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Ambasel and Kutaber Woredas (South Wollo) Baseline Nutrition Study

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Ambasel and Kutaber Woredas (South Wollo) Baseline Nutrition Study AMBASEL AND KUTABER WOREDAS (SOUTH WOLLO) BASELINE NUTRITION STUDY TABLE OF CONTENTS PAGE INTRODUCTION 1 1. Background to the Study 1 2. The Survey 2 2.1 The Purpose of the Survey 2 2.2 METHODOLOGY 2 Survey Methodology and Sampling Frame 2 Variables Measured and Recording Information 3 2.3 Organisation and Management of the Survey 3 Organisation 3 Training of the Data Collectors 3 Management of the Survey 4 2.4 Organisation and Management of the Data 4 Data Editing and Input 4 Data Analysis 4 2.5 Other Sources of Information 4 Focus Group Discussion 4 Market Survey 5 Discussions with the Woreda Sector Offices 5 3. Results of the Study and Discussions 5 3.1 Nutritional status 5 3.2 Vaccination and Health Status 6 3.3 Socio-economics and Food Situation of the Households 6 Head of Household and Household Size 6 Staple Foods of the Family 7 Pattern in Acquisition of Staple Foods 7 3.4 Family Health Aspects of the Interviewed Households 8 Health Institutions 8 Health Seeking Practices 8 3.5 Sanitation and Water Requirement Aspects of the Interviewed Households 9 Water Requirement and Source 9 Changes in Water Supplies and Quantity 9 Inadequacy of Water Year Round and the Reason for Shortfall 9 Area of Intervention 9 3.6 Focus Group Discussions 10 Results of Market Surveys 10 4. Further Discussions and Conclusions 11 4.1 Food Security and Related Activities 11 Principal Crops Cultivated 11 The Land 11 Development Schemes 11 4.2 Responses to the Crisis 12 General Ration 12 Supplementary Food Program 12 Other Handouts and Inputs 12 Selection Criteria and the Logistics of Distribution 13 4.3 Malnutrition Level and Related Stresses 13 5. Recommendations 15 EXECUTIVE SUMMARY This report offers major findings of a baseline nutrition survey that was commissioned by the Ethiopian Red Cross Society and undertaken by the consultant in Kutaber and Ambasel Woredas of the South Wollo Zone. Ambasel and Kutaber Woredas have a total population of 233,400 organised into 40 Kebele/Peasant Associations. A total of 91,401 Belg farming population is severely affected by drought-induced food shortages. ERCS distributes general dry ration to 20 Belg Kebeles and the rest are covered by the DPPC. The distribution centres are Kutaber (for Kutaber Woreda) and Wichale (for Ambasel Woreda). The ERCS has also distributed blankets for the poorest of the poor households and select seeds to the needy farmers. The selection criteria are said to encourage the sale of whatever livestock left including oxen in the household. Therefore, the selection criteria call for revision and improvement. A total of 36 clusters were studied from 8 K/PAs and an eligible child in a household was included for anthropometric measurement. Mothers were interviewed about family food, health and water using structured questionnaires. I NUTRITIONAL STATUS AT THE WOREDAS LEVEL <-2 Z-Score <-3 Z-Score LEVEL N % N % Weight-for- 209 31.3 25 3.7 length(WL), n=728 (27.9 – 35.0) (2.5–5.6) Among the studied children (n=728), Acute Malnutrition or wasting (<-2 Z Scores) affects 31.3% (N=209), 43.6% (317) out of 728 children were ill. The proportion of malnutrition observed is one of the highest recorded. The main staple diet of more than 53% (N=391) of the households is wheat grain and 97.4%, (N=725) of them have insufficient food items under their possession. The two Woredas have 9 clinics, 6 health posts and 1 rural hospital. Malaria and stomach ailments are prevalent in the Woredas. Water is fetched from unprotected springs and 92% of respondent household have to walk (both ways) less than 1 hour to fetch water. There were few rural development activities witnessed during the study except a reported WFP supported soil conservation work. II Recommendations Sensitisation of policy makers at all levels and advocacy for adequate food aid and inputs in health and water sectors development should be the priority task of the ERCS. The nutritional and health situations should closely be monitored. Follow-up nutritional surveys should be conducted every six months. Improving the selection criteria of beneficiaries and distribution systems should strengthen the rehabilitation program. Free or subsidised distribution of early-maturing crop seeds and introduction of root crops be encouraged. Water should be developed for sanitation and micro-irrigation schemes. Some of the hillside springs appear to be feasible for use in backyard gardening and the like. Related development activities or schemes like roads, forestry and soil sectors are indispensable. The ERCS should further strengthen its branch and sub-branch offices in South Wollo and extensively use its strong Youth Club bases to execute the rehabilitation and development schemes including nutrition and food diversification education. The use of baseline information for future projects appraisals, implementation, monitoring and impact evaluation is highly recommended. III 1. Background to the Study This report offers major findings of a baseline nutrition survey which was commissioned by the Ethiopian Red Cross Society and undertaken by the consultant in Kutaber and Ambasel Woredas of the South Wollo Zone (the TOR and map of the area are attached in the in as annexes). These two Woredas are situated in one of the areas highly vulnerable to food insecurity and related disasters and has been affected by four years consecutive drought-induced crop failures and the resulting food shortages. The two Woredas have a total population of 233,400 (Kutaber, 107,830 and Ambasel, 125,569) organised into 40 (Kutaber, 16 and Ambasel, 24) Kebele/Peasant Associations (K/PAs). According to the authorities of the two Woredas, 91,401 (31, 907 in Kutaber and 59,404 in Ambasel) Belg farming population are reported to have been severely affected by the current drought-induced food shortages. The Ethiopian Red Cross Society (ERCS) has been involved in these Woredas in terms of distribution of relief foods and other items (select seeds and blankets) and is well-established in the region in terms of understanding the situation and mobilisation of resources to contribute towards containing the crisis. In this context, a need was felt by the society to undertake baseline nutrition surveys in the Woredas to fine-tune the ERCS’s assistance as well as for further advocacy for resources and planning of health and nutrition-related interventions. This report, therefore, highlights the findings of the survey in the context of current food, nutrition and health insecurity the area is facing. Detailed results of the study are presented in appendices and annexes. 1 The report is presented in four parts. The first part deals with brief background and description of the study site while the second part highlights the objectives and the methodology. The third part presents discusses the major findings of the study. The fourth part of the report concludes the findings of the study in the context of the current situation in the study areas and the fifth and final part gives suggestions and recommendations for further action. 2. The Survey · 2.1 The Purpose of the Survey The first and most immediate purpose of the study is to assess the malnutrition level and generate a baseline information on food, health and water needs of the general population and determine immediate and future nutritional and health inputs for action and advocacy. 2.2 METHODOLOGY · Survey Methodology and Sampling Frame The consultant, maintaining WHO’s/FAO’s standards and using DPPC guidelines for such study, has determined the sample size and designed the survey. A final sample size of 728 children (70-110 cm length) was determined using sample calculation method for a 2-stage cluster sample survey (with 35%-estimated prevalence, 5% precision and 5% error risk). A total of 36 clusters were studied from 8 K/PAs and an eligible child in a household was included for anthropometric measurement. 2 · Variables Measured and Recording Information Recumbent length was recorded to the nearest 0.5 cm using standard length board. Each child was weighed, using hanging spring scale graduated by 0.1 kg, with minimum clothing (estimated deductions for the clothing were made) and the weight of each child was recorded to the nearest 100 gram. Wherever available, age and vaccination status have been recorded from their EPI card whilst the mothers’ responses were recorded in the absence of such a card. Mothers were interviewed about family food, health and water using structured questionnaires (Annex 2). 2.3 Organisation and Management of the Survey · Organisation The survey work was organised into 4 teams consisting of a team leader (a Nutrition Field Worker); two/three trained assistants (ERCS Youth Volunteers) and a guide/interpreter. The assistants help the team leader in measuring the children, recording and filling-in the questionnaires. The guide/interpreter would help each team in locating the selected K/PA introducing the team. The consultant supervised the data collection at random to ensure consistency and qualities were maintained. · Training of the Data Collectors The survey team leaders and assistants were assigned by the consultant. Although the team leaders were experienced Nutrition Field Workers (NFWs) who have been conducting such surveys, a refresher orientation, in the context of the current study, was given for 2 days in Addis. A further one-day orientation on the survey and practical training was given to ten assistants selected and provided from the ERCS Youth Volunteers in Dessie town (ERCS Branch Office). 3 · Management of the Survey Assignment of teams/supervisors and random selection of Kebele/Peasant Associations (K/PA) for each team plus setting of survey dates and times for each cluster were carried out by the consultant.
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