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Goal Ethiopia Findings of Nutrition Survey Borana

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Goal Ethiopia Findings of Nutrition Survey Borana GOAL ETHIOPIA FINDINGS OF NUTRITION SURVEY BORANA ZONE-OROMIA REGION JUNE 12th – 26th, 2000 JANE BLACKHURST GOAL NUTRITIONIST ADDIS ABABA JULY 2000 2 ACKNOWLEDGEMENTS I would like to thank to the following people for their help support and advice in the preparation and implementation of this survey. All GOAL staff in Yabello, Addis Ababa and Dublin The Oromia DPPB Borana Zonal Health Department The Yabello and Teltele Emergency Task Force Committees Yabello and Teltele Health Authorities Extra Special thanks to Kerren Hedland – WFP for all her help with EPI –info among other things and to Colette Kirwin GOAL, my survey partner. 3 LIST OF ABBREVIATIONS CBR Crude Birth Rate CDC Centre for Disease Control CMR Crude Mortality Rate DPPC Disaster Prevention and Preparedness Commission GAM Global acute malnutrition (<-2 Z-scores W/H +/- oedema) MoH Ministry of Health MSF Médecins Sans Frontières MUAC Mid-upper arm circumference NCHS National Centre for Health Statistics PA Peasant Association SAM Severe acute malnutrition (<-3 Z-scores W/H +/- oedema) UNHCR United Nations High Commission for Refugees WFP World Food Programme W/H/L Weight for height or length as a percentage of the median WHO World Health Organisation 4 TABLE OF CONTENTS 1.0 EXECUTIVE SUMMARY ...................................................................... 1 1.1 OBJECTIVES ........................................................................................... 1 1.2 METHODOLOGY ...................................................................................... 1 1.3 RESULTS................................................................................................ 2 1.3.1 Nutritional indices of children 6-59 months (65-110cm W/L/H)...... 2 1.3.2 Nutritional indices of a convenience sample of elderly people ...... 2 1.3.3 Food security................................................................................. 2 1.4 CONCLUSIONS ........................................................................................ 3 1.5 RECOMMENDATIONS ............................................................................... 3 2.0 INTRODUCTION AND BACKGROUND INFORMATION ....................................... 5 3.0 OBJECTIVES ........................................................................................... 5 4.0 METHODOLOGY ...................................................................................... 5 4.1 Sampling Method .............................................................................. 5 4.2 Sample size....................................................................................... 6 4.3 Sample Population............................................................................ 6 4.4 Data collected ................................................................................... 6 4.5 Team Composition............................................................................ 7 4.6 Implementation ................................................................................. 7 5.0 RESULTS................................................................................................ 8 5.1 Demographic Distribution.................................................................. 8 5.2 Nutritional status by z-scores and percentage of the median............ 8 5.3 Levels of Malnutrition in the Elderly................................................. 10 5.4 Food security .................................................................................. 11 6.0 LIMITATIONS ......................................................................................... 15 7.0 CONCLUSIONS ...................................................................................... 15 8.0 RECOMMENDATIONS ............................................................................. 15 REFERENCES............................................................................................... 18 5 LIST OF TABLES TABLE 1 HOUSEHOLD DEMOGRAPHY ..........................................................................8 TABLE 2 DISTRIBUTION OF SAMPLE BY AGE AND SEX....................................................8 TABLE 3 NUTRITIONAL STATUS - CHILDREN 6-59 MONTHS OR 65-110CM W/L/H............8 TABLE 4 PREVALENCE OF MALNUTRITION BY AGE CATEGORY .......................................9 TABLE 5 PREVALENCE OF MALNUTRITION BY WOREDA ................................................9 TABLE 6 MEAN WEIGHT/LENGTH/HEIGHT BY WOREDA ..................................................9 TABLE 7 PREVALENCE OF GLOBAL MALNUTRITION BASED ON MAIN PRE- DROUGHT LIVELIHOOD STATUS ...................................................................................10 TABLE 8 PREVALENCE OF SEVERE ACUTE MALNUTRITION BASED ON MAIN PRE-DROUGHT LIVELIHOOD STATUS ...................................................................................10 TABLE 9 NUTRITIONAL STATUS OF THE ELDERLY BY MUAC MEASUREMENTS ..............10 TABLE 10 FOOD AID RECEIVED BY TYPE AND POPULATION COVERAGE ..........................11 TABLE 11 CEREAL SOURCES PRE-DROUGHT AND CURRENTLY......................................11 TABLE 12 MILK SOURCES PRE-DROUGHT AND CURRENTLY...........................................11 TABLE 13 LIVELIHOODS PURSUED IN PRE-DROUGHT YEARS .........................................12 TABLE 14 CURRENT SOURCES OF INCOME OR FOOD BY HOUSEHOLD ............................12 TABLE 15 LANDHOLDINGS PER HOUSEHOLD................................................................14 TABLE 16 MORTALITY RATES.....................................................................................14 TABLE 17 PERCENTAGE AND FREQUENCY OF REPORTED CHILD ILLNESSES ...................14 LIST OF APPENDICES APPENDIX 1 MAP OF SURVEY AREA APPENDIX 2 SURVEY QUESTIONNAIRES APPENDIX 3 ANALYSIS OF MALNUTRITION BY CLUSTER 1 1.0 Executive Summary GOAL in collaboration with the Disaster Prevention and Preparedness Commission (DPPC) and Ministry of Health (MoH) conducted a baseline nutrition survey of the pastoral and agro-pastoral areas of Yabello and Teltele Woredas of Borana Administrative Zone, Oromia Regional State from June 12-26th 2000. 1.1 Objectives § To quantify the nutritional status of children aged 6-59 months or between 65-110cm in length in GOAL Ethiopia’s relief project areas of Borana Administrative Zone § To assess the nutrition status of people above 55 years old living in the project area using MUAC measurements of a convenience sample in the survey area § To examine the current situation with regard to food security with particular focus on the following: § Aid coverage § Food sources § Effects of the drought on livelihood strategies § Effects on health 1.2 Methodology A two stage 30 cluster survey was conducted, based on a population sampling frame of 18 peasant associations (PAs) (60 villages), 9 in Yabello woreda and 9 in Teltele woreda. Standard UNHCR/WFP/MSF methodology was followed. The sample size was calculated using the expected prevalence of malnutrition for Teltele woreda of 35% (CARE, April 2000). Precision was calculated at 3%, error risk at 5% and a design effect of 2. Weight, height, age, and presence or absence of oedema were recorded for 1,950 children aged between 6-59 months or with a length between 65-110cm. Anthropometric measurements were made by fully trained medical personnel. Results for weight and height index values are based on the Reference Population Table of the NCHS/CDC/WHO 1982. Mid-upper arm circumference measurements (MUAC) were taken on a convenience sample of people aged above 55 years, who lived in the household and were present at the time of interview. A questionnaire was completed for each child and data were collected on vaccination and health history and child feeding. Household surveys were conducted in 1,103 households and community interviews were carried out in 49 villages. Data collected included: household size and composition; births and deaths in the previous 12 months; pre-drought and current livelihood strategies, food types and sources, livestock status and land resources. 1 2 1.3 Results 1.3.1 Nutritional indices of children 6-59 months (65-110cm W/L/H) Sample by age and sex SEX No. % of sample Male 976 51.4 Female 922 48.6 Ratio M:F 1.06:1 Nutritional status of children between children 56-59 months or between 65-110cm length/height Anthropometric Indices No. % 95% CI* Z-Scores (Weight for height/length) > 2 Z-scores (obese) 20 1.0 0.9996-1.004 -2.0 to 2.0 Z-scores (normal) 1655 87.2 86.185-88.215 -3.0 to <-2.0 z-scores (moderate malnutrition) 199 10.5 10.486-10.514 <-3 z-scores or oedema (SAM) 24 1.3 1.295-1.305 Total <-2 Z-scores or oedema (GAM) 223 11.8 11.785-11.815 % of the median (Weight for height/length) <80% or oedema =GAM 141 7.4 7.388-7.412 <70% or oedema = SAM 6 0.3 0.298-0.302 Mean weight for length 94.5 SD 37.4 *95% confidence intervals with calculated cluster effect GAM = Global acute malnutrition SAM =Severe acute malnutrition 1.3.2 Nutritional indices of a convenience sample of elderly people Classification of Muac Nutritional Status No. % Measures Above 24cm Normal weight 50 22.7 23.1-24cm Mild malnutrition 29 13.2 22.1-23 cm Moderate malnutrition 38 17.3 Below 22cm Severe malnutrition 103 46.8 TOTAL 220 100 Total Malnourished 170 77.3 1.3.3 Food security Food security is poor with the majority of the population dependent on aid for their main source of food. Although crops and livestock benefited temporarily from scattered rainfall, crops are wilting and livestock are again threatened by lack of pasture, water
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