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Aweil West County Squeac ASSESSMENT PRELIMINARY Report

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Aweil West County Squeac ASSESSMENT PRELIMINARY Report AWEIL WEST COUNTY SQUEAC ASSESSMENT REPORT BY MARCH 22, 2018 Report By: Jacqueline Macharia Acknowledgement This is an expression of gratitude towards the individuals and organizations that effortlessly supported the processes of this noble exercise. The 2017 SQUEAC in Aweil West County would not have been successful without their inputs. • The donor for funding the assessment. • County Health Department for their support and authorizing the assessment process within the community to proceed as planned and supervising the assessment • The entire Aweil West community for their patience, willingness to give information to the best of their knowledge when called upon and in allowing screening of their children. • American Refugee Council (ARC) for providing some inputs used in triangulation as the nutrition partner in Aweil West. • Concern Worldwide for their inputs in planning for the assessment and mobilizing the community concerning the exercise. Thank you to the staff that went out of their way to assist during some processes for smooth running. 1 | P a g e Table of Content Acknowledgement ......................................................................................................................... 1 Abbreviations ................................................................................................................................ 4 Executive Summary ...................................................................................................................... 5 Introduction ................................................................................................................................... 7 1.1 Background ....................................................................................................................................... 7 1.2 Health and Nutrition Status ............................................................................................................. 8 1.3 Previous SQUEAC ............................................................................................................................ 8 1.4 Justification ....................................................................................................................................... 9 1.5 Objectives........................................................................................................................................... 9 1.6 Challenges and Limitation ............................................................................................................. 10 Methodology ................................................................................................................................ 10 2.1 Stage 1 .............................................................................................................................................. 10 2.1.1 Quantitative Data ..................................................................................................................... 10 2.1.1.1 Admission by Month ........................................................................................................................ 11 2.1.1.2 MUAC Admissions ........................................................................................................................... 12 2.1.1.3 Time to Default ................................................................................................................................. 13 2.1.1.4 Length of Stay ................................................................................................................................... 14 2.1.1.5 Discharge Outcomes ......................................................................................................................... 14 2.1.1.6 Documentation .................................................................................................................................. 17 2.1.2 Qualitative Data ....................................................................................................................... 17 2.1.2.1 Barriers and Boosters ....................................................................................................................... 18 2.2Stage 2 ............................................................................................................................................... 25 2.2.1 Methodology ............................................................................................................................. 25 2.2.2 Case Definition ......................................................................................................................... 26 2.2.3 Prior Formation ....................................................................................................................... 27 2.2.3.1 Histogram Prior ................................................................................................................................ 27 2.2.3.2 Concept Map ..................................................................................................................................... 27 2.2.3.3 Un-weighted Barriers and Boosters ................................................................................................ 27 2.2.3.4 Weighted Barriers and Boosters ..................................................................................................... 28 2.3 STAGE 3 .......................................................................................................................................... 29 2.3.1 Sample Size Calculation .......................................................................................................... 29 2.3.2 Sampling Frame ....................................................................................................................... 29 2.3.3 Case finding methodology ....................................................................................................... 30 2.3.4 Single Coverage Estimate ........................................................................................................ 30 2.3.5 Reasons for SAM Non-Attendance ......................................................................................... 31 Conclusion ......................................................................................................................................... 32 Annexes ........................................................................................................................................ 33 Annex 1: Recommendations ................................................................................................................. 33 Annex 2: Wide Area Survey Quantitative Data ................................................................................. 35 Annex 3: Point and Period Coverage Estimates................................................................................. 36 2 | P a g e Annex 4: Training Chronogram .......................................................................................................... 36 Annex 5: List of Trained Personnel during the SQUEAC Assessment ............................................ 37 Annex 6: Review of Selected Action Points from Previous SQUEAC in Aweil West and North .. 38 Annex 7: Mapping of the CWW OTP sites in Aweil West and Aweil North ................................... 39 Annex 8: Concept Map ......................................................................................................................... 40 List of Figures Figure 1: Admissions over Time (Dec 16 - Nov 17) .................................................................................. 11 Figure 2: MUAC Admission (Sep 17 - Nov 17) ......................................................................................... 12 Figure 3: MUAC Admissions of ≥11.5 CM by Facility (Sep – Nov 17) .................................................... 13 Figure 4: Time-to-Default (Sep 17 – Nov 17) ............................................................................................ 13 Figure 5: Length of Stay (Sep 17 - No 17) ................................................................................................. 14 Figure 6: Discharge Outcomes over Time (Dec 16 – Nov 17) ................................................................... 15 Figure 7: Admission and Discharge by Payam (Dec 16 – Nov 17) ............................................................ 16 Figure 8: BayesSQUEAC calculator plot of the prior mode: β(11.2,5.6) ................................................... 28 Figure 9: Beta Binomial Conjugate Analysis Posterior plot ....................................................................... 31 Figure 10: Reasons for SAM Non-Attendance ........................................................................................... 32 List of Tables Table 1: Admissions and Discharge by Payam ........................................................................................... 16 Table 2: Triangulated Barriers and Boosters .............................................................................................. 18 Table 3: Stage 2 Results by Village ............................................................................................................ 26 Table 4: LQAS Decision Rule Results ....................................................................................................... 27 Table 5: Weighted and Un-Weighted Barriers and Boosters .....................................................................
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