Anthropometric and mortality survey protocol, former Renk County, Upper Nile State, South Sudan (May 2018)
Renk County, located in northern South Sudan bordering Sudan’s White Nile, Blue Nile, and Sennar States, has been the main port of entry for the large number of returnees travelling from Sudan to South Sudan following Independence. As a result, the county experienced a massive influx of returnees which, due to the lack of onward transportation, often stayed in the county for months to years. The transient camps now also host IDPs from South Sudan, largely as a result of the internal conflict. From April 2014 to April 2015 the conflict between SPLA and SPLA (IO) continued with regular clashes causing extensive destruction and massive displacement of people. As such, the population numbers in Renk County remain volatile and Medair estimates this to be approximately 47, 316 .
Medair started the provision of health, nutrition, and WASH services for the returnees in 2011 after identifying critical baseline gaps in the provision of these basic services for transiting populations. In 2012, the Renk response was scaled up from a temporary response to a transitioning population to a more stable response with static teams based in Renk town when much of the camp population remained and were unable to be served by the existing County health and nutrition services. The overall objective of the program is to improve access to emergency health and nutrition services, safe water, sanitation, and improved health and hygiene practices to displaced populations and acutely vulnerable host communities through the provision of basic WASH, health and nutrition services.
Medair WASH, health and nutrition project locations now stretch from Wonthou in the North to southern Jelhak. At present Medair is managing three static emergency health and nutrition clinics; two clinics are run in IDP/returnee sites in Abayok and Wonthou. Emergency WASH services are also provided. The third health and nutrition clinic is a Ministry of Health Clinic located in Jelhak which is in a mainly host community populated area. Medair is also running 8 mobile nutrition clinics in the host and IDP community. Medair is the only nutrition actor in the county. The Outpatient Therapeutic Program (OTP) and Targeted Supplementary Feeding Program (TSFP) are integrated in all the Nutrition Clinics. Medair also runs 1 Stabilization centre in Abayok camp, alongside the OTP and TSFP. The clinics in the IDP sites provide services to both IDPs/returnees and some of the host population. From early 2015, Medair has been implementing a Care Group model program that promotes community health, hygiene and nutrition behavior change in peer to peer mothers’ groups.
The Standardized Monitoring and Assessment of Relief and Transition (SMART) survey conducted in May 2017 by Medair determined a GAM prevalence rate of 27.1% (21.7-33.2; 95% CI), and a SAM rate of 7.2% (4.2-12.2; 95% C.I) in the IDP/returnee population. The host population recorded a GAM prevalence rate of 32.3% (26.6-38.7; 95% CI), and a SAM rate of 7.6% (4.9-11.7; 95% C.I). This indicated that both settlements recorded above emergency thresh hold of acute malnutrition according to the World Health Organization classification.