Attachments
Executive Summary
Background: Fangak County is one of the eleven counties that make up Jonglei state of South Sudan. It is located between Guit County to the west, Koch county to the south west, Ayod County to the south, Piji Canal County to the east, Parinang county to the north west and Panyikang County to the northeast. The Zeraf Island, in which the town of Old Fangak located, comprises a large part of the county. Old Fangak/Fam al Zaraf town, the county headquarters, lies where the Bahr el Zeraf enters the White Nile from the east. The county consists of nine administratively payams1 (namely: Old Fangak, Pulita, Paguir, Mareang, Manajang, Toch, Barboy, New Fangak and Keew/Kuerdar). Between 17th - 22nd of March, 2022 Action Against Hunger- USA conducted nutrition and mortality SMART survey in Fangak County of Jonglei state, South Sudan. The proposal was reviewed and approved by the NIWG as well as permission letter/approval was obtained from the MoH for the Republic of South Sudan, Juba.
Objective: The overall objective of this survey was to determine the prevalence of acute malnutrition among children 6-59 months of age and asses the mortality situation of the community in Fangak County of Jonglei state, South Sudan.
Methodology: The assessment was a cross sectional study with two-stage cluster sampling using SMART methodology and the sample size of households to be surveyed was determined using Emergency Nutrition Assessment (ENA) software (January 11, 2020 updated version).
The first stage involves random selection of villages (clusters) from total of villages using probability proportion to size (PPS) and the second stage involved selection of households using simple random sampling. The sample size was determined using the various assumptions based on the given context and it was determined that for anthropometry, a total of 447 children in 393 households were calculated and a total of 3,057 persons in 394 households were required for the retrospective mortality survey as a representative sample size. As the two sample sizes are almost same, the sample size calculation for mortality survey was used.
Coverage of the survey: All Payams, Bomas and their respective villages (except those flooded due to the recent rain and became vacant as all households were left to other areas) were assessed. A total of 33 villages were selected by PPS and 12 households were selected per village.
Information collected: Anthropometric, mortality, morbidity, immunization, health seeking behaviour of mothers or caretakers, IYCF, maternal nutrition, WASH, and food security and livelihood (FSL) information were collected.
County level participation: In addition to local community members, staffs from partners (HoC and CHD offices) participated in the training and actual data collection as part of the survey teams and supervision.