September 17th to October 17th 2012
1. EXECUTIVE SUMMARY
The last nationwide survey including nutrition indicators was the Multiple Indicator Cluster Survey (MICS) carried out in 2009. It showed that 32.4% of children <5y (0-59 months) were stunted (Chronic malnutrition) (8.4% severely stunted) and that 5.2%1 of children were acutely malnourished (0.5% of the severe form). Since then two screenings of mid-upper-arm circumference (MUAC) have been done (October 2011 and February 2012) in the counties were a community management of acute malnutrition (CMAM) program is on-going. Another nutrition assessment using MUAC methodology was conducted in November 2011 in WFP operational counties. All of the MUAC assessments were conducted in different times so comparison of the findings with the national data is not possible but gives indication of seasonal child acute malnutrition in the assessed geographical areas.
The present survey was therefore needed to update the indicators for the population nutritional status. All 10 provinces have been included2 . Data collection was done from September 17th to October 17th 2012.
The methodology is based on SMART3 and MICS4 surveys. It is a clustered, stratified by provinces, two-stage sampling survey. The target population includes children under 5 and their mothers. The sample size per province is 400 children in Pyongyang municipality and 812 children in all other provinces for most indicators.
Chronic malnutrition, despite a modest drop since MICS 2009 (from 32.3% to 27.9% at national level) remains in the ranges labelled ‟medium‟. Stunting has irreversible impact on the development of children as a result on the Country development. The prevention of stunting in early life (starting during or even before pregnancy) as well as the prevention of anaemia in mothers and their children (mainly those under 2 years old) through different multi-sectoral interventions combining nutrition, health, WASH, social protection, food security and agriculture requires more efforts and resources.
The survey also shows a picture of the acute nutritional status of children modestly improved since 2009. The situation is not critical and does not suggest emergency operations.
However, attentions need to be paid to such factors as essential medicines, WASH situation and food security which affect the vulnerable children. The presence of acute malnutrition in women is also of concern. Programmes like the management of acute malnutrition at hospital and community levels (CMAM) need to be continued and expanded. Provision of nutritious food for children at institutions should also continue. On-going monitoring of the nutritional situation is important to identify the trends and changes in the situation and bring support as soon as possible when the situation is negatively changing5 .
In reference to the MDG 1, the achievement in decreasing underweight over time (from 60.6% in 1998 (MICS1 to 15.5% in the actual survey), as well as chronic and acute malnutrition, are primarily due to concerted efforts between the Government, the UN Agencies and others partners in DPRK in addressing the different causes of malnutrition. But malnutrition still remains and requires continued and strengthened interventions on chronic and acute malnutrition in order to have more impact on the underweight prevalence and to ensure a more optimal growth to the children.