nlp-thedeep/humsetbias huggingface dataset:
Children continue to be at risk of abuse. According to the monitoring and reporting mechanism of grave child rights violations, at least one form of grave child rights violation was recorded against 183 children  ( 35 per cent of whom are girls )  in 2020. Sexual violence, killing and maiming were the most common forms of violations, with all survivors of sexual violence being female.
Children's lives and their well being is threatened by conflict, floods, disease outbreaks, poverty, displacement, and unemployment, causing high levels of life altering traumatic injuries and stress.
( iii )  certain areas of Sudan, including some IDP camps, remain under the control of armed opposition groups and state security actors are not recognized in such areas;  ( iv )  UNAMID  [ UN Hybrid Operation in Darfur ]  withdrawal will leave gaps in the civilian protection apparatus in Darfur after having contributed to reducing risks to the population;
( v )  humanitarian presence in IDP camps/sites has gradually decreased over the years as a result of limited funding, thereby leaving serious gaps in protection support; and  ( iv )  the dire economic situation in Sudan continues to contribute to poor living conditions and limited livelihood opportunities, leading to heightened protection risks, exploitative practices, and limited coping capacities.
Several contextual factors further validate the conclusion that needs remain high:  ( i )  the GoS'  [ Government of Sudan ]  National Plan for the Protection of Civilians  ( NPPOC )  and recent peace agreements are yet to be implemented;  ( ii )  rule of law, access to justice and government social protection mechanisms remains weak in conflict affected areas;
In addition, MSNA  [ Multi Sector Needs Assessment ]  data indicates that 22 per cent of households have one or more members who do not possess any form of civil documentation, with significantly higher proportions in some localities.
Children's vulnerabilities have been further exacerbated by COVID 19. Children – and in particular UASC  [ Unaccompanied or Separated Children ] ,  ( many of whom require family reunification support, alternative care arrangements and assistance )  – continue to remain at heightened risk of harassment, exploitation, neglect and abuse.
At the same time, localized disputes – e.g. between farmers and herders, IDPs and host communities, and IDP returnees and non displaced – continue to escalate into violence and larger conflict.
Displaced youth have been reported to increasingly resort to violence to resolve disagreements with community leaders. Also, familial and community support networks in conflict and disaster affected areas of Sudan have eroded over time, due to multiple displacements, and prolonged dependency on dwindling humanitarian aid.
Persons with disabilities continue to be marginalized and neglected, with few government or humanitarian services targeted to meet their unique needs. Access to health care, particularly for the elderly and those with chronic illnesses, who are at heightened risk due to COVID 19, remains limited.
Unable to meet their basic needs, many vulnerable families have been compelled to adopt negative coping strategies. These include lax adherence to COVID 19 prevention measures in order to pursue economic survival, engagement in unsafe or exploitative labour, begging, and engaging in opportunistic economic crimes  ( e.g. theft ) ; while others undertake deadly journeys to Europe, exposing themselves to abuse and exploitation by smugglers and traffickers along the way.
Child marriage and child labour are on the rise. Access to birth registration continues to be a challenge in most locations, placing both IDPs and refugees at significant risk of not accessing basic services and even possible statelessness.
For women and girls, risks of GBV remain significant, particularly when they are on the move, working in fields, collecting water or firewood. Boys and men remain especially at risk of physical violence, injury and death during intercommunal clashes and arbitrary arrests, as they are often suspected of supporting armed opposition groups.
Vulnerable groups   such as women, children, elderly, persons with disabilities and chronic illnesses   face a range of challenges unique to their individual circumstances, compounded by their displacement where familial/community support networks have broken down or are overstretched.
They  [ vulnerable groups   such as women, children, elderly, persons with disabilities and chronic illnesses ]  suffer disproportionately from various protection risks, including violence, sexual and other forms of exploitation and abuse, and a range of human rights violations.
[ According to the Multi Sector Needs Assessment, ]  for people living in camps and informal settlements, priority needs were livelihoods, health, shelter, education and water.
Overall, there are 4.7 million people in need of protection support across the country. This includes 1.5 million IDPs, 369,000 returnees, 1.1 million refugees and 1.6 million vulnerable Sudanese. Years of conflict and protracted displacement, lack of basic services and the deteriorating economic situation, have all had profound consequences on conflict affected persons' immediate physical and mental well being, living standards, and their long term resilience.
Such  [ inter communal ]  clashes are exacerbated by the proliferation of firearms, competition over land and water resources between farmers and herders, unregulated migratory routes of nomads, and weak systems for land administration. As a result of such incidents in 2020, hundreds of civilians were killed or wounded with their property damaged, looted, destroyed or occupied; thousands of families were displaced; and civilian sites – such as schools and hospitals – were occupied.
Durable solutions for IDPs, returnees and refugees remain elusive, with no national durable solutions strategy in place. Roadmaps for implementation of peace agreements are yet to be agreed on, and the areas in Darfur, South Kordofan and Blue Nile that are under control of armed opposition groups continue to face access restrictions, lack of basic services and barriers to provision of humanitarian assistance.
Movement restrictions due to COVID 19 have also severely impacted livelihoods and mobility, and the damage caused by annual flooding has left families without basic shelter and livelihoods, and consequent heightened vulnerability to protection risks.
According to WFP  ( Food Security Monitoring Survey for Q1, 2020 ) , 44 per cent of refugee households in Sudan are food insecure.
Rule of law, access to justice and government social protection remains weak in conflict affected areas of Darfur, South Kordofan and Blue Nile. In particular, police, courts, civil registries and social welfare institutions have limited presence outside of urban centres and are ill equipped to address the scale of protection needs among IDPs in camps and informal sites, and returnees in rural villages.
The  [ Standard Expanded Nutrition Survey  ( SENS )  ]  survey also indicates high rates of anemia  ( >40 per cent )  among children and women  ( aged 15 49 years ) , as well as low Vitamin A supplementation coverage for refugees in all above mentioned refugee hosting states.
Standard Expanded Nutrition Survey  ( SENS )  conducted among refugees in White Nile, East Darfur, South and West Kordofan indicate ‘critical' rates  ( >15 per cent )  of global acute malnutrition  ( GAM )  and severe acute malnutrition  ( SAM )   ( >3 per cent )  among children between six to 59 months of age.
The Transitional Government of Sudan – as spelled out in the National Plan for the Protection of Civilians  ( NPPOC )  and recent peace agreements   is committed to ensuring the rights of its citizens, including those affected by protracted displacement. The key challenges are limited access to public services, protection of civilians, intercommunal conflict, recurrent disasters, and lack of durable solutions.
Sustaining health and nutrition screening services for refugees at border crossing points and reception centres remains a challenge.
Scaling up maternal nutrition services remains a concern with approximately 647,623 PLW  [ Pregnant or Lactating Women ]  in of need moderate acute malnutrition  ( MAM )  management services to attain adequate diet. Also, one million mothers need appropriate infant and young child nutrition  ( IYCN )  counselling services.
In the case of maternal nutrition approximately 883,000 pregnant and lactating women  ( PLW )  suffer from acute malnutrition annually in Sudan.
In 2020, 15 out of the 18 states had high global acute malnutrition  ( GAM )  rates. Around 95 localities reported extremely high levels of malnutrition. Around three million children under five suffer from acute malnutrition out of which an estimated 570,000 have severe acute malnutrition  ( SAM ) .
There has been an increase in the cost of basic foods and recent IPC data indicate a large decline in the proportion of people who could afford the local food basket in 2020. According to the latest IPC report, around 7.1 million people are severely food insecure.
Micro nutrient deficiencies are common with only 7.6 per cent of households using iodized salt for instance  ( S3M II survey ) . The development of malnutrition is underpinned by high food insecurity, poor WASH conditions and poor knowledge and practices among mothers on infant and young child nutrition. Despite efforts in 2020 to scale up nutrition services, a significant gap remains.
The most vulnerable communities live in areas ranked as severity four and five in terms of malnutrition – sensitive indicators for food security, clean drinking water and low social protection coverage.
Due to lack of resources and capacity among humanitarian actors, only 40 per cent of the total 3.2 million acutely malnourished children under five were targeted for treatment, leaving the rest susceptible to morbidity and mortality.
COVID 19 pandemic exacerbated prevailing conditions. Loss of livelihoods disrupted access to food and the health care system. COVID 19 containment measures limited the scale of response vis a vis the planning targets for 2020 for humanitarian partners.
Almost 900,000 people were affected by the flooding resulting in displacement, disease outbreaks and disruption in health and nutrition services  ( including access issues and destruction of food commodities ) .
Displacement is another important determinant of malnutrition. Frequent displacement, limited access to land, livelihood opportunities and the influx of refugees from South Sudan have exacerbated the situation since needs have increased in certain geographical areas.
Malnutrition in all its forms is a serious public health challenge in Sudan. When nutritional needs are not met, it is impossible for an individual to achieve optimal physical and mental health. This creates limitations on educational and employment opportunities.
Seasonal rains and floods are still the main hazards that can affect hundreds of thousands of people and increase the chance of cholera outbreaks specifically because of the chronic shortages and solutions to address the suboptimal WASH infrastructure.
During 2021, the health needs are expected to remain high with anticipated disease outbreaks of endemic, water borne, and vector borne diseases like haemorrhagic fevers and malaria.
The 2020 rainy season and associated floods   the worst in Sudan in a century   put further pressure on the fragile health system. Over two million people will be affected by vector borne diseases and around five million people will be at risk of waterborne diseases.
When accessing public health services refugees struggle to pay the out of pocket fees in a situation compounded by economic contraction and limited income opportunities.
Refugees often live in remote areas with limited health infrastructure that are understaffed and have a shortage of medical supplies
Elderly people are the most affected by complications from COVID 19 and are more likely to die due to the high prevalence of non communicable diseases, lack of free medicines, and the reduced access to specialized health care. It is estimated that 1.8 million people above the age of 60 are among the most vulnerable and in need of access to regular health services.
Children under five are exposed to vaccine preventable diseases due to reduced coverage of immunization program and a high prevalence of malnutrition. Based on 2020 vaccination coverage, around two million children under five might miss one or more of their vaccinations during 2021.
Despite having 127 health facilities across Sudan, only 15 facilities are dedicated for basic services  ( BEmONC ) . Out of the 23 CEmONC facilities in Khartoum only 30 per cent were fully operational during the second half of 2020.
Around 70 per cent of babies are delivered at home with suboptimal BEmONC and CEmONC service coverage and there is a weak referral system.
Across Sudan, around seven million women of reproductive age lack access to basic emergency obstetric and new born care services  ( BEmONC )  and comprehensive emergency obstetric and new born care services  ( CEmONC ) .
Women and girls living in remote areas have little or no access to reproductive health services, adequate antenatal care, or emergency obstetric care – leading to unwanted pregnancies and potential for serious health consequences in cases of complicated deliveries.
Despite the increased use of sentinel surveillance sites  [ to detect cases of malaria ]    an additional 128 reporting health facilities were setup  ( up from 1,659 at the beginning of 2019 to 1,787 in 2020 )    the facility based disease surveillance system only covers around 30 per cent of health facilities with significant disproportionality between urban and rural coverage..
The DPT3 vaccine coverage plummeted in 2020 to reach 63 per cent and the coverage of measles vaccination was 71 per cent. The decline is due to the deteriorating economy's impact on vaccination programs as well as COVID 19 contingency measures such as restriction of movement, and reallocation of the healthcare workers to the COVID 19 response.
According to figures by the federal and state ministries of health, there are 5,457 doctors  ( one doctor for every 8,200 people ) , 12,601 nurses, and 17,343 midwives in the country.
The lack of a full strength health cadre not only affects access to basic services but also hinders the scale up of the COVID 19 response.
There is a shortage of ventilators  ( there are only 160 and most of them are in Khartoum )  and specialized staff for intensive care management. No ventilators are available in North Darfur.
A lack of designated facilities, health staff and equipment contributed to the high fatality rate  [ from COVID 19 ] .
The highest CFRs  [ case fatality ratio ]  were reported from Central Darfur  ( 50 per cent ) , North Darfur  ( 32 per cent ) , and East Darfur  ( 24 per cent ) .
Sudan's humanitarian crises impacted the already fragile health systems' capacity to provide basic health services. The health system struggles to handle the multiple emergencies affecting the country. Health needs are exacerbated by the deteriorating economy, conflict, civil unrest, floods, and disease outbreaks. In September, WHO classified Sudan as grade 2 acute health emergency.
Food security needs will remain at similar levels in 2021 as in 2020, with a likelihood of worsening of the situation as the underlying causes remain unresolved.
Movement restrictions due to COVID 19 further reduced the capacity for self reliance by preventing refugees from moving to areas in Sudan with better work opportunities.
11 per cent of refugee households have poor food consumption. Those living in camps and large out of camp settlements remain largely dependent on monthly food distributions.
The level of food insecurity is particularly high among refugee households in Darfur, where 58 per cent are food insecure compared to 37 per cent in Southern and Eastern Sudan. Female headed households are more prone to food insecurity.
The lock down measures to prevent the spread of COVID 19 significantly decreased commodity movement, market function and cross border trade, and compromised livelihoods and daily labour opportunities, reducing household purchasing power and food access of the vulnerable population.
In this case, a robust strategy would be required to facilitate remote learning, ensure children return to school when schools reopen, and offer accelerated learning at school to mitigate against learning losses caused by prolonged absence from school
Food insecurity remains alarmingly high in Sudan with increased and protracted displacement, economic decline and inflation, and high food price hikes exacerbated by the impacts of the COVID 19 pandemic and the high inflation rates.
Educational needs are projected to remain high throughout all of 2021, with a slight peak in September due to the annual floods which directly impact schools and schoolchildren at the beginning of the academic year.
However, in some specific states, most notably West Darfur and West Kordofan, girls' primary school enrolment is significantly lower than boys  ( 22 and 20 per centage points lower in those two states respectively ) .
Overall, there is a high degree of gender parity across Sudan in terms of access to education.
Although there is limited data available on children with disabilities in Sudan, it is estimated that 15 per cent of children have at least one disability, which translates to 2 million school aged children  ( ages 6 16 )  living with disability.
More than three quarters of nomadic children were out of school prior to school closures  ( compared to 27 per cent of children out of school across all population groups ) .
Additionally, the high costs of schooling, limited educational facilities within a safe walking distance and the perception that education is not useful, particularly for girls, all present barriers to nomadic and pastoral children fulfilling their right to education.
Nomadic and pastoral children in Sudan face significant challenges accessing education as they are unable to attend a static school during the usual daytime hours of a conventional school year.
These children are at high risk of dropping out of school or having their educational attainment curtailed if they are not adequately supported through a full package of educational interventions, including school feeding.
These risks are expected to be further exacerbated in 2021 due to long periods of school closure during 2020 as well as increased food insecurity due to Sudan's deepening economic crisis.
There are currently 1.8 million non displaced children in Sudan enrolled at school who are experiencing crisis, emergency or catastrophic levels of food insecurity.
Additionally, families of refugee children are often unable to cover school fees and associated costs such as school uniforms. Many refugee children work outside the home to supplement the family's income.
The population groups most in need of humanitarian assistance to continue their education include IDPs, refugees and returnees, host community members facing severe food insecurity, nomadic populations, children with disabilities and, in some communities, girls.
In the first half of 2020, child protection risks were already on the rise, with a reported 24 per cent increase in early marriage  ( girls more affected than boys )  and a 35 per cent increase in child labour  ( boys more affected than girls ) .
There were also challenges transitioning to a new academic calendar and curriculum for the 2020 2021 academic year, which was compounded by flooding damaging more than 570 schools and rendering unusable an additional 70 schools that were used to shelter displaced families.
While previously the academic calendar included a ‘Group B' schedule running during the dry season when nomads remain in seasonal settlement areas, for the 2020 2021 academic year, Sudan is transitioning to a standard academic calendar starting in September during the rainy season, putting nomadic children at an even higher risk of dropping out of school.
By the end of 2018, an estimated 4.4 million school aged children  ( 6 16 years )  were out of school, many of whom live in the most vulnerable or conflict affected communities.
The lack of development funding will also have a negative effect in addressing protracted needs for displaced populations as this requires significant investment in durable solutions, services and infrastructure.
With the signing of the Peace Agreement on 3 October, there is a renewed optimism for the path to development. Negotiations are ongoing with the two groups that did not sign the peace agreement   Darfur based Sudan Liberation Army  ( SLA AW )  faction and the Sudan People's Liberation Movement North AlHilu  ( SPLM N ) .
Within this context  [ influx of refugees ] , there is an urgent need for more durable solutions that support greater self reliance and enhanced protection of IDPs, returnees and refugees, which also benefits host communities. Longer term solutions are needed to strengthen the resilience of refugees and their host communities, and to support refugees' self reliance, especially for those who are living in out of camp settlements.
Existing vulnerabilities of refugees are increased due to the deteriorating economic situation and protracted displacement. Sudan also hosts over one million refugees including 814,000 from South Sudan.
People's coping capacities have declined, and large parts of the population are facing food insecurity and nutrition crisis, particularly vulnerable groups such as IDPs and refugees.
This  [ favorable conditions along the Nile Valley ]  poses a risk for desert locusts developing and spreading in Sudan and negatively impacting the food security of vulnerable populations.
The ecological conditions are remained favourable in the eastern part of the country particularly in the Red Sea state as well as along the Nile valley
The unprecedented floods of 2020 had a negative effect on agriculture, an estimated 7.1 million people face crisis or worse levels of food insecurity  ( IPC phase 3 and above ) , a 22 per cent increase from last year.
Foreign exchange shortages, together with increasing dependence on imports for food, agricultural inputs, and medical supplies, among other items, are putting even more pressure on Sudan's foreign exchange demands and in turn, the ability to deliver on basic social services, weakening the ability of the population to respond to shocks.
The underlying factors will take time to address and are likely not to improve drastically in 2021. The risk of disease outbreaks therefore remains high in 2021.
Poor WASH conditions combined with a lack of knowledge about infant and young child nourishment, drive food insecurity and malnutrition.
Large protracted displacement remains, with limited returns. There are 2.5 million IDPs and 1.07 million refugees and asylum seekers who need humanitarian assistance and protection support, both in and out of camps and in host communities.
Major cities and towns are along rivers and seasonal water courses that are flood prone areas. There is limited understanding of the climate change related flood risks and impacts.
The most flood prone states include Kassala, Gedaref, and Sennar in the East; Blue Nile and White Nile; Khartoum; North, Central, West and South Darfur; and South and West Kordofan. Impacts of climate change and poor drainage and infrastructure are likely not to change in 2021, factors attributed to the increase of people affected, thus the risk of flooding will remain.
Heavy flooding occur seasonally in Sudan, peaking from July to September. In 2020, close to 900,000 people were affected in all 18 states against a five year average of 203,000  ( 2015 to 2019 )    an increase of over 105% from the people affected in 2019  ( 430,000 ) .
The Protection sector and UNAMID  [ UN Hybrid Operation in Darfur ]  identified 200 farming villages particularly vulnerable to attacks. Besides leading to displacements, the attacks usually result in crop destruction, killings, maiming and other abuses including sexual violence.
In 2021, 7.3 million people are affected by life threatening conditions and 13.3 million people cannot adequately meet minimal living standards. Most people that face life threatening situation also cannot meet minimal living standards, however, the same is not true in reverse   i.e. not everyone that has living standards issues is facing life threatening issues. An overlap is expected, however the number of people facing life threatening issues is high when compared with other protracted humanitarian emergencies.
In 2021, a total of 13.4 million people are expected to be in need across all of Sudan's 18 States, of whom 7.6 million are women and girls. Some 9.8 million people in need are vulnerable residents or people affected by years of conflict and economic crisis, while 2.5 million are IDPs, 1.1 million refugees, and 0.17 million returnees. Within these population groups, some of the vulnerable people that have specific needs include children, women at risk, elderly people, pregnant and lactating women and children under five with high levels of malnutrition.
Ways of communicating with affected people also can better target people's preferences. The MSNA  [ Multi Sector Needs Assessment ]  results suggest that face to face communication  ( 44%, 33% )  appears to be the preferred means of receiving information and providing feedback. However, the surveyed households trusted a wide range of sources of information, including friends, family members ( 19% ) , aid workers both from United Nation and International NGOs  ( 22%, 20% ) , Government ( 15% ) , and community youth groups ( 21% ) .
[ According to the Multi Sector Needs Assessment, ]  Internally displaced people  ( IDPs )  reported livelihoods, education and shelter were their main priorities.
The overall MSNA  [ Multi Sector Needs Assessment ]  findings suggest that health, livelihoods and education are the top three priority needs identified by surveyed households, however, the results varied depending on gender and the status of the respondent. Female headed households prioritised livelihoods, health, and education, whereas male headed households reported education, livelihoods, and health.
Between 31 August and 5 September, UNHAS  [ UN Humanitarian Air Service ]  suspended flights to Port Sudan and Kassala, following ethnic clashes in the wake of the controversial appointment of a civilian governor. Despite the constraints, humanitarians were able to conduct assessments and respond in areas affected by intercommunal conflict including Masterei and Geneina, Kassala and Kadugli.
The unprecedented floods that caused havoc during the rainy season aggravated access challenges. Flooding combined with a difficult physical terrain made roads in several states impassable, causing delays to aid activities particularly during August September. Several areas were affected. For example, in Jebel Marra  ( Central Darfur )  the road to Kwila was partly washed away due to flooding. Similarly, damage to road infrastructure made it difficult to reach areas in South Kordofan and Blue Nile, with some villages were accessed only by boat or helicopter.
The Government made provisions for the movement of humanitarian cargo, allowing aid operations to partly continue. Despite difficulties in movement and suspension of face to face activities, such as monitoring visits and community engagement, humanitarians managed to partly continue their work and assist 8.8 million people until September 2020.
As the COVID 19 pandemic hit Sudan in March 2020, the Government introduced measures to contain the spread of the virus. In line with most other countries, Sudan closed international borders, banned public gatherings and interstate movement, while the states introduced curfews.
Heavy administrative procedures continue to present obstacles to the provision of timely and quality humanitarian assistance. Administrative measures vary considerably between federal and state levels authorities, and among states.
The World Food Programme  ( WFP )  in Sudan announced on 11 March the expansion of its school feeding programme across 15 states and over 100 localities to reach 1.8 million people up from 1 million in 2020
As of 31 October 2020, Sudan hosted 26,523 CAR refugees. Many CAR refugees living in Central or South Darfur live in remote areas that are hard to reach. They lack access to local public services and have very limited coverage of refugee specific health and nutrition services.
The influx of new refugees into the country has slowed, partially due to the border restrictions implemented as a precaution against COVID 19,  [ however, ]  in November 2020, military confrontations started in Ethiopia between the Ethiopian Defense Forces  ( EDF )  and Tigray People's Liberation Front  ( TPLF ) .
As a result of the fighting in Tigray, close to 45,000 Ethiopian refugees have crossed the border into Sudan by 7 December. Initial population profiles indicate over 40 per cent are children. The UN and partners are projecting 100,000 arrivals from Ethiopia to Sudan over the next six months.
Most of the people have been displaced within the same state, mainly due to the logistical and security concerns associated with their sudden movement. Intermittent inter communal tension and violence in parts of Darfur, eastern Sudan and the Kordofan regions have heightened protection and rule of law concerns amongst the population. While there has been less new displacement due to conflict or inter communal violence over the past few years, 2.5 million remain protracted IDPs.
The Government of Sudan is generous in welcoming refugees but they are largely reliant on humanitarian assistance and have limited access to livelihood opportunities.
New displacement reduced in 2020 but remains a concern. There are approximately 2.5 million IDPs in Sudan. Of these IOM's Displacement Tracking Matrix  ( DTM )  has identified an estimated 2.4 million situated across the five Darfur states, as well as South and West Kordofan.
The four states with the highest concentration of IDPs are South Darfur  ( 33 per cent ) , North Darfur  ( 21 per cent ) , Central Darfur  ( 16 per cent )  and West Darfur  ( 14 per cent ) . Armed conflict was the primary reason for the majority of the displaced  ( 90 per cent ) , followed by communal clashes  ( 37 per cent )  due to ethnicity, land and/or livestock.
In 2020, there has been an increase in the cost of basic foods. Recent IPC data show a large decline in the proportion of people who could afford the local food basket.
Localities from all 18 states in Sudan have been IPC classified, except At Tina locality in North Darfur, and Abyei PCA box, where no data was collected. The states with the highest increases in severe food insecurity in the past year are North Kordofan  ( >335 per cent )  and Aj Jazirah  ( >219 per cent ) . Some localities in North Kordofan have seen food insecurity increase by more than 700 per cent. Khartoum state continues to have the highest numbers of food insecure people in absolute terms, given its high overall population.
In 2020, food insecurity increased in areas not traditionally targeted for humanitarian assistance. An estimated 7.1 million people are severely food insecure needing urgent action, according to the latest Integrated Food Security Phase Classification  ( IPC )  report.
The economic crisis, including inflation, and a surge in food prices, exacerbated by COVID 19, resulted in record high numbers of food insecure people. The COVID 19 measures significantly affected commodity movement, market functionality and cross border trade, and compromised livelihoods and daily labour opportunities. This reduced households' purchasing power and access to food for the most vulnerable people.
Rule of law, access to justice and government social protection remains weak across the country, but particularly in conflict affected areas. In 2020, the economic crisis and scarcity of resources has further impacted public service delivery and heightened the socio economic vulnerability of vulnerable people, particularly IDPs, and refugees. UNAMID's  [ United Nation African Hybrid Mission in Darfur ]  withdrawal will leave gaps in protection of civilians in Darfur, which coupled with a gradual decrease of presence of humanitarian partners in IDP camps / sites will have a negative impact on protection support.
Also, in these areas  [ where refugees are ] , there is limited access to quality secondary and tertiary medical care treatment, including no access to treatment for chronic illnesses. Refugees face mental health service gaps despite trauma related to persecution, asylum flights, and other mental health care needs.
Transport costs increased by 585 per cent, reflecting seven fold increase in rural and four fold increaase in urban areas, thanks to the partial removal of fuel subsidies. Further reductions in fuel subsidies will continue to drive inflation.
This  [ limitation of access to services and protection assistance ]  is aggravated by overcrowding and gaps in assistance in refugee camps and out of camp settlements. In camps, health clinics normally absorb demand for health services from host communities, with 30 50 per cent of all consultations comprised of host community members. In out of camp and urban locations, refugees are normally asked to pay for services at a higher rate than Sudanese nationals.
Refugees are often living in poorer areas with host communities who are similarly under served and have limited access to public services. Although supported by the host community, refugees have limited access to services and protection assistance.
About 8.1 million students have been unable to resume their studies and the re opening of schools was postponed until 2021.
In Khartoum state, 70 per cent of the primary health clinics were closed due to COVID 19 containment measures and in some facilities, stigma resulted in patients not being admitted for treatment of other illnesses.
This is a critical impediment to effectively respond to COVID 19, as well as to ensure people's general well being and survival. Between March and July 2020, COVID 19 lock down measures prevented children from accessing routine vaccinations.
The measures implemented by the Government to contain the spread of the COVID 19 pandemic affected crop production, mainly at the beginning of the season, with market closures resulting in shortages of some agricultural inputs and movement restrictions causing labour shortages and high costs of agricultural practices.
Severe desert locust infestations affected coastal areas along the Red Sea coast and riverine areas along the Atbara River. In December 2020, 101 300 hectares were surveyed and about 20 percent of this area was treated with 13 884 litres of concentrated pesticides.
As a result of the COVID 19 related restrictions of movements within and between states at the beginning of the season in April May, labour shortages were reported in some states, especially in the semi mechanized sector  ( Gedaref and Kassala ) . However, the labour availability in 2020 was overall adequate, but daily wage rates increased by 175 percent compared to 2019.
The total quantity of seeds delivered by the MoANR  ( Ministry of Agriculture and Natural Resources )  to the state ministries of agriculture in the 18 states amounted to 1 651 tonnes, representing about 90 percent of the target. Sorghum  ( Arfa Gadameck, Wad Ahmed, Tabat, Butana varieties )  represented 81 percent of the total, millet 5.6 percent, groundnuts 5.5 percent, sesame 5.5 percent and other crops  ( including cotton, and beans )  2.3 percent. The quantity delivered in 2020 was 14.6 percent lower than in 2019 due to high inflation underpinning the cost of seeds.
Although the total amount provided by the ABS  [ Agricultural Bank of Sudan ]  in 2020 was substantially higher than in 2019, the area financed, approximately 2.8 million hectares, was only 3.7 percent more than last year, due to the high inflation, which resulted in increased cost of inputs and agricultural operations
Loans to eligible farmers are provided through the interest free salam, with the ABS  [ Agricultural Bank of Sudan ]  charges levied in kind at a value fixed at planting time jointly by the Ministry of Finance, the Strategic Reserve Corporation, the ABS and the farmers' associations.
While a significant proportion of Sudan's population is struggling to meet basic needs and services, this is aggravated among the most vulnerable including IDPs and refugees.
A high percentage of urban housing has been built in a flood plain area, resulting in destructive impacts this decade. Another key root cause of urban flooding is lack of sewage, storm and rainwater collection systems and inadequate maintenance mechanisms for the existing systems. Sudan experiences sandstorms frequently impacting basic infrastructure on sewage and rainwater collection.
Sustaining health and nutrition screening services at border crossing points and reception centres remains a challenge.
The Sudanese economy is in a vicious cycle of low savings, investment, wages, productivity and skills, and high unemployment and poverty. High inflation, while exacerbated by monetization of the fiscal deficit, is largely cost push inflation as shown by the price index. In 2020 inflation averaged 254 per cent, with the rate at 277 per cent in rural areas and 226 per cent in urban areas.
Inflation doubled in 2018 to 60 per cent following an increase of bread prices and import duties, and rose to 254 per cent by November 2020 and is expected to remain in triple digits into 2021.
About 47 per cent of the population lives on less than USD$1.25 per day. Darfur and Kordofan states 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 )  follow.
Transitioning towards durable solutions remains one of the main priorities of the Government given the commitment, enshrined within the Constitutional Declaration as an aim to “end the war by addressing the root causes of the Sudanese problem and handling its effects.' The Juba peace agreement signed on 3 October 2020 offers an opportunity to progress towards durable solutions and enhance coordinated life saving and stabilization support for new and protracted IDPs and host communities.
The severe decline in GDP as well as a loss of approximately 42 per cent of fiscal revenues has had a concomitant impact on services. The country continues to face the humanitarian consequences of COVID 19, with over 18,254 people contracting the virus, including 1,265 deaths.
There are 2.5 million internally displaced people  ( IDPs )  in Sudan. Most of them are in Darfur, South Kordofan, and Blue Nile, which have been the epicentres of conflict over the past 17 years. These are also the areas where 52 per cent of people in need are concentrated. This means that almost half of the people in need are in non conflict central and eastern parts of the country, whereas in 2018, 74 per cent of people in need were in conflict areas   Darfur, South Kordofan and Blue Nile.
A decline in the economy is driving food insecurity, further disrupting health services, including the availability of medicines with 15 per cent of essential drugs available in the country.
Additional child friendly spaces in Village 8 and Hamdayet are also needed. Furthermore, an increasing number of persons with disabilities have approached the protection desk, requesting services, such as hearing aids, crutches or cash assistance, currently unavailable at any sites.
The Transitional Government initiated the Family Support Programme, with support of the World Food Programme  ( WFP ) , to mitigate the impact of the COVID 19 related restrictions on vulnerable families.
Over 1,600 health workers and rapid response teams in at least 277 localities across Sudan have been trained, hygiene kits distributed to nearly 500,000 people and protective equipment to attend the needs of 6,000 health centres in the country. Over 25 million people have been reached with campaigns to raise awareness to prevent transmissions and at least 2.8 million people were reached with food assistance in May.
Aid actors are establishing quarantine or isolation spaces and shelters, providing the country with COVID 19 testing kits and setting up water points and handwashing stations in IDP and refugee camps and in host communities.
Years of conflict, recurrent climatic shocks and disease outbreaks continue to affect the lives and livelihoods of many Sudanese. The situation is worsening and now over 9.6 million people are facing severe hunger, in a country with already high malnutrition rates.
While food insecurity remains a key driver of poor nutrition status across the camps, the findings also point to the wider effects of chronic underfunding for the response, especially in WASH, health and livelihoods sectors.
COVID 19 is having direct and indirect impacts on food access in Sudan, according to the latest food security alert report from FEWS NET  [ Famine Early Warning System Network ] . Some families lost their incomes at a time where they also face higher living costs, including due to increasing medical costs related to the pandemic, as well as the ongoing economic crisis
Prevention to COVID 19 is also a challenge in Sudan, as 63 per cent of the population do not have access to basic sanitation, 23 per cent do not have access to a hand washing facility with soap and water and 40 per cent do not have access to basic drinking water services. The risk of transmissions and increased humanitarian needs are especially high amongst the nearly 2 million internally displaced people  ( IDP )  and 1.1 million refugees living in collective sites or host communities across the country and the population living in urban slums.
Across Sudan, clinics and hospitals lack critical medicines, as they can no longer afford to stock them due to the economic crisis and also due to disruption in the supply chains. The situation makes it extremely challenging for the Government and aid organizations to respond to the pandemic and maintain essential services. Women and children have been especially affected. Maternal health clinics have closed, reproductive health services have been interrupted and over 110,000 children are missing out essential vaccines.
In Khartoum State alone, nearly half of the health centres closed during the pandemic, and Darfur had already closed a quarter of their facilities in 2018 due to lack of funds and staff. Sudan has only 184 beds in intensive care units  ( ICU )  and approximately 160 of them have ventilators, according to WHO. Only four ICU doctors three in Khartoum and one and Gezira State  are prepared to deal with patients infected with the virus, according to WHO.
Core relief items, shelter, and specialised psychosocial support should also be prioritised for foster families to ensure the children are safely accommodated and receive the care they need.
Three months on, UNHCR and partners continue to work to meet the growing needs of an increasing refugee population. Gaps remain in all sectors, from water  ( incl. water trucking and chlorine tablets ) , sanitation  ( incl. latrines, drainage, and waste management )  and hygiene  ( incl. shower rooms and handwashing facilities )  to health facilities  ( incl. general medicine, reproductive health, ambulances, solar power, isolation centres, health staff, medicines, laboratory tests, and medical supplies ) , food  ( incl. quality and variety ) , shelter  ( incl. durable emergency shelters )  and protection response, especially youth protection activities, mental health and psychosocial support and GBV response.
To mitigate potential health and security risks, the UN Refugee Agency  ( UNHCR )  and partners are working to relocate refugees to camps away from the border. Sudan's Government Commissioner for Refugees  ( COR )  is conducting preliminary registration at transit centres at the household level, while UNHCR is registering new arrivals in Um Rakuba using its electronic registration and case management system  ( ProGres v4 reception module )  at individual level.
Since early November, military confrontations between the federal and regional forces in Ethiopia's Tigray region, bordering both Sudan and Eritrea, have led to the flight of thousands of civilians to border areas in Sudan  ( most notably at Hamdayet and Lugdi/Village 8 ) .
Protection activities are also being provided  [ by INGO Welthungerhilfe ]  to women and children from both the refugee and host community where they are provided with safe spaces and are sensitized on key protection issues and referral pathways.
The Sudan Humanitarian Fund  ( SHF )  has provided nine humanitarian partners with US$6.3 million to respond to the needs of the refugees. As of 23 March, the UN Refugee Agency  ( UNHCR )  and the Government's Commissioner for refugees  ( COR )  have registered over 62,000 Ethiopian refugees who have crossed the border into eastern Sudan.
Flexible funding from Germany, Norway, Switzerland, the United Kingdom and the United States enabled WFP  [ World Food Program ]  to divert resources in the amount of US$5.2 million towards the immediate response to refugees right at the start of this emergency. Despite these generous contributions and efforts, WFP Sudan still requires US$173.8 million in funding for its operations in the first half of this year, of which US$8.6 million is needed to sustain food assistance and nutrition support for refugees arriving from Tigray over the coming four months.
WFP  [ World Food Program ]  rapidly responded to the influx of new refugees from day one, providing food for hot meals and high energy biscuits at reception centres on the border, giving logistical support to the humanitarian community, distributing monthly food rations to refugees in camps, and providing nutrition support to children under five and pregnant or nursing women
WFP  [ World Food Program ]  officially launched a ShareTheMeal fundraising campaign last week aiming for individual users of the ShareTheMeal app to share 1,000,000 meals. In addition to contributions from Japan and the Share the Meal campaign, WFP received €15,000 from Andorra for the refugee response.
The contribution from the Government of Japan helps WFP provide monthly food rations including sorghum, lentils, oil and salt to refugees fleeing Ethiopia's Tigray region after violence broke out on 4 November
The United Nations World Food Programme  ( WFP )  is appealing for funding to provide food and nutrition assistance to over 60,000 refugees who crossed from Ethiopia into eastern Sudan in recent months. WFP welcomes a contribution of US$800,000 from Japan.
Overall, humanitarian agencies in Sudan need US$1.9 billion to save lives and provide humanitarian assistance to 8.9 million people across the country in 2021. The cost of the response for 100,000 people in West Darfur for six months is estimated at $30 million. The key priorities are protection, WASH, shelter and NFIs, and education in emergencies.
In 2020, despite these challenges and restrictions related to COVID 19 containment measures, health sector partners in Sudan provided 3.9 million people in Sudan with access to health services, of whom 2.9 million were people assisted in Darfur.
The latest available data from the Central Bank of Sudan indicates that in January September 2020 Sudan imported about US$249 million worth of various medicines, about 14 per cent higher than during the same period of 2019, but is 25 per cent lower compared to 2017  ( the year before the economic crisis started ) . The lack of medicines is compounded by the cost of health services increasing by 200 per cent compared to last year.
Sudan's National Medical Supplies Fund reports that the availability of essential emergency medicines reduced to 47 per cent by the end of January 2021 compared to 88 per cent in January 2020.
The majority of the  [ Ethiopian ]  asylum seekers are living among the Sudanese host community who continue to welcome people seeking safety. UNHCR and partners are ramping up the response to support the government in its response. As of 31 January, UNHCR and partners have raised 48 per cent of the US$146 million requested under the inter agency appeal for the response to the Tigray situation.