Nutrition Survey Report JAJARKOT DISTRICT, NEPAL Report Submitted to: Concern Worldwide- Nepal Report submitted by: Sustainable Development Initiative Network-Nepal Babar Mahal, Kathmandu December, 2008 0 | P a g e Jajarkot Nutrition Survey Concern Worldwide / SUDIN – NEPAL December 2008 Table of Content 1 Background and Introduction ...................................................................................................................... 10 1.1 Background........................................................................................................................................... 10 1.2 Introduction ........................................................................................................................................... 10 2 Aims and Objectives of this Study ............................................................................................................... 13 2.1 General Objective ................................................................................................................................. 13 2.2 Specific Objective.................................................................................................................................. 13 3 Training ...................................................................................................................................................... 14 3.1 Overall Objective of the Training............................................................................................................ 14 4 Research Design and Methodology............................................................................................................. 15 4.1 Research Method.................................................................................................................................. 15 4.2 Study Variables..................................................................................................................................... 15 4.3 Type of Study........................................................................................................................................ 15 4.4 Target Population.................................................................................................................................. 15 4.5 Sampling Methods and Sample Size ..................................................................................................... 15 4.6 Tools and Techniques for Data Collection.............................................................................................. 15 4.7 Pre-testing the Data Collection Tools..................................................................................................... 17 4.8 Validity and Reliability of the Research .................................................................................................. 17 4.9 Limitation of the Study........................................................................................................................... 17 4.10 Plans for Supervision and Monitoring ................................................................................................ 17 4.11 Plans for Data Management.............................................................................................................. 18 4.12 Plans for Data Analysis ..................................................................................................................... 18 4.13 Classification of Malnutrition.............................................................................................................. 18 4.14 Expected Outcome of the Survey ...................................................................................................... 19 4.15 Plans for Dissemination of Survey Results ........................................................................................ 19 4.16 Plans for Utilization of the Survey Findings........................................................................................ 19 4.17 Work Plan ......................................................................................................................................... 19 5 Results ....................................................................................................................................................... 20 5.1 Anthropometric results........................................................................................................................... 20 5.1.1 Age and sex distribution of the sample population ......................................................................... 20 5.1.2 Anthropometric analysis: Global Acute Malnutrition (Wasting) WHO standard, Z-score.................. 21 5.1.3 Anthropometric analysis: Stunting and Underweight ...................................................................... 23 5.1.4 Anthropometric analysis: Mid-Upper Arm Circumference (MUAC) ................................................. 23 5.2 Results of health seeking behavior questionnaire .................................................................................. 23 5.3 Household information........................................................................................................................... 25 5.4 Water and Sanitation............................................................................................................................. 31 5.5 Household food and nutrition situation................................................................................................... 33 5.6 Child health and nutrition....................................................................................................................... 36 6 Causal Analysis .......................................................................................................................................... 44 6.1 Anthropometry ...................................................................................................................................... 44 6.2 Household Indicators............................................................................................................................. 45 6.3 Water and Sanitation............................................................................................................................. 48 6.4 Child Health and Nutrition...................................................................................................................... 49 7 Discussion .................................................................................................................................................. 56 7.1 Anthropometric Analysis........................................................................................................................ 56 7.2 Health Seeking Behavior ....................................................................................................................... 57 7.3 Household Information .......................................................................................................................... 57 7.4 Water and Sanitation............................................................................................................................. 58 7.5 Household Food and Nutrition Situation................................................................................................. 59 7.6 Child Health and Nutrition...................................................................................................................... 60 7.7 Risk Factors.......................................................................................................................................... 61 8 Recommendations...................................................................................................................................... 63 9 References ................................................................................................................................................. 65 10 Acknowledgements ............................................................................................................................... 66 1 | P a g e Jajarkot Nutrition Survey Concern Worldwide / SUDIN – NEPAL December 2008 11 Annex ................................................................................................................................................... 67 Annex 1: Nutrition Survey Training ................................................................................................................. 67 Annex 2: Health and Nutrition Survey Team ................................................................................................... 69 Annex 3: Selected Clusters ............................................................................................................................ 71 Annex 4: Additional Questionnaire for the Causal Analysis of Nutrition Status................................................ 72 Annex 5: Additional Health and Nutrition Survey Questionnaire ...................................................................... 78 Annex 6: Anthropometric Data Form and Code Book...................................................................................... 83 Annex 7: Activity Plan for Jajarkot Survey....................................................................................................... 84 2 | P a g e Jajarkot Nutrition Survey Concern Worldwide / SUDIN – NEPAL December 2008 List of Tables Table 1: Availability