nlp-thedeep/humsetbias huggingface dataset:
During the registration exercise, the enumerators collected vulnerability data to identify individuals who may require additional humanitarian assistance. Out of the total population registered, 14 per cent are people experiencing at least one of the vulnerabilities  ( shown below ) . Vulnerability figures are obtained through interviews with heads of households, in the presence of other family members. 87 per cent of the IDPs in Fufore were originally from LGAs in Borno state, of the 87 per cent: 44% were displaced from wards in Bama LGA, 32% from wards in Gwoza LGA, 8% from wards in Ngala LGA, 2% from wards in Damboa, 1% from other LGAs; 13 per cent of the IDPs were displaced from Adamawa state, this 13 per cent comprises of IDPs from wards in Fufore LGA  ( 12% ) , and wards in Madagali LGA  ( 1% ) .
5 MEASLES 5.1 In the reporting week, 1104 suspected cases of measles with nine laboratory confirmed and two deaths  ( CFR, 0.18% )  were reported from 34 states compared with 434 suspected cases and four deaths  ( CFR,0.92% )  reported from 35 states during the same period in 2018 5.2 Since the beginning of the year, 3723 suspected measles cases with 305 laboratory confirmed and six deaths  ( CFR, 0.16% )  were reported from 36 states and FCT compared with 1943 suspected cases and 20 deaths  ( CFR, 1.03 % )  from 36 States and FCT, during the same period in 2018
More than 40,000 men, women and children – mostly internally displaced people – have little or no access to food or services in the town of Rann, Borno State, due to heavy flooding of the River Kaalia in neighbouring Cameroon since 7 November. The flooding damaged an estimated 4,000 hectares of farmland, destroying crops that are the main source of food for internally displaced persons  ( IDPs )  staying in Rann, a remote town in an area where violent attacks from non State armed groups are frequent and access is difficult for humanitarian assistance due to the high insecurity and poor road conditions.
Madagali: 309 arrivals and 84 departures were recorded in Madagali LGA of Adamawa state. These include 140 arrivals from Girei I and Modire/Vinikilang wards of Girei LGA, 23 arrivals from Gombi South ward of Gombi LGA and 55 arrivals from Uba, Kwarhi and Banshika ward of Hong LGA. Other arrivals include 10 from Jambutu ward of Yola North LGA, 13 arrivals from Toungo ward of Yola South LGA and 15 arrivals from Shelleng ward of Shelleng LGA. Arrivals from Borno state include 18 from Uba ward of Askira/Uba LGA, 10 arrivals from Gadamayo ward of Gwoza LGA, 9 arrivals from Maisandari ward of Maiduguri Metropolitan Council and 8 arrivals from Dala Lawanti ward of Jere LGA. Departures include 19 from Fufore ward of Fufore LGA, 30 departures from Modire/Vinikilang ward and 35 departures from Girei II ward of Girei LGA. 74% of the new arrivals reported to have relocated due to improved security while 26% was due to fear of attack. 64% of the departure was due to fear of attack while 36% was due to poor living conditions.
Geographically, the highest proportions of households facing “high' or “very high' multi sectoral needs were found in Central and Northern Borno. Households living in a few LGAs exhibited high levels of multi sectoral needs regardless of displacement status. Damboa LGA, in Central Borno, calls for particular attention as two in three households showed “high' or “very high' multi sectoral needs  ( 66% )  and also the most severe needs  ( 27.7 out of 80 )    both the highest of any LGA in Borno. Both the prevalence of protection  ( 92% )  and shelter/NFI needs  ( 87% )  and the severity of protection  ( 5.7 )  and shelterNFI needs  ( 5.9 )  in Damboa, were the highest in Borno. Households in Guzamala LGA, in Northern Borno, were the second most likely to have “high' or “very high' needs  ( 65% )  in all of Borno, second to only Damboa. Guzamala households demonstrated the highest needs within Northern Borno for education, shelter/NFI, WASH, health, nutrition, and food security.
The main humanitarian needs in north east Nigeria result from a myriad of factors including chronic under development. Insecurity, particularly in Borno State, continues to be the main trigger for wide scale population displacement and dire humanitarian needs. Adamawa State is also affected by intercommunal tensions and recurrent flooding.
A total of 1.05 million people are in need of life saving and essential health services. Approximately nineteen percent  ( 19 per cent )  of health facilities are fully damaged and fourteen percent  ( 14 per cent )  partially damaged by the ongoing conflict . A significant proportion of women and children, particularly girls who are living in security compromised communities do not have adequate access to quality sexual and reproductive health  ( SRH ) , basic emergency obstetric care, immunization and child health services
Yola South: 208 arrivals and 10 departures were recorded in Yola South LGA of Adamawa state. These include 8 arrivals from Duhu/Shuwa ward of Madagali LGA, 152 arrivals from Pulka ward, 11 arrivals from Bulabulin/Gwoza ward and 10 arrivals from Wakane and Ngoshe wards of Gwoza LGA of Borno state. Other arrivals include 14 from Darajamal ward of Bama LGA and 13 arrivals from Walafa ward of Askira/Uba LGA of Borno state. The only departure was from Madzi ward of Michika LGA of Adamawa state. 90% of the new arrivals reported to have relocated due to poor living conditions, 4% due to fear of attack while 6% was due to the ongoing conflict. The departure however, was due to poor living conditions.
The proportions of households with “high' or “very high' needs in the health and education sectors were substantial and similar across population groups with 84% of IDPs, 82% of returnees and 87% of non displaced in need of health support and a statewide severity score of 7.3/10 and 88% of non displaced, 90% of returnees and 79% of IDPs in need of education support with a state wide severity score of 7.3/10. However, the proportion of households with unmet WASH need varied by population group. IDP households were more than four times less likely to have unmet WASH needs as compared to non displaced households, and more than twice less likely than returnee households, again indicating that infrastructural services in Adamawa may have been absent before the conflict and that targeted gap filling for those services has benefited IDPs more than nondisplaced groups.
New waves of displacement in 2018 add to the already high numbers of people in north east Nigeria who have fled their homes. Today 1.8 million⁸ people  ( 440,000 women, 364,000 men, 614,000 girls and 516,000 boys )  are internally displaced, with 94 per cent of the displacement attributed to ongoing conflict and over 80 per cent of displaced people in Borno State.A decade into the crisis, the protracted nature of displacement has eroded coping mechanisms, significantly weakened resilience, and heightened vulnerabilities.
Across all population groups in Yobe state  ( IDPs, returnees, and non displaced ) , 98% of households were found to be in need in at least one humanitarian sector. A breakdown by households' displacement status reveals unmet humanitarian needs in at least one sector among 100% of IDPs, 93% of returnees, and 90% of non displaced households. To inform planning of integrated humanitarian support in Yobe, Figure 3 illustrates the extent of multi sectoral needs by displacement status. Across Yobe, 24% of households reported “high' or “very high' needs in five or more sectors. By population group, returnee households were more likely to have “high' or “very high' needs  ( 27% )  than IDPs and nondisplaced households  ( 23% ) , and their needs were on average more severe  ( 21 on a scale of 80 )  than those of IDP and non displaced households  ( 19 and 17 respectively ) . Thus, the needs of displaced households in Yobe state are driving the 24% of households with “high' or “very high' needs seen state wide.
Despite humanitarian resources already being overstretched as a result of overcrowding in the camps, tens of thousands of new arrivals passed through reception centres and accessed multi sector humanitarian assistance through the Reception Management Strategy, including food assistance, health screenings, and protection services. Others were reached in the camps and host communities as part of regular aid delivery activities.
Threats of attacks, ongoing hostilities, lack of safety assurances by NSAGs, explosive hazards and restrictions on movements in active conflict zones hinder humanitarian actors ability to conduct thorough assessments of the estimated 823,000 people who remain in inaccessible areas.
Further, while Borno State remains the epicenter of the crisis, Adamawa State also experienced significant levels of inter communal violence with reports of over 100 communities affected. The scale of the offensive from the Nigerian Armed Forces and change in tactics by NSAGs has increased protection concerns for women and girls, including sexual and physical violence, as well as abduction by NSAGs. For men and boys, the fear of being abducted and conscripted to join NSAGs still looms large, while arbitrary detention in military screening sites is also an ongoing concern.
Yobe had the highest overall proportion of households in need of food security  ( 71% ) , rising to 82% among IDPs. Again, the key indicator driving high reports of food insecurity was limited access to markets, reported by 91% of non displaced and 100% of IDPs and returnee households. Over 58% of households in Yobe scored 10 or greater on the reduced Coping Strategies Index   thereby demonstrating that persons in the state are resorting to drastic measures to mitigate the effects of prolonged food insecurity, which are likely exacerbated by the lack of access to markets.10
Adamawa State has seen the highest number of returns at over 750,000, and Borno State over 650,000. While Government facilitated returns also started, including in coordination with military efforts underpinned by Operation ‘Last Hold,' concerns remain that many areas are not yet conducive for safe and sustainable returns due to insecurity and a lack of access to basic services and infrastructure. This is corroborated by the vast majority of displaced households reporting no active plans to return, citing insecurity and lack of access to services such as food, health and education as main reasons.
As a result, an estimated 900,000 children have lost access to learning while 75 per cent of children in camps do not attend school. 70 per cent of girls of primary school age are out of school in Borno State   the highest percentage in the country. Of those who do attend, 72 per cent are unable to read upon completion of grade six, while Borno State has the lowest literacy rates at only 35 per cent of female and 46 per cent of male adolescents
The security situation in Cameroon's Far North region remains precarious with a number of security incidents in Mayo Sava, Logone and Chari divisions during the third week of August.  A grenade explosion in a household in the locality of Mafoulsso killed two children and left the mother severely injured. On 20 August, a commercial transport vehicle was ambushed by suspected Boko Haram members, who kidnapped seven of the occupants.
On 14 August, a female suicide bomber killed seven people and wounded two others in Kaiga Kindjiria, in Chad, in the Haussa district  ( district that mainly hosts refugee populations ) .  In the Diffa region of Niger, there has been an increase in the number of kidnappings. Three individuals were kidnapped on 25 – 26 August in Toumour. In addition, two IDPs were kidnapped by Boko Haram elements near Toumour and one returnee killed. Three women were kidnapped near Bagué during the last week of August.
6 Yellow fever 6.1 In the reporting week 5  ( 28th January – 3 rd February, 2019 ) , no new confirmed case from Nigeria at WHO reference laboratory, Institute Pasteur Dakar  ( IP Dakar )  6.2 From the onset of this outbreak on September 12, 2017 to date, a total of 4,100 suspected yellow fever cases have been reported from 36 States & FCT. Of the 3,780 samples taken, 274 were presumptive positives in country 6.3 A total of 95 cases have been confirmed by IP Dakar from 14 states  ( Kwara, Kogi, Kano, Zamfara, Kebbi, Nasarawa, Niger, Katsina, Edo, Ekiti, Rivers, Anambra, FCT, and Benue States )  6.4 Since the onset of the outbreak, 27 deaths among IP Dakar confirmed cases and 50 deaths among suspected/presumptive positive cases have been recorded. Case Fatality Rates among IP Dakar confirmed cases and presumptive positives are 1.8% and 22. 4% respectively
IDP camps in Borno remain severely overcrowded, with 15,000–20,000 IDPs sleeping in the open and tens of thousands more sharing shelters with other families as of late May, according to the UN. Relief actors who believe that the actual number of people in need of urgent shelter assistance may be even higher than UN estimates suggest  note that overcrowding at the camps has strained humanitarian response capacity, exacerbated already acute shelter and protection needs, and increased the risk of fire and disease outbreaks.
The humanitarian crisis in Borno, Adamawa and Yobe states in North East Nigeria needs renewed support to face the recent escalation in violence and the evolving humanitarian needs. Tens of thousands of people have fled the violence and are at risk of disease with rainy season approaching. The UN and its partners have appealed for US$848 million in 2019 to provide lifesaving assistance to 6.2 million people. So far, the response is 32.6 per cent funded.
Lack of access to blankets/mats and mosquito nets have been largely reported by IDPs both in camps and host communities. Some 105,000 HHs are currently in need of NFIs in host communities, in addition to 80,000 HHs in camps or settlements.
 In Adamawa, Borno, and Yobe, nearly 3 million people or approximately 22 percent of the three states' assessed population of 13.8 million people will likely experience Crisis or Emergency levels of acute food insecurity during the 2019 June to August lean season, according to preliminary results of a June CH analysis.
In 80 per cent of wards in Borno State, survivors do not have access to more comprehensive GBV services, including psychosocial support, case management and access to legal assistance. Survivors need continuous safe, confidential, and survivor centred services otherwise they may be deterred from reporting incidents of GBV which may result in long lasting medical and emotional consequences.
7. Update on national Influenza sentinel surveillance, Nigeria week 1 – 7, 2019 7.1From week 1  7 2019, a total of 55 samples were recruited, of which 54 were Influenza like illness  ( ILI )  and one was Severe Acute Respiratory Infection  ( SARI )  . 7.2 A total of 55 samples were received and all samples were processed. Of the processed samples, 54 ( 98.2% )  were ILI cases and 1  ( 1.8% )  was Severe Acute Respiratory Infection  ( SARI ) . 7.3 Of the 54 processed ILI samples, 4  ( 7.4% )  were positive for Influenza A; 1 ( 1.9% )  was positive for Influenza B and 49  ( 90.7% )  were negative.7.4 The processed SARI sample was negative for both Influenza A and B. 7.5 Of the 54 processed samples, five  ( 9.1% )  were positive for Influenza, with four  ( 80.0% )  of these positive for Influenza A and one  ( 20.0% )  positive for Influenza B. 7.6 The subtypes A seasonal H3, 2009A/H1N1 and A/not subtyped account for four  ( 100.0% ) , 0  ( 0.0% )  and 0  ( 0.0% )  of the total influenza A positive samples respectively. 7.7 The subtypes B VICTORIA, B Not subtyped and B Yamagata account for 0 ( 0.0% ) , one ( 100.0% )  and 0 ( 0.0% )  of the total influenza B positive samples respectively 7.8 The percentage of influenza positive was highest  ( 75.0% )  in week 7
According to a recent Health Resources and Services Availability Monitoring assessment in Borno State, out of 809 assessed health facilities, 134 are nonfunctional while 252 have been damaged during the crisis; only 334 are fully functional and 89 are partially functional. Those that are functioning are short of staff, and lack safe water, basic drugs and equipment.
Displaced people in north eastern Nigeria face similar challenges whether or not they have previously sought refuge abroad. Living conditions are generally poor, particularly in camps, and many displaced people have no running water or toilet facilities. More than half of the survey respondents said they were living in tents or makeshift shelters.These findings are corroborated by UNHCR, which found: “Displaced populations are living in squalid conditions characterized by overcrowding and limited access to safe, sanitary and dignified accommodation.
Demographic dynamics also remain a challenge with a large portion of the population being young  ( 15 – 34 years of age ) , and the rate of unemployment higher in the northeast, especially among women. In 2017, while the national youth unemployment rate was 19 per cent, it was 37 per cent and 28 per cent in Yobe and Borno states respectively. The lack of employment and livelihood opportunities is a major cause of frustration and discontent with government – factors which compound social polarization and openness to radicalization.
The most severe and acute humanitarian needs are concentrated in areas affected by conflict and locations hosting large numbers of internally displaced people and returnees. This includes almost all Local Government Areas  ( LGAs )  of Borno State, the epicenter of the crisis. Moderate humanitarian needs are mainly in Adamawa and Yobe states, while southern Adamawa State has low humanitarian needs.
One in four conflict affected households in the north east has no access to economic opportunity as a result of the conflict while over 650 public buildings are completely destroyed or dysfunctional. The cost of damage attributable to the conflict has been significant across Borno State  ( $6.9 billion ) , Yobe State  ( $1.2 billion )  and Adamawa State  ( $829 million ) 2, in a region that already has a long history of chronic under development.
Access to basic services has still been a challenge characterized by inadequate WASH facilities and low basic health indicators being worse than the national average. Globally, Nigeria ranks 157 out of 189 in the Human Development Index  ( HDI ) , which puts the country in the low human development category. Rapid population growth has also hampered faster poverty reduction while the BAY states continue to suffer the most from underemployment across the country with 37 per cent and 28 per cent of youth unemployment rate in Yobe and Borno states respectively. The lack of provision of basic services and youth unemployment have also been underlined as key drivers of the conflict in the region as NSAGs sometimes offer better economic opportunities to young people.
Another barrier in accessing health services is related to high costs  ( as reported by 75 per cent of IDPs, 61 per cent of returnees and 80 per cent of non displaced households ) , including the high cost of quality medicines. In Nguru, Potiskum and Geidam LGAs in Borno State, the percentage of non displaced households reporting cost related challenges in accessing health services was higher than in other population groups, due to poverty and lack of resources.
Meanwhile, significant return movements have occurred: as of August 2018, 1.6 million displaced persons, including both IDPs and refugees, are reported as having returned. However, some of these returns have fallen short of international standards regarding voluntariness and have taken place to areas where essential conditions for sustainable returns, including safety, freedom of movement, access to basic services, and livelihood opportunities, are not yet in place. Absent conditions conducive for sustainable return, some “returnees', both refugees and IDPs, have gone back to or moved into displacement sites
Female headed households and childheaded households, unaccompanied and separated children, adolescent boys and girls, face heightened protection risks, including GBV, child recruitment and SEA. Groups with specific needs include: the elderly; the chronically ill; persons with physical and mental disabilities; and pregnant and lactating women.
In many displacement sites and settlements in all three BAY states, IDPs face the risk of eviction, often with very short notice and inadequate planning. As of October 2018, in Borno State alone, five IDP sites hosting a total of 300 IDPs were evicted IDPs who found temporary shelter in schools and other government buildings are particularly at risk of eviction, e.g. in Galtimari Primary School in Jere Local Government.
Area of Borno State; similar concerns have been reported in Damboa, Gubio, Monguno, Konduga, MMC, Konduga Nganzai, Gwoza, Mobbar and Dikwa LGAs. Returning IDPs and refugees often find their houses destroyed or severely damaged, or being occupied by others. Complicating property is a lack of documents to prove title/ownership, the destruction of administrative records and capacity, fraudulent sales, inheritance disputes, and a patriarchal system which discriminates against widows and orphans.
3.6 million people need support to meet their basic water, sanitation and hygiene needs across the BAY states. The main drivers of vulnerabilities related to WASH are closely linked to the conflict, including recurrent, unpredictable and continuous population displacements. Historically low levels of access to WASH services as a result of chronic underdevelopment have also contributed to the current situation.
The conflict has severely constrained access to clean water and safe sanitation facilities for 3.6 million people largely because of displacement that has forced thousands of people to concentrate in IDP camps, settlements and host communities – in short, in conditions that were not set up to deal with the constant influx of new arrivals. These include one million IDPs, 900,000 returnees, 700,000 people in host communities, and 800,000 people in inaccessible areas.
As of today  ( 24/05 ) , 395 shelters in camps and camp like settings in Borno State, including Zaynab's, have been damaged or destroyed since heavy rains began at the end of April. A total of 41 camps hosting more than 300,000 internally displaced persons  ( IDPs )  have been classified as prone to flooding; some in hard to reach areas like Monguno, Konduga, Bama and others.
There are serious protection concerns, including genderbased violence, sexual exploitation and abuse  ( SEA ) , abductions, and child recruitment which continue to be reported in displacement camps and sites. Reception/screening processes are compromising the safety and dignity of women, girls and the elderly
They were geographically categorized as follows: • Acute needs in eight LGAs  ( Askira/Uba, Bama, Dikwa, Gwoza, Magumeri, Monguno, Ngala, Nganzai )  in Borno State; • High needs in 11 and five LGAs in Borno and Adamawa states respectively; and • More chronic needs in 12 LGAs, six in Adamawa State and six in Yobe State.
Acoording to assessment reports, after food, NFIs remain the second most reported need of IDPs, both in camps or settlements, and host communities, due to the lack of prepositioned NFIs in key receiving areas given the short lifespan of shelter related NFIs. The three main NFIs requested by the affected populations are mosquito nets, mats and kitchen sets.
Households in Mobbar LGA were the most likely to report not having soap  ( 28% )  within Northern Borno. Although IDPs had the highest rate of WASH needs, non displaced households showed a greater proportion of households simultaneously having a vulnerability largely due to PLWs and female headed households. Of IDP households with WASH needs, female headed households and high agedependency ratios were the most common vulnerabilities observed, followed by PLWs.
With seasonal heavy rains come an increased risk of disease outbreak, particularly cholera, in north east Nigeria. During the last rainy season in late 2018, the area saw nearly 100 cholera related deaths. As part of the Water, Sanitation and Hygiene  ( WASH )  programme, IOM is conducting intensive door to door hygiene promotion and awareness raising campaigns to prevent the spread of cholera in communities.
In February, over 1.7 million children across the BAY states were screened for malnutrition and referred to various nutrition treatment services which included over 46,028 children among new arrivals in Teachers Village in Maiduguri, Monguno and Stadium IDP camps in Borno State. 15,056 children with severe acute malnutrition  ( SAM )  were admitted in the 711 OTP sites, of which 557 SAM cases with medical complications were referred to stabilization centres.
Overcrowded population in camps with weak infrastructure and services may raise public health threats and outbreaks. MMC, Jere, Monguno, Guzamala and Kukawa of Borno State are high risk areas for cholera due to WASH challenges and congested living conditions. Partners are reporting high number of SAM cases with medical complications as population coming out of bush and inaccessible areas. Reports of lack of supplies and drugs from some camps on which partners are working to fulfill the increasing demand of medicines and medical supplies.
Women constitute the backbone of the rural labour force in Nigeria. Between 60 to 79 per cent of rural work force are women. Although women represent the first Nigeria's rural labour force, males are five times more likely to own land than females43. On access to land, FGDs participants mentioned that land ownership and access, across all consultations made, remains a crucial resource, without which there would be no agricultural production. Respondents to the FGDs highlighted that land is owned by the head of family and traditional chief. They are the ones to decide on the land use. Even though the Nigeria Land Administration Act is egalitarian on paper, women's and girls' access to land is limited by a patrilineal system of land inheritance  ( from father to son or from male relatives )  and virilocal residence, including socio cultural norms44. It is also important to note that there are no religious norms that prevent women from owning land
Madagali: 182 arrivals and 152 departures were recorded in Madagali LGA of Adamawa state. These include 35 arrivals from Girei II and Moderi wards of Girei LGA, 16 arrivals from Gombi South ward of Gombi LGA, 10 arrivals from Fufore ward of Fufore LGA and 21 arrivals from Ganye II ward of Ganye LGA. Other arrivals include 36 from Kwarhi and Uba wards of Hong LGA, 25 arrivals from Vim�m and Yelwa wards of Mubi North LGA, 31 arrivals from Lamurde and Duvu/Chaba wards of Mubi South LGA and 9 arrivals from Doubeli ward of Yola North LGA. Departures include 29 from Damare ward of Girei LGA, 23 departures from Gombi South ward of Gombi LGA and 24 departures from Shelmi/Sukur/Vapura ward of Madagali LGA tracked at Waga ward of Madagali LGA. Other departures include 17 from Michika ward of Michika LGA, 8 departures from Bole/Yolde Pate ward of Yola South LGA and 51 departures from Gwoza LGA of Borno State. 84% of the new arrivals reported to have relocated due to improved security while 26% was due fear of a�ack. 36% of the departure was due to fear of a�ack, 34% due to improved security, 11% due to the ongoing conflict while 19% was due to poor living condi�ons.
In Borno, shelter / NFI needs were observed in nearly one in two households  ( 48% ) , mostly driven by households lacking at least half of the basic NFI kit items  ( 61% ) 11 or sharing their shelter  ( 51% )  with another family. Notably, IDPs registered the highest proportion of households with unmet shelter needs  ( 68% ) , among which 77% did now own at least half of the basic NFI kit items and 44% did not have adequate shelter. As IDPs would be the group most likely to be targeted for aiddriven shelter schemes and offered camp based shelters and NFI provisions, it is concerning that this basic need is not being met.
Across Borno, WASH needs were reported by 14% of households, with an average severity of 4.6. Needs were fairly similar across population groups, but differed by domain. WASH needs appeared less frequently than other sectoral needs in Borno state, in part because of the restricted scope of data collection to areas with more concentrated services, including availability of improved water points and latrine access. Southern Borno is the exception, as data collection extended to more rural settlements where access to improved water sources and functional latrines was poor. Due to this rural inclusivity, WASH needs appeared to be greatest in Southern Borno, with 26% of the population having an unmet need and an average severity score of 4.7. Although WASH needs were less widespread as compared to other sectors, 12% of households in Borno reported not having access to at least 15 liters of water per person per day, thereby putting their health and hygiene at risk.
The conflict continues to have a direct impact on people's nutrition status. Global acute malnutrition  ( GAM )  levels in children aged 6 59 months remain consistently concerning, with over one million children suffering from SAM and MAM across 18 LGAs in the BAY states115. This includes 367,000 children under five  ( 179,830 boys and 187,170 girls )  suffering from SAM and 727,000  ( 356,230 boys and 370,770 girls )  with MAM.
The second highest protection needs were reported in East Borno  ( 65% ) , with also the highest severity rank across the domains in Borno  ( 4.7 ) . IDP and returnee households were twice as likely to display protection needs  ( 69% and 61% )  as nondisplaced households  ( 31% ) . While non displaced households were unlikely to face explosive incidents, half of IDP and returnee households lived in a ward where key informants reported explosive incidents. The highest reports of missing family members in the state came from East Borno, with one in five IDP households affected.
The array of causal factors underpinning the crisis in Northeast Nigeria are both diverse and ongoing   conflict, flooding, poverty and disease outbreaks continue to complicate the delivery of life saving humanitarian aid, early recovery efforts, and the implementation of durable solutions in areas beginning to recover from the impacts of the crisis. Needs are further informed by infrastructural inequities in rural areas, ongoing displacement, and overcrowding in displacement sites and urban centers. Accordingly, needs demonstrated by the affected populations are multi dimensional and likely to remain severe across the BAY states for the foreseeable future.
Female headed households again reported the highest rates, with nearly half of households exhibiting “very high' or “high' multi sectoral needs  ( 44% ) . Female headed households had the worst access to education, with nearly three fourths of households reporting education needs. They were also the most or nearly the most frequent to report shelter/NFI needs  ( 49% )  or protection needs  ( 89% ) . Non displaced households in Northern Borno had considerably higher multi sectoral severity scores  ( 20.1 )  than IDPs and returnees  ( 17.8, 16.1 )  and showed higher needs in nutrition and livelihoods. IDP households showed the largest WASH needs, followed by non displaced households.
IDP households had the most severe multi sectoral needs within East Borno, though non displaced and returnee households still displayed average severity scores above the Borno state average severity score. Education, WASH and health needs were similar across groups, however non displaced households were more likely to express nutrition, food security and livelihoods needs than either IDP or returnee households. The most “very high' or “high' needs households in East Borno were found in Gwoza  ( 39% )  and Bama  ( 32% )  LGAs, followed to a lesser extent by Dikwa  ( 29% ) , Ngala  ( 26% )  and Kala/Balge  ( 17% ) .
Bama LGA had nearly one third of households with “high' or “very high' needs  ( 32% ) , due to greater protection  ( 88% ) , food security  ( 77% ) , WASH  ( 17% ) , and nutrition  ( 18% )  needs compared to other East Borno LGAs, and high shelter/NFI needs  ( 64% ) . While the proportion of households with needs was high, the overall severity of these needs was similar to other East Borno LGAs, with the exception of WASH severity  ( 5.8 )  which was much higher than the average WASH severity in East Borno  ( 4.8 ) . This is in line with previous reports that returnees have left Bama due to difficulty in meeting their basic needs due to many non functional water points and services throughout the town .
In Adamawa, 48% of households reported a livelihoods need, driven by two concerning indicators: 70% of households state wide reported that their income decreased in the three months prior to data collection and 19% reported that they have resorted to “emergency' level livelihoods strategies.Returnees in Adamawa demonstrated the greatest needs in all livelihoods indicators: 80% reported a decrease in income in the three months prior to data collection, 63% reported indebtedness and 29% reported not having access to cash. These proportions are similar to those reported by IDPs and both are relatively higher than the livelihoods needs reported by non displaced in Adamawa, demonstrating a disparity between displaced and non displaced populations overall. Similarly to Adamawa, livelihoods needs in Yobe were higher among displaced populations than non displaced populations with 66% of returnee and 56% of IDP households in need of livelihoods support, as compared to 46% of non displaced.
Measles cases are on decline after a robust reactive measles vaccination campaign in Borno State that vaccinated some 1.2 million children since the beginning of 2019. However, Acute Watery Diarrhoea cases  ( AWD )  is on the rise due to the onset of the rainy season and weak sanitation and drainage systems in many IDPs camps and host communities
The 10 year long conflict in north east Nigeria has caused a large scale humanitarian crisis across the worstaffected states of Borno, Adamawa, and Yobe with 7.1 million people in need of humanitarian assistance in 2019. An estimated 1.8 million people are internally displaced across the three states in the northeast; livelihoods have been lost, commercial markets and trade disrupted, resources of host communities are depleting, and large areas of Borno State remain inaccessible for humanitarian actors due to the volatile security situation.
As was the case in Borno state, the population groups in Adamawa with the highest proportion of households with unmet nutrition needs were also those with the highest levels of vulnerability. Three percent of Adamawa households included a child who presented either moderate acute or severe acute malnutrition and two thirds of these households also demonstrated at least one vulnerability. In Yobe, returnee households were over twice as likely to have unmet needs as non displaced households  ( 14% vs. 6% ) , and nearly five times as likely as IDP households  ( 3% ) , registering a rate of malnutrition higher than WHO emergency thresholds, which should trigger rapid, strategic engagement of health and nutrition professionals
This population group is often cut off from normal livelihoods activities during the rainy season, and has poorer access to markets and other services than groups who have been targeted by humanitarian assistance, which may underscore their demonstration of “high' needs. Female headed households also demonstrated large multi sectoral needs, with nearly onethird of households demonstrating “very high' or “high needs'  ( 31% ) .
Since 2010, the crisis in North eastern Nigeria has continued to affect populations and does not currently have an end in sight. Borno, Adamawa and Yobe states remain the most affected, with greater than 1.9 million internally displaced persons  ( IDPs )  and over 200,000 refugees having fled to neighbouring Niger, Cameroon and Chad. 14 Ongoing conflict between the Nigerian military and non state armed groups  ( NSAGs )  has led to continued population displacement into urban centers throughout Borno, as well as parts of Yobe and Adamawa States. In Adamawa, portions of the state have also been affected by ongoing herdsmen farmer conflicts, causing increased community tensions, killings and destruction of property. Aside from conflict, populations in certain geographical locations have weathered seasonal flooding and other natural disasters which has affected livelihoods. As a result of these challenges, nearly 10.2 million people have been estimated to be in need of humanitarian assistance.
The Cadre Harmonisé estimated nearly 3 million people in Borno, Adamawa and Yobe were in Phases 3 and 4 food insecurity between June to August 2018, and in need of emergency assistance16 . Due to insecurity, access of humanitarian actors to provide this assistance to affected populations is extremely restricted, particularly in Borno where the majority of areas outside of LGA capitals are considered hard to reach by international non governmental organizations  ( INGOs ) . It has been estimated that nearly 823,000 people are living in these hard to reach areas.17 Access to goods and services has been heavily curtailed due to the conflict, with destruction of health and educational facilities, and limited operation of markets, further impeding the ability of affected populations to seek support.
Vulnerabilities in Damboa had similar levels to the rest of Borno state, with more than half of households having at least one vulnerability  ( 57% ) . Approximately one third of households had a pregnant or breastfeeding woman  ( 32% ) , a quarter of households were female headed  ( 25% )  and some had high age dependency ratios  ( 16% ) . Households in Damboa indicated very tenuous living conditions, with nearly half of households reporting being under threat of eviction  ( 41% ) , most households not having adults with any documentation  ( 70% ) , nearly half having experienced a security incident in the last three months  ( 44% ) , and one fifth reporting a household member being missing or detained  ( 19% ) . Due to these conditions, many IDPs in Damboa  ( 41% )  reported actively making plans to leave within the next six months and those with the highest multi sectoral needs cited lack of security, shelter, food and access to health services as key push factors23 .
Households in East Borno had WASH needs which differed between LGAs, though the highest needs were observed in returnees and IDP households, with IDPs also having the most severe WASH needs compared to other groups. IDP households were the most likely to report having water consumption below Sphere standards31  ( 16% ) , compared to nondisplaced  ( 4% )  and returnees  ( 4% ) .
Meanwhile, IDP households in Borno showed the lowest rate of EBF  ( 11.9% )  and a higher rate of household vulnerability  ( 7%, among which 6% of households housed a PLW ) . Ten percent of non displaced households and 9% of returnee households in Borno had a child with moderate acute malnutrition, thereby indicating a serious prevalence of GAM as determined by UNHCR and Sphere standards33 , and 9% of returnee households housed a child with moderate acute malnutrition.
While overall 4% of households reported not having access to cash at all, among IDPs and returnees one in ten households were affected. Households reported using crisis and emergency livelihood coping strategies. Of those who reported using these strategies, returnees did so at the greatest rate with one tenth of households resorting to these solutions  ( 10% ) .
Health actors vaccinated nearly 800,700 children ages six months–six years across Borno during a UN World Health Organization  ( WHO )  May 14–20 measles vaccination campaign, representing a statewide vaccination coverage rate of more than 95 percent, WHO reports. WHO had recorded nearly 17,900 measles cases, as well as 85 related deaths, in 11 LGAs in Borno as of June 12, with children ages five years and younger comprising 85 percent of the cases. To prevent the spread of diseases such as cholera and measles in vulnerable communities, USAID/OFDA NGO partners and other health agencies continue to administer vaccines, conduct disease surveillance, and distribute water, sanitation, and hygiene  ( WASH )  supplies in Borno's Bama, Dikwa, Magumeri, and Ngala LGAs; one NGO partner is also treating individuals for measles in USAID/OFDA supported health facilities in Bama, Magumeri, and Ngala.
Since the onset of the conflict in 2009, more than 27,000 people have been killed in the BAY States, thousands of women and girls abducted and children used as so‐called “suicide' bombers38. In 2017, 1,462 children  ( predominantly girls )  were used as human bombs. In the first six months of 2018, 43 children were used in attacks39.The disruption of education puts children at risk of exploitation, child labour, human trafficking, recruitment by armed groups, and child marriage. In fact, children's recruitment into armed groups involve not only support roles such as cooks, messengers and look outs, but also direct combat roles as PBIEDs, planting Improvised Explosive Devices  ( IEDs )  landmines, burning of schools and houses40. Moreover, children have also reportedly been used as human shields to protect NSAG elements during military operations41. For the boys and young adults, engagement in sexual assault, theft, extortion, drug and alcohol abuse due to inactivity and poverty were also raised during the different FGDs
The Nigerian Army on Wednesday said its troops killed 11 Boko Haram members in a fresh attack coordinated by the insurgents at Madagali town, Madagali Local Government Area of Adamawa. In a statement, Col. Ado Isa, Deputy Director, Army Public Relations 7 Division, Sector 1 Operation Lafiya Dole, said the troops also destroyed and recovered high calibre ammunition and equipment from the insurgents. Ado disclosed that the insurgents had on Tuesday evening, invaded the town with five gun trucks, an Armoured Personnel Carrier  ( APC )  and an Improvised Explosive Device  ( IEDS )  borne vehicle. He said that the gallant troops successfully repelled the attack, killed five of the attackers, destroyed and recovered the ammunition from the insurgents, while others fled with gunshot wounds.
June 24: Boko Haram killed twenty farmers in Mobbar, Borno. June 24: Boko Haram killed nine in Guzamala, Borno. June 24: Three Boko Haram militants, one soldier, and three civilians were killed during a Boko Haram attack in Mafa, Borno. June 24: Nigerian troops killed eight bandits in Sabon Gari, Sokoto.
Poorer households are not able to cultivate enough land, and do not own enough livestock, to enable them to be selfsufficient. There is an urgent need for the perimeters of the government secured ‘garrison towns' to be expanded to enable freedom of movement so that communities can access their livelihoods  ( including fishing, grazing, farming and markets )  and basic services.
Exacerbated by two cholera outbreaks in 2017 2018, schools continue to be at higher risk for the spread of cholera. The lack of essential education supplies also contributes to a deterioration in the quality of education and low school attendance. In addition, the situation is compounded by challenges faced by teachers including poor remuneration, inadequate working environment and lack of social recognition. Teachers are demotivated as a result, further contributing to low student attendance and low primary, junior and senior secondary completion rates.
In IDP sites across the BAY states, congestion is a key constraint with almost 60 per cent of camps not fully aligned with international standards. In Borno state, 48 out of 148 camps have populations that exceed the accepted threshold. Access to land to help expand and decongest camps has been a major challenge. The influx of new arrivals as a result of ongoing military operations, flooding and other push and pull factors, has further exacerbated already overstretched resources on the ground. Protection risks are further exacerbated by overcrowding.
Only 58 per cent  ( 153 )  of the 263 displacement sites are currently receiving site management support, including mobile site facilitation from humanitarian partners. Gaps in the response have been reported across all camps, which can be attributed to overstretched available resources: 71 per cent and 15 per cent of IDPs reported unmet needs in food and NFIs, repectively. Insufficient community mobilisation and empowerment activities, through direct engagement and governance structures, have limited adequate services in sites which have elavated protection risks for vulnerable population.
Acute respiratory infection: In Epi week 4, 6,573 cases of acute respiratory infection were reported through EWARS. Of the reported cases, 489 were from Herwa Peace PHC in MMC, 389 were from Biu MCH in Biu, 239 were from Damasak MCH in Mobbar, and 228 were from Shuwari Host community clinic in Damboa, No associated death was reported.
Adolescent women  ( 15 – 19 years )  were 6 times more likely  ( 17.8 percent )  to be malnourished compared to counterparts aged 20 – 49 years ( 2.7 percent ) . The trend was consistent across all domains where there were at least, three times more adolescents aged 15 – 19 years that were malnourished compared to adult counterparts aged 20 – 49 years. The domains with the highest proportion of malnourished adolescents of reproductive age were Northern Borno  ( 28.6 percent ) , Northern Yobe A  ( 25.3 percent ) , Northern Yobe B  ( 21.5 percent ) , Southern Yobe  ( 21.5 percent ) , Central Yobe  ( 19.0 percent )  and Central Borno B  ( 19.0 percent ) . However, the prevalence of adult women aged 20 – 49 years across all domains in Yobe was higher compared to counterparts in neighboring states of Borno and Yobe.
For nondisplaced households, the three indicators that primarily fed into higher WASH needs were the same as those that drove the WASH needs state wide – with 66% of households reporting no access to improved water sources, 60% without access to functioning latrines and 40% needing more than 30 minutes to collect water. For returnees, the main issue reported was high water collection times for 46% of households, highlighting that potential locations of return may be in remote areas, with or without access to basic services. More than 56% of IDP households were in need of WASH while also presenting a vulnerability.
Overall in Southern Adamawa, while 62% of households were found to be in need of WASH, 44% of those were also deemed vulnerable households. In this domain, IDP households were found to be most affected by the combination of WASH needs and household vulnerabilitties, with 54% of households in need also including vulnerable members.
From 13 June   4 July 2019, out of the 8,005 individuals previously displaced from Sabon Gari community who were living in the open spaces by GSS Damboa  ( SSS Quarters ) . A total number of 45 households  ( 258 Individuals )  departed from Damboa LGA to Nzuda Wuyaram and Azur/Multe/Forfor wards within Damboa LGA and Mandaragirau ward in Biu LGA.
Currently, there are 1,762,793 million individuals who remain displaced in camps and host communities, and who are reliant on humanitarian assistance to meet their essential needs. While some affected populations have made efforts to resettle back into their communities and resume their livelihoods, pervasive security threats and constraints have hampered access to the most productive agricultural fields and the cultivation of wide range of crops. Between July and August 2018, a total of 24,872 new arrivals were recorded in the key hotspots of Bama, Banki, Damboa, Dikwa, Gwoza, Pulka, Mafa, Monguno, Magumeri and Ngala LGAs in Borno State, with poor living conditions, voluntary relocation, ongoing conflict and fear of attacks as the four main triggers for such movement .
In Borno and Adamawa states, the December 2017 Nutrition Surveillance Round IV found slight improvements in global acute malnutrition  ( GAM )  rates for children 6 to 59 months at 6 percent and 9 percent, respectively6 . This was consistent with seasonal variations observed in March 2017, and likely influenced by a scale up of the emergency nutrition humanitarian response. However, in Yobe State, a GAM rate of 12 percent, and an under five death rate of 3.05 children per 10,000 children under five per day, indicated a concerning situation.