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Anthropometric and Retrospective Mortality Survey in the County of Aweil East, Northern Bhar El Gazal State South Sudan

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Anthropometric and Retrospective Mortality Survey in the County of Aweil East, Northern Bhar El Gazal State South Sudan June 2009 Aweil East South Sudan Anthropometric and Retrospective Mortality Survey In the County of Aweil East, Northern Bhar El Gazal State South Sudan Funded by ACKNOWLEDGMENTS Action Against Hunger would like to express its deep gratitude for the support given during the Anthropometric and retrospective Mortality Survey 2009 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 to obtain good quality data. 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 area and for participating in the survey and to the UN World Food Program for providing assistance in transport. 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. For the funding of Anthropometric and Retrospective Mortality Survey Aweil East County, ACF-USA thanks the European Commission Humanitarian Office (ECHO) 2 ACF-USA nutrition surveys, Aweil East County, South Sudan, 2009 TABLE OF CONTENTS .I. EXECUTIVE SUMMARY ........................................................................................... 6 .II. INTRODUCTION ................................................................................................ 11 .III. OBJECTIVES .................................................................................................... 14 .IV. METHODOLOGY ............................................................................................... 14 .IV.1. Type of Survey ............................................................................................ 14 .IV.2. Sampling Methodology ................................................................................... 14 .IV.3. Data Collection and Field Work ........................................................................ 16 .IV.4. Guidelines and Formulas Used ......................................................................... 19 .IV.5. Survey Constraints ....................................................................................... 21 .V. RESULTS OF THE ANTHROPOMETRIC AND MORTALITY SURVEY ..................................... 22 .V.1. .Child Nutrition and Health ............................................................................. 22 V.1.1 Distribution by Age and Sex ............................................................................. 22 .V.2. Anthropometric Analysis ................................................................................. 23 .V.3. Vaccination Coverage .................................................................................... 25 .V.4. Children’s Morbidity ...................................................................................... 26 .V.5. Composition of the Households ......................................................................... 26 .VI. RESULTS OF THE QUALITATIVE QUESTIONNAIRE ...................................................... 27 .VI.1. Socio- demographic characteristics of the respondents ........................................... 27 .VI.2. Food Security and Livelihoods ......................................................................... 27 .VI.3. Health ...................................................................................................... 31 .VI.4. Water and Sanitation .................................................................................... 33 .VI.5. Maternal and Child Care Practices .................................................................... 35 .VII. DISCUSSION ................................................................................................... 36 .VIII. RECOMMENDATIONS ........................................................................................ 38 .IX. APPENDICES ................................................................................................... 40 .IX.1. Sample Size and Cluster Determination .............................................................. 40 .IX.2. Anthropometric Survey Questionnaire ................................................................ 49 .IX.3. Household enumeration data collection form for a death rate calculation survey (one sheet/household) ....................................................................................... 50 .IX.4. Enumeration data collection form for a death rate calculation survey (one sheet/cluster) ........................................................................................... 51 .IX.5. Calendar of Events ....................................................................................... 52 .IX.6. Qualitative Questionnaire ............................................................................... 54 3 ACF-USA nutrition surveys, Aweil East County, South Sudan, 2009 INDEX OF TABLES Table 1: Results Summary ........................................................................................................... 8 Table 2: UN Agencies, International NGOs and Ministries in Aweil East County ......................................... 13 Table 3: Population Figure, Prevalence, Precision, and Sample Sizes, Aweil East ...................................... 15 Table 4: Distribution of Age and Sex of Sample ............................................................................... 22 Table 5: Prevalence of Acute Malnutrition (based on weight-for height z-scores and/or oedema) .................. 23 Table 6: Distribution of Acute Malnutrition and Oedema (based on weight-for-height z-scores) ..................... 23 Table 7: Global and Severe Acute Malnutrition in z-scores .................................................................. 24 Table 8: Prevalance of Malnutrition by Age (based on weight -for- height percentage of the median and oedema) .......................................................................................................................................... 25 Table 9: Measles vaccination coverage .......................................................................................... 25 Table 10: Mortality Rate ........................................................................................................... 25 Table 11: Prevalence of Reported Illness in Children Two Weeks Prior to Inverview )n=835) ......................... 26 Table 12: Illness Breakdown in Children Two Weeks Prior to Inverview (n=835) ........................................ 26 Table 13: Household Composition ................................................................................................ 26 Table 14: Main Livelihood Activities (n=682) ................................................................................... 28 Table 15: How Households are Obtaining Main Food Sources (n=682) ..................................................... 29 Table 16: Top Coping Strategies When Food Stocks Decline (n=670) ...................................................... 29 Table 17: Most Commonly Consumed Foods .................................................................................... 30 Table 18: Current Water Sources (n=673) ....................................................................................... 33 Table 19: Time to and from the Water Source ................................................................................. 33 Table 20: Location of Defecation if there is no Toilet (n=654) ............................................................. 34 Table 21: Household Use for Soap (n=265)...................................................................................... 34 INDEX OF FIGURES Figure 1: Distribution of sex by age group ............................................................................................................................ 22 Figure 2: Weight for Height in z-scores compared to WHO population ........................................................................... 24 Figure 3: Number of Feddans Planted or to be Planted in 2009 ....................................................................................... 28 Figure 4: First Place of Treatment When Sick ...................................................................................................................... 31 Figure 5: Distance to the Nearest Health Facility ............................................................................................................... 32 Figure 6: Number of Times per day that Children are Fed ................................................................................................ 36 4 ACF-USA nutrition surveys, Aweil East County, South Sudan, 2009 LIST OF ABBREVIATIONS ACF-USA Action Contre la Faim- USA, Action Against Hunger-USA AMURT Ananda Marga Universal Relief Team ENA Emergency Nutrition Assessment FAO Food and Agricultural Organization GAM Global Acute Malnutrition IOM International Organization for Migration IDP Internally Displaced People INGO International Non Governmental Organization IRC International Rescue Committee MUAC Mid Upper Arm Circumference MSF-F Médecins Sans Frontières-France NBeG Northern Bahr el Ghazal NCHS National Center for Health Statistic OTP Outpatient Therapeutic Program PHCU Primary Health Care Unit SAM Severe Acute Malnutrition
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