Endline Nutrition Survey in the Kyrgyz Republic Analytical Report May 2018 ABOUT SPRING The Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project is a seven- year USAID-funded Cooperative Agreement to strengthen global and country efforts to scale up high- impact nutrition practices and policies and improve maternal and child nutrition outcomes. The project is managed by JSI Research & Training Institute, Inc., with partners Helen Keller International, The Manoff Group, Save the Children, and the International Food Policy Research Institute. DISCLAIMER This report is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of the Cooperative Agreement AID-OAA- A-11-00031 (SPRING), managed by JSI Research & Training Institute, Inc. (JSI). The contents are the responsibility of JSI and do not necessarily reflect the views of USAID or the United States Government. ACKNOWLEDGMENTS This report was a collaborative effort between SPRING and partners in the Kyrgyz Republic. Many individuals and organizations played a vital role in its preparation. SPRING would like to thank the research and consulting agency M-Vector, which carried out the fieldwork for the endline survey, cleaned and analyzed the data, and prepared an initial draft report. SPRING/Kyrgyz Republic staff was instrumental in linking with M-Vector and government officials to obtain approvals and keep survey activities on schedule. Many people reviewed the initial draft of this report and made helpful suggestions for improvements. Finally, SPRING is grateful to the Ministry of Health in the Kyrgyz Republic, which welcomed and authorized SPRING to carry out the survey, and to the people of Jalalabad, Naryn and Uzgen for their willingness to participate in interviews and answer questions about their families, homes and nutrition practices. RECOMMENDED CITATION SPRING. 2018. Endline Nutrition Survey in the Kyrgyz Republic: Analytical Report. The Strengthening Partnerships, Results and Innovations in Nutrition Globally (SPRING) Project. Arlington, VA. SPRING M-Vector JSI Research & Training Institute, Inc. 720064 Kyrgyz Republic, Bishkek 1616 Fort Myer Drive, 16th Floor Akhunbaev St., 42а, 2nd floor Arlington, VA 22209 USA Phone: +996 (312) 511815, Phone: 703-528-7474 +996 (312) 510829 Fax: 703-528-7480 Email: [email protected] Email: [email protected] Internet: www.m-vector.com Internet: www.spring-nutrition.org Table of Contents Acronyms ........................................................................................................................................................... ix 1. Executive Summary ...................................................................................................................................... xi 2. Introduction .................................................................................................................................................... 1 3. Regions Covered ............................................................................................................................................ 4 4. Methodology .................................................................................................................................................. 6 Organization of Fieldwork ............................................................................................................................................................ 8 Quality Control Measures ............................................................................................................................................................. 9 Ethical Considerations .................................................................................................................................................................... 9 Data Processing ............................................................................................................................................................................. 10 Limitations ....................................................................................................................................................................................... 10 Presentation of Results ............................................................................................................................................................... 11 5. Sociodemographic Information ................................................................................................................12 Survey Results ..................................................................................................................................................18 6. Maternal Nutrition and Antenatal Care ...................................................................................................18 7. Women’s Dietary Diversity ........................................................................................................................26 8. Children’s Nutrition .....................................................................................................................................34 Breastfeeding.................................................................................................................................................................................. 34 Early Initiation of Breastfeeding .............................................................................................................................................. 34 Exclusive Breastfeeding among Children 0–5 Months ................................................................................................... 36 Introduction to Complementary Feeding ........................................................................................................................... 38 Dietary Characteristics for Children Ages 6–23 Months................................................................................................ 41 Consumption of Vitamin-Rich Food...................................................................................................................................... 45 Minimum Dietary Diversity ....................................................................................................................................................... 45 Minimum Feeding Frequency .................................................................................................................................................. 47 Minimum Acceptable Diet ........................................................................................................................................................ 49 Junk Food Consumption ............................................................................................................................................................ 50 9. Sources of Foods ..........................................................................................................................................53 Foods Grown on Farms .............................................................................................................................................................. 53 Availability of Foods in Nearby Markets .............................................................................................................................. 56 Availability of Foods in the Household ................................................................................................................................ 58 Source of Foods Consumed ..................................................................................................................................................... 61 10. Food Storage and Preservation ..............................................................................................................66 Food Storage .................................................................................................................................................................................. 66 Food Preservation ......................................................................................................................................................................... 70 11. Water, Sanitation, and Hygiene ..............................................................................................................74 Safe Drinking Water Sources.................................................................................................................................................... 74 Sanitation ......................................................................................................................................................................................... 75 Handwashing .................................................................................................................................................................................. 77 12. Deworming .................................................................................................................................................82 13. SPRING Exposure Questions ....................................................................................................................84 May 2018 Endline Nutrition Survey in the Kyrgyz Republic: Analytical Report | iii 14. Conclusions and Recommendations .......................................................................................................90