Nutrition and Mortality Survey in Aden governorate Yemen 8 – 13 August 2015 Ministry of Public Health and Population Aden Governorate Health Office United Nations Children’s Fund (UNICEF) Nutrition and Mortality Survey Report Aden Governorate, Yemen Conducted 8 – 13 August 2015 ACKNOWLEDGEMENTS The Yemen Ministry of Public Health and Population (MoPHP)/ Aden Governorate Public Health and Population Office, in collaboration with UNICEF Yemen Country Office and UNICEF Aden Zone, and Field Medical Foundation (FMF), acknowledge the contribution of the various stakeholders in this survey. The UNICEF Yemen Country Office provided technical support, employing SMART methodology. The Survey Manager and his assistant were provided by IOM and CSSW. Survey enumerators, team leaders, and data entry team were provided by GHOs of Lahj and Aden. The data analysis and report writing were made by two FMF consultants. UNICEF YCO provided the overall technical assistance especially on sampling, questionnaire and the guideline. The Aden Governorate Public Health and Population with FMF oversaw the political and logistical arrangements for the survey, ensuring its smooth operation. The Nutrition survey was supported financially by UNICEF under a grant from the UK Department for International Development (DfID); this support is greatly appreciated. The contribution of local authorities in ensuring the survey teams’ security during fieldwork and in providing office facilities is gratefully appreciated. The data could not have been obtained without the co-operation and support of the communities assessed, especially the mothers and caretakers who took time off from their busy schedules to respond to the interviewers. Their involvement and cooperation is highly appreciated. UNICEF and MoPHP also express their sincere appreciation to the entire assessment team for the high level of commitment and diligence demonstrated during all stages of the assessment to ensure high quality of data collected, and the successful accomplishment of the exercise. List of acronyms ARI Acute Respiratory Infection WFP-CFSS World food programme- Comprehensive Food Security Survey CI Confidence Interval CMAM Community Management of Acute Malnutrition CSO Central Statistical Organization DHS Demographic Health Survey ENA Emergency Nutrition Assessment FHS Family Health Survey GAM Global Acute Malnutrition HAZ Height for age z-score IYCF Infant and Young Child Feeding MAM Moderate Acute Malnutrition MDD Minimum Dietary Diversity MoPHP Ministry of Public Health and Population MUAC Mid-Upper Arm Circumference OTP Out-patient Therapeutic Programme SAM Severe Acute Malnutrition SD Standard Deviation SMART Standardized Monitoring and Assessment of Relief and Transitions U5 Under-five UNICEF United Nations Children’s Fund WAZ Weight for Age z-scores WHZ Weight for Height z-scores Table of contents ACKNOWLEDGEMENTS.............................................................................................................................................3 List of acronyms ................................................................................................................................................5 Table of contents ..............................................................................................................................................6 Executive summary...................................................................................................................................................1 Introduction / background .......................................................................................................................................4 Assessment objectives ..............................................................................................................................................5 Methodology ............................................................................................................................................................6 Sampling Design and Sample Size Determination ................................................................................................6 Sampling Procedure: ............................................................................................................................................7 Survey Population and Data Collection Process ...................................................................................................9 Measurement Standardization and Quality Control ............................................................................................9 Clear job descriptions were provided to the teams before commencing the data collection to ensure appropriate guidance in delivering the assigned tasks (Annex 4: Survey Team Job Description). Field team head had to review the questionnaire and verify the accuracy of the details before the teams leave a household, thus minimizing possibility of incomplete data (missing variables) and outliers. .......................... 10 Data Entry and Analysis ..................................................................................................................................... 10 Data Entry Verification and Cleaning ................................................................................................................ 11 Results ................................................................................................................................................................... 12 Household Characteristics of Study Population: ............................................................................................... 12 Morbidity, Immunization Status of the U5 children:......................................................................................... 14 Infant and young child feeding (IYCF) practices: ............................................................................................... 14 Nutrition Status ................................................................................................................................................. 17 Mortality: ........................................................................................................................................................... 19 Discussion and variable association ...................................................................................................................... 20 Levels of Malnutrition: ...................................................................................................................................... 20 Vitamin A Supplementation and Malnutrition Levels: ...................................................................................... 22 Morbidity and Malnutrition Levels: ................................................................................................................... 22 Child Feeding and Malnutrition Levels .............................................................................................................. 22 Nutrition Status and Household Access to Food and Coping Strategies: .......................................................... 23 Water and sanitation with Nutrition situation: ................................................................................................. 23 Recommendations: ................................................................................................................................................ 24 Annexes ................................................................................................................................................................. 26 Annex 1: Aden governorate Nutrition Survey Questionnaire ............................................................................... 27 27 ...................................................................................................................................................... انتقل إلى النهاية 27 ...................................................................................................................................................................... لمديرية 27 ........................................................................................................................................................................العزلة 27 .............................................................................................................................................................. القرية/ الحارة 28 ............................................................................................................... غياب اﻷسرة حتى بعد الزيارة الثانية )1 نعم ، 2 ﻻ( 28 ................................................................................................................................................... الموافقة )1 نعم ، 2 ﻻ( 28 .................................................................................................................................................................. رقم الفريق 28 ........................................................................................................................................................ رقم استبيان اﻷسرة 28 ........................................................................................................................................ اﻷسرة مقيمة )1( أم نازحة )2( 28 ................................................................................................... في حال اﻷسرة المقيمة، هل تأوي أسرة نازحة )1 نعم ، 2 ﻻ( 28 ..............................................................................................................................................................