Ethiopia

Report on Nutrition training and Survey in Kuraz and Hamerbena woredas of south omo zone

Format
Assessment
Source
Posted
Originally published


SPONSORS
CHRISTIAN AID (CA)
DUTCH INTERCHURCH AID (DIA)
NORWEGIAN CHURCH AID (NCA)
ETHIOPIAN EVANGELICAL CHURCH OF MEKANEYESUS, SOUTH WEST SYNODOS (EECMY/SWS)

MAY 2000

EXECUTIVE SUMMARY

Nutrition training and nutrition survey were conducted in Kuraz and Hamer Bena woredas in South Omo zone between April 10 and May 9, 2000. The whole undertaking was sponsored by CA, NCA, DIA and EECMY/SWS and conducted by two senior nutrition researchers. The aim of the training was to enable nutrition and health workers to undertake similar surveys and establish nutrition surveillance systems in their respective areas. The aim of the survey in the other hand was to assess the magnitude of malnutrition as a result of three year long drought in the area and identify appropriate interventions that can mitigate the problem.

Among 46 peasant associations in Kuraz woreda and among 47 peasant associations in Hamer Bena woreda, five clusters each were randomly selected. A questionnaire addressing the impact of the drought and determinants of malnutrition was administered to at least a minimum of 50 households (mothers) in each cluster. Anthropometric measurements were taken from all under five children accompanying mothers selected for interview. Totally, 571 households and 730 children were included in the survey.

According to DPPC classification, nutritional status is poor in both woredas (Mean WFH/L less than 90%; and percentage of children below 80% greater than 10% in both woredas). When survey sites or localities are considered Gisma locality (Waito area) appears to be seriously affected (21% below 80% reference). Other localities are also very close to serious levels of malnutrition.

The serious impacts of drought is manifested in several ways. Substantial number of households have lost their family members over one year period (16% in Kuraz and 10.9% in Hamer Bena). Over a third and nearly a quarter of households in Kuraz and Hamer Bena woredas respectively reported that at least one member of the family was sick over the last fourteen days.

On average each household in Kuraz has lost 1.5 cattle and 2.9 shoats while in Hamer Bena each household has lost 1.2 cattle and 3.6 shoats in the last six months due to drought. Many households have resorted to consumption of wild foods (29.8% in Kuraz and 45.1% in Hamer Bena) which is an indication of serious food shortages. Prices for livestock has gone down, while the prices for food commodities have risen up considerably. A condition unfavorable for the poor pastoralists.

As the belg rains have failed further deterioration is expected unless timely actions are taken. Some of the potential interventions to improve the current situation and prevent further deterioration are recommended below.

RECOMMENDATIONS

Short term

Magnitude of malnutrition in Gisma and Erbore localities (both from Woito area) is critical and needs an immediate distribution of supplementary foods and establishment of feeding centers at least within the clinics.

It is recommended that all under five’s in both woredas receive supplementary foods in order to prevent further deterioration in nutritional status.

It was observed that nearly all households in both woredas had no grain reserve in their stores. Therefore the ongoing food aid for the entire population must be strengthened. Regularity must be maintained and efforts to reach all households must be intensified. It is also recommended that oil and salt be included in the rations.

As indicated earlier health status in both woredas is poor. Malaria and Diarrhea are major diseases. The existing health institutions must be supplied with adequate medicines at least for these ailments. Additional health institutions must be established and public health education need to be initiated to reduce morbidity and improve general health status.

Immunization coverage in the two woredas is low and in some places the service is unavailable. It is recommended that vaccination programme should be strengthened.

One of the main problems raised by the communities was disease of livestock. Strengthening provision of veterinary medicine is an area that can be considered as potentially useful.

Long-term

The two woredas are endowed with relatively rich resources favorable for large

scale agriculture such as abundant irrigable farming land, relatively good soils and rivers, that can easily be used for irrigation purposes (especially Omo and Woito rivers)

All concerned stakeholders must work together to utilize these resources and sustainably prevent the recurrent drought in the area.

Although it is believed that the rivers and the lakes in the area have fish reserves the use seems to be negligible. Promotion of the use and production of fish is another area to be considered in the area

All efforts to educate the people must be strengthened. Boarding elementary school education programme which was initiated by EECMY in Turmi village need to be supported, encouraged and promoted to the other parts of the woredas in order to disseminate knowledge on health/nutrition, agriculture and other development issues.

Populations of the two woredas depend mainly on livestock for their living. The large number of cattle and shoats owned by the household are of inferior quality and low productivity. In addition, scarcity of pasture, drought and livestock diseases are the major problems regarding livestock rearing. Therefore all efforts to alleviate these impediments should be strengthened.

It was indicated that health problems in the two woredas is quite high, while in the contrary there are only a few health institutions. It is therefore highly recommended that the attempt to increase the number of health institutions as well as health services must be strengthened.


NUTRITION TRAINING AND SURVEY IN KURAZ AND HAMERBENA WOREDAS OF SOUTH OMO ZONE

INTRODUCTION

BACKGROUND

According to the reports of EECMY/SWS, missionaries working in the area and Drought Prevention and Preparedness Commission’s (DPPC) food appeals, large segment of the population in the two woredas are currently facing serious food shortages and that the situation can deteriorate further. In an effort to improve the current situation as well as minimize the possible human suffering in the future, NCA/DIA/CA/EECMY commissioned nutrition survey and nutrition training workshop for nutrition and health workers in the area. Both the survey and the training were led by two senior nutritionists (Cherinet Aboye and Tsegaye Demissie). All the trainees of the workshop participated in data collection. The aim of the training was to enable nutrition and health workers to undertake similar surveys in future and establish nutrition surveillance systems in their respective areas. The aim of the survey in the other hand was to assess the magnitude of malnutrition as a result of three year long drought in the area and identify appropriate interventions that can mitigate the problem. Specific objective of the nutrition training include:-

1. Identify and examine the importance of the three anthropometric indices

2. Perform precise measurements of weight and height in children aged 6- 59months

3. Minimize and correct errors and reduce the possibility of introducing biases into survey

4. Correctly interpret anthropometric results and take appropriate actions

5. Establish nutritional surveillance system for their project areas

The specific objectives of the survey were:-

1. The overall objective of the survey is to provide basic information/data nutritional problems, status of the children under five and the general socioeconomic situation in the two woredas, and define operational mechanisms for emergency assistance.

2. To empower the EECMY/SWS staff in the project area to under take similar survey in the future.

3. To forward possible recommendations to DIA/NCA/CA and EECMY for the future action.

The methodologies used, the results obtained and conclusions/recommendations that emerged from the survey will be forwarded in this report. Instead of presenting the results of the two woredas separately, it was decided to present them side by side so that it will be easy for comparative purposes.

PROFILE OF THE SURVEY AREA

Geographically, the two woredas, Kuraz and Hemer Bena, are located in the Southern tip of South Omo zone (Ethiopia as well), bordering kenya to the South, Borena zone to the east, North Omo zone to the north and Bench Maji zone to the west. The estimated total land area of Kuraz woreda is about 4280 square kilometers inhibited by about 56426 people (see annex 6 for more details). The major ethnic groups residing in the woreda include Desenech, Bume and Mugezi. The land area and population of Hamer Bena woreda in the other hand is estimated to be 9996 square kilometers and 69063 respectively (see annex 6 for more details). Hamer, Erbore and Tsemai are the major ethnic groups living in the woreda. As the entire landmass of Kuraz and the major portion of Hamer Bena woreda is lowland (370-470 meters above sea level) the climate is that of a typical lowland. Very hot and windy days and worm nights are common. As most parts in the country, the small rains usually start in February and end in September.

As a typical lowland people, the entire population can be considered as agro-pastoralists depending on livestock primarily and primitive agriculture secondarily. The major types of livestock reared are cattle, goats, sheep and donkeys, where as sorghum is the major crop cultivated. Both livestock rearing and farming highly depend on Omo river in Kuraz woreda, while much of these activities depend on rain in Hamer Bena woreda (except those living around Waito river). With adequate rain in the central highlands Omo river brings fertile soils which later is used for planting sorghum and pasture for cattle when the water resides to its course.

Kuraz woreda is probably the most remote and primitive areas in Ethiopia. Infrastructures are unavailable or poorly developed. There are only three health posts and one school. Markets are poorly developed while there is only one all weather road. The woreda town Omorate does not have either electric power or telephone services. Swedish Philadelphia Mission and Mekane Eyesus are the only NGO working in the woreda. It appears that Hamer Bena woreda is relatively better in comparison with Kuraz woreda in terms of infrastructures and number of institutions. There are 5 clinics, 1 health center and 2 health posts and fourteen junior secondary and elementary schools. There are a few well established markets and the road net work is relatively better. Mekane Eyesus Church, SIM, NCA and Catholic mission are operating in the woreda.

METHODOLOGY

SITE AND SAMPLE SELECTION

Among 46 kebeles/villages in Hamer Bena and 47 in Kuraz, twelve clusters six from each woreda (see Annex 1) were randomly selected using probability proportional to Size (PPS) approach. One cluster in hamer bena and another one in Kuraz were dropped later on because people have moved to other places. From each selected cluster, fifty households (a total of (571) were selected for interview. Height and weight of all under five’s (a total of 730) of mothers selected for the interview were measured.

SURVEY TOOLS

Questionnaire

A structured questionnaire (see Annex 3) consisting of questions on demography, diet, nutrition and drought situation was used. Questionnaire was administered to the mothers of the children.

Discussions with focus group and key informants

Over all situations of drought and coping mechanisms were discussed with community elders and government officials of the two woredas. Guiding questions used during the discussions is attached (Annex 5)

Market survey

Market price survey on a few major items was conducted in one market in Hamer bena Woreda. Current prices and last year prices of three different sizes or amounts of the same items were recorded and averages were taken. The format used is attached (annex 4)

Anthropomerty

Anthropometric measurements were taken following standard procedures in measuring weight and height. Weight was taken to the nearest 0.1kg while height was recorded to the nearest 0.1cm. For children less than two years of age length was measured. WFH/L was used to classify nutritional status of the children. The following classification developed by DPPC to assess the level of malnutrition in a community was used.

Table 1: Nutritional status classification

Status
Mean %WFH/L
Percent below 80% reference
Good
>95
<5
Satisfactory
94-90
6-10
Poor
89-85
11-20
Serious
<85
>20
(DPPC, 1995. Guidelines on nutritional status data and food relief)

Training

One of the objectives of the consultancy undertaking was to train nutrition field workers. Three days intensive training was given to 15 professionals (see annex 2 for details of their qualifications and institutions) to be involved in future nutritional activities. Following the theoretical training all trainees participated in practical exercise and variations in data collection were assessed and measures were taken to reduce them.

RESULT AND DISCUSSION

A) SURVEY RESULTS

1) Demographic characteristics of the study population

Some of the major demographic characteristics of the study population are presented in table 2. Most of the households are headed by men in Kuraz woreda, while slightly more households are headed by women in Hamer Bena woreda. Nearly all household heads in both woredas are below the ages of 50 years with slightly more household heads over 50 years in Hamer Bena. Mean household sizes are nearly equal in both woredas and similar to household sizes in other regions. The proportion of monogamous households is substantially higher in Kuraz woreda compared to Hamer Bena. The proportions of various categories of physiological status of women are similar in both woredas and comparable to the proportions in other areas.

2) Livestock conditions

The type and number of livestock owned currently, type and number of livestock sold and died in the last six months is presented in Table 3. More cattle is owned by households in kuraz woreda (12/household) and similarly more cattle were sold and died in Kuraz when compared to Hamer Bena woreda. More shoats were owned by households in Kuraz woreda as well but the number of shoats sold and died are slightly more in Hamer Bena woreda. Total number of cattle died in both woredas is about 648 ( 264 in Kuraz and 384 in Hamer Bena). On average each household has lost 1.5 cattle, 2.9 shoats in Kuraz and 1.2 cattle, 3.6 shoats in Hamer Bena in six months time due to drought. This clearly indicates that the situation has been serious in the area.

The main reasons indicated by the households regarding livestock death are obviously, lack of pasture, water and disease. Several livestock diseases were mentioned, among which some are not common in the area, while others have re-emerged with the drought.

Table 2: Demographic characteristics by woreda

Woredas
Characteristics
Kuraz
Hamerbena
Sex of the household head
Male
Female

97.7%
2.3%

89.6%
10.4%
Age of the household head
<50 years
>50 years

89.0%
11.0%

97.9%
2.1%
Mean house size (range)
5.8 (1-12)
5.7 (1-15)
Marital status
married monogamous
married polygamy
single
divorced/separated

70.9%
20.1%
1.1%
7.9%

70.8%
4.1%
3.1%
22.0%
Physiological status
pregnant
lactating
non lact. Non
pregnant

13.7%
67.9%
18.4%

12.9%
68.6%
18.5%
Table 3: Type of livestock sold and died per household during the last six months and currently owned (mean and range)
Kuraz woreda
Hamer bena woreda
Type
currently owned
sold
Died
Currently owned
sold
died
cattle
12.0(0-400)
2.1(0-19)
1.5(0-21)
5.6(0-100)
1.5(0-19)
1.2(0-49)
shoats
15.2(0-500)
2.1(0-20)
2.9(1-30)
9.8(0-250)
2.2(0-32)
3.6(0-50)
3) Food consumption

Major types of foods consumed by the household as well as by the index child a day prior to the survey is presented in table 4A and 4B. Most of the households, 29.8% in Kuraz and 45.1%, in Hamer reported that they consumed wild foods that are not consumed in normal times. The same wild fruits were also consumed by the majority of children (23.4% in Kuraz and 40.2% in Hamer). These included plant roots (lokote, chilma) fruits (geba, chewanza, demch) and leaves. Wheat and Maize based foods were also consumed by many households, the source of which is food aid. The usual sorghum based foods, meat and milk were consumed by a small proportion of the households indicating that households are largely depending on wild foods and food aid as a result of the three year long drought.

Table 4A: Major types of foods consumed by the household a day prior to the survey

Woredas
Food type
Kuraz (n=251)
Hamerbena (n=320)
Wild fruits, leaves and roots
29.8%
45.1%
Potato
14.2%
nil
Wheat porridge
11.3
3.2%
Wheat nifro
7.3%
1.9%
Meat
7.1%
2.5%
Fish
6.6%
nil
Sorghum porridge
5.2%
2.4%
Milk
5.0%
nil
coffee
4.1%
5.8%
Wheat kurkufa
2.1%
13.2%
wheat bread
1.0%
3.7%
Sorghum kurkufa
nil
4.4%
Aleco
nil
5.2%
Sorghum bread
nil
4.7%
Maize kurkufa
nil
3.0%
Table 4B: Major types of foods consumed by the child a day prior to survey
Woredas
Food type
Kuraz (n=302)
Hamerbena (n=428)
Wild fruits, leaves and roots
23.4%
40.2%
Breast milk
25.5%
15.3%
Sorghum porridge
25.5%
22.6%
Wheat kurkufa
2.2%
12.3%
Wheat porridge
9.2%
9.6%
Meat
9.8%
1.3%
Milk
24.5%
3.7%
Fish
8.7%
0.0%
4) Morbidity and mortality

Number of deaths in a household over one year period and sickness over 14 days as reported by household heads/mothers is presented in table 5A and 5B. Over 16% households in Kuraz and about 10% in Hmaer reported that at least one member of the household died over one year period. This is higher than the mortality rates elsewhere and although the major reasons forwarded for the death is sickness, it still reflects the seriousness of the drought. As usual more under five’s died in both woredas compared to other age segments (38.5% in Kuraz and 45.3% in Hamer). As indicated in table 4B over 35% households in Kuraz and about 21% in Hamer reported that at least one member of the household was sick in the last 14 days. Again underfives were more affected in both woredas (Kuraz 65.7% and Hamer 48.6%) compared to other age groups. Malaria, diarrhea and cough are the major diseases reported in both woredas. 28.4% in Kuraz and 51.4% in Hamer did not seek medication the reason forwarded being lack of money.

Table 5A: One year death rates by woreda

Woreda
Kuraz
Hamerbena
% of households reporting the death of at least one member.
16.0%
10.9%
Age of death
<5 years
5-18 years
18-60 years
>60 years

38.5%
34.5%
23.2%
3.8%

45.3%
24.6%
23.8%
6.3%
Sex of the deceased
male
female

67.7%
32.3%

50.0%
50.0%
Reason for death
sickness
drought
other

74.2%
22.6%
3.2%

67.6%
26.5%
5.9%
Table 5B: Fourteen days morbidity by woreda
Woreda
Kuraz
Hamerbena
% of households reporting the sickness of at least one member.
35.8%
23.1%
Age of sickness
<5 years
5-18 years
18-60 years
>60 years

65.7%
16.4%
16.5%
1.5%

48.6%
16.8%
33.6%
1.4%
Sex of the sick
male
female

50.0%
50.0%

44.6%
55.4%
Type of sickness
malaria
diarrhea
cough
fever
pneumonia
gastritis
other

39.7%
16.2%
13.2%
11.8%
4.4%
1.5%
13.2%

20.5%
20.5%
16.4%
1.4%
1.4%
8.2%
31.5%
Medication sought
yes
no

71.6%
28.4%

48.6%
51.4%
5) Child feeding practices

Breast feeding and vaccination status of the index children is presented in Table 6. Among our index sample children nearly similar number of children are currently breast feeding in both woredas. Nearly 94% in Kuraz and 90% in Hamer are breast fed more than a year which is a good practice. As it is elsewhere the major reason for terminating breastfeeding is due to mother being pregnant in both woredas. Vaccination status appears also to be fair. Only 21.7% in Kuraz and 10% in Hamer were not vaccinated. Major reason for not completely vaccinated include distance, service terminated and appointment missed for various reasons.

6) Nutritional Status

Nutritional status of under five children is shown in tables 7,8 and 9 by woredas and study areas. Nutritional status of study children in all survey areas of the two woredas was poor.

The prevalence of acute malnutrition (Weight-For-Height/Length) less than 80% was extremely high (18.3% and 21.1%) in Erbore and Gisma respectively when compared to the rest of the sites in Hamer Bena woreda. According to the nutritional guideline of DPPC, malnutrition was severe in these areas requiring an immediate initiation of feeding centers. Although nutritional status in Turmi, Dimeka and Alduba areas appears relatively better currently, the possible deterioration is expected and food aid and supplementary feeding should also continue in these areas as well.

Regarding acute malnutrition in Kuraz woreda all study areas (Loyore, Libamuket and Bume) attained poor level of nutritional situation based on the guidelines of DPPC in Ethiopia.

Table 6: Breastfeeding and vaccination situation by woreda

Woreda
Kuraz
Hamerbena
Breastfeeding status
currently breastfeeding
currently not breastfeeding

43.6%
56.4%

55.6%
44.4%
Age of weaning
<1 year
<2 years
<3 years
<4 years

5.1%
67.3%
98.0%
100.0%

10.0%
70.0%
92.5%
100.0%
Reason for terminating breastfeeding
pregnancy
big enough/child refused
mother's sickness

55.4%
40.1%
4.5%

47.4%
44.2%
8.4%
Vaccination status
complete
partially complete
not vaccinated

56.6%
21.7%
21.7%

72.2%
17.8%
10.0%
Reason for not completely vaccinated
distance from clinics
appointment missed
fear of side effects
service terminated

17.1%
42.5%
21.3%
19.1%

27.5%
47.5%
12.5%
12.5%
Table 7: Nutritional status by Woreda (WFH/L)
Woreda
mean WFH/L%
% below 80%WFH/L
% below 70%WFH/L
Kuraz
88.3
15.3
2.6
Hamer Bena
89.9
14.5
2.1
Table 8: Nutritional status by study localities in Kuraz Woreda (WFH/L)
Localities
mean WFH/L%
% below 80%WFH/L
% below 70%WFH/L
Loyore Kapsia Bubya (East Omorate area)
88.9
17.2
1.0
Libemuket, Debrmuz (West Omorate area)
88.1
10.5
0.0
Aipa, Natakar Bume area
87.6
16.3
4.3
Table 9: Nutritional status by study localities in Hamer Bena Woreda (WFH/L)
Localities
mean WFH/L%
% below 80%WFH/L
% below 70%WFH/L
Turmi area
91.0
9.7
0.7
Dimeka area
92.1
8.2
2.7
Alduba area
94.1
16.7
0.0
Gisma area
86.8
21.1
4.4
Erbore area
88.6
18.3
1.4
B) MARKET SURVEY

The initial idea of conducting market survey in Kuraz woreda failed as there were no established markets. House to house transactions are taking place and this became difficult to assess price fluctuations in the area.

Unlike Kuraz woreda, Hamer Bena woreda however has a well established markets and one major market (Dimeka market) was surveyed. Four major items were seen. Table 10 shows average current price, average last years price and the difference between the two years. The prices of animals have substantially dropped as it is usually the case during drought, while the prices of sorghum and maize have gone up because sellers were bringing sorghum and maize from other parts of the country as local production has failed due to drought. Both conditions are against the pastoralists as they sell their cattle in a very low prices and buy food items in higher prices.

Table 10: Market prices of selected items

Item
Average current price
Average last year’s price
Difference last year-current
Oxen
175 birr
500 birr
325 birr
Goat
80 birr
100 birr
20 birr
Sorghum
1.0 birr/tin
1.80 birr/tin
-0.80 birr
Maize
1.0 birr/tin
1.80 birr/tin
-0.80 birr
C) Results of focus group and key informants discussion

Key informants as well as woreda administrative authorities in Kuraz and Hamerbena unanimously agreed that severe food shortage prevails currently in the area. The main reason for the severe shortage of food is cumulative effect of three years lack of rain that affected the cattle and the sorghum cultivation. Along with lack of pasture several livestock diseases which were not known in normal years has been killing the cattle in both woredas. Lung disease, cough, swelling of the head and legs and several other diseases were mentioned.

As reported by woreda officials the human due to food shortage was not substantially high because several coping strategies were being excised. The major coping strategy, basically intended to safe the cattle as well as the young and children, is to migrate to places where water and pasture is available. In Kuraz woreda nearly all households have moved deeper and deeper to Turkana lake along Omo river, while people in Hamer Bena woreda have migrated to several sites in the woreda. As explained by the focus group discussions and key informants, migration has its own consequences. The most obvious one is clashes among different ethnic groups in Ethiopia and Kenya. One of the worst incidents is the recent clashes between Gelebs (Ethiopians) and Turkana (Kenyans) which claimed death of many people and loss of 19000 cattle and goats by Gelebs. Another side effect of such migration is increased risk of disease as health assistance becomes difficult.

Consumption of dying animals or killing of the weak animals and or sucking blood can be considered as an in built mechanism to evade death due to famine. In Geleb, consumption of fish can also be considered as one factor mitigating the possible dangers of drought. Other coping strategy widely used is, consumption of wild fruits which are not consumed in normal times. Several wild fruits are mentioned, which are either tree fruits, lake/river weeds or roots of various plants.

The consumption of wild fruits, however is not free of any problem. Some wild fruits cause diarrhea to children, some are not easily cooked and easily consumed by children.

Other important factor which has prevented mass death is the food AID. The food aid is distributed by the woreda administrative body. It was said that 12.5kg of wheat or maize was given per individual per month. Due to lack of transport however, neither the amount nor the schedule is maintained.

Oil and salt were not distributed at all while some supplementary food has just arrived in both woredas.

One area in Hamer Bena probably deserves attention. The Elbore area which has been depending on the Woito river for agricultural activities are now in a serious problem due to the establishment of a large scale agricultural enterprise in the upper part of the river. The informants said that there was an attempt to ration the water of the river among the residents and the enterprise. But it was neither adequate nor regular.

ANNEX 1. MAP OF THE STUDY WOREDAS AND STUDY LOCALITIES

ANNEX 2. LIST OF PARTICIPANTS

Name
Professional background
Organization
1. Asaminew Godane
Nurse
DCBHP
2. Girma Odo
Health assistant (H/A)
SIM
3. Senait Demissie
Nurse
SPCM
4. Gustav Stenson
Visiting student
SPCM
5. Kinfu Kena
Project manager
SPCM
6. Demo Bezabih
H/A
SIM
7. Dillo Gorjale
Elementary
Gisma clinic
8. Geda Gorjale
Elementary
"
9. Eruket Achew
"
Woito Clinic
10. Lemma Yerar
"
EECMY
11. Ellias Lemma
H/A
Clinic
12. Mellesse Mamo
H/A
DCBHP
13. Amenu Endale
H/A
Health office
14. Yohannes Birhanu
Evangelist
EECMY
15. Begena
Nurse
Turmi Clinic
16. Mariyo Walle
Nurse
EECMY/SWS
ANNEX 3. HOUSEHOLD QUESTIONNAIRE

NUTRITION SURVEY IN TWO WOREDAS OF SOUTH OMO ZONE, SOUTH ETHIOPIA

I. IDENTIFICATION

1. Woreda _________ Fa _____________ Village ____________

2. Name of household head _____________ Age _______ Sex __ 1=male 2=female

3. Interviewer’s name _________________ Interview date ______________

II. SOCIOECONOMIC, HEALTH AND DEMOGRAPHIC INFORMATION

1. Occupation of the head of the household 1=farmer 2=merchant 3=civil servant 4=other

2. Household size ______ No. of people <5------- and >60-------

3. Marital status of the hhh___ 1=maried 2=single 3=divorced/separated 4=widow

4. Household monthly income _________________ in birr

5. Source of income____________________

6. Physiological status of the mother 1=pregnant 2=lactating 3=non pregnant and non lactating 4=preganat and lactating

7. Are there any hh members who left the house in the last six month 1=yes 2= no

8. If yes what was the reason___________________________________________

9. Has any member of the hh died in the last one year 1=yes 2= no

10. If yes what was his/her age when she/he died _____sex_______

and what was the reason of his/her death________________________________

11. Were there any household members who were sick in the last 14 days 1=yes, 2=no

12. If yes fill the following information

S.no
Name
age
sex
sickness
medication sought
if yes where?
If no why not?
Codes; sex 1=m, 2=f, medication sought 1=yes, 2=no

13. Do you think your household is currently facing serious food shortage 1=yes 2=no

14. What are the strategies your household is using to cope up with the food shortage?

1= migration, 2=consumption of wild foods, 3=reducing number of meals, 4=reducingwork, 5=food for work, 6=other (specify)

15. Information regarding livestock

Se.no
type
Number currently owned
number sold last 6 months
reason for selling
number died last 6 months
reason for death
Reason for selling codes= 1=get money to purchase food items, 2=get rid of them because it is difficult to keep them, 3= other (specify)

Reason for death of cattle codes, 1=lack of pasture, 2=lack of water, 3= disease

III. DIETARY INFORMATION

1. How many meals/day does your family eat currently?

2. How many meals/day does your family eat in normal times?

3. List the type of foods consumed last week, their sources and indicate whether these foods are consumed in normal times

S.No
Type of food
Source
Is it consumed in normal times
1.
2.
3.
4.
5.
6.
7.
4. List the foods usually consumed in normal times______________________________

5. List the type of foods consumed yesterday, their sources and indicate whether these foods are consumed in normal times

S.No
Type of food
Source
Is it consumed in normal times
1.
2.
3.
4.
5.
6.
7.
6. Are you currently receiving any food aid. 1=yes, 2=no

7. If yes, what is the source 1=NGO, 2=Church, 3=Government, 4=other

8. If yes, list the type and amount of food you are receiving

Se.no.
Type
Amount
9. How much food do you have in your stock_____________________

10. How long will it last____________________

IV. INFORMATION REGARDING THE INDEX CHILD

1. Is the index child still being breast fed 1=yes 2=no

If yes complete all information except 6 and 7. if no start from question 6 and fill the rest

2. How many times did you breast fed your child?

3. Do you think it was different than in normal times? 1=yes, 2=no

4. Do you think that your child was satisfied? 1=yes, 2=no

5. If no why not

6. At what age did the child stopped breast feeding?

7. Why did you stopped breast feeding?

8. List the type of foods your child consumed yesterday and frequency

Se.no
type of food
frequency
is it usual
9. Vaccination status of the index child 1=completed, 2=parrtially completed 3= not at all vaccinated

10. If not at all vaccinated or partially vaccinated what is the reason?

V. ANTHROPOMETRY

Name
age*
sex
weight
height
* age of the child should be recorded in months

ANNEX 4. MARKET SURVEY QUESTIONNAIRE

ITEM
CURRENT PRICE
LAST YEAR PRICE
GOOD YEAR PRICE
1
2
3
AVERAGE
ITEM
1
2
3
AVERAGE
ANNEX 5. FOCUS GROUP QUESTIONNAIRE

ANNEX 6. POPULATION BREAK DOWN BY AGE AND PHYSIOLOGICAL STATUS

Kuraz
Hamer Bena
Less than 1 year
1496
3087
less than 3 years
4435
8453
less than 5years
8289
13025
Child bearing age women
13402
14372
Pregnant women
1693
2071
Total
56426
69063