WHO_KARAMOJA NUTRITION SURVEILLANCE REPORT, May 09

2010-09-15T09:00:00.000-07:00

KARAMOJA NUTRITION SURVEILLANCE REPORT, May 09

NUTRITION SURVEILLANCE FOR DISTRICTS IN KARAMOJA SUB-REGION
	Z SCORE <-3	Z SCORE <-2	Z SCORE <-1	Z SCORE > -1	EDEMA	Total children screened	Completeness of reporting
	Z SCORE <-3	Z SCORE <-2	Z SCORE <-1	Z SCORE > -1	EDEMA	Total children screened	Completeness of reporting
Abim	1	12	463	64	0	540	100%
Kaabong	0	5	253	30	2	290	100%
Kotido	0	0	235*	18*	0	1001	100%
Moroto
Nakapiripirit	12	48	140	180	1	380	100%
Total Karamoja sub-region	13	65	1091	297	3	2211	100%

* Data for Kacheri and Nakapelimoru was not included

Highlights

Ø This reporting month a total of 2211 children aged 6-59 months were screened at the 15 nutrition sentinel surveillance sites in the 5 districts of Karamoja.

Ø Overall 1176 children (75%) compared 50% last month were found to have some form of malnutrition

Ø Children scoring <- 1 interpreted as mild malnutrition accounted for 20% of the total children screened. There were 13 child was shown to have severe malnutrition in the region with a Z score = -3; the majority from Nakapiripirit district

Ø Three children as well had edema.

Ø This month 12 sentinel sites were active in screening all children 6-59 months and were supervised by the DHT.

Contextual issues

Ø Out migration of rural villagers to other areas have continued this month. The reasons provided include agriculture, causal labour, livestock etc.

Ø Anecdotal observation suggested an increase in rainfall amounts and consistency during the month of May in most districts. The community mainly women have also been active in cultivation of crops in many places though visible land use for cultivation remain quiet low.

Ø There are reports of declining milk production during the month of April and perhaps May due to lack of availability of pasture. The foliage has continued to become green. Milk is one of the vital foods for children in Karamoja. April reports indicated that an average cow produce 0.5 -1.2lts/daily compared to 0.5 -1.5lts/day in the past month (ACTED, April 09).

Ø Food prices for cereals and legumes remain high but declined in Nakapiripirit in April 09. WFP increased the general food distribution ratio and could be impacting on supply and demand for these items

Ø Possible rise in food stock loses due to increasing use of cereals in alcohol brewing

Ø Increasing trends in admissions in the OTP & TFC since January 09 (UNICEF Karamoja OTP & TFC data)

Ø WFP provides food aid to an estimated 85% of the population in the region.

Background:

Nutrition surveillance was introduced in Karamoja in February 2009 but actual screening of children began in March. Ministry of Health, Nutrition Section was supported by WHO to kick start the program in the region. Each of the 5 districts of Karamoja has identified 3 health units for the activity which involves screening of all children aged 6-59 months in the OPD during all working days. Because of the staff problems in the health units, village volunteers (Village Health Teams) are participating in screening of the children supervised by the health staff. Two district health team members conduct routine supervision and follow of the screening activities. WHO continues to collaborate with the districts in the establishment of the sites and monitoring of the nutrition status of the children in the region.

Description of the findings:

Completeness of reporting from the Nutrition sentinel sites remained 100% in all the 12 sites in four districts. The number of children screened increased by 56% compared to the past month probably related to increased utilization of the health units and morbidity of mainly due to communicable diseases. The number of children with all forms of malnutrition increased by 30% attributed to intake deficiencies that could have a background on supply loses due to loss of cereals used in alcohol brewing. Children found with severe forms of malnutrition were referral to TFC while others are provided with therapeutic foods (plumpynut) supplied through UNICEF to districts.

The figure below illustrates the nutrition status of the children at the sentinel sites. The proportion of children found with mild malnutrition increased by 25% compared to the past month. Other forms of malnutrition; severe or moderate were recorded in fewer children. Children who scored in the category of no malnutrition; i.e. Z scores > -1 accounted for 20% of the children screened. Edema was presented in 0.2% of the children compared to 0.4% recorded in the past month. Below the chart for illustration.

Comparison among the district was done through standardization of the data. Overall, there is an upward trend in mild forms of malnutrition in the region. Among the sick, Abim & Kotido are the most affected. These districts as well screened the largest number of children in the program. This is contrary to many assessments in the region but given the hunger period and the observation of increased admissions in the OTP & TFC in Abim further investigation may be required.

District situation:

Abim:

All 3 health units of Nyakwae HC III, Orwamuge HC III and Alerek HC II submitted reports. Compared to the past week, the trend suggested a 75% increment in the number of malnourished children significantly those in the category of mild malnutrition. The number of children found to have mild malnutrition jumped from 264 to 463. The increase may be attributed to intake deficiency among the children which could be a result of low availability of food or food supply loses mainly cereals used as raw materials to make alcohol consumed by adults. Below is the graphics

Kaabong:

This month a higher number of children received care at the Nutrition surveillance sites. The reports were obtained from the health units of Karenga, Kathile and Kalapata. The majority of the children were registered in Kathile and Kalapata. The data suggests an increase in the number of children with mild malnutrition whereas those with moderate and severe forms remained low. The increase could be mainly attributed to improved reporting but there is need to evaluate other causes of malnutrition including intake deficiencies, worm infestation etc. Below is the graphics:

Kotido:

This month there was a slight increase in the number of children with atleast one form of malnutrition; the majority being those in the mild categories. Kacheri & Nakapelimoru reported outlier figures of mild malnutrition. The 2 units were excluded because they also run a SFC and same staff participated in the screening of the children. According to the data of the 748 children screened, 743 had mild malnutrition. The Nutrition team is investigating the screening process especially selection of children to rule out the possibility that additional children were enrolled from the self selected SFC program. Below is the graphics showing the trend in Panyangara HC II & Kotido compared.

None the less, on the overall the trend suggest an upsurge in the number of children with mild malnutrition. There were no children that scored in the category of severe or moderate malnutrition in Kotido.

Nakapiripirit district:

This week there was an increase in the number of children screened and those found to have at least one type of malnutrition. Nakapiripirit recorded the highest level of Moderate & severe malnutrition in the region; the majority of the children being from Lolachat HC III & Namalu HC III. Mild malnutrition doubled among the children screened this month. The Nutrition team has continued to maintain close contact with the health workers & screeners in the health units. The increase may be attributed to limited access to interventions and intake deficiencies. Below is the graphics

Conclusion:

The outlook suggests an upward trend in mild forms of malnutrition likely due to intake deficiencies. The nutrition teams supporting the surveillance activities have continued to regularly supervise the screening process. There is need for more effort to improve further data quality and to ensure an effective screening process.

Innocent Komakech, Dated 6June 2009 at WHO Moroto field office.

Karamoja facts

2010-09-15T08:44:00.000-07:00

	KARAMOJA INDICATORS 2007/2008
	ABIM	KAABONG	KOTIDO	MOROTO	NAKAPIRIPIRIT	KARAMOJA
Population UBOS (note 1)	69,685	301,200	179,300	265,300	217,500	1,032,985
U5 mortality rate (note 2)						17.4%
infant mortality/1000						105/1000
Measles coverage	123%	63.4%	81.6%	94%	43%	74.4%
water coverage	71.5%	61.6%	86.6%	91.6%	69.3%	75.8%
latrin coverage	2%	2%	2%	10%	3%	4.26%
ITN ownership	48.0%	38.4%	62.2%	29.0%	33.0%	34.6%
under weight children below 5 -2SD%						(note 2) 53,6%
Prevalence of severe anemia
Prevalence o severe diarrhoea	8.6%	5.8%	8.6%	4.1%	3.4%	5.4%
HIV prevalence 14-49 WCBA
HIV prevalence >18 female	15.0%	4.7%	7.7%	10.6%	6.7%	9.0%
HIV prevalence at ANC sites	5.2%	2.6%	2.1%	3.0%	1.9%	2.6%
Female literacy rate ( some primary school))						(note 2) 29,5%
Female literacy rate ( compleated primary school))						(note 2) 1,1%
Female Survival rate up class 5 ( male and female)						(note 2) 1,1%
Birth registration						(note2) 5,2%
Acess to mass. Radio	100%	60%	100%	90%	80%
Phone acess	85%	70%	85%	90%	80%

Note 1 - ABIM population for UBOS is 54100 but is underestimated.
Note 2 - from Demographic and Health Survey 2006

"Data from UNEPI MoH, UN Agency « Karamoja Health Data Center." Karamoja Health Data Center. N.p., n.d. Web. 15 Sept. 2010. http://www.karamojahealthdatacenter.org/?page_id=115.

(Original source data in the works)

Health Indicators

2010-09-15T08:41:00.000-07:00

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2010-09-01T05:56:00.000-07:00

USAID Karamoja Casestudy

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2010-08-26T09:52:00.000-07:00

Hello, my name is Julie. I decided to start this blog despite the fact that I retain a general dislike for these sorts of things. The main reason being, Hannah... my international partner in crime, and I, are planning to return to Uganda in July 2011 to ...welll... we aren't exactly sure yet. That is where the importance of this blog comes in. We are in the beginning stages of hammering out plans for the trip and confronting possibilities. The blog will help you, and us, keep track of our progress and see where we can go with what we have. (What we have being two young women and a lot of ideas...so needless to say, not much.)

Well.. here we go!

A Little PEACE...

WHO_KARAMOJA NUTRITION SURVEILLANCE REPORT, May 09

Karamoja facts

Health Indicators

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