Project Description
Concern Worldwide is an international, non-governmental, humanitarian organisation dedicated to the reduction of suffering of vulnerable people. Concern Worldwide is implementing a project titled “Integrated Multi-Sector Support to Nutrition at Risk Communities in Sindh, Pakistan”. The principal objective of the project is to improve the resilience of the drought-affected population in Sindh province, with a special emphasis on immediate humanitarian needs of drought affected communities.
In the recent past, district Umerkot is afflicted with drought. The drought situation in the district has affected the nutritional status of Under Five Children. The GAM rate in district Umerkot is above the provincial average and above the global emergency threshold of 15%. In order to verify the malnutrition situation, its associated factors and to design an intervention that contributes in saving lives of children and women from malnutrition, Concern Worldwide has conducted SMART nutrition survey with the collaboration of District Health Department, Umerkot and Provincial Nutrition Cell, Sindh.
Under this exercise, a sample of 415 household was surveyed to assess the nutritional status of Under Five Children and Pregnant & Lactating Women (PLW). Data about Infant and Young Child Feeding Practices (IYCF) and Water, Sanitation & Hygiene (WASH) related dimensions was collected as well. A total of 434 children of 6-59 months and 179 PLW were assessed for their nutritional status by anthropometric measurements.
The results of the survey revealed that on the basis of Mid Upper Arm Circumference (MUAC), Global Acute Malnutrition (GAM) rate was 19.1 %, whereas Severe Acute Malnutrition (SAM) rate was 5.8 %. The GAM rate as per the weight and height was reported at 28.8 % and SAM was 10.1 % respectively. These findings were reflective of dilapidated state of nutritional status of under-five children. Marked variations were seen when the data was analysed for children living in urban and rural settings. The situation was comparatively more grim in rural areas; GAM rate (Weight for Height) was 30 %, in rural areas, whereas it was 19 % in urban settings. Almost half of the children surveyed were stunted and signs of stunting and wasting were prominent from an early age group of 6-17 months. The Acute Malnutrition Rate in PLW was found to be 18.99%.
Survey data showed that 36% children were Exclusively Breast Fed. The early initiation of breast feeding within first hour was only 26% in surveyed population. Only 28% of the children were initiated with complementary feeding at the age of six months. 40% of the children aged 6-8 months were provided with supplementary food twice daily and 45% of the children in age group of 9-23 months were receiving three complimentary meals other than the breast milk. Only 25.5% children received a diet that met the minimum standard of dietary diversity, however for the children aged between 6 to 11 months it was 22% and 26.9% in case of children aged between 12 to 23 months. The most frequently consumed food groups were, milk & dairy products; 91.4% of the respondents claimed that they used this food group in last 24 hours. Cereals were consumed by 56.2% of the population surveyed, sugar with tea by 46.5%, vegetables and fruits stood at 23.8% & legumes by 11.4% of the population surveyed. Legumes were the least utilised food group, across the sample population.
The prevalence of diarrhea and ARI were highest among the surveyed children, almost 16% of the children had suffered from either of the diseases in the past two weeks (at the time of survey). The coverage of immunization against preventable diseases was only 55% among Under Five Children. Only 55% of the children aged between 6-59 months had received Vitamin A drops according to mothers recall and only 61% of the children had received a measles vaccination based on the card observation and mother’s recall. The children who had received deworming tablets were only 23%.
The conditions of WASH were alarming as 61% of the household were practicing open defecation. The household’s source of improved water has been hand pump as well as piped water. Whereas 46% of the population had to rely on unimproved water sources. Contrary to this only 2.9% of the surveyed household were using boiled water to make it safe for drinking and 66% were not treating water before drinking at all. Hand washing is one of the main barrier in feco-oral route of transmission, only 14% of respondents were practicing it after the use of toilet and 36% had ensured it before having food.
