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Emergency Nutrition Assessment Final Report Cox's Bazar, Bangladesh 28 April

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Emergency Nutrition Assessment Final Report Cox's Bazar, Bangladesh 28 April EMERGENCY NUTRITION ASSESSMENT FINAL REPORT COX’S BAZAR, BANGLADESH 28 APRIL - 28 MAY 2018 1 ACKNOWLEDGMENTS The Emergency Nutrition Assessment in Cox’s Bazar, Bangladesh was conducted on behalf of the Nutrition Sector by Action Against Hunger In collaboration with the Government of Bangladesh, the United Nations High Commissioner for Refugees, the World Food Programme, the United Nations Childrens’ Fund, Save the Children, and the Centers for Disease Control and Prevention. The assessment was funded by the United Nations Childrens’ Fund, the United Nations High Commissioner for Refugees, the World Food Programme, and the Swedish International Development Cooperation Agency, however, the opinions expressed in this report may not reflect the official opinion of these organizations. Action Against Hunger wishes to thank the Government of Bangladesh and the local governments of Cox’s Bazar, Ukhia, and Teknaf for their support in making this assessment a reality. Action Against Hunger also thanks the persons surveyed for their availability and flexibility, without which the results of this assessment could not have been possible. Family members and their measured children are warmly thanked for their cooperation and for welcoming survey teams into their homes for data collection. Action Against Hunger also thanks the community volunteers and community leaders for their collaboration in identifying survey areas and households during data collection. Action Against Hunger also thanks the International Organization for Migration for the providing Needs and Population Monitoring estimates which contributed to high-quality sampling. Special thanks and gratitude to the survey teams who made the assessment possible through their professionalism and dedication in the field. Coordination team: Leonie Toroitich-Van Mil, Health and Nutrition Head of Department, Action Against Hunger, Bangladesh Mohammad Lalon Miah, Survey Manager, Action Against Hunger, Bangladesh Alexandra Humphreys, Flying Survey Manager, Action Against Hunger Technical support: The Nutrition Assessment Technical Working Group Eva Leidman, Epidemiologist, CDC Emergency Response and Recovery Branch Sharmila Shetty, Medical Epidemiologist, CDC Emergency Response and Recovery Branch Yara Sfeir, Regional Health and Nutrition Advisor Asia, Action Against Hunger, France 2 TABLE OF CONTENTS ACKNOWLEDGMENTS ............................................................................................................................. 2 TABLE OF CONTENTS ............................................................................................................................... 3 LIST OF TABLES ........................................................................................................................................ 6 LIST OF FIGURES ...................................................................................................................................... 9 ACRONYMS ............................................................................................................................................ 10 EXECUTIVE SUMMARY ........................................................................................................................... 12 OBJECTIVES ........................................................................................................................................ 12 METHODOLOGY ................................................................................................................................. 12 RESULTS ............................................................................................................................................. 12 1. BACKGROUND ............................................................................................................................... 14 1.1 CONTEXT ...................................................................................................................................... 14 1.1.1 Geography and Demography ............................................................................................... 14 1.1.2 Displacement and the Camps ............................................................................................... 15 1.1.3 Health ................................................................................................................................... 17 1.1.4 Water, Sanitation, and Hygiene ........................................................................................... 18 1.1.6 Food Security and Livelihoods .............................................................................................. 19 1.1.7 Nutrition ............................................................................................................................... 19 1.1.8 Infant and Young Child Feeding Practices ............................................................................ 20 1.1.9 Nutrition Programming ........................................................................................................ 21 1.2 Survey Justification ...................................................................................................................... 26 1.3 Survey Objectives ........................................................................................................................ 27 2. METHODOLOGY ............................................................................................................................. 29 2.1 Type of Survey and Target Population ........................................................................................ 29 2.2 Sample Size Calculation ............................................................................................................... 30 2.3 Sampling ...................................................................................................................................... 32 2.3.1 Cluster Selection ................................................................................................................... 32 2.3.2 Household Selection ............................................................................................................. 34 2.3.3 Selection of Individuals to Survey ........................................................................................ 35 2.4 Collected Variables ...................................................................................................................... 35 2.4.1 Anthropometry ..................................................................................................................... 35 2.4.2 Anaemia ................................................................................................................................ 36 2.4.3 Morbidity .............................................................................................................................. 36 2.4.4 Infant and Young Child Feeding ............................................................................................ 37 2.4.5 Receipt of Rations ................................................................................................................. 37 3 2.4.6 Nutrition Programming ........................................................................................................ 37 2.4.7 Retrospective Mortality ........................................................................................................ 38 2.5 Indicators and Cut-offs ................................................................................................................ 38 2.5.1 Anthropometric Indices ........................................................................................................ 38 2.5.2 Anaemia ................................................................................................................................ 40 2.5.3 Mortality ............................................................................................................................... 41 2.6 Questionnaire, Training, and Supervision ................................................................................... 42 2.6.1 Questionnaire ....................................................................................................................... 42 2.6.2 Training ................................................................................................................................. 42 2.6.3 Survey Teams and Supervision ............................................................................................. 43 2.7 Data Management ....................................................................................................................... 43 2.8 Ethical Considerations ................................................................................................................. 44 3. RESULTS ............................................................................................................................................. 46 3.1 Makeshift Settlements ................................................................................................................ 46 3.1.1 MS Sample ............................................................................................................................ 46 3.1.2 MS Demography ................................................................................................................... 46 3.1.3 MS Data Quality ...................................................................................................................
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