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Sitakunda Upazila Chittagong District Bangladesh

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Sitakunda Upazila Chittagong District Bangladesh Integrated SMART Survey Nutrition, Care Practices, Food Security and Livelihoods, Water Sanitation and Hygiene Sitakunda Upazila Chittagong District Bangladesh January 2018 Funded By Acknowledgement Action Against Hunger conducted Baseline Integrated SMART Nutrition survey in Sitakunda Upazila in collaboration with Institute of Public Health Nutrition (IPHN). Action Against Hunger would like to acknowledge and express great appreciation to the following organizations, communities and individuals for their contribution and support to carry out SMART survey: District Civil Surgeon and Upazila Health and Family Planning Officer for their assistance for successful implementation of the survey in Sitakunda Upazila. Action Against Hunger-France for provision of emergency response funding to implement the Integrated SMART survey as well as technical support. Leonie Toroitich-van Mil, Health and Nutrition Head of department of Action Against Hunger- Bangladesh for her technical support. Mohammad Lalan Miah, Survey Manager for executing the survey, developing the survey protocol, providing training, guidance and support to the survey teams as well as the data analysis and writing the final survey report. Action Against Hunger Cox’s Bazar for their logistical support and survey financial management. 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 surveyors, supervisor and Survey Manager for their tremendous efforts to successfully complete the survey in Sitakunda Upazila. Statement on Copyright © Action Against Hunger | Action Contre la Faim Action Against Hunger (ACF) is a non-governmental, non-political and non-religious organization. Unless otherwise indicated, reproduction is authorized on condition that the source is credited. If reproduction or use of texts and visual materials (sound, images, software, etc.) is subject to prior authorization, such authorization will render null and void the above-mentioned general authorization and will clearly indicate any restrictions on use. Acronyms ACF Action Contre La Faim ‖ Action Against Hunger ARI Acute Respiratory Infection BBS Bangladesh Bureau of Statistics BDHS Bangladesh Demographic and Health Survey CI Confidence Interval CMAM Community Based Management of Acute Malnutrition DPHE Department of Public Health Engineering ENA Emergency Nutrition Assessment EPI Expanded Program on Immunization FAO Food and Agriculture Organization FSL Food Security and Livelihoods GAM Global Acute Malnutrition HAZ Height-for-Age z-score HDDS Household Dietary Diversity Score HFA Health Facility Assessment HH Household HYSAWA Hygiene Sanitation and Water Supply IDDS Individual Dietary Diversity Score IPC Integrated Food Security Phase Classification IPHN Institute of Public Health Nutrition IYCF Infant and Young Child Feeding 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 ODF Open Defecation Faeces 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 Programme WHO World Health Organization WHZ Weight-for-Height Z-score 3 Table of Contents Acknowledgement ........................................................................................................................................ 2 Acronyms ..................................................................................................................................................... 3 Executive Summary ...................................................................................................................................... 6 1. Introduction ............................................................................................................................................. 11 1.1Survey Objectives .............................................................................................................................. 12 2. Methodology ........................................................................................................................................... 12 2.1 Survey Area ...................................................................................................................................... 12 2.2 Type of survey .................................................................................................................................. 13 2.3 Sample size ...................................................................................................................................... 13 2.4 Survey Target Population .................................................................................................................. 13 2.5 Sampling procedure: selecting clusters ............................................................................................. 14 2.6 Sampling procedure: selecting households and children ................................................................... 14 2.7 Case definitions and inclusion criteria ............................................................................................... 15 2.8 Questionnaire, Training and supervision ........................................................................................... 17 2.9 Data Entry, Data management and Analysis ..................................................................................... 18 3. Results ................................................................................................................................................... 19 3.1 Household and family composition .................................................................................................... 19 3.2 Age and Sex Ratio in Children 6-59 Months ...................................................................................... 19 3.3 Acute Malnutrition (Wasting) based on WHZ: .................................................................................... 20 3.4 Acute Malnutrition Based on MUAC .................................................................................................. 21 3.5 Underweight ...................................................................................................................................... 22 3.6 Chronic Malnutrition/ Stunting ........................................................................................................... 23 3.7 Childhood Morbidity .......................................................................................................................... 25 3.8 Child care practices including Infant and Young Child Feeding (IYCF) .............................................. 26 3.9 Food Security and Livelihoods .......................................................................................................... 29 3.10 Water and Sanitation ....................................................................................................................... 35 4. Discussion and Conclusion ..................................................................................................................... 38 4.1 Nutrition and Health .......................................................................................................................... 38 4.2 Child Care including Infant and Young Child Feeding (IYCF) Practices ............................................. 39 4.3 Food Security and Livelihoods .......................................................................................................... 41 4.4 Water, Sanitation and Hygiene .......................................................................................................... 42 5. Limitation and Bias ................................................................................................................................. 43 6. Ethical Considerations ............................................................................................................................ 43 7. Recommendations and priorities ............................................................................................................ 43 8. Appendices ............................................................................................................................................. 45 Appendix 1: Plausibility Report ................................................................................................................ 45 Appendix 2: Assignment of Clusters ........................................................................................................ 57 Appendix 3: Evaluation of enumerators (Standardisation test results) ..................................................... 58 Appendix 4: Questionnaire ...................................................................................................................... 60 Appendix 5: Event Calender ...................................................................................................................
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