Wau County is one of the three counties of Western Bahr el Ghazal State. It consists of five administrative payams—Wau North, Bagari, Wau South, Besselia and Kpaile—with an estimated total population of 179,111.i,ii,. Cattle herding remains the primary determinant of wealth and status. Livestock are sold for cash, traded for other products, are gifted as marriage dowries, and act as a source of milk and meat. Bee hiving also serves as a source of food in the region. Chronic shortages of food in the market worsen food security in the county. Often, commodities are accessible and acquired through the sale of household assets and natural resources.
The region was originally inhabited by the Jur, Balanda, Ndogo, and Keresh peoples who are predominantly agro-pastoralists. In recent years, people from Upper Nile, Unity, and Jonglei have moved into the area. Since December 2013—specifically since fighting erupted in Mapel in April—large numbers of extended family members have joined these homes, particularly in Bagari and Wau Town Payams.
Nutrition surveys in neighboring counties have revealed Global Acute Malnutrition (GAM) prevalence of 3.4% in Nagero to the South, 24.9% in Aweil Centre and 27.5% in Gogrial West to the North. Rates of Severe Acute Malnutrition (SAM) in these counties also range widely from 0.6% to 8.2%.iii,iv. Prior to this survey, no recent nutrition surveys had been implemented and validated in Wau County.
PSI has been working in South Sudan since 2005. In addition to integrated Community Case Management (iCCM), PSI South Sudan implements a water, sanitation, and hygiene (WASH) program which includes the social marketing of safe water products in Central and Western Equatoria and Western Bahar el Ghazal, as well as LLIN distribution throughout the country.
The anthropometric and retrospective mortality survey was conducted in preparation for upcoming Outpatient Therapeutic Programming (OTP) for the treatment of uncomplicated SAM cases in the Wau and Jur River Counties. The survey was carried out in coordination with the Relief and Rehabilitation Commission (RRC), the Western Bahr El Ghazal State Ministry of Health (SMoH), and the Wau County Health Department (CHD). Data collection was conducted between 21 and 25 July, and a data quality control exercise carried out in the field on 9 and 10 August to investigate outlying findings.