Sindh (Pakistan) Nutrition survey
The study aimed to identify the extent of malnutrition in the World Vision (WV) nutrition intervention sites and catchment areas. WV staff conducted a greater coverage screening in 13 union Councils (UCs) of two districts Sukkur and Khairpur, on the basis of it’s Community Management of acute Malnutrition (CMAM) program operating areas.
The result of screening 23,505 children aged 6-59 months using mid – upper arm circumference (MUAC) measurement showed in annex 1.
• 9% severe acute malnutrition (SAM) (<11.5cm),
• 20% moderate acute malnutrition (MAM) (12.5 cm to 11.5 cm).
• Out of 4,206 pregnant and lactating women (PLW) screened staff identified
• 29% as suffering moderate acute malnutrition (MAM).
Staff conducted a small sample survey of 274 households to validate the results of the initial screening and to explore the underlying causes of the malnutrition. As the physical houses and yards contained joint families the survey ended up measuring 762 children in the age group, double what was expected in regard to children in the age bracket for that number of single households.
Some data was discarded as outliers at the individual measurement analysis stage (and across the HH survey in appended tables) which explains why in the body of the report the total number of children measured varies from analysis of one set of measurements to another. At the end of the report the team has cross verified this approach by discarding any household’s data at the start and keeping a consistent number of children as the base across the analysis. Some small variation occurred but not enough to discount the general findings and analysis using either data cleaning approach.
Among 620 children aged 6-59 months assessed in the sample survey for height for age
• only 18% of the children were seen as greater than minus two standard deviations (>-2Zscore) below the anticipated measurements.
• This leaves 82% with some degree of stunting and among those
• 429 children ( 69%/620) were measured at greater than three standard deviations below the anticipated measurements (under -3 Z scores) indicating severe stunting.
The findings were similar for boys as they were for girls in the disaggregated data
To confirm these alarming figures staff analyzed the SAM cases at the intervention sites height for age and came up with not dissimilar figures regarding stunting amongst the SAM cases.
Out of 712 children measured for weight for height (wasting)
• 180 (25%) showed severe malnutrition (<-3SD), two and a half times above what is considered the critical level of (10%)
• A further16% (111) were under -2SD measures for weight for heath indicating moderate acute malnutrition.
Rates for girls and boys were the same for severe wasting however moderate wasting was higher (66% compared to 44%) for girls than in the boy’s sample. 3
Out of 762 children measured for acute malnutrition using MUAC tape,
• 69 ( 9% ) were recorded with severe acute malnutrition and
• 122 (16 % ) were recorded with moderate acute malnutrition.
This is the same SAM rate as in the greater screening but less MAM cases than recorded in the greater screening.