Humanitarianresponse Logo

UNHCR Nutrition Survey among Afghan Refugees Residing in Afghan Refugee Villages of Pakistan (March, 2014)


1. Measure the prevalence of acute malnutrition in children aged 6-59 months
2. Measure the prevalence of stunting in children aged 6-59 months
3. Determine the coverage of measles vaccination among children 9-59 months
4. Determine the coverage of vitamin-A supplementation during the last six months among children aged 9-59 months
5. Assess the two-week period for prevalence of diarrhea among children 6-59 months of age
6. Measure the prevalence of anemia in children aged 6-59 months and non-pregnant women of reproductive age between 15-49 years
7. Investigate infant and young child feeding (IYCF) practice among children aged 0-23 months and their caregivers.
8. Assess the availability and consumption of water for the households.
9. Determine the population’s access to, and use of, improved water, sanitation and hygiene facilities.


The survey was designed by using Standardized Monitoring and Assessment of Relief and Transitions (SMART) methodology and UNHCR Standardized Expanded Nutrition Survey (SENS) guidelines for Refugee Population (version 2.0, 2013). The anthropometric indicators were analyzed using ENA Software. The quantitative method has been used to gather the survey data from Afghan Refugee Villages in the provinces of Balochistan, KPK and Punjab.

Key findings: 

Household Information:
A total of 774 households were surveyed. None of the households were locked. Women were present; however, male members and children were absent in some of the households. Distribution of male and female population was equal in the surveyed Refugee villages. The average household composition was 7-8 members per household. 60.1 percent males and 93.5 percent females >15 years of age had no schooling. Majority of the household heads were laborers (45.2 percent) followed by small-businessmen (14.8 percent) and shopkeepers (10.3 percent). Majority (97.1 percent) of the women were housewives. 77 percent of the population above 15 years of age was married and 20.9 percent was unmarried.

Anthropometrics and Hemoglobin Concentration in Children 6-59 Months
After data cleaning, a total of 1055 out of 1222 children were analyzed for anthropometrics. 167 children were excluded because of refusal and absent cases or values beyond the statistical cut-off (+/-4 SD). The ‘boy: girl’ ratio was 1.1 that demonstrates the unbiased inclusion of children in the study. The nutritional status of these children was determined through prevalence of stunting, wasting and underweight using WHO growth standards.
Global Acute Malnutrition (GAM):
It is a basic indicator for determining the severity of humanitarian crisis and depicts the nutritional status of a population. It is a weight-for-height indicator less than -2 z-score. In villages of Afghan Refugees in Pakistan, prevalence of GAM was 4.3 percent. In boys, GAM prevalence was higher (6.3 percent) as compared to girls (2.2 percent). Prevalence of MAM was 2.9 percent. Boys were more affected from MAM (4.4 percent) as compared to girls (1.2 percent) in the surveyed villages. Prevalence of SAM was 1.5 percent, out of which, 1.9 percent were boys and 1.0 percent were girls. The sample size was statistically representative of the sexes as the boy to girl ratio was 1.1.
Prevalence of Stunting:
This is known as chronic malnutrition or stunting and refers to low height-for-age. In Afghan Refugee villages, prevalence of stunting was very high i.e. 43.2 percent, which lies in the critical range of WHO standards. Almost an equal proportion of boys (43.4 percent) and girls (42.9 percent) suffered from this chronic form of malnutrition.
Prevalence of Underweight: It is defined as low weight-for-age, where a child can be either thin or short for his/her age and is measured by less than -2 z-scores. A total of 1053 children were analyzed for this parameter and 12.01percent children were found to be under weight. Among these, 14.3 percent were boys, while 9.6 percent were girls.

Sample size: 
774 households, 1015 children under 5 years old
Assessment Report: 
Assessment Questionnaire: 
Not Available
Assessment Data: 
Not Available
Assessment Date(s): 
14 Sep 2016

Level of Representation

Report completed
Unit(s) of Measurement: 
Collection Method(s): 
Structured Interview
Population Type(s): 
Children under 5
Leading/Coordinating Organization(s): 
United Nations High Commissioner for Refugees