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Greater Ikwoto county Nutrition and Mortality SMART survey - 2019


The main objective of the survey was to assess: current prevalence of acute malnutrition, crude and under-five retrospective death rates, and food security conditions.


The Standardized Monitoring and Assessment for Relief and Transitions (SMART) which applies a two-stage cluster sampling was used. A total of 613 children aged 6-59 months from 570 households in 39 clusters were sampled for anthropometric measurements. The mortality assessment was conducted concurrently in all 570 households.
Additional information on the food security and livelihoods situation of Ikwoto was collected in the 570 households visited, in order to provide more insight into possible risk factors associated with acute malnutrition.

Key findings: 

The prevalence of GLOBAL ACUTE MALNUTRITION (GAM) defined as Weight-for-Height <-2 Z scores and/or oedema for the County was 9.2% (6.6 - 12.8 95% C.I.) and the severe acute malnutrition (SAM) prevalence defined as Weight-for-Height <-3 Z scores and/or oedema was 2.0% (1.0 -4.0 95% C.I.). The GAM rate indicated a poor nutrition situation while SAM prevalence was classified as critical according to the WHO classification. There were no oedema cases identified during the assessment.
The CRUDE MORTALITY RATE (CMR) and the under-five mortality rate (U5MR) were 0.42 (0.22-0.79) and 0.46 (0.15-1.44) respectively. Both the CMR and the U5MR were classified as normal as per the WHO emergency thresholds of 1/10,000/day and 2/10,000/day respectively. Most deaths were due to illness (81.8%).
FOOD SECURITY INDICATORS show that half of the population experience one or more constraints. Only 38.6% of the surveyed households had acceptable food consumption. Most of the households (66.3%) said they were experiencing little to no hunger. Additionally, 61.1% of sampled households had low diet diversity. The mean HDD score for all households in the survey was 4.1 food groups which show that on average, households consumed 4 or fewer food groups the previous day of the interview. The vast majority of households (95.8%) had a low reduced coping strategy index. However, a substantial number of households (47.7%) reported using one or more livelihood based coping strategies in the month prior to the survey.

Sample size: 
613 children aged 6-59 months from 570 households in 39 clusters
Assessment Report: 
Assessment Questionnaire: 
Publicly Available
Assessment Data: 
Publicly Available
Assessment Date(s): 
21 Jun 2019 to 01 Jul 2019

Level of Representation

District / Province / Locality / County
Report completed
Unit(s) of Measurement: 
Collection Method(s): 
Structured Interview
Population Type(s): 
Children under 5
Leading/Coordinating Organization(s): 
AVSI Foundation
Integrated Food Security Phase Classification (IPC)