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Anthropometric Nutrition Survey and IYCF Study-Laghman Province

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Anthropometric Nutrition Survey and IYCF Study-Laghman Province Anthropometric nutrition survey Children from 6 to 59 months Pregnant - Lactating women And Infant and Young Child Feeding Practices study Children from 0 to 23 months Final Report Mihtarlam and Qarghayi districts Laghman province, Afghanistan From the 22 nd to the 28 th of May 2011 Funded by UNICEF Islamic Republic of Afghanistan 1 Anthropometric nutrition survey and Infant and Young Child Feeding Study Mihtarlam and Qarghayi districts - Laghman province – May 2011 - Afghanistan ACKNOWLEDGEMENT With funding from UNICEF, this anthropometric nutrition survey and Infant and Young Child Feeding study could be undertaken in Mihtarlam and Qarghayi districts, Laghman province. The coordinator of this project was Ms Brigitte Tonon, ACF Health - Nutrition Coordinator highly supported by M. Tariq Khan, ACF Nutrition Program Manager. This work would not have been possible without the dedicated efforts of the nutrition community and the local population in Afghanistan. These partners included: • The Ministry of Public Health and particularly the Public Nutrition Department, for their collaboration in this project; • The Nutrition Cluster body for their support; • The community representatives of the surveyed villages who have supported the nutrition survey teams during the data field collection; • The community members in the surveyed villages for welcoming and supporting the nutrition survey teams during the field work ; • The numerous Non Governmental Organizations and United Nations agencies for sharing information on the general situation in Laghman province and particularly in the selected districts; • The entire ACF and SCA Teams for their great support in this project; 2 Anthropometric nutrition survey and Infant and Young Child Feeding Study Mihtarlam and Qarghayi districts - Laghman province – May 2011 - Afghanistan LIST OF ABBREVIATIONS ACF Action Contre la Faim AIMS Afghanistan Information Management System BPHS Basic Package of Health Services CMAM Community Management of Acute Malnutrition CI Confidence Interval CSO Censes Statistics Office EPI Expanded Program for Immunization ENA Emergency Nutrition Assessment EPHS Expended Package of Hospital Services FAO Food and Agriculture Organization FEWS NET Famine Early Warning Systems Network GAM Global Acute Malnutrition HH House-hold HMIS Health Management Information System IYCF Infant and Young Child Feeding MAM Moderate Acute Malnutrition MoPH Ministry of Public Health MUAC Mid Upper Arm Circumference NCHS National Centre for Health Statistics NGO Non Governmental Organization NRVA National Risk and Vulnerability Assessment OCHA Office of Coordination of Humanitarian Affairs OTP Out patient Therapeutic Program PND Public Nutrition Department RC Reserve Cluster SAM Severe Acute Malnutrition SC Stabilization Centre (CMAM Context) SCA Swedish Committee for Afghanistan SMART Standardized Monitoring and Assessment of Relief and Transitions SFP Supplementary Feeding Program TFU Therapeutic Feeding Unit UN United Nations U-5 Under Five Children UNICEF United Nation Children’s Fund WFP World Food Program W/H Weight for Height index WHO World Health Organization 3 Anthropometric nutrition survey and Infant and Young Child Feeding Study Mihtarlam and Qarghayi districts - Laghman province – May 2011 - Afghanistan TABLE OF CONTENTS EXECUTIVE SUMMARY ........................................................................................................................ 5 1. INTRODUCTION .................................................................................................................................... 9 1.1. Agencies ...................................................................................................................................... 9 1.2. Surveyed area.............................................................................................................................. 9 1.3. Data population – Demography ................................................................................................. 10 1.4. Geography and climate.............................................................................................................. 10 1.5. Administrative organisation........................................................................................................ 11 1.6. Economic – Food security situation ........................................................................................... 11 1.7. Water and sanitation situation.................................................................................................... 12 1.8. Health situation and intervention................................................................................................ 12 1.9. Nutrition intervention.................................................................................................................. 13 1.10. Humanitarian interventions ........................................................................................................ 13 2. SURVEY OBJECTIVES........................................................................................................................ 14 3. METHODOLOGY.................................................................................................................................. 15 3.1. Sampling strategy: sampling design and sample size calculation.............................................. 15 3.2 Final stage sampling: Selection of households and children .......................................................... 20 3.3 Data collected and measurement techniques................................................................................. 24 3.4 Definition of nutritional status of children 6-59 months: .................................................................. 28 3.5 IYCF indicators ............................................................................................................................... 29 3.6 Training and supervision................................................................................................................. 31 3.7 Data analysis .................................................................................................................................. 32 4. RESULTS ............................................................................................................................................. 33 4.1. Nutritional status of children 6-59 months (according to WHO standards 2006)........................ 33 4.2. Anthropometric results: Pregnant/Lactating women (based on MUAC criterion) ....................... 39 4.3. Measles vaccination coverage – Children 9-59 months............................................................. 40 4.4. Vitamin A supplementation coverage – Children 6-59 months .................................................. 41 4.5. IYCF study ................................................................................................................................. 41 5. DISCUSSION........................................................................................................................................ 46 5.1 Constraints and bias....................................................................................................................... 46 5.2 Acute malnutrition problematic – Children 6-59 months old............................................................ 47 5.3 Chronic malnutrition problematic – Children 6-59 months old ........................................................ 47 5.4 Acute malnutrition problematic - Pregnant/Lactating women.......................................................... 48 5.5 Causal analysis............................................................................................................................... 48 6. CONCLUSION...................................................................................................................................... 51 7. RECOMMENDATIONS......................................................................................................................... 52 8. REFERENCES ..................................................................................................................................... 54 9. ANNEXES............................................................................................................................................. 55 9.1 Annex 1: Map Laghman province, Afghanistan May 2011 – Source: MoPH –HMIS ...................... 55 9.2 Annex 2: Map Detailed districts - Laghman province, Afghanistan –.............................................. 56 9.3 Annex 3: List of 114 villages excluded due to security constraints, Mihtarlam (71) and Qarghayi (44) districts, Laghman province, Afghanistan May 2011 – Source: CSO – 2010/2011....................................... 57 9.4 Annex 4: Cluster selection, Mitharlam and Qarghayi districts, Laghman province, May 2011........ 59 9.5 Annex 5: Selection of cluster with Probability Proportional to Population Size (PPS)..................... 60 9.6 Annex 6: Household selection sheet – SMART Training Package – Version 2011 ........................ 62 9.7 Annex 7: Anthropometric survey – children 6-59 months old, Mitharlam and Qarghayi districts, Laghman province, May 2011....................................................................................................................... 63 9.8 Annex 8: Local event calendar, Nangarhar/Laghman provinces, Afghanistan, May 2011.............. 64 9.9 Annex 9: IYCF survey
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