ACF SMART NUTRITION AND MORTALITY SURVEY IN HUDUR TOWN INTEGRATED NUTRITION AND MORTALITY SMART SURVEY REPORT HUDUR TOWN, BAKOOL REGION, SOMALIA OCTOBER 2020 I ACF SMART NUTRITION AND MORTALITY SURVEY IN HUDUR TOWN ACKNOWLEDGEMENTS Action against Hunger (AAH), 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 supports provided by Hudur Municipality and the Ministry of Health in South West state of Somalia, facilitations 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 input and validation. ➢ Appreciation also goes to SIDA/DFID, for the generous financial support to conduct this nutrition and mortality survey. II ACF SMART NUTRITION AND MORTALITY SURVEY IN HUDUR TOWN TABLE OF CONTENTS Contents ACKNOWLEDGEMENTS ................................................................................................................................. II TABLE OF CONTENTS .................................................................................................................................... III Contents ................................................................................................................................................... III LIST OF TABLES .......................................................................................................................................... V LIST FIGURES ............................................................................................................................................ VI ACRONYMS AND ABBREVIATIONS .............................................................................................................. VII EXUCUTIVE SUMMARY................................................................................................................................. IX 1. INTRODUCTION AND SURVEY OBJECTIVES ........................................................................................... 1 1.1. Background ................................................................................................................................... 1 1.2. Justifications ....................................................................................................................................... 1 1.3. Objectives........................................................................................................................................... 2 1.3.1. Overall objective: ........................................................................................................................ 2 2. 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. ................................................................................................................. 4 2.6 Variables collected .............................................................................................................................. 6 2.7 Data Managements ............................................................................................................................. 7 2.7.1 Survey Teams ............................................................................................................................... 7 2.7.2: Quality Assurance ....................................................................................................................... 7 2.7.4: Data Analysis and Reporting ....................................................................................................... 8 3. RESULT ...................................................................................................................................................... 9 3.1 Planned versus the actual ................................................................................................................... 9 3.2 Demographic Characteristics .............................................................................................................. 9 III ACF SMART NUTRITION AND MORTALITY SURVEY IN HUDUR TOWN 3.3 Education Level ................................................................................................................................. 10 3.4 Anthropometric results (based on WHO standards 2006): .............................................................. 10 3.4.1 Acute Malnutrition among 6 – 59 months children, based on WHZ ......................................... 10 3.4.2. Distribution of age and sex of sample ...................................................................................... 11 3.4.2. Distribution of age and sex of sample ...................................................................................... 11 3.4.3. Prevalence of acute malnutrition based on weight-for-height z-scores (and/or oedema) and by sex .................................................................................................................................................. 11 3.4.5. Prevalence of acute malnutrition by age, based on weight-for-height z-scores and/or oedema ............................................................................................................................................................ 12 3.4.6. Prevalence of acute malnutrition based on MUAC cut off's (and/or oedema) and by sex ...... 13 Table 12: Prevalence of acute malnutrition by age, based on MUAC cut off's and/or oedema ....... 14 3.4.7. Prevalence of acute malnutrition by age, based on MUAC cut off's and/or oedema .............. 14 3.4.8.Prevalence of combined GAM and SAM based on WHZ and MUAC cut off's (and/or oedema) and by sex* ......................................................................................................................................... 15 3.4 Mortality results (retrospective over 93 days prior to interview) .................................................... 16 3.5 Children’s morbidity .......................................................................................................................... 16 3.6. Health Seeking Behiviours ............................................................................................................... 17 3.7 Vaccination Results ........................................................................................................................... 18 3.8 Program coverage ............................................................................................................................. 18 3.9 Vitamin A Supplementations and Deworming.................................................................................. 19 3.10. Maternal Malnutrition ................................................................................................................... 19 3.10.1. Physical Status for Mothers .................................................................................................... 19 3.10.2. Maternal nutrition and Multiple Micronutrient supplementations. ...................................... 20 3.11. Dietary diversity and CSI ................................................................................................................ 20 3.12. Water Sanitation and Hygiene (WASH) ......................................................................................... 21 4. DISCUSSIONS ........................................................................................................................................... 22 4.1 Nutritional status .............................................................................................................................. 22 4.2 Mortality ....................................................................................................................................... 22 4.3 Causes of malnutrition ...................................................................................................................... 22 IV ACF SMART NUTRITION AND MORTALITY SURVEY IN HUDUR TOWN 5. CONCLUSIONS ......................................................................................................................................... 23 6. RECOMMENDATIONS AND PRIORITIES ..................................................................................................... 1 6. REFERENCES .............................................................................................................................................. 1 7. ANNEXES ..............................................................................................................................................