SMART survey. Dadu district, Sindh Province, Pakistan. November 2014

Transcription

1 SMART survey Dadu district, Sindh Province, Pakistan November 2014 Title: SMART survey Preliminary Report Place: Dadu District of Sindh Province, Pakistan Funded By: EU By: Basharat Hussain, Action Against Hunger / ACF International

2 1. Introduction The National Nutrition Survey (NNS) 2011 indicates that malnutrition rates are very high (15.1% wasting and 43.6% stunting rates among under five children) at national level. Food security was also reported to be alarming, with around 57% of the 30,000 households surveyed nationally facing food insecurity. Moreover, the NNS says that the malnutrition rate and situation in Sindh province is worse than other provinces. NNS 2011 results for Sindh province indicated a very high rate of acute malnutrition, with a global acute malnutrition rate (GAM) of 17.5% and severe acute malnutrition rate (SAM) of 6.6%, with GAM above emergency threshold of 15%. The nutritional anthropometric and mortality survey conducted 2013 by ACF International to continue monitoring the nutritional situation in Dadu district, reported a GAM rate of 12.7% and a SAM rate of 1.8%. ACF-International has been supporting implementation of a multi sector program in Dadu district, with a major aim of reaching acutely malnourished children under five years of age, as well pregnant and lactating women. Currently, the nutrition sensitive program operates under an EU funded project, and is in year one period of implementation. In order to continue monitoring the nutritional situation in Dadu, and to make the program and its intervention more effective, ACF has conducted a SMART nutrition anthropometric and mortality survey in Dadu District, Sindh Province from Nov. 23 rd through Dec. 2 nd, Objectives The general objective of the nutrition survey was to measure the extent and severity of acute malnutrition in children aged 6 to 59 months and their caregivers (pregnant and lactating women). The specific objectives for Dadu District were: To estimate the prevalence of acute and chronic malnutrition among children 6-59 months of age; To estimate the prevalence of maternal malnutrition among pregnant and lactating women; To assess crude mortality rate and under five mortality rates; To assess morbidity and immunization coverage among 6-59 months children; To give appropriate recommendations for intervention programs in district. Page 2 of 5

3 3. Methodology Study area: The survey was conducted in Dadu District of Sindh Provide targeting all union councils. Study period: The study was conducted from November 17 to December 2nd Study design: A cross sectional study with two-stage cluster sampling using Standardized Monitoring of Relief and Transition (SMART) methodology. Villages are considered as the smallest geographical unit (clusters). Study population: Children 6 59 months old: Anthropometric measurements and Oedema was measured from children 6-59 months old in the sampled household in all selected villages. Pregnant and Lactating Mothers: To estimate the prevalence of malnutrition among pregnant (2nd and 3rd trimester) and lactating mothers in all selected villages. Household members: To assess the retrospective mortality rate Sample size: SMART software (10th Nov, 2014 version) was used for sample size calculation. Sample size parameters are specified in Annex Preliminary results For the sake of timely presentation of survey results, Table 1 summarizes preliminary findings with regards to nutrition indicators. A total of 551 children aged 6-59 months were assessed for their nutritional status through anthropometric measurements from 520 sampled households. The data quality analysis is presented in annex 2 (plausibility check on anthropometric results). Table 1: Summary of Nutrition and Health indicator results, Dadu District, Sindh Province, Nov 2014 Results presented in brackets are expressed with 95.0% confidence interval (CI). Index Indicators Dadu Result (%) WHO s HAZ- s WAZ-s MUAC Global Acute Malnutrition (GAM) Weight for height< -2 z and/or oedema Severe Acute Malnutrition (SAM) Weight for height < -3 z and/or oedema Stunting Height for age <-2 z- Underweight Weight for age <-2 z- Global Acute Malnutrition MUAC <125 mm or oedema 14.3 ( ) 2.6 ( ) 52.6 ( ) 42.4 ( ) 10.5 ( ) Page 3 of 5

4 Severe Acute Malnutrition MUAC <115 mm or oedema (<115mm) The final report will be available in the coming weeks 3.8 ( ) Page 4 of 5

5 Annex 1: Sample size calculation for nutrition status using ENA for SMART software (Nov10th, 2014 version) Estimated GAM Precision DEFF U5 Population Av. HH size Contingency Sample size Children Sample size HHs Clusters (13HHs/ Cluster) 12.6% 4% % 7 5% Annex 2: Plausibility check summary CRITERIA Flagged data (% of in-range subjects) Overall sex ratio Overall age distribution Weight Height MUAC Standard deviation Skewness Kurtosis Poisson distribution Overall SCORE 0 (2.4 %) 0 (p=0.160) 0 (p=0.140) 0 (4) 0 (7) 0 (5) 0 (1.01) 0 (-0.08) 0 (0.05) 3 (p=0.001) 3% Interpretation Excellent Excellent Excellent Excellent Excellent Excellent Excellent Excellent Excellent Acceptable Excellent