The survey confirms results from previous nutrition survey in Liberia that have consistently shown high levels of stunting for a national average. 40% of the randomly surveyed children in Grand Gedeh County were stunted (too short for their age) with nearly one of every six (16.4%) children severely stunted. Also high were under-five mortality rate (U5MR) at 3.34 deaths per 10,000 per day and underweight at 25%.
"The high Under-Five Mortality rate requires urgent follow-up. Time and again, the main causes of deaths among Liberia's under-five year old children are malaria, diarrhoeal diseases and acute respiratory infections. These are all preventable diseases and due directly to inadequate health care, unsafe water and poor child feeding practices," says WFP Country Director Justin Bagirishya.
Higher rates of underweight are a national concern as it signifies general poor growth of children which, if not corrected, eventually has a heavy negative toll on the economy. A malnourished child is more likely to suffer more episodes of common child illness, which is not only an economic drain but also has implications of child survival.
Over half (52%) of the surveyed children had developed a symptom of sicknesses in the two weeks prior to the survey. The most common symptom of sickness experienced by the children was fever followed by diarrhea, malaria, and coughing in that order. Nearly three out of four of the surveyed children were introduced to solid foods either too early or too late and less than 4% continue to breastfeed up to the recommended age of two years.
Furthurmore, 56% of the mothers had suffered from either fever or diarrhea in the two weeks prior to the survey with about one-sixth of the interviewed mothers indicating that they suffered from both the two disease symptoms.
Although over a third of the households surveyed report at least a family member receiving WFP ration within the month preceding the assessment, 90-99% of the food rations were mainly provided through the emergency school feeding in the county. Grand Gedeh has had relatively limited humanitarian operations since the end of 2003 due to the uncertain security situation. The county is now opening up for humanitarian operations albeit at a slow pace mainly due to extremely poor infrastructural network and limited data to guide interventions as Grand Gedeh has never been surveyed.
"Teen-age mothers are reported to be the norm and less than 16% of the mothers sleep under mosquito nets with their young children. HIV/AIDS awareness reveals appallingly high levels of ignorance about the pandemic, stigmatization, and discrimination. Half of the respondents would not allow an active healthy looking teacher to continue teaching if they discover that the teacher has the HIV/AIDS virus. The same treatment will be given to a healthy looking HIV infected shopkeeper whose goods will not be bought by 71% of the respondents," Bagirishya elaborated.
Less than one-fifth of the assessed household have appropriate knowledge on the spread, prevention and care for the pandemic despite the reported cases of sexually transmitted infections (mainly gonorrhoea) amongst the residents.
The report recommends urgent follow up on the high under-five mortality in the county; rehabilitation of basic infrastructures such as schools and skills training facilities; health service provision especially urgent in remote parts of Tchien District; improvement in sanitation situation through construction of latrines and education, etc. Other recommendations include initiation of income generating activities especially those involving women and the youth; focusing on education of girls to control teen-age motherhood; provision of agricultural tools and equipment; intensification of health and nutrition education mainly focusing on primary health care and child feeding practices and concerted HIV/AIDS awareness campaigns in the county.
WFP conducted the survey in collaboration with the Ministry of Health and Social Welfare, UNICEF, and UNHCR in March 2005. The survey provides baseline information on the key food security and nutrition indicators and possible causes of vulnerability in the County. The results will facilitate the review of the already existing programmes and guide the planning and appropriate targeting of future food assistance in Grand Gedeh County and in Liberia in general. The survey was made possible with assistance from the Ministries of Planning and Economic Affairs, Health and Social Welfare, LRRRC, ICRC, SC-UK, the Humanitarian Information Centre, UNICEF, FAO, UNHCR, and community groups.
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