Nutrition sentinel site surveillance report Southern Sudan, Aug-Sep 2008, Tonga payam, Panyikang County, Upper Nile State



Tonga bulletin collates initial data collected in Nyibodo, Atigo, Tonga centre, Yom, Nyijwad and Dinyo Bomas constituting Tonga payam, Panyikang County.

Tonga Payam comprises of nine Bomas; Papuojo, Aidhajo, Nyibodo, Atigo, Tonga centre, Yom, Nyi-jwad and Dinyo. The main inhabitants are Shilluk and to a lesser extent Nuers among other commu-ties. The total population of the payam was 23,286(1). Settlements were situated mainly along the stretch of river Nile. Most of the areas get marooned by swamps easily during the rainy season due to the low lying topography of the area. During the inception phase, appropriate background information analysis and stakeholder consultations were done to establish the site. International NGOs; World Vision International (WVI), Medicins du Monde (MDM) and National NGO, Church Ecumenical Association in Sudan (CEAS) are operating programs in Food Security, Health, Water, Sanitation and Education in the area. Five Health Workers at the Tonga PHCU run by the MDM were trained in principles of sentinel surveillance and thereafter participated in actual data collection. The site was set up to monitor malnutrition trends in the greater Panyikang County due to changing food security status as observed in the past (WVI and WFP information sources).

LQAS methodology was utilized upon which 33 clusters with 6 children in each cluster were assessed. Anthropometric and qualitative questionnaires were administered in each household that was randomly identified for assessment. The households with children aged 6-59 months were targeted.


Anthropometric data was analyzed using ENA for SMART and LQAS decision rule. Various indicators were used to elucidate the prevailing situation; GAM(2) and SAM(3) being the main ones. These findings were then expressed in WHZ at 95% confidence intervals due to its statistical significance.

Morbidity is an underlying cause of malnutrition more so in children aged below five years of age due to their vulnerability to infections. As such, 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.

Additional qualitative data included household health care seeking practices, water and sanitation, child care as well as household dietary diversity.