Transcript Mwingi Nutrition Survey Summary Results

GREATER MWINGI (Mumoni, Kyuso,
Migwani, Tseukuru, Mwingi East and
Mwingi central districts)
KITUI COUNTY
An anthropometric
nutrition surveys was
implemented in Greater
Mwingi in March 2012.
The geographical areas
surveyed were:-Mwingi Central district
-Mwing East district
-Tseukuru district
-Migwani district
-Kyuso district
-Mumoni district
The objectives for the survey were
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To evaluate the nutritional status of children aged 6-59 months
To estimate measles and immunization coverage of children aged
9-59 months.
To estimate the coverage of Vitamin supplementation among the
targeted children.
To estimate the retrospective morbidity, crude and under five
mortality rate.
To assess infant and young child feeding practices
To estimate the coverage of general food distribution and feeding
programs
To describe the current household food security situation
To describe the current water and sanitation situation and hygiene
practises.
To recommend appropriate interventions based on survey
findings.
METHODOLOGY
• Two-stage cluster sampling using SMART methodology
was applied to randomly identify clusters with the
probability of being selected proportional to the
population size in each cluster.
• 40 clusters children between 6-59 were sampled. A total
of 601 households were sampled for the survey and a
total of 40 clusters were selected for the survey.
• 16 households per cluster were included in the survey
RESULTS
Anthropometric and Mortality data results
Child Nutrition Status W/H
(WHO)- Z scores (534)
Child Nutrition status W/H
(NCHS)- Z-scores(536)
Child Nutrition Status H/A
(WHO)- Z scores (520)
Child Nutrition Status H/A
(NCHS)- Z scores (520)
Global Acute Malnutrition (GAM)
(<-2 z-score and/or oedema)
2.8% [1.5- 5.0]
Severe Acute Malnutrition (SAM)
(<-3 z-score and/or oedema)
0.0% [0.0- 0.0]
Global Acute Malnutrition (GAM)
(<-2 z-score and/or oedema)
3.0% [1.8- 4.9]
Severe Acute Malnutrition (SAM)
(<-3 z-score and/or oedema)
0.2% [1.6- 4.7]
Prevalence of stunting
(<-2 z-score)
46.2%[41.8-50.6%]
Prevalence of severe stunting
(<-3 z-score)
15.2%[12.4-18.5]
Prevalence of stunting
(<-2 z-score)
39.2% [35.3-43.4]
Prevalence of severe stunting
(<-3 z-score)
11.2% [8.4-14.7]
Child Nutrition Status W/A
(WHO)- Z scores (536
Child Nutrition Status W/A
(NCHS)- Z scores (536)
Mortality
Child MUAC (567)
Prevalence of underweight
(<-2 z-score)
25.9&[21.9-30.5]
Prevalence of severe
underweight
(<-3 z-score)
5.0% [3.3-7.6]
Prevalence of underweight
(<-2 z-score)
31.9%[27.3-36-9]
Prevalence of severe
underweight
(<-3 z-score)
5.0[3.2-7.8]
Crude Death rate/10,000/day
0.67[0.35-1.30]
0-5 Death rate/10,000/day
1.95[0.83-4.53]
SAM (<115 mm)
GAM (<125mm)
At risk ( >125-<134 mm)
0.5%
4.1%
11.8%
Maternal nutrition
status (lactating and
pregnant mothers)
% Women with MUAC
<21 cm
% Women Pregnant
and lactating
Maternal nutrition
status (lactating and
pregnant mothers)
<21.0
0.4%
55.0%
0.7%
Vaccination coverage, Vitamin A and Iron supplementation
Measles coverage ≥ 9
months (509)
Card
According to mother
Not Immunized
68.6%
22.6%
8.8%
De-worming (471)>= 1
year
Received once in last 6
months
23.4%
Card
According to mother
Not immunized
71.1%
22.5%
6.4%
Received
Not received
47.7%
52.3%
Vitamin A coverage (611) Last 6 months (71)
Received
Not received
39.4%
60.6%
Vitamin A coverage (1259) Last 6 months (472)
Received
Not received
Mother Iron
supplementation (last
pregnancy)
Yes
No
Don’t Know
DPT3 (n =543)
Vitamin A coverage
(last 6 months) (543)
45.8%
54.2%
64.2%
33.2%
2.6%
Morbidity for the last 2 weeks
Child Illness in the
last 2 weeks
Treatment Sought
for diarrhoea
Child Slept under
mosquito net last
night
Yes
No
ORS
Homemade sugar salt
solution
Another homemade
liquid
Zinc
Other drugs
Nothing
Yes
No
59.4%
40.6%
27.6%
13.8%
6.9%%
17.2%
20.7%
13.8%
70.8%
29.2%
Disease patterns in the last two weeks before the survey
Type of illness children < 5years suffered in the last 2 weeks
other (eyes, burns, ring
worms, eye infections)
7.6
Illness
W.diarrhoea
3.7
50.3
cough/flu
38.4
fever
0.0
10.0
20.0
30.0
Percentage
40.0
50.0
60.0
Infant and young child feeding practice
Exclusive breastfeeding
0-5 Months (n=43)
23.3%
Early Initiation of breast feeding
0- 23 Months (n=205)
85.4%
Continued breastfeeding at 1year
12-15 Months (n=33)
97.0%
Introduction of solid, semi-solid or soft
foods
6-8 Months (n33)
97%
Minimum diet diversity (all)
6-23 Months (n=162)
16.1%
Minimum diet diversity (breast fed)
6-23 Months (n=151)
15.9%
Minimum diet diversity (non breast fed)
6-23 Months (n=11)
18.2%
Minimum meal frequency
6-23 Months (n=162)
79.6%
Minimum meal frequency (Breast fed)
6-23 months (n-151)
78.8%
Minimum meal frequency (non breast
fed)
6-23 Months (n= 11)
90.9%
Minimum Acceptable diet
6-23 Months (n=162)
15.4%
Minimum Acceptable diet (Breast fed)
6-23 months (n=151)
Minimum Acceptable diet (non Breast
fed)
6-23 Months (n= 11)
18.2%
Child ever breastfed
0-23 months (203)
99.0%
Continued breastfeeding at 2years
20-23 months (n=30)
83.3%
15.2%
Main sources of water
40
35
30
Percentage
25
20
15
10
5
0
Borehole
Protected
HH
Protected Dam / Pond
Open
sand
Shallow well connection / spring
shallow well scooped
Stand pipe
wells
/Tanker
Sources of water
Rock
Catchment
Water treatment for household use
70
60
Percentage
50
40
30
20
10
0
Nothing
Boling
Filtering with a cloth
Letting it settle
Treatment
Chlorination
tree leaves
Latrine ownership
Latrine use
N
%
latrine
304
67.7
Hole
9
2
Designated open area
10
2.2
Undesignated Open area
126
28.1
Total
449
100
Main source of dominant food consumed in the household
Source
N
%
Own production
343
76.1
purchases
103
22.8
gifts from friends
1
0.2
food aid
4
0.9
451
100
Total
Food security
• Most of the respondents 70.7% kept goats, 36.6% Donkey,
37.2% Cattle while only 4.2% kept sheep.
• Majority of the household had 98.8% practiced crop farming;
among the popular crops they plant included maize 83.7%,
millet 52.6%, cow peas 61.2%, green grams 43.0%, and
sorghum 37.4%, beans 27.5% 18.8% pigeon peas
• In the households most of them 69% said they consumed 3
meals and above normally while during the survey 70.1% of
them consumed 3 or more times in a day showing no significant
difference
• Among the respondents 40.8% had received food aid in the last
three months, 17% were in food for work program while 12.4%
were in cash grants program.
Food diversity
• Food diversity was measured during the
survey and the food diversity score was 5.54,
meaning that most of the respondents ate
less than half of the 12 food groups
• Majority of them 96.9% ate cereals, 75%
legumes, sugar 82.5%, milk 68.8%,
condiments 84.5% while the least consumed
foods were fish, eggs tubers and meat.
Food diversity Mwingi March 2012
condiments
sugar
Oil
Milk
Percenatge
Legumes
Fish
Meat
Eggs
Fruits
Vegetables
Tubers
Cereals
0.0
10.0
20.0
30.0
40.0
50.0
Food groups
60.0
70.0
80.0
90.0
100.0
Conclusion
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The surveys results 2.8% and 0.0% GAM and SAM respectively are
lower below the emergency cut off of 15%. The survey covered the
larger Mwingi districts that could be compared with a survey done in
2008, that had a GAM of 3.6% and was not significant different with
the current survey. The KDHS 2008 had a GAM of 4.7% for eastern
province. This shows that the survey was not significant different
between the two assessments.
Another nutrition survey done in the April 2011 had a GAM of 10.2%
and SAM of 1.5% but was done only in two districts Tesukur u and
Mwingi east, hence the results cannot be compared with the current
survey.
The underweight and stunting for both surveys was high as April 2011
had underweight prevalence of 37.3% and stunting of 35.1% while
March 2011 had 25.9% and 46.2% underweight and stunting
respectively –
• The acute malnutrition shows good good nutrition
state in the larger Mwingi districts this could be
attributed to the fact that last seasons short rains
were good and the community harvested enough
food that there were consuming during the survey.
• The under five mortality was quite high though below
emergency cut off this is attributed to the outbreak of
measles in the community that’s was reported late
last year and early 2012 that caused mortality to
some children in the community.
• The religious sect Kavonokya that cuts across many
villages in the larger Mwingi district has also
contributed to poor health seeking behaviour hence
mortality and low immunization coverage as there
sect members don’t accept medicine and any sort of
modern treatment or prevention of disease.
• Infant and young child feeding (IYCF) practices were
good especially, early initiation to breastfeeding,
continued breast feeding and meal frequency, while
exclusive breast feeding and food diversity was quite
poor.
• The water sources were not potable and majority of
the households did not treat their water before
drinking predisposing them to water borne diseases
• 25.1% did not wash their hands with soap
• The current food security in the area is average as
most of the households their main source of food
was from their farm
• There is also an uptake of growing of traditional
crops which survive under minimal rain fall that is
usually experienced in the region that has enhanced
the food security of the populace.
• The food diversity score was average and this could
be attributed to lack of appropriate nutrition
education on importance of these foods.
Short Term recommendations
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Continue treatment of the severely malnourished and moderate
malnourished children and ensure smooth flow of nutrition
supplies in the county.
Community sensitization to the Kavonokya religious sect on
health seeking practices.
Improve on Vitamin A coverage through campaigns
Promote improved access to safe water and WATSAN education
to the communities.
Initiate IYCF trainings to improve breastfeeding and Infant
feeding especially exclusive breast feeding and food diversity
Initiate nutrition education in the communities to improve diet
diversity.
Continue Advocacy for drought resistant crops for the
communities
Long Term Recommendations
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Establish community units to cover the this will
enhance
– Quick and timely referrals for malnourished and
sick children
– Access to health services
– Vaccination coverage and micro nutrient
supplementation.
– Positively towards hygiene and sanitation
practices
Provide long lasting solution for water problems in
dry areas boreholes and Dams
Plausibity check
Indicator
Survey
Comments
Digit preference - weight
2
good
Digit preference - height
0
good
0.93
good
WHZ (Skewness)
0
good
WHZ (Kurtosis)
0
good
Percent of flags
0
good
WHZ ( Standard Deviation)
good
Age distribution (%)
good
Group1
6-11 mo
Group 2
12-23 mo
0.8
good
Group 3
24-35 mo
0.9
good
Group 4
36-47 mo
1.1
good
Group 5
48-59 mo
1.1
good
1.1
good
Age Ratio : G1+G2/G3+G4+G5
Sex Ratio
1.0
good
General acceptability
6%
good