Nutrition and retrospective mortality survey highlands and lowlands livelihood zones of Hajjah Governorate, Final SMART survey report, Yemen, March 2018



In March 2018, Action Contre la Faim (ACF), in collaboration with Ministry of Public Health and Population (MPHP) represented by Hajjah Governmental Health Office (GHO), conducted two nutrition assessments in Lowlands and Highlands’s ecological zone in 28 districts, out of 31, in the governorate. This was in response to the need to determine the malnutrition levels and trends for the different ecological zones and to inform on the intervention response for the governorate.
The main objective was to assess the current nutrition situation in Highlands and Lowlands of Hajjah governorate together with key determinants of Nutrition, Health and Food Security situation and provide key recommendations.
A two-stage cluster sampling methodology, using a probability proportional to population size (PPS) sampling methodology, was followed to randomly select 39 clusters for Highlands and 37 clusters for Lowlands ecological zones for both anthropometry and mortality assessments. A total of 1304 children aged 0-59 months (547 from Lowlands and 757 children from Highlands’s zones) were sampled for anthropometry, where 1292 were measured (542 lowland and 750 from Highland) were taken anthropometric measurement. Nutritional status for women of reproductive age 15 – 49 years was determined. A total of 1771 women were assessed (780 in Lowlands and 991 in Highlands) using MidUpper Arm Circumference (MUAC). Other indicators collected during the survey included household demographics, Health, Water, Sanitation and Hygiene (WASH) and Food security. Data collection period was 10th to 22nd March 2018.
The survey results indicated an high Global Acute Malnutrition (GAM) rate of 14.9 % (11.8 - 18.8 95% C.I.) classified as serious and 8.9% (6.5– 12.1 95% CI) classified as poor in the Lowlands and Highlands livelihood zones respectively. The results also indicated a very high rates of chronic malnutrition of 53.3% (47.9 – 58.7 95% CI) and 55.2 % (50.2 - 60.1 95% C.I.) in Lowlands and Highlands livelihood zones respectively.
The Infant and Young Child Feeding (IYCF) results showed a low exclusive breastfeeding rates of 17.6% (8.4 -30.9 95% CI) and 30.3% (21.0 – 41 95% CI) and low minimum acceptable diet: 7.1% (3.6 -13.2 95% CI) and 4.0 % (1.8 -8.1 95% CI) for Lowlands and Highlands livelihood.
The survey results on food security indicated a household’s dietary diversity of 6.7 and 7.4 for Lowlands and Highlands zones respectively. The food consumption score noted that 52.0 and 53.0 percent of households consume food from poor and borderline food consumption group in lowland and highland zones respectively.
The survey results for other key indicators are in table 1 below, the summary of recommendations generated from the findings are presented in table 2.


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