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Smart Survey Draft Report for Baidoa District

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Smart Survey Draft Report for Baidoa District SMART SURVEY DRAFT REPORT FOR BAIDOA DISTRICT AUGUST 2019 1 Acknowledgements Appreciation goes to SCI nutrition team for the support given during the entire exercise including review of technical aspects for the proposal, the community and local administration for cooperation in data collection and approval of the survey. The AIM working groups Somalia cluster for technical support in validating the protocol. 2 Acronyms SCI Save the children International HH Household GAM Global Acute Malnutrition MAM Moderate Acute Malnutrition SAM Severe Acute Malnutrition CDR Crude Death Rate U5DR Under5 Death Rate WHO World Health Organization MoH Ministry of Health WASH Water Sanitation and Hygiene FSL Food Security and Livelihood SMART Standardized Monitoring and Assessment in Relief and Transition IDPs Internally Displaced Populations U5MR Under 5 Mortality Rate CMR Crude Mortality Rate ENA Emergency Nutrition Assessment MUAC Mid Upper Arm Circumference WHZ Weigh for Height z-score WAZ Weight for Age Z-score HAZ Height for Age z-score EPI Extended programme on Immunization BCG Bacillus Chalmette–Guerin C.I Confidence Interval FSNAU Food Security and Nutrition Assessment Unit AAH Action Against Hunger SNS Strengthening Nutrition in Somalia ARI Acute respiratory infection IYCF Infant and Young child feeding MDD Minimum Dietary Diversity MMF Minimum Meal frequency rCSI Reduced Coping Strategy Index HDD Household Dietary Diversity IDD Individual Dietary Diversity UNFPA United nations Population Fund FGS Federal government of Somalia PESS Population Estimation survey of Somalia VAS. Vitamin A supplementation 3 Table of Contents EXECUTIVE SUMMARY ................................................................................................................. 6 1. INTRODUCTION ..................................................................................................................... 8 1.1 SURVEY OBJECTIVES .................................................................................................................... 8 2. METHODOLOGY .................................................................................................................. 10 2.1 SAMPLE SIZE ............................................................................................................................ 10 2.2 SAMPLING PROCEDURE: SELECTING CLUSTERS. ................................................................................. 10 3.3 SAMPLING PROCEDURE: SELECTING HOUSEHOLDS AND CHILDREN ........................................................ 10 2.3 SAMPLING PROCEDURE: SELECTING HOUSEHOLDS AND CHILDREN .......................................................... 11 2.4 CASE DEFINITIONS AND INCLUSION CRITERIA .................................................................................... 11 2.5 QUESTIONNAIRE, TRAINING AND SUPERVISION ................................................................................. 12 QUESTIONNAIRE ........................................................................................................................................ 12 2.6 DATA ANALYSIS ........................................................................................................................ 13 3. RESULTS .............................................................................................................................. 14 3.1 ANTHROPOMETRIC RESULTS (BASED ON WHO STANDARDS 2006): ...................................................... 14 POPULATION PYRAMID .................................................................................................................... 14 3.2 MORTALITY RESULTS (RETROSPECTIVE OVER X MONTHS/DAYS PRIOR TO INTERVIEW) ................................. 20 3.3 CHILDREN’S MORBIDITY .............................................................................................................. 21 3.3.1 SYMPTOMS BREAKDOWN ................................................................................................................... 21 3.3.2 HEALTH SEEKING BEHAVIOR ............................................................................................................... 22 3.5 VITAMIN A AND DEWORMING ..................................................................................................... 22 3.6 INFANT AND YOUNG CHILD FEEDING PRACTICES ................................................................................ 23 3.6.1 EARLY INITIATION BREASTFEEDING ....................................................................................................... 23 3.6.2 MINIMUM DIETARY DIVERSITY ............................................................................................................. 24 3.6.3 MINIMUM MEAL FREQUENCY ............................................................................................................. 25 3.7 MATERNAL NUTRITION .............................................................................................................. 25 3.8 FOOD SECURITY AND LIVELIHOODS ................................................................................................ 25 3.9 WATER, SANITATION AND HYGIENE .............................................................................................. 26 3.9.1 MAIN WATER SOURCE ....................................................................................................................... 26 3.9.2 HAND WASHING PRACTICES ................................................................................................................ 26 3.9.3 DEFECATION PRACTICES ..................................................................................................................... 27 4. DISCUSSION ........................................................................................................................ 28 4.1 CAUSES OF MALNUTRITION ......................................................................................................... 28 5. CONCLUSION ...................................................................................................................... 29 4 6. RECOMMENDATIONS .......................................................................................................... 30 7. REFERENCES ........................................................................................................................ 31 8. APPENDICES ........................................................................................................................ 32 8.1 APPENDICES 1: BAIDOA PLAUSIBILITY REPORT ................................................................................. 32 5 Executive summary Background Baidoa or “Baydhaba” as it is locally known is located in bay region. It is a strategic economic hub and is considered the seat of agro-pastoralism in Somalia given its reputation for the high potential sorghum production, the relative farming in the area as well as optimum livestock production. Over the past few years, there has been a steady influx of IDPs into Baidoa town from within and outside the region. The town is swelling with large number of IDP camps. As of August 2019, there were 435 IDP sites independently hosting a combined 51, 322 households according to CCM. Given their vulnerability combined with strained household resources, the humanitarian situation of most households in the IDP is precarious making households with the under 5 children the most affected. In a bid to alleviate the growing humanitarian situation, SCI is one of the leading INGOs that have operated in the district implementing key interventions in the areas of Nutrition prevention and treatment, FSL, protection and education. Methodology SMART methodology was used in the surveys. Two-stage cluster sampling was employed with clusters being selected at first stage and HH selection at the second stage. Random number generator was used to randomly select individual HH from a Data collection was conducted using ODK and daily checks were done to ensure that feedback on data quality was timely and also any challenges in data collection were addressed on time. A total of 36 clusters was surveyed in Baidoa district. Survey Objectives: The overall survey objective was to estimate the nutrition status of children under 5 years as well as Crude and under5 mortality rates for Baidoa district. Results Summary results for the districts are as shown below: Baidoa GAM 10.4 %( 7.8 - 13.9 ) MAM 9.2 % (6.5 - 12.7) SAM 1.3 % (0.7 - 2.5) CDR 0.40/10000/day U5DR 0.36/10000/day Morbidity 22.56% (19.28-26.20, 95% C.I.) Vitamin A 53.5%(33.5%-73.5%) Baidoa district has a prevalence of both serious acute malnutrition levels as well as high stunting rates. 6 Recommendations: Finding Explanation Recommendation Priority Responsible Serious levels of GAM rates in Baidoa Sustain existing Immediate SCI/Cluster GAM. indicates serious programs and improve levels sustained on recruitment over the past three years. High stunting The prevalence of Upscale IYCF practices rates stunting is high especially through above 30% and has increased breastfeeding remained so over and complementary the past three years feeding counselling at if data from this both household and at survey and other community level assessments are anything to go by Undertake an in-depth investigation on the causes of stunting in Baidoa and Bay region at large. If possible, undertake the cost of the diet assessment in bay agro- pastoral in order to propose low-cost nutritious diets. Low vitamin A Vitamin A Advocate for Mid SCI/Cluster
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