nlp-thedeep/humsetbias huggingface dataset:
The COVID 19 outbreak is a public health emergency, which in the context of Sudan's lack of a viable national social safety net, poses multiple protection challenges and threats to the most vulnerable.
The IDP population would be at substantial risk, particularly those with chronic medical issues, older persons, separated and unaccompanied children, persons with disabilities, persons in detention and pregnant women.
Floods, intercommunal clashes, food insecurity and subsequent displacement, have affected the resilience and coping mechanisms of families and individuals and strained the humanitarian response system.
The majority of IDPs in Sudan live in camps, gathering sites and host communities with limited access to basic healthcare services.
The COVID 19 outbreak and response has created multiple protection risks. COVID 19 does not recognize borders or social status and it has affected the most vulnerable populations, including the 2.55 million* IDPs in Sudan
61% of the assessed sites do not have functional handwashing facilities available at communal facilities whereas 39% have functional handwashing facilities available at communal facilities.
66% of the assessed site/camp residents faced challenges to access water whereas 34% did not face any challenges accessing water.
As part of the COVID 19 response, 6  ( 11% )  of the sites had soap and other hygiene material prepositioned, while 32  ( 89% )  of the sites had no supplies in the pipeline.
Consequently, 28  ( 74% )  of the locations had issues with overcrowding at water points while 10  ( 26% )  did not have issues with overcrowding.
Another key element required as part of the WASH response is availability of soap. Only 4  ( 11% )  of the sites had regular access to soap, with the majority, 34  ( 89% )  of sites not having consistent access to soap which is a major concern.
With overall availability of WASH facilities being below par, only 21  ( 55% )  of the sites had access to clean water, while 17  ( 45% )  had shortfalls in continuous availability of clean water.
55% of the assessed site/camp is accessible for ambulances whereas 45% of the assessed site/camp cannot access ambulances.
The RCCE partners had In person feedback collection ( 26% ) , Suggestion/feedback boxes ( 26% )  and Hotline  ( 26% )  as their major feedback modalities along with SMS messaging  ( 9% )  and other ( 14% )  modalities.
24  ( 63% )  of the locations covered had complaint mechanisms in place when the RCCE outreach was done, while 14 locations  ( 37% )  did not have mechanisms in place. The complaint mechanisms were also supported by feedback modalities such as hotlines and in person feedback collection.  ( In IDP Sites )
Posters, megaphone announcements, and door to door information sharing were the main three methods used to disseminate information. Additional methods included banners, radio announcements, flyers, text messaging and social media.  ( In IDP sites )
At the time of the survey, 21 partners  ( 55% )  already had information on COVID RCCE at hand, while 11  ( 29% )  did not have the information, and 6  ( 16% )  either did not have the information or did not have the capacity to relate the COVID 19 RCCE information.
By June 2020, the number of refugees biometrically registered is 112,895, refugees accessed over 81,000 health consultations, and over 38,000 received food assistance. Despite the COVID 19 restrictions, almost 4,000 refugees were biometrically registered. In terms of water availability, refugees in the East have an average of 32 liters/person/day, which is above the Sphere minimum standard of 20/l/p in post emergency situations. While work is ongoing to provide one latrine per household, refugees in the East share on average one facility between 12 individuals. This average is better than for other refugee populations but needs to continue to be improved.
The number of refugees and host community reached with COVID 19 related messaging is 284,378.
3,505 Chadian refugees living in Sudan as of June 2020, including 13 new arrivals until June 2020. An average number of liters of potable water available per person per day is 20 L.
1,074,061  ( 50% Male and 50% Female )  Refugees living in Sudan as of June 2020, including 21,806 new arrivals until June 2020. The highest no. of refugees according to country of origin is South Sudan is 820,687.
Total Fund required is $ 505,879,963. Total fund received is $ 176 million  ( 35% )  and still unfunded amount is $330 million  ( 65% ) .
Number of health consultations in health facilities accessed by refugees 31,861  ( 14 % ) , where as, the target was 452,476. Number of refugees and host community reached with COVID 19 related messaging 284,378. of refugees receiving food assistance were 354,860  ( 58% ) , where as the target was 610,000. Average number of liters of potable water available per person per day was 17 Liters and the target was 20 Liters per day. Numbers of persons per toilet / latrine was 23 persons and the target was <20 persons per latrine
Number of refugees receiving specialized protection assistance was 31,861 ( 14% ) , where as the target was 225,000. Number of refugee children with specific needs receiving assistance was 11,532  ( 13% ) , where as the target was 89,359. Number of refugees biometrically registered by the mid 2020 was 30,439  ( 5% ) , where as the target was 598,576.
The remaining 5.5 million people in need of WASH support are non displaced conflict affected communities; people affected by WASH related epidemics; and people identified as vulnerable elsewhere in the country based on the IPC analysis.
The most affected population groups are IDPs, returnees, non displaced host communities and refugees. 1.7 million IDPs and 291,000 returnees are in dire need of WASH support – 26 per cent of the total people in need.
About 7.6 million people need water, sanitation and hygiene services. These people include IDPs, returnees, non displaced and vulnerable host communities with limited access to WASH services.
The highest number of victims was registered in South Kordofan state, followed by Kassala and Blue Nile. During the first half of 2019, children accounted for approximately 87 per cent of the known victims of ERW's and UXO's.
According to the HNO severity analysis, 43 localities were reported to be impacted by landmines/ERWs, out of which 37 are ranked as being highly, very highly, or severely impacted. Landmines/ ERWs affect the lives and livelihoods of more than 3.1 million people, particularly IDPs, returnees, pastoralists, nomads and.
According to a study by UNWOMEN, 80 per cent of women interviewed in Darfur recognized domestic violence as a problem, 70 per cent identified economic violence as an issue, and 5 per cent cited rape as a concern.
In areas with lack of economic resources and livelihoods opportunities, women's financial status forces them to work in harmful and insecure environments by venturing into the forest to collect firewood or straw for sale, which exposes them to potential attacks and violence.
An average of 500 to 1,000 new asylum seekers arrive each month through Sudan's eastern border, but over 50 per cent migrate onward, becoming vulnerable to criminal networks involved in smuggling and trafficking of people.
Across all Darfur states, only 14 to 21 per cent of health facilities provide CMR services. This gap in services is further exacerbated by the shortage in trained personnel and weak referral pathways. Community structures are weak with only a few localities with functioning community based protection networks and women's centres offering GBV services.  [ Specific location assessed   Darfur States ]
Although October is the actual beginning of the earlier harvest in Sudan, and the period when the food security situation is considered to stabilize or begin to improve compared to the lean season, food insecurity remains widespread across different parts of Sudan. This is mainly due to the prevailing poor macroeconomic conditions in the country. There has been an extreme increase in prices of all food and non food commodities. Prices have more than doubled compared to the previous year and have increased by more than 500% compared to the five year average.
Nearly 1.3 million people will likely remain in Emergency  ( IPC Phase 4 ) , nearly 6 million people in Crisis  ( IPC Phase 3 )  and over 17 million people are estimated to be in Stressed  ( IPC Phase 2 ) . This marks an increase of 2 percentage points  ( from 6.4 million to 7.1 million )  of people in Crisis  ( IPC Phase 3 )  and Emergency  ( IPC Phase 4 ) , compared to the projection made in June 2020 for the October   December 2020 period.
During the projection update of October   December 2020, an estimated 7.1 million people, representing 16% of the total analysed population, are expected to face high levels of acute food insecurity  ( IPC Phase 3 or above )  through December 2020 and are in need of urgent action to save lives, protect livelihoods and reduce food consumption gaps.
GBV, especially sexual violence, continues to affect women and girls especially among the IDP communities. Particularly vulnerable are over 200,000 women headed refugee households, and nearly 7,800 child headed refugee households.
According to safety audits conducted among children in 103 villages in 57 localities, an average of 74 per cent of children  ( 40 per cent female )  reported having challenges in accessing quality child protection response services, including but not limited to clinical care, psychosocial support, social workers, legal services, community based child protection structures, and referral systems.
Pre existing systemic weaknesses in delivering quality protection services such as psycho social support, legal assistance and health assistance have been exacerbated by high staff turnover among social workers; ailing case management systems; poorly maintained social service facilities; and lack of capacity of key child protection workers. This has further increased the number of children in need of care and support services.
Additionally, based on information available from FCPU police, 2019 witnessed an increase compared with 2018 in the number of crimes involving children, and an estimated 66 per cent increase in the number of children in contact with the law.
During the first half of 2019, available information suggests that some 9,338 children  ( 45 per cent girls )  were unaccompanied and separated children  ( UASC ) , with the highest numbers in Jebel Marra, Abyei, Khartoum, Red Sea, and North Darfur. This represents a 73 per cent increase compared to the same period in 2018, when only 3,500 UASC were recorded.  [ Specific location assessed   Jebel Marra and Abyei ]
Along these migratory routes, refugees and asylum seekers can be exposed to various forms of exploitation that can result in human rights violations. The large number of unaccompanied and separated children arriving through these routes is of concern.
The limited access to livelihoods for IDPs has resulted in high risk of exploitation, while the collapse of traditional community support structures has increased the vulnerability of IDPs, in particular persons with specific needs. Disputes over land between nomads and farmers remain a concern. Community protection risks also remain high, with reports of increasing intercommunal tension in some areas in light of political polarization
Heavily armed militias are increasingly harassing farmers, including IDPs and returnees, preventing them from accessing their land during the planting season. This includes reports of extortion, violence, sexual abuse and abduction.
According to available information on GBV cases in Sudan, women and girls account for over 90 per cent of survivors, and although grossly underreported, cases of sexual violence against men and boys have also been reported. FGM remains prevalent in Sudan, affecting 87 per cent of women aged 15 49 years old, and 32 per cent of girls 14 or younger.
About 55 per cent of displaced people are women and girls, with 27 per cent of those women below the age of 18. They are particularly exposed to protection risks, such as threats, harassment, and sexual violence from armed men, as they engage in daily chores such as farming and fetching water and firewood.
There are 1.8 million people at risk of Gender based violence  ( GBV ) . Women and girls continue to suffer disproportionately from GBV, poverty and violations of basic rights due to insecurity; low economic status and lack of livelihood opportunities; and lack of community awareness on women's rights due to cultural and societal norms.
About three million school aged boys and girls, the majority of whom are displaced, are out of school mainly due to a lack of financial means; the prolonged closure of schools and disruption of school calendars; congestion in schools; and poor hygiene and sanitation conditions   including lack of menstrual hygiene management supplies and facilities for girls. Children out of school are at increased protection risk. An estimated 67 per cent of refugees across Sudan do not have access to primary education, while up to 94 per cent are not able to receive secondary education.
IDPs and refugees on the move are particularly vulnerable, as they are often uninformed about local landmine or ERW contamination, putting them at higher risk of injury or death. Additionally, there are more than 3 million people living in or moving through areas affected by landmines or ERW, who are in need of humanitarian assistance which could be hindered or limited because of the presence of landmines or ERW.
While South Kordofan has the highest recorded concentration of landmines and ERW, Darfur states are affected by ERWs only. The presence of these devices poses a direct threat to the lives of both residents and humanitarian workers. In Sudan, there are more than 3.6 million at risk of injury or death from mines.  [  Specific location assessed   Darfur States ]
Over 56 per cent of newly arrived South Sudanese refugees are children. Unaccompanied or separated refugee children continue to arrive in Sudan and are in urgent need of individual case management and access to targeted services, including financial assistance.
While fighting has subsided in large parts of Darfur, sporadic clashes between Government forces and the Sudan Liberation Army Abdul Wahid  ( SLA/AW )  continued in the Jebel Marra area, resulting in the displacement of civilians; killing and maiming of children; children being subjected to sexual violence; and children being abducted. Localized armed clashes by different tribes in Blue Nile, South Kordofan, Sennar, Port Sudan and parts of Darfur continued to pose major risks for children, making them vulnerable to abuse, violence, exploitation and neglect.  [ specific location assessed   Darfur, Jebel Marra and Sennar  ]
Refugees face additional challenges and are in need of targeted and specific protection assistance. Lack of documentation is a key driver of refugee vulnerability, especially for refugees living in out of camp settlements, as they are unable to access social services where they are available, have limited access to formal and stable livelihoods opportunities, and face movement restrictions.
Nutrition support is lacking, particularly for some 530,000 pregnant and lactating women. Approximately 70 per cent of these women do not have access to nutrition treatment services due to lack of resources. The geographic coverage of grown monitoring programmes  ( GMP )  is lowest in West Kordofan  ( 1.1 per cent )   ( S3M II, 2018 ) .
This situation is particularly harmful to children 6 23 months old, who are at the stage of rapid growth and have high nutritional requirements. The national prevalence of stunting in Sudan is high at 37 per cent  ( Five states have stunting rates above 30 per cent including, River Nile, Al Gezera, Sennar, Red Sea and Kassala.  [ Specific location assessed   Al Gezera, Sennar ]
There are approximately 287,600 refugees in urgent need of nutrition interventions. Among these are 140,374 children below five years old; 91,702 pregnant and lactating women; 32,605 infants and young children; and 22,919 others. For refugees living in camps in East Sudan, the recent SENS survey indicates a GAM rate of 13 per cent in the Shagarab camps, and over 11 per cent for all other camps. Stunting prevalence is critical in Shagarab camps at 53 per cent, as well as for Abuda, Um Gargour and Fau 5 at 45 per cent. The SENS survey also indicate high rates of anaemia  ( >40 per cent )  among children under five years and women aged 15 49 years.
Young mothers constitute a particularly vulnerable group. Early marriages, pregnancy in physically immature adolescent girls, and mothers giving birth to low birthweight infants are common. The prevalence of low birth weight infants is 32 per cent  ( MICS, 2014 ) .
In the case of pregnant and lactating women, the average iron deficiency anemia level is 16 per cent, while the highest level  ( 24 per cent )  is found in East Darfur  ( S3M II, 2018 ) . Some 40,000 children may die due directly or indirectly to malnutrition, accounting for 45 per cent of all child deaths  ( Background Note on Sudan, GNC Annual side event, 2018 ) .
Approximately 522,000 children under 5 require treatment for SAM, and approximately 2.2 million children require treatment for moderate acute malnutrition  ( MAM ) .
While food insecurity remains a key driver of poor nutrition status for the general population, the wider effects of chronic underfunding of the refugee response, especially in WASH, health and livelihoods, also play a part. These contribute to aggravating factors such as high anaemia, high prevalence of diarrheal disease, low coverage of measles vaccines  ( especially for refugees in out of  camp locations ) , and low latrine coverage.
Over the past three decades, the rate of malnutrition in children under 5 and among pregnant and lactating women in Sudan has changed little, with an estimated 52 per cent of those suffering from malnutrition living in the 9 non conflict affected eastern states  ( Sennar, Al Gazeera, Khartoum, River Nile, Northern, North Kordofan, Red Sea, Kassala and Gedaref ) , where the response has been inconsistent. According to a study on the cost of hunger in Africa, Sudan loses about $2 billion per year in GDP due to malnutrition.  [  Specific location Assessed   Sennar and Al Gazeera  ]
On 8 September 2019, the Federal Ministry of Health announced an outbreak of cholera in Blue Nile state, following recent floods and a deteriorating health and WASH situation in the state. White Nile, Sennar, Jazeira, Kassala, Khartoum and River Nile states were identified as high risk states.  [  Specific location Assessed   Jazeira ]
Of these, around 3.5 million children under 5 years of age are in need of integrated management of childhood illness  ( IMCI )  programs for early diagnosis and treatment of life threatening health conditions. Additionally, the vulnerability of these children is increased by low immunization coverage, which makes them more at risk of future outbreaks of vaccine preventable diseases.
Many pregnant women live in areas where provision of maternal, new born, child and adolescent health services is limited. In addition, the overall lack of adequate emergency obstetric care services, safe blood banking services, and referral services contribute to high maternal mortality. Out of the total population in need of humanitarian assistance, there are currently 2 million pregnant women and women of reproductive age in need of sexual and reproductive health services.
Approximately 30 per cent of refugees in Sudan still lack access to primary health care services. A significant proportion of refugees and their host communities live in remote and often hard to reach areas, often with limited quality of health infrastructure.
Over 175,000 people in need are facing a catastrophic health situation  ( severity level 5 ) ; 2.5 million people are in extreme need of health assistance  ( severity level 4 ) ; and 5 million people are in areas of severe need of health lifesaving activities  ( severity level 3 ) .
The existing facility based disease surveillance system in place covers less than 40 per cent of health facilities across the country, which limits the capacity for the health sector to ensure timely monitoring of needs.
In 2019, inter communal conflict was one of the principal drivers of protection needs. Areas in Darfur saw an increase in tensions caused by land occupation and conflict between farmers and herders during the harvest season, which further exacerbated the protection environment.  [ specific location assessed   Darfur ]
Nutrition sites are unevenly distributed geographically with some localities lacking services. 30 per cent of the population lives more than 5 kilometres from a health or nutrition facility. Many women in particular face challenges traveling long distances to nutrition facilities due to a lack of affordable transport.
An estimated 2.7 million children under 5 suffer from acute malnutrition, including an estimated 522,000 who are severely malnourished are nine times more likely to die.
Children under 5 and pregnant and lactating women  ( PLW )  have high nutritional needs and are the most vulnerable groups receiving support through the nutrition sector. About 123 out of the 186 localities in Sudan have GAM rates above 10 per cent.
Imports of medicines and medical supplies dropped by about 35 per cent compared to the same period in 2018, which contributed to cost increases of 50 100 per cent, reducing the overall availability of essential medicines in the public sector from 60 per cent in 2018 to 43 per cent in 2019, and restricting access to essential life saving health care services.
An additional 11.8 million people are estimated to be in stress phase  ( IPC Phase 2 ) . In West Darfur State, based on the January March 2019 IPC projection, around 1.2 million people are suffering from some levels of food insecurity  ( 77 per cent of the population ) , of which 334,000  ( 21 percent )  are facing emergency and crisis levels of acute food insecurity  ( 21 per cent ) .
Out of these, around 1 million people are facing emergency levels of food insecurity  ( IPC Phase 4 ) , and 4.8 million are in crisis  ( IPC Phase 3 ) , characterized by highly inadequate levels of food consumption, extreme levels of asset depletion, critical nutritional status, highly inadequate access and availability of food and adoption of irreversible coping strategies.
Based on several recent food security assessments, the main needs of the most vulnerable communities   including IDPs, returnees, refugees and host communities   include physical and financial access to adequate and sufficient nutritious foods through markets or their own food production; and the ability to produce sufficient good quality agricultural products while ensuring their availability and affordability on the market.
As in recent years, in 2019 there has been a reduction in new displacement, mainly due to lower levels of conflict and the government's disarmament of militias in Darfur. However, there are still pockets of conflict and localized displacement in South Darfur, Central Darfur, Blue Nile and South Kordofan. A number of areas in North, South and East Darfur also continue to receive returnees – over 26,000 in the past year.
Despite a decrease in new displacement in 2019, with only 10,203 newly displaced people, localized conflict remains in areas of Darfur  ( mainly in Jebel Marra ) , causing displacement to safer areas. Several refugees need shelter and NFI assistance.  [ Specific Location assessed   Darfur ]
In areas where localized conflict remains, such as in Jebel Marra  ( Central Darfur ) , education needs are particularly acute. In Golo and Rokero localities, access to education remains low, with approximately 42 per cent of school age children out of school.
Approximately 55 per cent of children at pre school age  ( 4 5 years )  are not in school because of lack of educational spaces, teachers, and learning and play materials. The major gaps are in the Darfur states, Blue Nile, Kassala, Gedaref and West Kordofan. Enrolment rates stand at 19 per cent in East Darfur, 24 per cent in West Darfur, and 29 per cent in Gedaref.  [  Specific Location assessed   Darfur States  ]
From 2009 to 2016, the gross enrolment rate  ( GER )  in basic education remained stable at 72 per cent, while the primary net enrolment rate remained at 60 per cent, with more boys completing school than girls. However, since 2018, these rates have declined steadily. Enrolment rates vary significantly between states, – Kassala, Red Sea, East Darfur and South Darfur remain far below the national average. There are also lower rates among rural areas than urban areas, at 45 per cent and 40 per cent respectively. The situation is exacerbated by the economic crisis, natural hazards and insecurity.
This was followed by 71 percent of households in West Kordofan. The highest proportion of households adopting emergency coping mechanisms were found in Red Sea at 36 percent.
The sorghum prices sharply increased in all states by 28 to 90 percent compared to the same period of the previous year. The sorghum prices were higher by 182 to 280 percent in all states compared to the 5 year average of May.
In 2020, almost 900,000 people were affected in the worst flooding the country had experienced in 100 years, which destroyed homes and farmland, damaged infrastructure, and impeded humanitarian access.
Inflation has also sparked nationwide protests that have led to seven states declaring a state of emergency, imposing curfews, shutting down schools, and limiting access to markets.
While data is lacking on the prevalence of disability in Sudan, it is estimated that 15 per cent of the total population live with some type of disability. This is exacerbated by the deteriorating economy, lack of supportive social networks, and shortages in specialized health staff. According to the Federal Ministry of Health, 32 per cent of disabled persons have a visual disability; 24 per cent have a mental disability; 13 per cent have an auditory impediment; and 4 per cent a speech impediment.
Children under 5 years of age are particularly exposed to vaccine preventable and infectious diseases compounded by poor nutritional status. Malnutrition is the leading cause of deaths of children under five in hospitals, contributing to 17 per cent of such deaths. Septicemia  ( 11 per cent ) , malaria  ( 9 per cent ) , and diarrheal diseases  ( 5 per cent )  are also significant causes.
As a consequence, between 2018 and 2019, the percentage of women who received the minimum four anti natal care visits during their latest pregnancy across Sudan was 51 per cent, with the fewest visits reported in West Kordofan  ( 41 per cent )  Gedaref  ( 37 per cent )  and 40 per cent on average across Darfur states. Women of reproductive age constitute one of the key vulnerable groups, representing 24 per cent of the total population.  [ specific location assessed   Darfur States ]
In eastern Sudan, the availability of these packages is as low as 15 per cent in Gedaref and Sennar states, 12 per cent Gezira State, and 10 per cent in North Kordofan.  [ Specific location assessed   Gezina  ]
As a result, medicine availability was only 43 per cent in the national medical supply fund, 49 per cent in the national health insurance fund, and 59 per cent in the private sector34. The lowest availability of medicines was in Red Sea  ( 10 per cent ) , followed by West Darfur  ( 12 per cent ) , Northern  ( 30 per cent ) , and South Kordofan  ( 31 per cent ) .
DTM teams activated EET  ( Emergency Event Tracking )  to monitor the displacement of individuals affected by a fire outbreak in the Hai Al Jabal area of Al Fasher town, North Darfur, on 13 February 2021.
Poor infrastructure, meagre resourcing and humble capacities have stretched the fragile health system. Rural people are particularly affected due to heightened economic vulnerability and food and nutrition insecurity.
The arrival of COVID 19 has exposed these vulnerabilities, with nearly 14,000 reported cases,13 over 800 heaths, and a disproportionately high case fatality rate outside of Khartoum.
In addition, a new influx of refugees from CAR has increased the need for humanitarian partners to react quickly to provide basic assistance, including life saving emergency shelter and household items such as plastic sheeting, plastic mats, jerry cans, blankets and cooking sets.  [ CAR   Central African Regions ]
9.3 million people are in need, among them 55% are women, 58% children and 15% with disability.
Refugee children in East Sudan, Darfur and in Khartoum also lack access to inclusive and equitable education. Lack of access to livelihoods and household income is a key barrier to refugee children attending school, especially in out of camp contexts.  [  Specific Location assessed   Darfur ]
There are approximately 400,000 school aged refugee children living in Sudan, 77 percent of them of primarily school age. About 67 per cent of primary school aged refugee children remain out of school.
23 percent of households were forced to cut back on medical expenses, and 16 percent had to sell their last remaining female animals, causing an irreversible loss of livelihoods
These food based coping strategies include eating less preferred foods, borrowing money to buy food, limiting portion sizes, reducing the number of meals, and reducing adult consumption in favour of smaller children.
Access to water and sanitation also varies according to patterns and standards of living, with a huge gap in favour of urban areas and the wealthy segments of the population. Widespread open defecation, limited access to safe water supply and unhygienic conditions are also compounding health and nutrition vulnerabilities across all states.
Refugee families cannot afford to keep their children in school due to lack of access to livelihoods, and dependence on assistance. The lack of access to quality education in asylum reduces refugee children's lifetime income earning capacity and will undermine their resilience throughout adulthood, perpetuating cycles of poverty and vulnerability to discrimination and persecution.
The lack of quality education – whether due to conflict, underinvestment, or shocks – compounds needs. The Gross Enrolment Rate had stabilized around 72 per cent, but has been declining since 2018. Enrolment for pre school is even lower, with 55 per cent of children at pre school age out of school because of lack of educational spaces, teachers, and learning and play materials. This has consequences for the children's intellectual, social, emotional, language and even physical development. Only 40 per cent of children at the age of secondary education are enrolled in school.
Increasing food prices, and poor WASH systems and health services, continue to drive malnutrition across the country. Approximately 522,000 children under 5 are severely malnourished and some 2.2 million children are moderately malnourished  ( MAM ) .
Within Khartoum state, 75 per cent of households surveyed in a rapid assessment of the impact of the economic situation  ( October 2018 )  were unable to satisfy their basic needs without selling assets, borrowing money, or reducing their spending on health and food. In the same assessment, 27 per cent of respondents indicated they had been forced to reduce education expenses by transferring their children to a lower quality school or withdrawing them from school entirely. 24 per cent of respondents said they could not afford health services. Asked to rate their living conditions after January 2018 compared to before January 2018, 82 per cent of those surveyed said living standards were “much worse' or “worse'
Sudan is a transit and destination country for refugees, asylum seekers and migrants along the eastern Africa migratory route into North Africa and Europe. Based on information from IOM, the main reasons for migrating to other countries are economic, with 76 per cent of people interviewed highlighting economic reasons for leaving Sudan, followed by 16 per cent of respondents who mentioned targeted violence or persecution.
There are nearly two million internally displaced people in Sudan, for whom durable solutions have not been achieved, and over 300,000 are living as refugees in neighbouring countries. Greater stability and the overall low level of conflict have contributed to some increase in returns, but many of these are seasonal as people return to farm. During the last four years, an estimated 395,000 people have returned to Sudan from other countries.
Sudan also has a young population with 41 per cent of the population under the age of 15, a further 20 per cent between 15 to 24 years old, and less than 8 per cent older than 55. About 47 per cent of the population live on less than $1.25 per day. Darfur and Kordofan are the poorest areas, with poverty rates as high as 67 per cent in Central Darfur and South Kordofan. Red Sea  ( 51 per cent )  and White Nile  ( 41 per cent )  are not far behind.  [ specific Location Assessed Kordofan ]
[ Sudan, February 2020 ]  During the past five years, Sudan has seen an overall increase in the number of people in need of humanitarian assistance from 5.4 million people in 2015 to 9.3 million in 2020. In 2019, 4.3 million people were reached with some kind of assistance, against a target of 4.4 million people. The number of people reached was 51 per cent of the 8.5 million of people estimated to be in need. The level of funding received since 2016 has remained stable, between 45 and 58 per cent of the overall HRP requirements. Between 2016 and 2018, the number of people reached in relation to the overall number of people in need remained steady with an annual average of 4.1 million people reached.
The highest sorghum price was recorded in East Darfur  ( SDG21.8/Kg )  while the lowest was observed in Central Darfur  ( SDG13.2/Kg ) .
The national average price of groundnut was higher by 124 percent compared to the fiveyear average of May.
The national average price of groundnut was higher by 24.0 percent compared to the same month of the previous year. This is due to the inflationary increase in the cost of production and demand for export markets.
In 2019, children's ability to access education was affected by instability in the country at large, including delays on the school calendar, and closures of schools due to the insecurity caused by protests and military presence. On 29 July, after a series of demonstrations, four children were killed in El Obeid, North Kordofan
Refugees have also been targeted in 2019. Following attacks on South Sudanese in certain neighbourhoods in Khartoum on 5 6 June, over 7,000 South Sudanese refugees fled Open Areas in Khartoum to camps in White Nile State. A July 2019 survey of returnees to Bentiu, South Sudan showed that 75 per cent cited “insecurity' as a reason for their spontaneous return
For the 1.87 million internally displaced people  ( IDPs )  in Sudan mostly in Darfur, South Kordofan and Blue Nile, durable solutions have not been achieved and the root causes of their displacement remain unaddressed. While at a smaller scale compared to previous years, new displacement continues, with over 10,000 people newly displaced in 2019.  [ specific location assessed Darfur ]
During the first half of 2019, 9,338 unaccompanied and separated children  ( 45 of whom were female )   ( UASC )  were recorded by child protection workers.
From June 2018 to April 2019, UNAMID reported 268 human rights violations affecting 573 people – from Jun 2017 to April 2018, 385 human rights violations, affecting 975 people were recorded.
[ 2019, Sudan ]  More than 2,136 victims of landmines/ERWs are registered in Sudan.
Women headed households also have a higher rate of food insecurity, of around 41 percent, and have less ability to afford a minimum of 1 local food basket  ( LFB )  at the local market price values.
The Integrated Food Security Phase Classification  ( IPC ) , as of August 2019, estimated that 5.8 million people  ( 14 per cent of the total population )  were experiencing crisis or emergency levels of food insecurity  ( IPC Phase 3 and above ) . Of these, one million people were facing emergency levels of acute food insecurity  ( IPC Phase 4 )  and 4.8 million people were in Crisis  ( IPC Phase 3 )
In July, the national average price of a local food basket reached SDG 31.5 per person, which is 14 per cent higher than the previous month and 40 per cent higher than in December 2018. East Darfur, followed by South Darfur and White Nile recorded the highest prices.
Despite a good mid year harvest in 2019, the economic crisis has kept food costs high. Inflation, combined with uneven and unpredictable rain, drives food insecurity. In some Darfur areas, prices in July were 15 to 25 per cent higher than the same time one year ago.  [ specific location assessed Darfur ]
Regional disparities regarding access to safe drinking water and sanitation are significant. For instance, access to safe drinking water ranges from over 94 percent in Northern state to an average of 31 percent in the states of Red Sea, White Nile and Gedarif.
According to the 2014 MICS survey, the proportion of the population with sustainable access to an improved water source was 68 percent, and the proportion with improved sanitation was 33 percent. In spite of modest progress, Sudan has retained one of the lowest sanitation rates in sub Saharan Africa.
Lack of quality education also affects refugees, with children being particularly vulnerable. About 67 per cent of primary school aged refugee children and around 94 per cent of secondary school aged refugee children are out of school.
Sudan remains prone to disease outbreaks including cholera, chikungunya, dengue, malaria, measles and Rift Valley fever. Since the government declared a cholera outbreak on 8 September 2019, 338 cases were recorded  ( as of 12 November 2019 ) .
The poor health coverage, combined with poor WASH infrastructure, contributes to disease outbreaks. According to survey of more than 7,700 water sources by WHO and Health Ministry, only 25 per cent met the standard chlorination rate – a measure of water potability. An estimated 50 percent water sources are contaminated
The facility based disease surveillance system covers less than 40 per cent of health facilities across the country, limiting health monitoring capacity. Only 32 per cent of health facilities fully provide emergency obstetric care services, leaving pregnant women at risk of obstetric complications, maternal deaths and disabilities.
In health facilities, there have been significant shortages of medicines for the second year in a row. Imports of medicine already declined by a third from 2017 to 2018, and fell further during the first six months of 2019, to $123 million from $139 million a year earlier.
130,000 young people enter the labor market each year, but there are only 30,000 jobs available
Livelihood initiatives in agriculture and in the energy and environment sector continue to be a priority. Protection interventions, including individualized assistance for sexual and gender based violence  ( SGBV )  survivors, victims of trafficking, unaccompanied and separated children  ( UASC )  and people living with mental illness also need to continue and be strengthened in the remaining part of the year.
The small outbreaks in refugee camps in Darfur and in an urban area in Khartoum were quickly identified and controlled by the Ministry of Health in partnership with Country Refugee Response Plan  ( CRP )  partners, including WHO. Thanks to fruitful coordination, refugees affected by the virus or in contact with a positive case were placed in isolation and had access to health services.  [ specific location assessed   Darfur ]
Despite the efforts, Chadian refugees continue to have difficulties in accessing education, health and medicines, while inadequate number of latrines and access to potable water remains a challenge.
During the reporting period, partners provided and delivered basic services to Chadian refugees such as registration, camp management, provision of monthly food rations, WASH activities, non food items and shelter materials, as well as child protection, education, health, nutrition and livelihood activities.
Partners stepped up the response and joint forces to assist in covering the basic needs of refugees. Despite COVID 19 restrictions, over 3,500 refugees were registered with  ( Contracting Officer's Representative ) COR and over 2,700 received food assistance. A large number of refugees, over 2,700, also received specialized protection assistance and over 3,000 were reached with COVID 19 related messaging.
Inter agency partners see an urgent need for more durable solutions that support greater self reliance and enhanced protection of refugees while supporting host communities as well.
By June 2020, refugees accessed over 81,000 health consultations and over 38,000 received food assistance. Despite the COVID 19 restrictions, almost 4,000 refugees were biometrically registered.
Lack of livelihood opportunities and income generating activities remain a serious gap in the refugee response. Lastly, there is also the need to strengthen peaceful co existence committees formed by the refugee community, host communities and nomads, to reduce potential tensions and pave the way for dialogue towards sustainable peace.
In addition, there is the need for the provision of sanitary kits to women and girls of reproductive age and the need to rehabilitate schools to ensure the safety of children and teachers. An increase on the teachers' incentives is also needed to ensure continuity on the provision of education to refugee children.
Almost 41 per cent of female headed households adopt crisis or emergency coping mechanisms, comparted to 37 per cent of male headed households. In some states, this gender divide is quite striking.
Information available from the MICS 2014 survey suggests that 34 per cent of women aged 15 49 years are victims of domestic violence. Female genital mutilation  ( FGM )  is highly prevalent among the same age group, with approximately 87 per cent of women having had some form of female genital mutilation
16% of respondents said that they thought paying to receive humanitarian assistance was ok. 11% of respondents said that they thought paying for humanitarian assistance might be OK, depending on the situation.
[ 2019, Sudan ]  In spite of the progress achieved on the access to health services in recent years, the humanitarian situation in Sudan continues to be complex, driven by continuous man made and natural disasters including conflict, floods, and drought.
[ 2019, Sudan ] However, as this Humanitarian Response Plan  ( HRP )  goes to press, Sudan is in the midst of a profound political transformation following the overthrow of the regime of President Omar el Bashir.
The health facilities in IDP sites are basic with limited supplies and poor infrastructure. Lack of medical staff and high turnover are common challenges. Most of these facilities do not have the capacity for COVID 19 management, and referral mechanisms are weak due to resource constraints.
A third of the households have access to proper sanitation. About 68 per cent of households have access to improved drinking water sources, only a third have access to proper sanitation. All together a third of the households have access to both water and sanitation, with wide disparities between states as well as urban and rural populations.
According to the Joint Monitoring Programme for Water Supply, Sanitation and Hygiene, about 23 per cent of people in Sudan have regular access to basic hygiene services  ( soap and water )
More than one third of the households had to adopt food based coping strategies e.g eating less preferred foods, limiting portion sizes, reducing the number of meals per day to maintain minimum food consumption levels
More than 9.6 million Sudanese, almost a quarter of the entire population, are now severely food insecure. The figures, the highest ever recorded in the history of the IPC analysis in Sudan, represents an increase of 65 per cent if compared with the same period  ( June to September )  last year. This includes about 2.2 million people facing emergency acute food insecurity  ( IPC Phase 4 ) .
Additionally, more than half of resident households had to resort to livelihood based coping strategies including sale of productive assets or animals thus depleting their assets
Approximately 81 per cent of the population does not have access to a functional health centre within two hours of their home.
At the time of the survey, 21 partners  ( 55% )  already had information on COVID RCCE  ( Risk Communication and Community Engagement )  at hand, while 11  ( 29% )  did not have the information, and 6  ( 16% )  either did not have the information or did not have the capacity to relate the COVID 19 RCCE information.
Their  ( women and girls )  reproductive healthcare needs will likely suffer from curfews, lockdowns, funding diversion and scarcity of care services. Underlying gender biases of government policies that consider men as the main breadwinner could compound the risks of women falling into poverty as their significant presence in the informal work sectors and as heads of households is often overlooked.
Curfews and lockdowns will limit their  ( women and girls )  work and economic opportunities. The domestic and caregiving burdens that women and girls perform within the home exposes them to greater health risks
For refugees, it is particularly concerning as the health facilities in camps and other refugee hosting locations are basic with inadequate supplies and poor infrastructure that do not meet infection control standards.
With a huge debt burden and an IMF projection of GDP contraction by 7.2 per cent in 2020, the prevention and response measures, for example curfew, restricted transportation, physical distancing, and working from home to address the COVID 19, will significantly worsen an already struggling economy.
At higher risk are 12 million people that lack access to improved water sources, 28 million people who lack access to improved sanitation, and 7.5 million people that lack access to hygiene services as well as the over 500,000 children suffering from severe acute malnutrition  ( SAM ) .
The potential loss of household income earners can have a longer term and widespread economic impact on women.
Women and girls are more likely to experience a worsening of existing inequalities and disproportionate secondary impacts of restrictions to slow the pandemic as compared to men and boys.
The risk of transmission is especially high among the nearly 2 million IDPs and 1.1 million refugees living in collective sites or host communities across the country, as well as among people living in urban slums. The risk of disease outbreaks remains high in 2021.
An estimated 7.1 million people faced Crisis or worse  ( IPC Phase 3 and higher )  levels of food insecurity between October–December 2020, a 22% increase from the same period in 2019. IDPs, returnees, households living in conflict areas, and refugees are among the people most affected by food insecurity.
A peace agreement, signed in September 2020 between the government and some armed groups, aimed to resolve conflict in the country, namely in Darfur region and in South Kordofan and Blue Nile states. Despite the agreement, humanitarian activities are still disrupted because of the recent escalation of violence across the country, particularly in Darfur.
Over 61,000 refugees have arrived in eastern Sudan since the beginning of conflict in Tigray region  ( Ethiopia ) . Most refugees are living in reception areas, camps, or with host communities across Kassala and Gedaref state.
A recent wave of violence in Darfur came shortly after the mandate of the UN–African Union Mission in Darfur  ( UNAMID )  ended on 31 December 2020.
The complex crisis has led to the internal displacement of 2.5 million Sudanese since 2010, mainly in Darfur, South Kordofan, and Blue Nile states.
In September 2020, Sudan also faced an outbreak of viral hemorrhagic fevers, as well as the reemergence of polio in at least seven states.
Sudan's health system was already under extreme stress prior to the pandemic and has been further stretched to prevent, contain, and treat COVID 19. Clinics and hospitals lack critical medicines as they can no longer afford to stock them because of the economic crisis and disruptions in the supply chain.