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Nutrition and Mortality SMART survey in Hirat province (May 2016)

Subject/Objective: 
To estimate Crude Death Rate(CDR) and Under five Death Rate(U5DR)  To determine prevalence of under nutrition among children aged 0-59 months  To determine core Infant and Young Child Feeding(IYCF) practices among children aged 0-23 months  To determine the nutritional status of pregnant and lactating women based on MUAC assessment  To assess Water, Sanitation and Hygiene (WASH) proxy indicators: household water storage, water use and caregiver hand washing practices.  To estimate vitamin A supplementation and deworming coverage in the last 6 months among under-fives.  To estimate Iron-folate supplementation coverage among pregnant women.  To estimate coverage of measles and BCG vaccination  To assess morbidity among children 0-59 months based on a two weeks recall period.
Methodology: 
The sample size of households to be surveyed was calculated using ENA for SMART software version 2011 (up dated 9th July 2015). A two stage cluster methodology was being applied. In the first stage, it entailed random selection of clusters/villages (46 clusters) from total list of villages using probability proportion of size (PPS). This was done before starting the data collection at the office or training hall. In the second stage, it entailed random selection of household (12 households) from an updated list of households in each randomly selected cluster. The table 1 and 2 highlights sample size calculation for anthropometric and mortality surveys.
Key findings: 
A total of 4048 individual living in 530 households were assessed. 782 children aged from 0 to 59 months and 627 women of childbearing age in the selected households. The anthropometric results are from 700 children from 6 to 59 months of age.  Global Acute Malnutrition (GAM) and Severe Acute Malnutrition (SAM) prevalence based on Weight –for- Height Z-scores (WHZ) was at 6.6 %( 4.6 - 9.5 95% C.I.) And 1.0 %( 0.5 - 2.3 95% C.I.) Respectively.  GAM prevalence by WHZ <-2 z-scores and/or MUAC<125 mm and/or the presence of bilateral oedema was 5.6 % (3.8- 8.2 95 % CI) and SAM of 1.3 %( 0.6 - 2.7 95% C.I) respectively.  The combines GAM and SAM caseloads at 10.9 % (8.6- 13.2 95% CI) and 3.6 % (2.2 – 4.9 95 % CI) respectively.  Prevalence of stunting was 34.2 % (30.4 - 38.1 95% C.I.) and severe stunting was 11.7 % (9.2 - 14.9 95% C.I) respectively.  Prevalence of underweight was 17.4 % (14.0 - 21.4 95% C.I.) and severe underweight was 5.4 %( 3.5 - 8.3 95% C.I) respectively.  Crude Death Rate (CDR) and Under-five Death Rate (U5DR) was 0.09 (0.04-0.21 95 % CI) and 0.59(0.27-1.28 95 % CI) respectively.  The maternal nutrition status of the childbearing age women (CBA) was 12.8%.  Coverage of Measles aged 9-59 months confirmed by recall and cards and BCG aged 0-59 month’s children confirmed by scare was 87.4% and 96.1%.
Sample size: 
700 children
Assessment Report: 
Assessment Questionnaire: 
Available on Request
Assessment Data: 
Available on Request
Webspace(s): 
Assessment Date(s): 
16 May 2016
Status: 
Report completed
Unit(s) of Measurement: 
Households
Individuals
Collection Method(s): 
Structured Interview
Population Type(s): 
Children
Children under 5
Lactating women
Pregnant women
Cluster(s)/Sector(s): 
Leading/Coordinating Organization(s): 
Action against Hunger
Participating Organization(s): 
Bakhtar Development Network (Afghanistan)
Location(s): 
Hirat