Inter-agency nutrition assessment using SMART methodology
1 October 2012 - 1 November 2012
||780 households-host community and 480 HH-Zaatari
Population in Camp, Urban / Rural Population, Host Communities
1. Having a discussion with MOH and all other partners to set up mechanism for acute malnutrition management as well as capacity strengthening for the ministry of health services, for preparedness.
2. Reinforcing role and responsibility of the nutrition sub group and its respective members to organize and coordinate the nutrition sector and response.
3. Setting up a screening mechanism of children and mothers for malnutrition upon arrival in Jordan.
4. Setting up services for children and mothers that are screened and ensure adequate treatment is available for those identified with Severe Acute Malnutrition, including those with medical complications, and Moderate Acute Malnutrition.
5. Developing guidelines or protocol for acute malnutrition management and prevention as well as national plan of training.
6. Strengthening the awareness, promotion, and protection of positive Infant and young child feeding practices through NGOs activities by accelerating sensitization and awareness creation on appropriate breast-feeding and complimentary feeding practices as well as micronutrient provision.
7. Integrate nutrition into primary health care in Za’atri and NGO clinics in the Northern governorates including growth monitoring and promotion for children aged six to 59 months.
8. Improving Education and communication strategies in the health centers and in the community including integrating communication for development strategies to positively influence behavior and practices.
9. Support NGOs providing services to unregistered Syrians to integrate management of SAM and MAM into their services.
10. Scale-up of hygiene promotion activities (including adequate access to soap through either distribution or the means to purchase) and improve water quality access and monitoring the quality of water to address disease incidence and facilitate disease treatment through the health facilities.
1. Integrating the nutrition surveillance system in the existing Health Surveillance System.
2. Putting a proper targeting of the most vulnerable refugees and host communities with a minimum response package on health and nutrition surveillance, disease treatment, appropriate health and nutrition promotion, adequate food security, water and sanitation services, shelter against harsh weather, etc.
- The prevalence of global acute malnutrition (GAM), among children 6-59 months, in the two assessments was more than 5% but less than 10% (5.1% in the refugees in the host communities and 5.8% in Za’atri camp) and is defined as a poor of public health concern as per WHO classification.
- The proportion of the “At Risk of Acute Malnutrition” category (WHZ_WHO scores between -1 SD and -2 SD) was analyzed. The findings of the two surveys showed that children 6-59 months in Za’atri camp are more at risk of acute malnutrition than children 6-59 months who lived in host communities (5.6% vs. 4.6%). However, the difference of 1% is statistically insignificant.
- The prevalence of stunting and underweight among children 6-59 months in the two assessments was lower than previously available data (FHS 2009) in Syria and the rates are within acceptable levels as per WHO classification. However, the findings of the two assessments show that the total prevalence of stunting and underweight, among Syrian refugees in Za’atri camp was higher than the prevalence of stunting and underweight in
Syrian refugees living among the Jordan host communities.
- The assessments collected data on diarrhea, cough and fever which are closely linked to nutritional status. It was found that the surveyed children aged 6-59 months in Za’atri camp had suffered more from the 3 surveyed illnesses, two weeks prior to the survey. This morbidity might explain the high rate of Risk of Acute Malnutrition in Za’atri camp.
- The coverage of Polio immunization is largely similar in the two assessed groups with recorded coverage of over 92% for the 1st dose of OPV, over 80% for 2nd dose of OPV and about 70% for 3rd dose of OPV. However, the coverage for measles is higher in Za’atri camp. For the supplementation of vitamin A, usually the coverage should be the same as the coverage of Measles vaccination. The results of the assessment showed that the coverage of Vitamin A supplementation is very low relatively to the coverage of Measles. This difference could be explained by the fact that the surveyors were supposed to show the vitamin A capsule to the mother or to the caregiver but they did not have vitamin A capsules.
- 42.7% of children born in the last 24 months, among refugees in host community, are still breastfed and this proportion is 49.6% among refugee children born in the last 24 months and living in Za’atri camp. In the two communities, more than 50% of the surveyed children were breastfed up to 1 year but much less than 50% were breastfed up to two years. However, only 13.3% (in host communities) and 7.9% (in Za’atri camp) of mothers or caregivers reported that they gave 5 times or more complementary food to the children of 6-12 months age group.
- The assessment showed that there is 6.3% malnourished (MUAC < 23 cm) women aged 15-49 years and among them 0.9% severely malnourished (MUAC < 21 cm) in the refugee community in the host communities. In Za’atri camp, the assessment shows that there are 6.1% malnourished (MUAC < 23 cm) women 15-49 years of age, among them 1.1% being severely malnourished (MUAC < 21 cm).
- Access to sufficient water for the family needs was assessed. In the host communities, 81% of Syrian families have access to sufficient water and in Za’atri camp; the proportion of Syrian families with access to sufficient water was 94%. In host communities, 54% of families reported “Buying Water” as a main water problem while in Za’atri camp, 41% of families did not have any water problem.
- With regard to having “Soap and/or Hygienic products”, among refugees in host communities, 27.5% of families reported that they did not have “Soap and/or Hygienic products” while in Za’atri camp, 65% of families reported that they did not have “Soap and/or Hygienic products”.
- The food assistance was reported by 42% of the families as their main food sources in Za’atri camp in comparison with 19.2% for refugee families in host communities. However, families in host communities received 25.5% of their food from charity as gift. To complement their meals with some fresh food, some families (32%) needed to buy other food items.
- Number of meals per day: Among refugees in host communities, 91% of the families have 2 meals or more per day while among those in Za'atri camp, the proportion having 2 meals or more per day was more than 97%.
- Consumption of canned food: Among the refugees in host communities, 75.5% of the families consume canned food and more than 90% of families consume this canned food in Za’atri camp. Moreover, more than 50% of Syrian families in Jordan consume canned food 2 or 3 days per week and in Za’atri camp, 21% of families consume canned food almost every day.
Water Sanitation Hygiene
Syrian Arab Republic