GREATER MWINGI GREATER MWINGI (Mumoni, (Mumoni, Kyuso, Migwani, Tseukuru, Kyuso, Migwani, Tseukuru,

Mwingi East and Mwingi central Mwingi East and Mwingi central districts)districts)

KITUI COUNTYKITUI COUNTY

An anthropometric nutrition surveys was implemented in Greater Mwingi in March 2012.

The geographical areas surveyed were:--Mwingi Central district-Mwing East district-Tseukuru district-Migwani district-Kyuso district-Mumoni district

The objectives for the survey were

• To evaluate the nutritional status of children aged 6-59 months

• To estimate measles and immunization coverage of children aged 9-59 months.

• To estimate the coverage of Vitamin supplementation among the targeted children.

• To estimate the retrospective morbidity, crude and under five mortality rate.

• To assess infant and young child feeding practices• To estimate the coverage of general food distribution and

feeding programs• To describe the current household food security situation• To describe the current water and sanitation situation and

hygiene practises.• To recommend appropriate interventions based on

survey findings.

METHODOLOGY

• Two-stage cluster sampling using SMART methodology was applied to randomly identify clusters with the probability of being selected proportional to the population size in each cluster.

• 40 clusters children between 6-59 were sampled. A total of 601 households were sampled for the survey and a total of 40 clusters were selected for the survey.

• 16 households per cluster were included in the survey

RESULTS

Anthropometric and Mortality data results

Child Nutrition Status W/H (WHO)- Z scores (534)

Global Acute Malnutrition (GAM)(<-2 z-score and/or oedema)

2.8% [1.5- 5.0]

Severe Acute Malnutrition (SAM)(<-3 z-score and/or oedema)

0.0% [0.0- 0.0]

Child Nutrition status W/H(NCHS)- Z-scores(536)

Global Acute Malnutrition (GAM)(<-2 z-score and/or oedema)

3.0% [1.8- 4.9]

Severe Acute Malnutrition (SAM)(<-3 z-score and/or oedema)

0.2% [1.6- 4.7]

Child Nutrition Status H/A (WHO)- Z scores (520)

Prevalence of stunting(<-2 z-score)

46.2%[41.8-50.6%]

Prevalence of severe stunting(<-3 z-score)

15.2%[12.4-18.5]

Child Nutrition Status H/A (NCHS)- Z scores (520)

Prevalence of stunting(<-2 z-score)

39.2% [35.3-43.4]

Prevalence of severe stunting(<-3 z-score)

11.2% [8.4-14.7]

Child Nutrition Status W/A (WHO)- Z scores

(536

Prevalence of underweight(<-2 z-score)

25.9&[21.9-30.5]

Prevalence of severe underweight(<-3 z-score)

5.0% [3.3-7.6]

Child Nutrition Status W/A (NCHS)- Z scores

(536)

Prevalence of underweight(<-2 z-score)

31.9%[27.3-36-9]

Prevalence of severe underweight(<-3 z-score)

5.0[3.2-7.8]

Mortality

Crude Death rate/10,000/day

0.67[0.35-1.30]

0-5 Death rate/10,000/day 1.95[0.83-4.53]

Child MUAC (567)

SAM (<115 mm)GAM (<125mm)At risk ( >125-<134 mm)

0.5% 4.1%11.8%

Maternal nutrition status (lactating and pregnant mothers)

% Women with MUAC <21 cm% Women Pregnant and lactatingMaternal nutrition status (lactating and pregnant mothers) <21.0

0.4%

55.0%

0.7%

Vaccination coverage, Vitamin A and Iron supplementation

Measles coverage ≥ 9 months (509)

CardAccording to mother

Not Immunized

68.6%22.6%8.8%

De-worming (471)>= 1 year

Received once in last 6 months

23.4%

DPT3 (n =543)Card

According to motherNot immunized

71.1%22.5%6.4%

Vitamin A coverage (last 6 months) (543)

ReceivedNot received

47.7%52.3%

Vitamin A coverage (6-11) Last 6 months

(71)

ReceivedNot received

39.4%60.6%

Vitamin A coverage (12-59) Last 6 months (472)

ReceivedNot received

45.8% 54.2%

Mother Iron supplementation (last pregnancy)

YesNo

Don’t Know

64.2%33.2%2.6%

Morbidity for the last 2 weeks

Child Illness in the last 2 weeks

YesNo

59.4%40.6%

Treatment Sought for diarrhoea

ORSHomemade sugar salt solutionAnother homemade liquidZincOther drugsNothing

27.6% 13.8% 6.9%% 17.2% 20.7% 13.8%

Child Slept under mosquito net last

night

YesNo

70.8%29.2%

Disease patterns in the last two weeks before the

survey

38.4

50.3

7.6

3.7

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Percentage

fever

cough/flu

W.diarrhoea

other (eyes, burns, ringworms, eye infections)

Illn

es

s

Type of illness children < 5years suffered in the last 2 weeks

Infant and young child feeding practiceExclusive breastfeeding 0-5 Months (n=43) 23.3%

Early Initiation of breast feeding 0- 23 Months (n=205) 85.4%

Continued breastfeeding at 1year 12-15 Months (n=33) 97.0%

Introduction of solid, semi-solid or soft foods

6-8 Months (n33) 97%

Minimum diet diversity (all) 6-23 Months (n=162) 16.1%

Minimum diet diversity (breast fed) 6-23 Months (n=151) 15.9%

Minimum diet diversity (non breast fed)

6-23 Months (n=11) 18.2%

Minimum meal frequency 6-23 Months (n=162) 79.6%

Minimum meal frequency (Breast fed)

6-23 months (n-151) 78.8%

Minimum meal frequency (non breast fed)

6-23 Months (n= 11) 90.9%

Minimum Acceptable diet 6-23 Months (n=162) 15.4%

Minimum Acceptable diet (Breast fed)

6-23 months (n=151) 15.2%

Minimum Acceptable diet (non Breast fed)

6-23 Months (n= 11) 18.2%

Child ever breastfed 0-23 months (203) 99.0%

Continued breastfeeding at 2years 20-23 months (n=30) 83.3%

0

5

10

15

20

25

30

35

40P

erce

nta

ge

Borehole ProtectedShallow well

HHconnection /Stand pipe

/Tanker

Protectedspring

Dam / Pond Openshallow well

sandscooped

wells

RockCatchment

Sources of water

Main sources of water

0

10

20

30

40

50

60

70P

erce

nta

ge

Nothing Boling Filtering with a cloth Letting it settle Chlorination tree leavesTreatment

Water treatment for household use

Latrine use N %

latrine 304 67.7

Hole 9 2

Designated open area 10 2.2

Undesignated Open area 126 28.1

Total 449 100

Latrine ownership

Source N %

Own production 343 76.1

purchases 103 22.8

gifts from friends 1 0.2

food aid 4 0.9

Total 451 100

Main source of dominant food consumed in the household

• Most of the respondents 70.7% kept goats, 36.6% Donkey, 37.2% Cattle while only 4.2% kept sheep.

• Majority of the household had 98.8% practiced crop farming; among the popular crops they plant included maize 83.7%, millet 52.6%, cow peas 61.2%, green grams 43.0%, and sorghum 37.4%, beans 27.5% 18.8% pigeon peas

• In the households most of them 69% said they consumed 3 meals and above normally while during the survey 70.1% of them consumed 3 or more times in a day showing no significant difference

• Among the respondents 40.8% had received food aid in the last three months, 17% were in food for work program while 12.4% were in cash grants program.

Food security

Food diversity

• Food diversity was measured during the survey and the food diversity score was 5.54, meaning that most of the respondents ate less than half of the 12 food groups

• Majority of them 96.9% ate cereals, 75% legumes, sugar 82.5%, milk 68.8%, condiments 84.5% while the least consumed foods were fish, eggs tubers and meat.

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Food groups

Cereals

Tubers

Vegetables

Fruits

Eggs

Meat

Fish

Legumes

Milk

Oil

sugar

condiments

Per

cen

atg

eFood diversity Mwingi March 2012

Conclusion

• The surveys results 2.8% and 0.0% GAM and SAM respectively are lower below the emergency cut off of 15%. The survey covered the larger Mwingi districts that could be compared with a survey done in 2008, that had a GAM of 3.6% and was not significant different with the current survey. The KDHS 2008 had a GAM of 4.7% for eastern province. This shows that the survey was not significant different between the two assessments.

• Another nutrition survey done in the April 2011 had a GAM of 10.2% and SAM of 1.5% but was done only in two districts Tesukur u and Mwingi east, hence the results cannot be compared with the current survey.

• The underweight and stunting for both surveys was high as April 2011 had underweight prevalence of 37.3% and stunting of 35.1% while March 2011 had 25.9% and 46.2% underweight and stunting respectively –

• The acute malnutrition shows good good nutrition state in the larger Mwingi districts this could be attributed to the fact that last seasons short rains were good and the community harvested enough food that there

were consuming during the survey.• The under five mortality was quite high

though below emergency cut off this is attributed to the outbreak of measles in the community that’s was reported late last year and early 2012 that caused mortality to some children in the community.

• The religious sect Kavonokya that cuts across many villages in the larger Mwingi district has also contributed to poor health seeking behaviour hence mortality and low immunization coverage as there sect members don’t accept medicine and any sort of modern treatment or prevention of disease.

• Infant and young child feeding (IYCF) practices were good especially, early initiation to breastfeeding, continued breast feeding and meal frequency, while exclusive breast

feeding and food diversity was quite poor.

• The water sources were not potable and majority of the households did not treat their water before drinking predisposing them to water borne diseases

• 25.1% did not wash their hands with soap

• The current food security in the area is average as most of the households their main source of food was from their farm

• There is also an uptake of growing of traditional crops which survive under minimal rain fall that is usually experienced in the region that has enhanced the food security of the populace.

• The food diversity score was average and this could be attributed to lack of appropriate nutrition education on importance of these foods.

Short Term recommendations

• Continue treatment of the severely malnourished and moderate malnourished children and ensure smooth flow of nutrition supplies in the county.

• Community sensitization to the Kavonokya religious sect on health seeking practices.

• Improve on Vitamin A coverage through campaigns • Promote improved access to safe water and WATSAN

education to the communities.• Initiate IYCF trainings to improve breastfeeding and Infant

feeding especially exclusive breast feeding and food diversity

• Initiate nutrition education in the communities to improve diet diversity.

• Continue Advocacy for drought resistant crops for the communities

Long Term Recommendations

• Establish community units to cover the this will enhance

– Quick and timely referrals for malnourished and sick children

– Access to health services– Vaccination coverage and micro nutrient

supplementation.– Positively towards hygiene and sanitation

practices• Provide long lasting solution for water

problems in dry areas boreholes and Dams

Plausibity checkIndicator Survey Comments

Digit preference - weight 2  good

Digit preference - height 0  good

WHZ ( Standard Deviation) 0.93  good

WHZ (Skewness) 0  good

WHZ (Kurtosis) 0  good

Percent of flags 0  good

Age distribution (%)  good

Group1 6-11 mo 1.1  good

Group 2 12-23 mo 0.8  good

Group 3 24-35 mo 0.9  good

Group 4 36-47 mo 1.1  good

Group 5 48-59 mo 1.1  good

Age Ratio : G1+G2/G3+G4+G5  good

Sex Ratio 1.0  good

General acceptability 6%  good