Sudan

Sudan: Anthropometric Nutritional Survey (Summary Report)


Coverage: Malualkon, Aweil East County (southern Sudan)
Locations: Malualbai, Madhol, Baac, Mangartong, Mangok, Wunlang, Yargot, Korok

4 - 7 June 2001

Compiled by: Esther Ogonda (Tearfund Nutritionist)

Assessment Team:
Esther Ogonda (Tearfund Nutritionist)
Julius Maina (International Rescue Committee - Logistician)
George Mbaluto (Tearfund Feeding Nurse)
Vicky Kuria (Tearfund Feeding Nurse)
Joseph Mwirigi (International Aid Sweden - Agr. Officer)
Ben Ebenyo (Tearfund Feeding Nurse)
Paul Wachira (Tearfund Mechanic)
Tearfund Nutrition Extension Workers
SRRA Counterparts

NUTRITION SURVEY SUMMARY REPORT FOR AWEIL EAST COUNTY
BAHR-EL GHAZAL REGION - JUNE 2001

Date of the survey: 4 th -7 th June 2001

Area of the coverage: Eight payams: Madhol , Mangok , Malualbai, Yargot, Baac, Wunlang , Korok , Mangar tong.

Methodology: Two -stage cluster sampling method (30 clusters of 30 children). Semi structured interview schedules were used to collect the data and all the enumerators and team leaders attended the half day training session prior to the survey.

Targeted Group: Children 6-59 months in age (65-115 cm in height)

Sample size: 895 Children

Objectives

  • To assess the nutritional status of children aged between 6-59 Months in Aweil East County Bahr-el Ghazal region.
  • To determine the various food sources used during the current hunger gap period.
  • To estimate the proportion of displaced persons that have arrived within the community over the last 7 months and to estimate their nutritional status.


RESULTS INDICATOR

Population assessed: 936
Population analysed: 895
Total number of households analysed: 565

Nutritional status of children between 6-59 months

Global acute malnutrition rate (<-2 z-scores ) - 28.9% (95%CI 24.9% -32.9% )
Severe acute malnutrition rate (<-3 z-scores ) - 5.5% (95%CI 3.38% -7.62% )

Global acute malnutrition rate (<80% median ) - 19.6% (95%CI 16.24% -22.96%)
Severe acute malnutrition rate (<70% median) - 3.0% (95%CI 1.6% -4.4%)

MUAC (Mid upper arm circumference )

Moderate malnutrition rate (<12.5 cm ) - 16.1%
Severe Malnutrition rates (< 11.0 cm ) - 1.79%

Oedema - 0.0%

Nutritional status (6-24 months)

Global acute malnutrition rate (-2 z score) - 35.4% (95%CI 31.4% -39.4%)
Severe acute malnutrition rate(-3 z score) - 7.9% (95%CI 5.78% -10.02%)

Global acute malnutrition rate(<80% median) - 24.5%
Severe acute malnutrition rate(<70% median) - 3.6%

MALNUTRITION RATES PER PAYAM

Payam
No. of children assessed
Proportion malnourished
Madhol
30
46.7%
Mangok
30
33.3%
Malualbai
33
27.3%
Yargot
90
38.8%
Baac
121
32.2%
Wunlang
173
28.9%
Korok
185
24.8%
Mangar-Tong
233
24.0%
FOOD SOURCE
Propotion of dependency
WFP
63.6%
Trade
13.7%
Wild plants and indigenous foods
77.6%
Cultivation
21.8%
Kinship sharing
14.7%
Livestock
6.0%
Population movements
Percentage of displaced persons
16.6%
Percentage of returnees
6.7%
Percentage of residents
76.7%

Discussion

The survey was carried out in the hunger gap period - a time characterised by increased starvation as a result of the low food baskets available to the population, which has been compounded by continued insecurity which has affected the planting season. The situation was further aggravated by the poor previous harvest due to insufficient rains.

The results indicate a very high global acute malnutrition rate of 28.9% z scores (CI 95% 24.9% -32.9%). Comparing these levels with the last survey in March 2001 which recorded a malnutrition rate of 15.5% (z scores) the situation is evidently becoming more alarming and may reach crisis conditions should insecurity cause large scale displacement into the region. Tearfund recorded a global acute level of 36.2% (z scores) and 12.1% severe in Aweil East during the height of the 1998 famine.

A severe malnutrition rate of 5.5% (z scores) was recorded in this present survey. This figure has increased from the last recorded levels of 1.8% (z scores) in March mainly as a result of the now empty food baskets at the household level (buried food has now been dug up and eaten). It is also important to note that the children in the age bracket of 6-24 months are again the most affected category primarily as a result of weaning practices. These figures portray a serious condition at this stage of the hunger gap with over two months to go before the advent of the first ground nut harvest.

The results also indicate that most of the population (77.6%) depend on indigenous foods and wild plants as their main source of food. A relatively high percentage (63.6%) of the people also rely on the WFP general ration. The remaining 36.4% of the population does not have access to this intervention and can be said to be insecure in terms of food security and as a result stand a higher risk of a rapid deterioration in their nutritional status.

Most of the population ssessed did not have livestock on the ground, leaving more than 90% of the people with no access to milk or any form of meat foods. 13.7% of people surveyed were involved in various forms of trade, enabling them to cope to some degree with the current food insecurity.

RECOMMENDATIONS

Nutrition

It is essential that the mobile supplementary feeding programme is continued to prevent a general deterioration in the situation with many more children becoming severely malnourished.

Extensive household visits should be carried out by the nutrition extension workers to increase the coverage of the supplementary feeding beneficiaries. Those eligible for the therapeutic feeding centre should be given the opportunity to enroll into the programme.

It will be important to conduct a follow up nutritional survey in the location preferably after a 4 month period so as to evaluate the impact of the on going interventions. Tearfund should also carry out more longitudinal surveying across a smaller number of households in each supplementary feeding site per week. This will enable nutrition extension workers to gain a micro understanding of changing food and health patterns rather then sporadic nutritional snapshots.

Health education, nutrition and food security lessons should be conducted alongside the feeding sessions to ensure that the chronic situation in the location is addressed in the long run.

Tearfund should continue to work closely with the International Rescue Committee (IRC) and other INGO’s in Malualkon to co-ordinate health, nutrition and food security programming.

Food security

The general food distribution ration (WFP) needs to be increased from the current 50% to 75% particularly during this phase of the hunger gap to enable the beneficiaries to be able to meet their nutritional needs.

A more targeted intervention aiming at increasing the food basket of the currently affected people (the beneficiaries at the feeding centres) should be put into place so as to hasten their recovery rate.