INTEGRATED NUTRITION AND MORTALITY SMART SURVEY REPORT ELBARDE DISTRICT, BAKOOL REGION, SOMALIA NOVEMBER 2020 I ACKNOWLEDGEMENTS Action against Hunger (ACF), would like to acknowledge all the support provided during the preparation, training and field activities of the survey, which includes but not limited to; ➢ Technical and logistical support provided by Elbarde Municipality and the Ministry of Health in South West state of Somalia, facilitation during the training and field work. ➢ We would like to acknowledge the roles of the assessment teams including the team leaders, enumerators and community field guides and all the parents/caregivers who provided valuable information to the survey team, and participated the assessment. ➢ Assessment Information Management Working Group (AIMWG) members for the technical inputs and validations. ➢ Appreciation also goes to SIDA, for the generous financial supports to conduct this nutrition and mortality survey. 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IV List of Figures ........................................................................................................................................... VI 1. INTRODUCTION ......................................................................................................................................... 1 1.1. Background ........................................................................................................................................ 1 1.2. Justifications ....................................................................................................................................... 1 1.3 Overall objective: .......................................................................................................................... 2 1.3.1. Specific objectives ....................................................................................................................... 2 2.0. METHODOLOGY ..................................................................................................................................... 3 2.1. Survey Design ..................................................................................................................................... 3 2.2. Study Population ................................................................................................................................ 3 2.3. Geographic target area and population group .................................................................................. 3 2.4. Sample size calculation ...................................................................................................................... 3 2.5. Cluster Sampling Strategy. ................................................................................................................. 5 The survey employed a two stage cluster sampling technique where ..................................................... 5 2.6. Variables collected ............................................................................................................................. 6 2.7 Case Definitions and inclusion Criteria ............................................................................................... 6 2.7.1 Anthropometry ............................................................................................................................ 6 2.7.2. Mortality ..................................................................................................................................... 8 2.7.3. Health .......................................................................................................................................... 8 2.7.4 Morbidity ..................................................................................................................................... 8 2.7.5. Water Sanitation and Hygiene (WASH) ...................................................................................... 8 2.8. Data Management and Survey Teams. .............................................................................................. 9 2.8.1. Survey Teams .............................................................................................................................. 9 2.8.2 Quality Assurance ........................................................................................................................ 9 2.8.3 Data Analysis and Reporting ........................................................................................................ 9 2.9. COVID-19 Preventive Measures ....................................................................................................... 10 3. RESULT .................................................................................................................................................... 11 3.1 Demographic ..................................................................................................................................... 11 3.2 Education Level ................................................................................................................................. 11 III 3.3 Anthropometric results (based on WHO standards 2006): .......................................................... 12 3.3.1 Acute malnutrition (Weight-for-height Z score (WHZ) .............................................................. 12 3.3.2. Acute Malnutrition based on MUAC ......................................................................................... 14 3.3.3. Prevalence of Underweight based on weight for Age Z - scores .............................................. 15 3.3.4. Prevalence of Stunting based on Height for Age Z - scores ...................................................... 16 3.4 Mortality results (retrospective over x months/days prior to interview)......................................... 17 3.5. Children’s morbidity ......................................................................................................................... 18 3.6. Health Seeking Practices .................................................................................................................. 19 3.7 Vaccination Results ........................................................................................................................... 19 3.8 Programme coverage ........................................................................................................................ 20 3.9 Vitamin A Supplementations and Deworming.................................................................................. 20 3.10. Maternal Malnutrition ................................................................................................................... 20 3.10.1. Physical Status for Mothers .................................................................................................... 20 3.10.2. Maternal nutrition and Multiple Micronutrient supplementations ....................................... 21 3.11. Water Sanitation and Hygiene (WASH) ......................................................................................... 21 3.12. Food Security and Livelihood ......................................................................................................... 21 3.12.1. Dietary diversity ...................................................................................................................... 21 3.12.2. Reduced Coping Strategies Index (rCSI) and Household Hunger Scores (HHS) .......................... 22 4.0. DISCUSION ........................................................................................................................................... 23 5. CONCLUSIONS .................................................................................................................................... 23 6. RECOMMENDATIONS AND PRIORITIES............................................................................................... 24 7. REFERENCES .......................................................................................................................................... 1 8. APPENDICES .......................................................................................................................................... 2 Appendix 8.1: Plausibility Report for: Elbarde Deyr' 2020.as ................................................................... 2 Appendix 8.2. Assignment of Clusters ...................................................................................................... 3 Appendix 8.3. Evaluation of Enumerators ................................................................................................ 4 List of tables Table