In April 2014, the International Rescue committee (IRC) in South Sudan in coordination with the South Sudan Nutrition cluster conducted a SMART nutrition and mortality survey covering eight out of ten payams (excluding two payams Nyal and Mayom due to insecurity and inaccessibility) in Panyijiar County, Unity State. The main objective of the survey was to assess the current prevalence of acute malnutrition in the county and to provide baseline indicators for food security, water and sanitation, infant and young child feeding practices among the population. This was the first SMART nutrition survey in Panyijiar County.
The Standardized Monitoring of Relief and Transitions (SMART) methodology was used which included a two-stage cluster sampling. A total of 484 children aged 6-59 months from 429 households in 36 clusters were selected for anthropometric measurements. Assessments on mortality were conducted concurrently in 417 households (with a 2.6% non response rate. ). Additional information was gathered to provide more insight into suspected risk factors associated with the high acute malnutrition prevalence.
The prevalence of Global Acute Malnutrition (GAM) (WHZ<-2 and/or oedema) for the county was 32.8% (95% CI: 27.7-38.3), and the severe acute malnutrition (SAM) prevalence (WHZ<-3 and/or oedema) was 10.8% (95% CI: 7.7-14.9). The GAM and SAM prevalence surpass the critical threshold of 15% and 1% respectively according to WHO classification.
The Crude mortality rate (CMR) and under five mortality rate (U5MR) were 0.49 (95% CI: 0.29-0.81) and 1.07 (95%CI; 0.46-2.48) respectively. Both CMR and U5MR rates were below the WHO’s alert thresholds of 1/10,000/day and 2/10,000/day respectively. Most deaths among adults and children over 5 years were due to violence/physical injuries (57.1%) reflecting the outcome of tribal/political clashes that affected some of the villages assessed since January 2014. Diarrhea also contributed to most of the deaths especially among children below five years (29.0%).
The percentage of children who had reportedly suffered from one or more illness in the two weeks prior to the survey was 83.9%. This was higher than expected, however, owing to fact that the majority of children were malnourished, this could have contributed to low immunity hence high prevalence of morbidities. More than half (63.9%) of the reported illnesses were fever; 37.2% diarrhea while 13.9% reported cough.
Low vitamin A supplementation was reported with only half (50%) of the sampled children 6-59 months having received vitamin A supplementation in last six months (since November 2013). Measles immunization coverage of children (9-59 months) was low at 61.0%, below World Health Organization (WHO) recommended standards of >80%.