewhat improved, and overall household income still remains below typical levels. Labor migration within northern Ethiopia is still not a viable option for households due to insecurity.

    Humanitarian assistance: According to information from the Prioritization Committee, as of early January, each round of assistance distribution has reached 8 to 10 million people. Distributions continue to be prioritized across conflict- and drought-affected areas of the country. In the Somali Region, the fourth round of assistance was completed in December, and the start of Round 5 is underway. Around 2.3 million people received a total of roughly 39,000 metric tons of food, which equates to about 60 percent of a household’s kilocalorie needs for about 50 days. In SNNPR, Sidama, and Oromia regions, woredas where JEOP operates received the fourth round of distribution.

    In Tigray, humanitarian assistance distributions are slowly increasing as humanitarian access improves. However, distribution levels are well below the level of need. While aid distributions in December were higher than the same time last year, they have only just recovered to the levels of aid distributed in early 2021. From mid-November to late December, humanitarian organizations reached around 2.27 million people with approximately 38,700 metric tons of food.

    In Afar, WFP completed the first four rounds and started the fifth round of distribution, while the Ethiopian Disaster Risk Management Commission is still completing its first-round relief distribution and starting the second round of distribution in a few woredas. Extreme delays and incomplete dispatches are observed in most of the government’s operational areas, where only the first round of distribution was completed, and the second round has begun.

    Acute malnutrition: Acute malnutrition outcomes remain elevated in northern, southern, and southeastern Ethiopia. According to the Emergency Nutrition Coordination Unit’s RNA in early December, the proxy GAM rate ranged between Critical (GAM WHZ 15-29.9 percent) and Extremely Critical (GAM WHZ ≥30 percent) levels in Raya Kobo of North Wollo and Sekota Zuria woredas in Wag Hamra Zone of Amhara. Around 25,000 children in Tigray were screened for acute malnutrition in late December, and over 30 percent were diagnosed with Global Acute Malnutrition. In November and December, a find-and-treat campaign found very high proxy GAM rates in Somali and Oromia regions, which are among the worst-drought-affected areas in the country. In the Somali region, proxy levels of acute malnutrition ranged from near 20 percent to over 30 percent.

    Current food security outcomes: Although the meher harvest has driven some improvement in food availability and access in parts of Ethiopia, the severe drought in the south and southeast  and the aftermath of conflict in northern Ethiopia continue to result in severe acute food insecurity outcomes. In southern and southeastern pastoral areas, access to food and income from livestock remains minimal, and millions of people are relying on food aid to mitigate the size of their food consumption deficits. Amid large-scale and ongoing assistance, Emergency! (IPC Phase 4!) outcomes are assessed in the worst drought-affected areas, including Borena Zone of Oromia and Dawa, Liban, and Afder zones of Somali Region. In the absence of this assistance, it is expected that outcomes would be worse than currently mapped. In neighboring drought-affected areas, Crisis! (IPC Phase 3!) and Emergency (IPC Phase 4) outcomes are likely ongoing.

    In most conflict-affected areas of Tigray and adjacent areas of Amhara and Afar, household access to food has relatively improved due to the availability of the meager meher harvest and a slight decline in staple food prices. These improvements, alongside rising levels of humanitarian food assistance, are mitigating the severity of food consumption deficits. However, while the reach of humanitarian aid has improved within Tigray and is likely reducing the size of food consumption deficits among recipients, current levels of aid are inadequate to compensate for the considerable loss of food and income from the low harvest and prevailing low purchasing power. Emergency (IPC Phase 4) and Crisis! (IPC Phase 3!) outcomes remain widespread. 

    [1] Displacement and repatriation in Tigray were not considered in the IOM’s assessment, nor was displacement due to insecurity in Benishangul Gumuz, Afar, Amhara, and Somali regions. As a result, the total IDP population is likely higher than the reported numbers.



    The assumptions used to develop FEWS NET’s most likely scenario for the October 2022 to May 2023 Ethiopian Food Security Outlook remain valid. 


    Much of Ethiopia is expected to continue to experience very high levels of acute food insecurity through at least May 2023, rendering it among the world’s worst humanitarian crises as the historic 2020-2023 drought persists in the south and southeast, the long-term impacts of conflict hinder livelihood activities and recovery in the north, and poor macroeconomic conditions take a toll on purchasing power nationwide.   

    In southern and southeastern pastoral areas, current and planned humanitarian assistance is expected to continue to prevent more extreme levels of starvation and prevent more widespread destitution, but Emergency! (IPC Phase 4!) and Crisis! (IPC Phase 3!) outcomes will most likely persist. While the analysis of rainfall forecasts by FEWS NET’s climate scientists suggests deficits during the rainfall season in early 2023 will be less severe than the past year, which would moderate the level of excess livestock deaths, poor households are still expected to have little income from livestock-related sources due to the cumulative reduction or total loss of their herds during the drought and long timelines for livestock reproduction. Many households will primarily rely on limited income earned from self-employment activities and food assistance to access food. While humanitarian food assistance is expected to reach over 5.0 million people in the Somali and Oromia regions in early 2023, and while the worst-affected areas in Borena, Liban, Afder, Dawa, and parts of Shabelle zones will be prioritized for food aid distributions, the size and frequency of distributions will most likely be outpaced by the extreme level of need. As a result, high levels of acute malnutrition and elevated mortality are expected to persist. 

    In Tigray, the meager meher harvest and some improvements in market access are likely to mitigate large numbers of people from experiencing extreme hunger, but these are not expected to be sufficient to drive widespread and large-scale improvements in area-level outcomes, particularly since the below-average harvest will only last a few months. Similarly, it will continue to take time for humanitarians to fully re-establish supply chains and scale up assistance further within the region. Due to the significant erosion of local livelihoods, households will continue to face significant difficulty in accessing food and income. Emergency (IPC Phase 4) outcomes are expected to persist in much of Tigray through at least May. In conflict-affected areas of Amhara and Afar along the border with Tigray, households will most likely face similar difficulties accessing food and income as they gradually return to their areas of origin and rebuild their livelihoods. In Afar, Emergency (IPC Phase 4) outcomes are expected to persist in areas that saw the largest declines in herd sizes. In areas of Afar and Amhara where humanitarians are distributing assistance, Crisis! (IPC Phase 3!) and Stressed! (IPC Phase 2!) outcomes are likely.

    In many belg-producing areas of Oromia, SNNPR, Sidama, and Southwestern regions, households are expected to face difficulty accessing food due to the poor 2022 harvests and associated below-average incomes. In areas with the largest production deficits, food stocks are expected to be exhausted in early 2023. As a result, Crisis (IPC Phase 3) outcomes are expected. 


    Figure 1


    Source: FEWS NET

    Figure 2

    Figure 1

    Source: FEWS NET analysis of data from ACLED

    Figure 3

    Figure 2

    Source: UCSB Climate Hazards Center

    Figure 4

    Figure 3

    Source: FEWS NET/USGS

    Figure 5

    Figure 4

    Source: Data from the regional governments of Ethiopia

    Figure 6

    Figure 5

    Source: WFP

    Figure 7

    Figure 6

    Source: FEWS NET

    This Food Security Outlook Update provides an analysis of current acute food insecurity conditions and any changes to FEWS NET's latest projection of acute food insecurity outcomes in the specified geography over the next six months. Learn more here.

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