Nutrition sentinel site surveillance report South Sudan, Sep 2008 - Malakal southern zone, upper Nile state


This report presents the results of the seventh round of data collection of nutrition sentinel site surveillance carried out in the SouthernZone, Malakal County of upper Nile state in September 2008.

The main inhabitants of Malakal belong to Shiluk ethnicity with increasing numbers from other ethnic groups particularly the Nuer and Dinka. The main sources of livelihood in the area are employment and trade(1). There are quite a number of agencies operating programs in food security, nutrition, capacity building, health, water, sanitation, education as well as infrastructure reconstruction in the area. Nutrition sentinel site surveillance allows continuous monitoring of nutrition and other related indicators which generates time series data that enable detection of changes in trends. As a result, sentinel site surveillance acts as a key early warning tool which enhances appropriate identification potential emergencies and initiation of timely investigative and response measures.

The Lot Quality Assurance Sampling (LQAS) methodology was employed for datacollection where 33 clusters of 6 children were assessed. The anthropometric and qualitative questionnaire was administered in every randomly selected household with children aged 6-59 months. Anthropometric data was analyzed using ENA for SMART and LQAS decision rule whereas qualitative data was analyzed by use of Statistical Package for Social Sciences (SPSS) version 12.


The nutritional status indicators used by the sentinel site surveillance to illustrate the current situation include GAM(2) and SAM(3). These findings were subsequently expressed in WHZ at 95% confidence intervals. Weight for Height index expressed in Z-score (WHZ) is a good indicator for underweight (lowweight for height)/nutritional status.

Morbidity is an underlying cause of malnutrition among children who are under five years due to their susceptibility to infections. Therefore, BCG vaccination status and availability of a vaccination card were used as proxy indicators of risk of prevalence of immunizable childhood illnesses and child health care practices amongst caretakers.

Qualitative data such as household health care seeking practices, water and sanitation, child care well as household dietary diversity was also collected.