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BACKGROUND:
In 2023, a comprehensive SMART survey was conducted across the flood-affected districts of Sylhet Division, Bangladesh, due to a critical lack of recent, districtspecific nutrition data. Existing sources like Bangladesh Health Demography Survey (BDHS) 2022 and Multiple Indicator Cluster Survey (MICS) 2019 only provide divisional insights, masking district-level disparities. Sylhet division, compared to national prevalence, shows persistent challenges in malnutrition. Wasting in the Sylhet division decreased from 12.1% in 2014 to 10.4% in 2017- 18 but rose again to 12.2% in 2022, indicating ongoing acute malnutrition issues. Underweight prevalence in Sylhet dropped from 39.8% in 2014 to 31.7% in 2022, showing improvement but remaining above the WHO critical threshold (>30%). Stunting in Sylhet declined significantly from 49.6% in 2014 to 31.2% in 2022, reflecting positive progress, though still categorized as "very high" by WHO standards (>30%).1 In addition, Sylhet Division is significantly impacted by recurrent floods, particularly from May to July. The devastating floods of June 2022 affected approximately 7.2 million people in Sylhet division, causing extensive destruction to infrastructure, homes, and livelihoods2 .Furthermore, 269,550 population are living in the division at IPC phase 4 categorized as emergency level of acute food insecurity3 . The persistent challenges and lack of district-level nutrition data have highlighted the need for evidence to guide appropriate, context-specific nutrition programming. This survey recommended by the National Nutrition Service (NNS) and nutrition cluster partners, the survey aims to assess the nutritional status of children aged 6–59 months and pregnant lactating women, identify malnutrition situation, and reveal district-level disparities. This data-driven approach enables us to make decisions regarding the timely, effective implementation of life-saving interventions and guides post-recovery efforts. Therefore, WFP with the technical support of ACF, decided to carry out the survey to evidence-based programming and advocacy to address Sylhet's nutritional challenges and foster sustainable improvements.