Date of Graduation


Document Type


Degree Name

Master of Science in Community Health Promotion (MS)

Degree Level



Health, Human Performance and Recreation


Leah Jean Henry

Committee Member

Bart Hammig

Second Committee Member

Robert Davis


public health, food insecurity, national emergency response plan (ERP)


The purpose of the study was to assess the impact of COVID-19 on the number of admissions of severe acute malnutrition among children under 5 years of age seeking nutrition services in Afghanistan especially in the provinces where the prevalence of COVID-19 was high, for the period of February – September 2020. The study used comparison and analysis of secondary datasets of the Integrated Management of Acute Malnutrition – a national program for detection and management of moderate and severe acute malnutrition in the country.

This study analyzed the association between COVID-19 cases and severe acute malnutrition (SAM) admissions of children under 5 years of age seeking nutrition services in Afghanistan at national level and in the provinces most affected by COVID-19. For the number of SAM admissions, the inclusion criteria were children 6-59 months of age registered or admitted to OPD-SAM section of IMAM program, boys and girls, from February – September 2020. For COVID-19 cases, all the confirmed cases at national and provincial levels, regardless of their age and gender, were taken in account, and were extracted from the Office for the Coordination of Humanitarian Affairs (OCHA) database. SAM admissions in 2020 were compared to the number of SAM admissions done before COVID-19, in 2018 and 2019, for the same period (February – September) to determine the difference in the number of admissions among them.

Results indicated that there was a significant positive association between a total of 208,106 SAM (OPD-SAM) admissions and 2,247,025 COVID- 19 cases which was reported from national level (34 provinces) of Afghanistan during February – September 2020 (r = .80, p = .016). At provincial level, the differences were assessed only for five provinces where the COVID-19 cases were high, and where in the beginning of the pandemic, testing centers for COVID-19 were available. For three provinces Kabul, Herat and Nangarhar the correlation was strong, positive, and statistically significant (r = .85, p = .006, r = .78, p =.021, r = .77, p = .024). In Balkh province there was also a positive, strong but not statistically significant correlation between SAM admissions and COVID-19 cases (r = .60, p = .116). In contrast, in Kandahar province the correlation was moderate, and the two variables were not statistically significant (r = .31, p = .447).