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Anthropometric and Retrospective Mortality Survey Aweil East County

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Anthropometric and Retrospective Mortality Survey Aweil East County June 2010 Anthropometric and Retrospective Mortality Survey Aweil East County, Northern Bahr el Ghazal State Southern Sudan ACF-USA Nutrition Survey, Aweil East County, Southern Sudan, June 2010 1 Acknowledgement Action Against Hunger would like to express its deep gratitude for the support given during the Anthropometric and retrospective Mortality Survey 2010 in Aweil East County. We would like to thank ACF-USA staff, particularly the support team without which the survey wouldn’t have been possible. Furthermore, we would like to thank the survey teams, for their endurance, dedication and team spirit which enabled survey to reach the end successfully. Thanks also to all drivers who ensured timely and safe movement of the survey teams. A special thanks to the SSRRC of Aweil East County for providing vital information on the geographical areas. We finally like to say many thanks to the individual families who pleasantly allowed the survey teams measure their children and provided the survey team with the information required to make it a success. ACF-USA Nutrition Survey, Aweil East County, Southern Sudan, June 2010 2 Table of Contents Executive Summary ....................................................................................................................................................... 5 1. Introduction ......................................................................................................................................................... 7 2. Objectives of the survey ...................................................................................................................................... 8 3. Survey Methodology ............................................................................................................................................ 8 3.1 Type of Survey ............................................................................................................................................. 8 3.2 Sampling methodology ................................................................................................................................ 8 3.3 Training and Data Collection ........................................................................................................................ 9 3.4 Anthropometric survey .............................................................................................................................. 10 3.5 Mortality survey ......................................................................................................................................... 10 3.6 Food Security and Livelihood, Water and Sanitation ................................................................................. 10 3.7 Data Quality Control Assurance ................................................................................................................. 11 3.8 Field Exercise.............................................................................................................................................. 11 3.9 Data Entry and Analysis ............................................................................................................................. 11 4. Guidelines and Formulae used .......................................................................................................................... 11 4.1 Acute Malnutrition ..................................................................................................................................... 11 4.2 Mortality .................................................................................................................................................... 12 5. Survey Constraints ............................................................................................................................................. 12 6. Results: Anthropometry and Retrospective Mortality ....................................................................................... 12 6.1 Anthropometric analysis (WHO Standards, 2006) ..................................................................................... 13 4.2 Vaccination Coverage ................................................................................................................................ 14 4.4. Mortality .......................................................................................................................................................... 14 3.5 Child Morbidity .......................................................................................................................................... 15 7. Results on Qualitative data ................................................................................................................................ 15 7.1 Socio- demographic characteristics of the respondents ............................................................................ 15 7.2 Food Security and Livelihoods ................................................................................................................... 16 7.3 Health ......................................................................................................................................................... 17 7.4 Water and Sanitation ................................................................................................................................. 19 7.5 Maternal and Child Care Practices ............................................................................................................. 20 8. Discussion .......................................................................................................................................................... 21 9. Conclusion and Recommendations ................................................................................................................... 22 10. Annexes .......................................................................................................................................................... 23 ACF-USA Nutrition Survey, Aweil East County, Southern Sudan, June 2010 3 Abbreviations ACF-USA Action Contre la Faim- USA (Action Against Hunger-USA) BSFP Blanket Supplementary Feeding Program CMR Crude Mortality Rate ENA Emergency Nutrition Assessment EPI Expanded Program on Immunization FGD Focus Group Discussion GAM Global Acute Malnutrition GFD General Food Distribution IDP Internally Displaced People INGO International Non Governmental Organization IOM International Organization for Migration MAM Moderate Acute Malnutrition MOH Ministry of Health MUAC Mid Upper Arm Circumference NCHS National Center for Health Statistic OTP Outpatient Therapeutic Program PHCC Primary Health Care Center PHCU Primary Health Care Unit SAM Severe Acute Malnutrition SFP Supplementary Feeding Program SMART Standardized Monitoring and Assessment of Relief and Transitions SSRRC Southern Sudan Relief and Rehabilitation Commission TFP Therapeutic Feeding Program UNICEF United Nations Children’s Fund U5MR Under Five Mortality Rate WFH Weight for Height WFP World Food Program WHO World Health Organization WVI World Vision International ACF-USA Nutrition Survey, Aweil East County, Southern Sudan, June 2010 4 Executive Summary Aweil County is located in Northern Bahr el Ghazal state of Southern Sudan. Aweil East County is one of the five counties that make up the state of Northern Bahr el Ghazal in Southern Sudan. Its borders include Gogrial West County to the east, Southern Kordofan to the north-east, Southern Darfur to the north, and Aweil South County to the south. The County consists of the seven administrative payams of Malualbai, Baac, Madhol, Mangartong, Mangok, Yargot and Wunlang running from north to south. The current population of Aweil East County is estimated at 180,948. According to April and May 2009 National Baseline Household Survey, the incidence of poverty (calculated at an income of 72.9 SDG per person per month) in Southern Sudan range from one fourth in Upper Nile to three fourths in Northern Bahr el Ghazal. This makes Northern Bahr el Ghazal is one of the poorest and most food insecure state in Southern Sudan. Aweil East/Northern Bahr el Ghazal is traditionally an agro-pastoralist region with cattle ownership being the primary determinant of wealth and status. The topography of Aweil East makes it prone to flooding during rainy seasons. The County lies in the western flood plain livelihood zone which is prone to seasonal flooding; especially in August and September. The flat terrain and sandy and clay soils contribute to this flooding pattern. The fact that sanitation and waste disposal is very poor in the region and especially in Aweil East, the population is always susceptible to Acute Watery Diarrhea. Poverty, food insecurity, insufficient heath services and high child morbidity, poor infant and child feeding practices, low immunization coverage and high vulnerability to Acute Watery Diarrhea aggravate each other subjecting Aweil East to a vicious cycle of malnutrition. An anthropometric and retrospective mortality survey was conducted between 13th and 25th June 2010. The survey was aimed at assessing the prevalence of acute malnutrition in children aged 6-59 months, estimating the crude and under five mortality rate, estimating the coverage of measles among targeted children and identifying some of the underlying causes/factors contributing to malnutrition in Aweil East. The sampling frame included all the 7 payams of Aweil East County. The survey used
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