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Nutrition and Mortality Survey Report Socotra Governorate, Yemen 28 March to 4 April 2018

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Nutrition and Mortality Survey Report Socotra Governorate, Yemen 28 March to 4 April 2018 Republic of Yemen Ministry of Public Health and Population Nutrition and Mortality Survey Report Socotra Governorate, Yemen 28 March to 4 April 2018 Acknowledgements The Yemen Ministry of Public Health and Population (MoPHP)/Socotra Governorate Public Health and Population Office, in collaboration with UNICEF Yemen Country Office and UNICEF Aden Zone, acknowledge the contribution of the various stakeholders in this survey. The UNICEF Yemen Country Office provided technical support, employing SMART methodology. The Survey Manager and his assistants, supervisors were provided by Socotra, Adh Dhale, Al-Baidha, Hadhramout, Lahj, and Abyan GHOs and the central MoPHP in Aden. Survey enumerators and team leaders were provided by GHO of Socotra. Data entry team were provided by GHOs of Socotra and the head of data entry was provided by Lahj GHO. The protocol was finalised by Socotra GHO with technical support of UNICEF YCO. UNICEF YCO provided technical assistance especially that related to daily quality check, data analysis and report writing were made by UNICEF YCO. Socotra Governorate Public Health and Population Office over saw the political and logistical arrangements for the survey, ensuring its smooth operation. The survey was supported financially by UNICEF under a grant from the USAID's Office of U.S. Foreign Disaster Assistance (USAID/OFDA); this support is greatly appreciated. The contribution of local authorities in ensuring the survey teams’ security during fieldwork and in providing office facilities is gratefully appreciated. The data could not have been obtained without the co-operation and support of the communities assessed, especially the mothers and caretakers who took time off from their busy schedules to respond to the interviewers. Their involvement and cooperation is highly appreciated. MoPHP and UNICEF also express their sincere appreciation to the entire survey team for the high level of commitment and diligence demonstrated during all stages of the assessment to ensure high quality of data collected, and the successful accomplishment of the exercise. Content Acknowledgements ................................................................................................................... 1 Content ...................................................................................................................................... 2 Introduction ................................................................................. Error! Bookmark not defined. Assessment objectives ............................................................ Error! Bookmark not defined. Methodology ............................................................................... Error! Bookmark not defined. Study and sampling design .................................................................................................... 9 Sampling Procedure (The second stage) ............................................................................. 10 Survey Population and Data Collection Process .................................................................. 10 Measurement Standardization and Quality Control ........................................................... 11 Data Entry and Analysis ....................................................................................................... 12 Results and discussion ............................................................................................................. 14 The survey sample ............................................................................................................... 14 Background indicators ......................................................................................................... 15 Household income situation ................................................................................................ 16 Water, sanitation and hygiene ............................................................................................ 17 Child Nutrition ..................................................................................................................... 19 Acute malnutrition by WHZ .............................................................................................. 20 Acute malnutrition by MUAC ........................................................................................... 21 Underweight .................................................................................................................... 23 Stunting ............................................................................................................................ 25 Mean z scores, design effects and flags ........................................................................... 26 Change in Nutrition status between 2012 and 2017 ........... Error! Bookmark not defined. IYCF practices ....................................................................................................................... 27 Child morbidity .................................................................................................................... 28 Vitamin A supplementation and child vaccination .............................................................. 28 Women nutrition ................................................................................................................. 29 Mortality .............................................................................................................................. 29 Associations of the nutritional status .................................................................................. 30 Acute malnutrition ........................................................................................................... 31 Underweight .................................................................................................................... 32 Stunting ............................................................................................................................ 33 Child nutrition in related to mother nutrition ..................................................................... 34 Recommendations .................................................................................................................. 34 Global, moderate and severe acute malnutrition prevalence used for caseload calculation ............................................................................................................................................. 34 References ............................................................................................................................... 35 Annexes ................................................................................................................................... 36 Annex 1: Ibb March-April 2017 Nutrition Survey Questionnaire ........................................ 36 Annex 3: Calendar of events ................................................................................................ 53 Annex 4: Age determination job aid ........................................ Error! Bookmark not defined. Annex 5: Ibb March-April 2017 Survey Plausibility Check ................................................... 59 Annex 6: Ibb Nutrition Survey Standardization Test Report for Evaluation of Teams ........ 60 Annex 7: Clusters for Ibb March-April 2017 Nutrition Survey ............................................ 64 Annex 8: Tables of Weighted Levels of Anthropometrical Indicators ... Error! Bookmark not defined. Annex 9: Decision Tree for Household Selection (SMART Sampling Guideline, June 2012) ................................................................................................. Error! Bookmark not defined. Introduction Introduction: Socotra in general: Figure 1. Socotra Governorate Map Socotra is an archipelago of six islands located in the Arabian Sea, the largest island of which is also known as Socotra. The territory is part of Yemen, and had long been a subdivision of the Aden Governorate. In 2004, it administratively became part of Hadhramaut Governorate, which is much closer to the island than Aden. In 2013, the Archipelago became the 22nd Yemeni governorate called Socotra Governorate. The island of Socotra constitutes around 95% of the area of the Socotra Archipelago. It lies 380 kilometers (240 mil) south of the Arabian Peninsula. The island is very isolated, home to a high number of endemic species; up to a third of its plant life is endemic. It has been described as "the most alien-looking place on Earth." The island measures 132 kilometers (82 mil) in length and 49.7 kilometers (30.9 mi) in width. The Governorate is calm and there is no conflict in progress. Geography and Climate: The main island has three geographical terrains: the narrow coastal plains, a limestone plateau permeated with karstic caves, and the Haghier Mountains. The mountains rise to 1,503 metres (4,931 ft.). The island is about 125 kilometres (78 mil) long and 45 kilometres (28 mil) north to south. The climate of Socotra is classified in the Köppen climate classification as BWh and BSh, meaning a tropical desert climate and semi-desert climate with a mean annual temperature over 25 °C or 77 °F. Yearly rainfall is light to medium and rare heavy, but is fairly spread throughout the year. Due to orographic lift provided by the interior mountains, especially during the northeast monsoon from October to December, the highest inland areas can average as much as 800 millimetres (31.50 in) per year and receive
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