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Emergency Nutrition Assessment Final Report Cox's Bazar, Bangladesh October 22- November 27 2017

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Emergency Nutrition Assessment Final Report Cox's Bazar, Bangladesh October 22- November 27 2017 EMERGENCY NUTRITION ASSESSMENT FINAL REPORT COX’S BAZAR, BANGLADESH OCTOBER 22 - NOVEMBER 27 2017 Action Against Hunger / Emergency Nutrition Assessment / Cox’s Bazar, Bangladesh / Oct - Nov 2017 1 ACKNOWLEDGEMENTS The Emergency Nutrition Assessment in Cox’s Bazar, Bangladesh was conducted on behalf of the Nutrition Sector by Action Against Hunger In collaboration with the Government of Bangladesh, the United Nations High Commissioner for Refugees, the World Food Programme, the United Nations Childrens’ Fund, Save the Children, and the Centers for Disease Control and Prevention. The assessment was funded by the United Nations High Commissioner for Refugees, the United Nations Childrens’ Fund, and the European Commission Humanitarian Aid and Civil Protection, however the opinions expressed in this report may not reflect the official opinion of these organizations. Action Against Hunger wishes to thank the Government of Bangladesh and the local governments of Cox’s Bazar, Ukhia, and Teknaf for their support in making this assessment a reality. Action Against Hunger also thanks the persons surveyed for their availability and flexibility, without which the results of this assessment could not have been possible. Family members and their measured children are warmly thanked for their cooperation and for welcoming survey teams into their homes for data collection. Action Against Hunger also thanks the community volunteers and community leaders for their collaboration in identifying survey areas and households during data collection. Special thanks and gratitude to the survey teams who made the assessment possible through their professionalism and dedication in the field. Coordination team: Leonie Toroitich-Van Mil, Nutrition Head of Department, Action Against Hunger, Bangladesh Mohammad Lalon Miah, Survey Manager, Action Against Hunger, Bangladesh Alexandra Humphreys, Flying Survey Manager, Action Against Hunger Technical support: The Emergency Nutrition Assessment Technical Working Group Eva Leidman, Epidemiologist, CDC Emergency Response and Recovery Branch Oleg Bilukha, Associate Director of Science, CDC Emergency Response and Recovery Branch Blanche Greene Cramer, EIS Officer, CDC Emergency Response and Recovery Branch Aimee Summers, Epidemiologist, CDC Emergency Response and Recovery Branch Emilie Robert, Health and Nutrition Technical Advisor, Action Against Hunger, France Claudia Grigore, Mobile Data Collection Officer at CartONG Action Against Hunger / Emergency Nutrition Assessment / Cox’s Bazar, Bangladesh / Oct - Nov 2017 2 TABLE OF CONTENTS ACKNOWLEDGEMENTS ................................................................................................................................. 2 TABLE OF CONTENTS ..................................................................................................................................... 3 LIST OF TABLES .............................................................................................................................................. 7 LIST OF FIGURES .......................................................................................................................................... 10 ACRONYMS ................................................................................................................................................. 11 EXECUTIVE SUMMARY ................................................................................................................................ 13 OBJECTIVES ............................................................................................................................................. 13 METHODOLOGY ...................................................................................................................................... 13 RESULTS .................................................................................................................................................. 14 1. INTRODUCTION ................................................................................................................................... 15 1.1 CONTEXT ........................................................................................................................................... 15 1.1.1 Geography and Demography ..................................................................................................... 15 1.1.2 Displacement and the Camps .................................................................................................... 16 1.1.3 Food Security and Livelihoods ................................................................................................... 18 1.1.5 Water, Sanitation, and Hygiene ................................................................................................. 19 1.1.6 Health ......................................................................................................................................... 20 1.1.7 Nutrition ..................................................................................................................................... 22 1.1.8 Infant and Young Child Feeding Practices .................................................................................. 22 1.1.9 Protection................................................................................................................................... 23 1.1.10 Humanitarian Actors ................................................................................................................ 23 1.2 Survey Justification ........................................................................................................................... 26 1.3 Survey Objectives .............................................................................................................................. 27 1. METHODOLOGY .................................................................................................................................. 29 2.1 Type of Survey and Target Population .............................................................................................. 29 2.2 Sample Size Calculation .................................................................................................................... 29 2.3 Sampling ............................................................................................................................................ 32 2.3.1 Cluster Selection ........................................................................................................................ 32 2.3.2 Household Selection .................................................................................................................. 33 2.3.3 Selection of Individuals to Survey .............................................................................................. 34 2.4 Collected Variables............................................................................................................................ 35 2.4.1 Demography & Mortality .................................................................................................... 35 Action Against Hunger / Emergency Nutrition Assessment / Cox’s Bazar, Bangladesh / Oct - Nov 2017 3 2.4.2 Anthropometry .......................................................................................................................... 35 2.4.3 Morbidity ................................................................................................................................... 35 2.4.4 Infant and Young Child Feeding ................................................................................................. 36 2.4.5 Receipt of Services ..................................................................................................................... 36 2.5 Indicators and Cut-offs ...................................................................................................................... 37 2.5.1 Mortality Indices ........................................................................................................................ 37 2.5.2 Anthropometric Indices ............................................................................................................. 38 2.5.3 Anaemia ..................................................................................................................................... 40 2.6 Questionnaire, Training, and Supervision ......................................................................................... 41 2.6.1 Questionnaire ............................................................................................................................ 41 2.6.2 Training ...................................................................................................................................... 41 2.6.3 Supervision ................................................................................................................................. 42 2.7 Data Management ............................................................................................................................ 42 2.8 Ethical Considerations ....................................................................................................................... 43 2.9 A Note on Interpretation .................................................................................................................. 43 3. RESULTS ..................................................................................................................................................
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