Akoka County Faces Critical Nutrition and Humanitarian Crisis, Survey Finds

Credit: CGTN

Akoka County in Upper Nile State is facing a severe humanitarian and nutrition crisis, with nearly three in 10 children suffering from acute malnutrition, according to a June 2026 SMART survey conducted by REACH.The survey, conducted from June 11-16 across Akoka County’s five payams, assessed 388 children aged 6-59 months from 320 households in 32 villages. It examined nutrition, mortality, food security, health service coverage, water and sanitation, and infant and young child feeding practices.

The survey found that 28.8% of children aged 6-59 months were acutely malnourished, while 9.8% suffered from severe acute malnutrition. When different anthropometric indicators were combined, global acute malnutrition rose to 34.3% and severe acute malnutrition to 12.6%.

The findings are consistent with Akoka’s classification under IPC Acute Malnutrition Phase 5, or Extremely Critical. The report says the situation has deteriorated, with conflict, displacement, severe food insecurity, disrupted humanitarian assistance, limited health and nutrition services, disease outbreaks, flooding and market disruptions contributing to the crisis.

The survey also recorded an elevated mortality rate. Twenty-two deaths were reported during the 98-day recall period, including five children under 5. The crude mortality rate was 1.18 deaths per 10,000 people per day, above the emergency threshold of 1 death per 10,000 people per day. Illness accounted for 77.3% of reported deaths, while 18.2% were attributed to injuries or trauma.

The report linked some of the deaths to limited access to health services, particularly in remote areas where essential medicines were reportedly unavailable for extended periods.

Food insecurity was widespread, with 73% of households classified as food insecure and 98% relying on emergency-level livelihood coping strategies. About 20% of households experienced severe or very severe hunger.

Feeding practices among young children were also poor. Only 10.5% of children aged 6-23 months met the minimum meal-frequency standard, 40.7% achieved minimum dietary diversity and just 3.5% received a minimum acceptable diet. About 73.3% of children consumed no vegetables or fruit on the day covered by the survey.

The report said the poor feeding practices appear to be driven not only by gaps in knowledge but also by the collapse of household food access. It recommended combining urgent food security assistance with nutrition counseling and infant and young child feeding support.

Water, sanitation and hygiene conditions were also severely inadequate. Only 31% of households had improved water sources, while 96% reported not treating their water. About 76% practiced open defecation and 97% lacked soap.

The survey also found low coverage of key child health interventions. Measles vaccination coverage stood at 55.1%, vitamin A supplementation at 50.8% and deworming at 51.9%.

The report found that access to nutrition treatment was particularly difficult in remote areas. In Wunpith and Payuel, some severely malnourished children were estimated to be two to three hours’ walk from nutrition centers, limiting access to treatment.

REACH said the findings demonstrate the need for a coordinated humanitarian response addressing acute malnutrition, food insecurity, health services, water and sanitation, and access to nutrition treatment.The survey is intended to support humanitarian planning, program targeting and prioritization in Upper Nile State and to inform advocacy for increased humanitarian assistance in Akoka County.