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The Directorate of Food and Nutrition of Sierra Leone’s Ministry of Health and Sanitation and Action Against Hunger Sierra Leone, with funding from Irish Aid, conducted the National Nutrition Survey 2017 in close collaboration and partnership with Sierra Leone Nutrition Technical Working Group.
A nutrition and mortality assessment using SMART methodology was applied and the survey covered 15 statistical (14 districts plus 1) domains countrywide. The main objective of the survey was to assess the current nutrition status of the population, especially children 6-59 months old and women of reproductive age (15-49 years of age). The survey also looked at the major contextual factors contributing to undernutrition such as infant and young child feeding (IYCF) practices; food security indicators; water, sanitation and hygiene indicators; and health situation in Sierra Leone.
A total of 9069 children, aged 6‐59 months, were examined for anthropometry; 4550 children, aged 0-23 months, assessed for IYCF practices, including 1106 children, aged 0-5 months, assessed for exclusive breastfeeding practices. A total of 9,496 women were assessed for their nutrition status and dietary diversity. Household related data, such as food security and livelihoods, water, sanitation and hygiene indicators as well as access to health services were also collected in the 9469 households during the assessment.
The national prevalence of Global Acute Malnutrition (GAM) was 5.1% (95%CI: 4.6-5.6), Moderate Acute Malnutrition (MAM) was 4.0% (95% CI: 3.6-4.5) and the Severe Acute Malnutrition (SAM) rate was 1.0% (95%CI: 0.8-1.3). Boys were more acutely malnourished than girls were (p<0.05), and younger children (aged 6-29 months) were more malnourished (p<0.05) than the older (aged 30-59 months) children.
The national prevalence of stunting was 31.3% (95% CI: 30.0-32.6) translating to 293,736 stunted children (based on 2015 population census) with 21.3% (95% CI: 20.3-22.3) moderately stunted and 10.0% (95% CI: 9.2-10.7) severely stunted, with more boys than girls reportedly stunted (p<0.05). Although the levels of both wasting and stunting have shown an improving trend over the past 10 years, stunting rates remain high (>30%) indicating a persistent serious chronic malnutrition situation according to WHO Classification that needs to be addressed comprehensively.
Moreover, 25,9% of the women surveyed were overweight. This occurrence of both under and over nutrition is an indication of the emerging double burden and complexity of malnutrition in the country.
Water, sanitation and hygiene indicators reveal a lack of access to the resources and poor practices. 80% of the households surveyed do not have access to latrine or toilet and 28% do not have access to a protected source of drinking water. If 70% use soap while washing hands, only 30% of those wash their hands at least three critical times a day.
The poor acute nutrition situation and serious chronic nutrition situation in the country is attributed to multiple and interrelated factors that call for continued integrated intervention efforts to address both immediate needs in addition to developing long-term strategies to enhance access to basic services; support to sustainable livelihood systems and social protection mechanisms.
To learn more about the recommendations and the findings of the survey, please download the full report.