One year of nutrition response in Gaza – Nutrition Cluster Bulletin – State of Palestine (Jan – Dec 2024) – UNICEF

05 February 2025

Situation Update:

Acute malnutrition was almost nonexistent in Gaza before the conflict. However, 15 months of ongoing conflict have led to widespread population displacements, including significant displacements from Northern part of Gaza in October 2023, from Rafah in May 2024, and from North Gaza in October 2024. These displacements, coupled with restricted entry of supplies and goods and the destruction of health and WASH systems, have severely impacted access to nutritious food and essential services, including healthcare, water, sanitation, and hygiene.

Households’ ability to mitigate food consumption gaps remained critically poor, as indicated by the IPC analysis conducted in September 2024, which classified the entire Gaza Strip as IPC AFI Phase 4 (Critical). Approximately 86% of the population—1.84 million people—were in IPC Phase 3 or above, unable to meet their food needs, including nearly 133,000 people experiencing catastrophic food insecurity (IPC Phase 5). While this represented an improvement from May 2024, when 2.13 million people were classified in IPC Phase 3 or above and 343,000 were in IPC Phase 5, it still reflected a significant portion of the population unable to meet daily nutritional requirements. Access to food remained poor by end of 2024. Daily truck entries plummeted to 58 in Oct 2024, the lowest since the war began with the majority being humanitarian trucks. Food access was severely limited by the soaring prices as shown by the Food Consumer Price Index which increased by 312 percent in Sep 2024 compared to prewar times in an area with a complete collapse of livelihoods.

Throughout the year, food consumption in nutritionally vulnerable groups in Gaza has been critically poor. Over 90% of children aged 6–23 months, along with pregnant and breastfeeding women, experienced severe food poverty, consuming two or fewer food groups daily. The food available to them was of the lowest nutritional value—primarily bread and pulses—and did not meet their essential nutrient requirements, leaving them highly vulnerable to acute malnutrition.

The WASH environment has deteriorated in 2024 due to barriers to accessing improved sanitation facilities, including destruction, frequent displacement, and overcrowding in shelters. According to the WASH Cluster Rapid Assessment (Aug 2024), over 90% of households reported access to a latrine. However, barriers to accessing functional or improved latrines remain prevalent with around 25% of the population reporting access only to broken or non-functional latrines while half of the population relies on unclean or inadequate latrine facilities. Almost half of the households lack safe and clean water, and do not meet minimum standard of 15L per person per day.

The rapid WASH assessment (Aug 2024) revealed that disease prevalence has been alarmingly high due to poor living conditions, overcrowding, and inadequate WASH infrastructure. Between 25% and 35% of assessed children were reported to have been ill in the two weeks preceding the assessment. The most common illnesses were acute respiratory infections, acute jaundice syndrome and diarrhea. This high disease burden is particularly concerning in a context where access to health services is severely restricted by insecurity, displacement, and the collapse of health systems. Over 94% of health facilities have been either destroyed, non-functional or partially functional with huge shortage of health workers affecting delivery of health/care services including disruption of key routine immunizations. Despite the challenging environment, a potential health crisis was mitigated. Apart from surges in diseases like acute jaundice syndrome, acute watery diarrhea, acute respiratory infections and a circulating vaccine derived poliovirus type 2 (cVDPV2)—which broke out in Gaza after 25 years of being polio free and was contained through two rounds of vaccination—there were no major disease outbreaks that could have significantly worsened rates of acute malnutrition.

Infant feeding practices in Gaza are suboptimal with high use of infant formulas and bottle feeding which interferes with exclusive breastfeeding exposing children risks of infectious diseases. The impact of low level of exclusive breastfeeding in an emergency could be more problematic than in a normal situation, due to scarcity of clean drinking water which will further expose young children to an increase in the risk of infection and subsequently malnutrition.