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Northern Uganda Nutrition Survey in IDP Camps Gulu District, Northern

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Northern Uganda Nutrition Survey in IDP Camps Gulu District, Northern Northern Uganda Nutrition Survey in IDP Camps Gulu District, Northern Uganda Action Against Hunger (ACF-USA) June 2005 2 ACKNOWLEDGEMENTS ACF-USA would like to acknowledge the help and support from the following people, without whom this survey would not have been conducted. Thanks to OFDA for their financial support in conducting the survey. Thanks to the District Department of Health Services (DDHS) for their agreement to let us conduct the survey and for their support of our activities within the District. Thanks to all the Camp Leaders, Zonal Leaders, and selected camp representatives who assisted us in the task of data collection. Thanks to the survey teams who worked diligently and professionally for many hours in the hot sun. Last and not least, thanks to the mothers and children, and their families who were kind enough to co- operate with the survey teams, answer personal questions and give up their time to assist us. 3 TABLE OF CONTENTS I EXECUTIVE SUMMARY .......................................................................................................................... 6 I.1 OBJECTIVES............................................................................................................................................. 6 I.2 RESULTS.................................................................................................................................................. 6 I.3 RECOMMENDATIONS ............................................................................................................................... 6 II INTRODUCTION ........................................................................................................................................ 8 II.1 NORTHERN UGANDAN CONTEXT............................................................................................................. 8 II.2 GULU DISTRICT IDP CAMPS.................................................................................................................... 8 II.3 ACF-USA ACTIVITIES IN GULU DISTRICT .............................................................................................. 9 III OBJECTIVES........................................................................................................................................... 9 IV METHODOLOGY ................................................................................................................................... 9 IV.1 SURVEY DESIGN ...................................................................................................................................... 9 IV.2 THE NUTRITIONAL ANTHROPMETRIC SURVEY....................................................................................... 10 IV.3 TRAINING OF THE NUTRITION SURVEY TEAMS...................................................................................... 10 IV.4 DATA COLLECTION AND MEASUREMENT TECHNIQUES ......................................................................... 11 IV.4.1 Children from 6 to 59 months:...................................................................................................... 11 IV.4.2 Children less than 6 months: ........................................................................................................ 11 IV.5 MORTALITY........................................................................................................................................... 12 IV.6 CUT-OFF GUIDELINES AND FORMULAS USED ........................................................................................ 12 IV.6.1 Weight for Height Index................................................................................................................ 12 IV.6.2 MUAC........................................................................................................................................... 13 IV.7 SURVEY IMPLEMENTATION.................................................................................................................... 13 IV.8 CONSTRAINTS........................................................................................................................................ 13 V RESULTS.................................................................................................................................................... 14 V.1 AGE AND GENDER DISTRIBUTION OF CHILDREN 6 TO 59 MONTHS.......................................................... 14 V.2 WEIGHT FOR HEIGHT INDEX (W/H) OR ACUTE MALNUTRITION ........................................................... 15 V.2.1 Acute Malnutrition in Z-scores ..................................................................................................... 15 V.2.2 Acute Malnutrition in Percentage of Median ............................................................................... 16 V.3 MUAC ANALYSIS................................................................................................................................. 17 V.4 MEASLES VACCINATION COVERAGE ..................................................................................................... 17 V.5 NUTRITION INFORMATION ON INFANTS UNDER 6 MONTHS .................................................................... 18 V.5.1 Evaluation of the prevalence of malnutrition ...............................................................................18 V.5.2 Feeding practices.......................................................................................................................... 18 V.5.3 Mortality ....................................................................................................................................... 19 VI DISCUSSION.......................................................................................................................................... 19 VII RECOMMENDATIONS........................................................................................................................ 21 VIII APPENDICES......................................................................................................................................... 23 VIII.1 APPENDIX 1: LOCAL EVENTS CALENDAR TO CALCULATE AGE IN MONTHS...................................... 23 VIII.2 APPENDIX 2: CLUSTER SELECTION, GULU CAMPS 2005..................................................................... 25 4 LIST OF TABLES TABLE 1 GAM AND SAM BY AGE GROUP IN Z-SCORES, GULU DISTRICT, UGANDA, JUNE 2005........................... 6 TABLE 2 ACUTE MALNUTRITION BY AGE GROUP IN % OF THE MEDIAN, GULU DISTRICT, UGANDA, JUNE 2005. .. 6 TABLE 3 ACUTE MALNUTRITION CUT-OFF FOR DEFINITION OF POPULATION NUTRITIONAL STATUS...................... 12 TABLE 4 MUAC CUT-OFFS FOR DEFINITION OF MALNUTRITION STATUS............................................................... 13 TABLE 5 MORTALITY RATE CUT-OFF FOR DEFINITION OF STATUS OF THE POPULATION......................................... 13 TABLE 6 AGE AND GENDER DISTRIBUTION 6-59 MONTHS, GULU DISTRICT, UGANDA, JUNE 2005. ..................... 14 TABLE 7 WEIGHT FOR HEIGHT DISTRIBUTION BY AGE IN Z-SCORES, GULU DISTRICT, UGANDA, JUNE 2005....... 15 TABLE 8 WEIGHT FOR HEIGHT AND OEDEMA DISTRIBUTION, GULU DISTRICT, UGANDA, JUNE 2005................... 15 TABLE 9 GAM AND SAM BY AGE GROUP IN Z-SCORES, GULU DISTRICT, UGANDA, JUNE 2005......................... 15 TABLE 10 GAM AND SAM DISTRIBUTION BY GENDER IN Z-SCORES, GULU DISTRICT, UGANDA, JUNE 2005...... 15 TABLE 11 WEIGHT FOR HEIGHT DISTRIBUTION BY AGE IN PERCENTAGE OF MEDIAN, GULU DISTRICT, UGANDA, JUNE 2005. .................................................................................................................................................... 16 TABLE 12 GAM AND SAM BY AGE GROUP IN PERCENTAGE OF MEDIAN, GULU DISTRICT, UGANDA, JUNE 2005. ...................................................................................................................................................................... 16 TABLE 13 GAM AND SAM DISTRIBUTION BY GENDER IN % OF THE MEDIAN, GULU DISTRICT, UGANDA, JUNE 2005.............................................................................................................................................................. 17 TABLE 14 MUAC DISTRIBUTION IN UNDER-5 POPULATION, GULU DISTRICT, UGANDA, JUNE 2005. ................... 17 TABLE 15 MEASLES VACCINATION COVERAGE, GULU DISTRICT, UGANDA, JUNE 2005. ..................................... 17 TABLE 16 AGE AND GENDER DISTRIBUTION OF INFANTS MORE THAN 49.0 CM HEIGHT, GULU DISTRICT, UGANDA, JUNE 2005 ..................................................................................................................................................... 18 TABLE 17 PREVALENCE OF ACUTE MALNUTRITION AMONG INFANTS MORE THAN 49.0CM HEIGHT, GULU DISTRICT, UGANDA, JUNE 2005..................................................................................................................................... 18 TABLE 18 LONGITUDINAL COMPARISON OF ACF SURVEY WASTING RESULTS IN Z-SCORES, GULU DISTRICT, UGANDA, JUNE 2005..................................................................................................................................... 19 LIST OF FIGURES FIGURE 1 DEMOGRAPHICS OF SURVEY SAMPLE (AGE AND SEX), GULU DISTRICT, UGANDA, JUNE 2005. ........... 14 FIGURE 2 WEIGHT FOR HEIGHT DISTRIBUTION IN Z-SCORES, GULU DISTRICT, UGANDA, JUNE 2005. ................. 16 5 List of Acronyms ACF-USA Action Against Hunger-USA CHW Community Health Workers CI Confidence Interval DDHS District Department
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