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Integrated SMART Survey Nutrition, WASH, Food Security and Livelihoods

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Integrated SMART Survey Nutrition, WASH, Food Security and Livelihoods Integrated SMART Survey Nutrition, WASH, Food Security and Livelihoods DeSHARI Project Locations Satkhira & Jessore Districts Bangladesh August 2017 Acknowledgement Action Against Hunger would like to acknowledge and express great appreciation to the following organizations, communities and individuals for their contribution and support in carrying out this survey: District and Upazila Authorities for their assistance to successful implementation of the survey in Satkhira and Jessore Districts. Health and Family Planning staff at Upazila and community level for their active support during survey period ECHO for funding to implement the Integrated SMART Survey in Satkhira and Jessore Districts. Christian Aid, CCDB, Dan Church Aid, DSK, Muslim Aid and Shushilan for extending their support in recruitment of local enumerators and effective coordination with district authorities. Md. Abdullah Al Mamun, Consortium Manager and DHoD-FSL & DRR, Tapan Chokrobarty, HoD- FSL & DRR, Leonie Toroitich-van Mil HoD-Nutrition and Health, Md. Amir Hossain, DHoD- Nutrition and Health, Mita Rani Ray Chowdhury, MHCP Coordinator, Md. Maksudul Amin, DHoD- WaSH, Md. Lalan Miah, Survey Manager for their valuable contributions to implement the survey successfully Mothers, Fathers, Caregivers and children who took part in the assessment during data collection. Action Against Hunger would like to acknowledge the community representatives and community people who have actively participated in the survey process for successful completion of the survey. Finally, Action Against Hunger is thankful to all of the survey enumerators, team leaders and Survey Manager for their tremendous efforts to successfully complete the survey in the districts. Acronyms ACF Action Contre La Faim ‖ Action Against Hunger ARI Acute Respiratory Infection BBS Bangladesh Bureau of Statistics BDHS Bangladesh Demographic and Health Survey CA Christian Aid CCDB Christian Commissions for Development in Bangladesh CI Confidence Interval CMAM Community Based Management of Acute Malnutrition DSK Dushtha Sasthya Kendra ENA Emergency Nutrition Assessment EPI Expanded Program on Immunization FAO Food and Agriculture Organization FCS Food Consumption Score FSL Food Security and Livelihoods GAM Global Acute Malnutrition HAZ Height-for-Age z-score HDDS Household Dietary Diversity Score HH Household IDDS Individual Dietary Diversity Score IPC Integrated Food Security Phase Classification IYCF Infant and Young Child Feeding MA Muslim Aid MAM Moderate acute malnutrition MEB Minimum Expenditure Basket MHCP Mental Health and Care Practice MoHFW Ministry of Health and Family Welfare MUAC Mid-Upper-Arm-Circumference. NGO Non-Governmental Organization OTP Outpatient Therapeutic Program PLW Pregnant and Lactating Women PPS Probability Proportion to Size rCSI Reduced Coping Strategy Index SAM Severe Acute Malnutrition SD Standard Deviation SFP Supplementary Feeding Program SMART Standardized Monitoring and Assessment of Relief and Transition U5 Under Five WaSH Water, Sanitation and Hygiene WAZ Weight-for-Age Z-score WFH Weight For Height WFP World Food Program WHO World Health Organization WHZ Weight-for-Height Z-score Table of Contents Acknowledgement ........................................................................................................................................ 2 Acronyms ..................................................................................................................................................... 3 1. Executive Summary ................................................................................................................................. 8 Summery findings ..................................................................................................................................... 9 1. Introduction ...................................................................................................................................... 13 1.1Survey Objectives .............................................................................................................................. 14 2. Methodology .................................................................................................................................... 14 2.1 Survey Area ...................................................................................................................................... 14 2.2 Type of survey .................................................................................................................................. 15 2.3 Sample size .................................................................................................................................. 15 2.4 Survey Target Population .................................................................................................................. 16 2.5 Sampling procedure: selecting clusters ............................................................................................. 16 2.6 Sampling procedure: selecting households and children ................................................................... 16 Selection of number of household per cluster / per day ........................................................................... 17 2.7 Case definitions and inclusion criteria ............................................................................................... 17 2.8 Questionnaire, training and supervision ........................................................................................ 20 2.9 Data analysis and quality .............................................................................................................. 20 3. Results ............................................................................................................................................. 22 3.1 Household and Family composition ................................................................................................... 22 3.2 Distribution Age and Sex ................................................................................................................... 22 3.3 Acute Malnutrition based on Weight for Height Z-score ..................................................................... 23 3.4 Acute Malnutrition based on Mid Upper Arm Circumference ............................................................. 24 3.5 Underweight ...................................................................................................................................... 25 3.6 Chronic Malnutrition/ Stunting ........................................................................................................... 26 3.7 Childhood Morbidity .......................................................................................................................... 28 3.8 Child Care practices including Infant Young Child Feeding (IYCF) .................................................... 29 3.8.1 Early Initiation of Breastfeeding ................................................................................................ 29 3.8.2 Exclusive Breastfeeding ............................................................................................................ 29 3.8.3 Continued Breastfeeding (at 1 year and 2 years) ..................................................................... 29 3.8.4 Complementary feeding ............................................................................................................. 30 3.9 Knowledge of mothers on child care practices (0-23 months) ........................................................... 31 3.10 Food Security and Livelihoods .................................................................................................. 32 3.10.1 Household Source of Income ....................................................................................................... 32 3.10.2 Source of Food .............................................................................................................................. 33 3.10.3 Household Dietary Diversity Score .............................................................................................. 33 3.10.4 Reduced Coping Strategy Index (rCSI) ........................................................................................ 34 3.11 Water and Sanitation ................................................................................................................ 35 3.11.1 Main sources of water by percentage of HH ................................................................................ 35 3.11.2 Distance to water source .............................................................................................................. 35 3.11.3 Water Transport and Storage ........................................................................................................ 36 3.11.4 Sanitation and Hygiene ................................................................................................................. 37 3.11.5 Hand washing Behaviour .............................................................................................................. 38 4 Discussion & Conclusion .................................................................................................................. 39 Nutrition .................................................................................................................................................. 39 Child Morbidity and Immunization ..........................................................................................................
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