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Tana River County SMART Survey Report February 2020

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Tana River County SMART Survey Report February 2020 i ACKNOWLEDGEMENT Tana River County SMART survey was made successful through the contribution of a number of partners. The County Department of Health led in the survey management. The County appreciates the immense support accorded by partners at different levels in making this year’s SMART survey a success. These partners include; UNICEF and Concern Worldwide. Special gratitude to; The Tana River County Nutrition Technical Forum and Nutrition Information Technical Working Group for their technical guidance during the survey, County government of Tana River for creating an enabling environment during the data collection exercise , Tana River County community for taking time to provide information which will be of importance in making informed decisions in the nutrition sector programming and last but not least the dedicated survey team members who worked hard in ensuring quality data is collected during this exercise. ii LIST OF ABBREVIATIONS ARI Acute Respiratory Infection FAO Food and Agriculture Organization BCG Bacillus Chalmette Guerin CIDP County Integrated Development Plan CLTS Community Led Total Sanitation CSG County Steering Group CHS Community Health Strategy CHMT County Health Management Team CSI Coping Strategy Index ENA Emergency Nutrition Assessment GAM Global Acute Malnutrition IPC Integrated Phase Classification KEPI Kenya Expanded Program on Immunization MNPs Micronutrients Powders MUAC Mid Upper Arm Circumference NDMA National Drought Management Authority ODK Open Data Kit OPV Oral Polio Vaccine PLW Pregnant and lactating women SAM Severe Acute Malnutrition SBCC Social Behaviour Change and Communication SMART Standardized Monitoring Assessment on Relief and Transition SPSS Statistical Package for Social Sciences UNICEF United Nation Children Fund WASH Water hygiene and Sanitation WHO World Health Organization. CNC County Nutrition Coordinator NSO Nutrition Support Officer IPs Implementing Partners iii Table of Contents ACKNOWLEDGEMENT .........................................................................................................ii LIST OF ABBREVIATIONS .................................................................................................... iii List of Tables .....................................................................................................................vi List of Tables .....................................................................................................................vi EXECUTIVE SUMMARY ...................................................................................................... viii CHAPTER ONE: INTRODUCTION ........................................................................................... 1 1.1 Background Information .............................................................................................. 1 1.2 Rationale of the Survey ............................................................................................... 1 1.3. Survey Objectives ..................................................................................................... 2 1.4. Specific Objectives .................................................................................................... 2 1.5. Survey Timing ........................................................................................................... 2 CHAPTER TWO: SURVEY METHODOLOGY ............................................................................ 3 2.0 Survey Area ............................................................................................................... 3 2.1 Survey Design ........................................................................................................... 3 2.2 Study Population ........................................................................................................ 3 2.3 Sample Size ............................................................................................................... 3 2.4 Cluster and Household Selection .................................................................................. 4 2.5 Data Collected ........................................................................................................... 4 2.6 Survey Organisation ................................................................................................... 4 2.7 Questionnaire ............................................................................................................ 5 2. 8: Data collection ......................................................................................................... 5 2.9 Data Analysis and Report Writing ................................................................................. 5 2.10 Referrals ................................................................................................................. 6 2.11 Ethical consideration ................................................................................................ 6 2.12 Quality Assurance .................................................................................................... 6 2.13 Survey Limitation ..................................................................................................... 7 CHAPTER THREE: SURVEY FINDINGS AND DISCUSSION ........................................................ 8 3.1 Response Rate .......................................................................................................... 8 3.2 Demographics ........................................................................................................... 8 3.2.1: Marital Status ..................................................................................................... 8 3.2.2. Education Level of the Household Head .................................................................. 8 iv 3.2.3 School Enrolment for 3-18 years ............................................................................. 9 3.2.4 Main Occupation and Source of Income of the household head................................... 9 3.3 Anthropometric results (based on WHO standards 2006)................................................ 10 3.3.1 Age Verification ................................................................................................. 10 3.3.2: Distribution of Age and Sex (Under-fives) ............................................................. 10 3.3.3. Prevalence of Acute Malnutrition (Wasting) ........................................................... 11 3.3.4. Trends of Acute Malnutrition in Tana River County ................................................. 13 3.3.5 Prevalence of Acute Malnutrition based on MUAC ................................................... 14 3.3.6 Prevalence of Underweight based on WFA ............................................................. 14 3.3.7 Prevalence of Chronic Malnutrition (Stunting) based on Height for Age (HFA). ............ 15 3.4 Children Morbidity and Health Seeking ........................................................................ 15 3.4.1 Therapeutic Zinc Supplementation during watery diarrhoea episodes ........................ 16 3.4.2 Health Seeking ................................................................................................... 16 3.5. Child Immunization, Vitamin A and Micronutrients Supplementation and Deworming ........ 17 3.5.1. Immunization .................................................................................................... 17 3.5.2 Vitamin A Supplementation and Deworming ........................................................... 18 3.6 Maternal Nutrition ........................................................................................................ 18 3.6.1 Women physiological status .................................................................................... 19 3.6.2 Iron and Folic Acid Supplementation (IFAS) ............................................................... 19 3.6.3 Maternal Nutrition Status ..................................................................................... 20 3.7 WATER SANITATION & HYGIENE ................................................................................... 20 3.7.1 Main Source of Water ............................................................................................. 21 3.7.2 Distance to Water Source and Queuing Time ............................................................. 21 3.7.3. Household water treatment ..................................................................................... 22 3.7.4 Storage of Drinking water ........................................................................................ 23 3.7.5. Payment of Water and Consumption ........................................................................ 23 3.7.6 Hand washing ....................................................................................................... 23 3.7.7 Sanitation Facilities Ownership and Accessibility ....................................................... 24 3.8 FOOD SECURITY ......................................................................................................... 25 3.8.1 Dominant foods and food groups consumed by households and women ....................... 25 3.8.2 Minimum Household Dietary Diversity (HHDS) ........................................................... 26 3.8.3 Women Dietary diversity score ................................................................................ 28
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