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World Food Programme Liberia WWWOOORRRLLLDDD FFFOOOOOODDD PPPRRROOOGGGRRRAAAMMMMMMEEE LLLIIIBBBEEERRRIIIAAA Grand Gedeh County FOOD SECURITY AND NUTRITION SURVEY TABLE OF CONTENTS 3 Acknowledgement 3 Executive Summary 4 Background and Introduction Economy of Grand Gedeh County Survey justification Objectives and methodology 7 Part I—Community Level Findings Demographic information Land and resource access Education services Community perception of needs 10 Part II—Household Level Findings Household Demography Household Circumstances Housing Assets ownership Agriculture Sources of Incomes Household Expenditures Frequency of food consumption Food aid Shocks and coping strategies 17 Part III—Nutrition and Health Child nutritional status Health services HIV/AIDS knowledge 26 Part IV—Household Food Security and Consumption Typologies Classification by Food consumption Description of the consumption groups 30 Recommendations 31 Appendices Page 2 of 51 ACKNOWLEDGEMENT households were assessed. Food security, nutrition, mortality and other health indicators were collected WFP Liberia sponsored the Grand Gedeh County during the assessment. Food Security and Nutrition Survey in March 2005. WFP wishes to acknowledge the assistance provided The assessment indicates unstable food security by Government counterparts, NGOs and UN sister situation in the county. The survey reveals that some agencies. In particular, WFP is grateful to LRRRC and populations are not attaining adequate food ICRC in providing basic statistics and population consumption levels; characterized by low food figures, which were crucial for the development of the diversity, high proportion (over 60%) of household sampling frame and cluster identification. UNICEF’s expenditure used for food purchases at the expense support in the training of enumerators and supervision of other basic needs, low frequency of daily food of the whole exercise is also appreciated. UNHCR intake, low household asset holdings (mainly limited to Zwedru office seconded a vehicle and senior officer utensils and other relatively less valued household for supervision during the exercise. Their gesture is goods) and unreliable income sources. Agricultural highly acknowledged. The participation in production is still limited with over 80% of food items enumeration and supervisory assistance provided by sourced through markets. the Ministry of Planning and Economic Affairs (MPEA) and Ministry of Health and Social Welfare (MOH & SW) Although the communities are resettling in their through the County Health Team (CHT) is highly appreciated. villages, seeds and farming tools are not readily available nor do they have the capacity to purchase The contribution from the SC-UK which seconded the required farm tools. They will still heavily rely on their staff to assist with the data collection was external support to undertake farming activities. extremely helpful. The Humanitarian Information Centre (HIC) provided the much needed basic Generally, the communities have limited capacity to statistics on population data and maps. Various respond to problems afflicting them. For example, organizations including UNHCR, FAO, SC-UK and their capacity to construct schools, health facilities, others participated in the planning process and provided useful comments that were valuable in and involvement in constructive farming endeavours is carrying out the exercise. WFP is grateful for the constrained by high poverty levels. This makes them members of households, key informants and heads of extremely vulnerable to negative affects of shocks. community groups who rendered their time and Results indicate that while 50% of the households had provided the crucial information on livelihoods in experienced some shock ((in food or income access) Grand Gedeh County. over the previous 12 months, a significant proportion (10-20%) did not have enough mechanisms to absorb Finally, WFP is grateful to all who contributed in the negative impacts. various forms for the success of this survey including leadership of Grand Gedeh County, and county health Team. The nutrition survey results indicate a global acute malnutrition of 4.5% and severe acute malnutrition was 0.7%. The survey confirms high stunting levels EXECUTIVE SUMMARY (40%) with severe stunting (17%) observed in Liberia. Underweight is also high at 25%. Crude Mortality Rate (CMR) is 1.27 deaths per 10,000 per day while WFP in collaboration with MOH & SW, UNICEF, and Under-Five Mortality Rate (U5MR) is extremely high at UNHCR conducted a food security and nutrition 3.34 deaths per 10,000 per day. The high Under Five survey in Grand Gedeh County from March 3-11, Mortality requires urgent follow up. Main causes of 2005. The survey provides baseline information on deaths among under-five year old children are the key food security and nutrition indicators and malaria, diarrhoeal diseases and acute respiratory possible causes of vulnerability in the County. The infections. Inadequate provision of health care results will facilitate the review of the already existing services, unsafe water and poor child feeding programmes and guide the planning and appropriate practices remain major issues of concern. Nearly targeting of future food assistance in Grand Gedeh three-quarters of the surveyed children were County and in Liberia in general. introduced to solid foods either too early or too late while only less than 4% continue to breastfeed up to The survey utilized both quantitative and qualitative the recommended age of two years. This signals information collected at both household and inadequate feeding practices. Teen-age pregnancies/ community levels. A two-stage cluster sampling mothers are reported to be the norm. High incidences methodology was used in which 30 communities were of malaria, diarrhoea and respiratory infections are randomly selected. In each community, at least 25 also reported while less than one-sixth of the mothers Page 3 of 51 sleep under mosquito nets with their young children. atmosphere of free movement in the County. In Assessment of HIV/AIDS awareness reveals appalling February 2005, Grand Gedeh was declared one of the statistics characterized by high levels of ignorance thirteen counties ready for resettlement in Liberia. about the pandemic, stigmatization, and discrimination. Less than one-fifth of the assessed Since the last population census of 1984, no other household have appropriate knowledge on the census has been conducted. However, population spread, prevention and care for the pandemic despite estimates by the National Seed and Tools Committee the reported cases of sexually transmitted infections in 1999 put the figure of Grand Gedeh County at (mainly gonorrhoea) amongst the residents 100,652 inhabitants. Majority were thought to reside in Tchien (52,060 people) while the population figures The survey reveals low enrolment of children in for Gbarzon and Konobo Districts were estimated at schools mainly due to inadequate equipment, long 24, 368 and 24, 224 respectively. However, like any distances, or lack of facility. Health service provision other remote county in Liberia, Grand Gedeh is far from adequate in the county. The communities experienced a net outflow of its residents during the heavily rely on sourcing basic food items from far wars of 1990s to 2003. The wars resulted into heavy markets in the neighbouring countries. losses including destruction of property and loss of life. The report recommends the following actions as a Currently, it is estimated that about 28,587 people are priority in the county: urgent follow up on the high expected to be resettled in the county. This under-five mortality in the county; rehabilitation of population is still scattered in various camps in and outside Liberia, but mainly in camps around Monrovia. basic infrastructures such as schools and skills The county is also a home to some Internally training facilities; health service provision especially Displaced Persons (IDPs) and returnees, refugees urgent in remote parts of Tchien District; improvement and Third Country Nationals (TCNs) from Cote D’ Ivoire. in sanitation situation through construction of latrines and education, etc. Other recommendations include initiation of income generating activities especially Economy of Grand Gedeh County those involving women and the youth; focusing on education of girls to control teen-age motherhood; For a long time, the economy of Grand Gedeh County provision of agricultural tools and equipment; depended on timber production. However, following intensification of health and nutrition education mainly the imposition of UN sanctions on timber exports from focusing on primary health care and child feeding Liberia, timber production has somehow dwindled. practices and concerted HIV/AIDS awareness There is however an ongoing illegal indiscriminate campaigns in the county. felling of trees and subsequent black market sales as witnessed by the continued presence of trucks loaded with woods and timbers seen crossing though the BACKGROUND AND INTRODUCTION Guinean borders via Nimba County. Grand Gedeh County is situated in the south-eastern Before 1990, residents of Grand Gedeh were also part of the Country and is bordered to the east by actively involved in large scale cash crop production Cote D’Ivoire. The county is enclosed by River Gee (mainly coffee and cocoa) as well as food crop and Sinoe counties to the South, and Nimba County production (mainly rice farming but also cassava and to the Northwest. The county has three districts,
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