INTER-AGENCY NUTRITION ASSESSMENT SYRIAN REFUGEES IN LEBANON ASSESSMENT CONDUCTED: September 2012 FINAL REPORT JANUARY 2013 Nutrition Assessment Report for Syrian Refugees in Lebanon, using SMART methodology 2 ACKNOWLEDGMENTS UNICEF and WFP Lebanon, in collaboration with WHO and with support of ACF Lebanon, commissioned and coordinated the assessment. The technical support for the assessment was provided by the Nutrition Consultant Oumar Hamza, the Lebanon Task Force/ committee members (particularly Dr Alissar Rady from WHO Lebanon), UNICEF Regional Office Advisors and WFP Regional Bureau advisors. Gratefully acknowledge the important contributions made by so many people that made this assessment possible, particularly all agencies involved in planning and executing of the assessment. Specific thanks to UNICEF, WFP, WHO, MOPH, UNHCR and ACF Lebanon teams for their collaboration in the entire duration of the exercise. Thanks to all the participants who engaged in data collection and data entry. Particularly thanks to the assessment teams including drivers and administrative support team. Most importantly, thanks to the women, men and children from different Syrian refugees’ families who agreed to be interviewed, measured and weighed during this assessment. 3 TABLE OF CONTENTS Acknowledgments ........................................................................................................................................................... 3 Table of contents ............................................................................................................................................................ 4 List of tables .................................................................................................................................................................... 6 List of figures................................................................................................................................................................... 7 Acronyms and abbreviations .......................................................................................................................................... 8 Introduction ................................................................................................................................................................... 15 I. Background and rationale................................................................................................................................... 16 II. Justification of the assessment .......................................................................................................................... 17 III. Task force committee ......................................................................................................................................... 18 IV. Objectives ........................................................................................................................................................... 18 V. Methodology ....................................................................................................................................................... 19 1. Study population ................................................................................................................................. 19 2. Sampling and sample size determination ........................................................................................... 19 3. Questionnaire ...................................................................................................................................... 21 4. Measurement methods ....................................................................................................................... 21 5. Different definitions and calculations .................................................................................................. 23 A. Malnutrition in children 6-59 months ......................................................................................... 23 B. Infant and young child feeding practices in children 0-24 months ............................................ 24 C. Malnutrition in women of reproductive age ............................................................................... 24 D. Children anthropometric data ................................................................................................... 24 6. Training and coordination ................................................................................................................... 25 7. Pilot testing and revision of the assessment tools .............................................................................. 25 8. Data collection ..................................................................................................................................... 25 9. Field work and quality control ............................................................................................................. 26 10. Data analysis ....................................................................................................................................... 26 VI. Results - Individual levels ................................................................................................................................... 28 1. Response rate ..................................................................................................................................... 28 2. Demography ........................................................................................................................................ 28 3. Health assistance ................................................................................................................................ 29 4. Children 6-59 Months .......................................................................................................................... 29 A. Anthropometric results (based on WHO growth standards 2006) ............................................ 29 B. Child morbidity .......................................................................................................................... 33 C. Children vaccination coverage .................................................................................................. 34 D. Infant and young child feeding .................................................................................................. 34 5. Women 15-49 years ............................................................................................................................ 36 A. Physiological status .................................................................................................................. 36 B. Women malnutrition .................................................................................................................. 36 VII. Results - Household level – WASH and food security ....................................................................................... 38 1. WASH.................................................................................................................................................. 38 A. Access to sufficient water ......................................................................................................... 38 B. Main water problems................................................................................................................. 38 C. Have soap and/or hygienic products ........................................................................................ 38 4 2. Food security ....................................................................................................................................... 39 A. Food sources ............................................................................................................................ 39 B. Number of meals per day ......................................................................................................... 39 C. Consumption of canned food .................................................................................................... 40 D. Food consumption score .......................................................................................................... 40 E. Food stocks ............................................................................................................................... 42 F. Coping strategies ...................................................................................................................... 43 Limitations ..................................................................................................................................................................... 45 Discussion ..................................................................................................................................................................... 46 Conclusion .................................................................................................................................................................... 51 Recommendations and priorities .................................................................................................................................. 52 Annex ............................................................................................................................................................................ 53 Annex 1: Sample for Syrian refugees in Lebanon.............................................................................................