Dissertation to obtain the Master of Public Health Degree
Factors associated with severe acute malnutrition among children aged 6-59 months:
Longechuk County, Upper Nile, South Sudan.
In September 2018, Longechuk’s global acute malnutrition (GAM) has scored 12% with 0, 8% of severe acute malnutrition. Only one year later, the GAM rate became 14, 6% with a SAM rate of 1,9%. This change shows 2.6% increase of the prevalence of the global acute malnutrition and 1.1% increase of the prevalence of severe acute malnutrition.
Based on WHO-UNICEF new threshold classification, 13 with GAM 14.6 % and SAM 1.9%, the nutrition situation of Longechuk County is classified at ‚high? level. The fact that the GAM prevalence was above the WHO emergency threshold highlighted the acute needs in Longechuk.
Indicator Prevalence Level in Longechuk County WHO-UNICEF Cut-off group WHO-UNICEF Severity level
Prevalence of Wasting 14.6% 10%- 15% High
Prevalence of stunting 7.4% 2.5 10% Low
Prevalence of underweight 7.6% 20% Low
Pertinence of the study:
The high prevalence of malnutrition in Longechuck has motivated my decision to explore further regarding the potential underlying causes or associated factors to this malnutrition increased rate.
The findings of my research will inform the future health and nutrition program in the targeted areas; and all the future planning, strategies and interventions aiming to reduce malnutrition in Longechuk will use the findings of this research to better adapt the nutrition intervention and update the ongoing learning process and re-programme the nutrition humanitarian assistance in that particular region.
Despite different intervention put in place by different NGOs in Longechuk county , acute malnutrition still takes lives and cause suffering of many under five year old south Sudanese children. Effective policies and programs to alleviate acute malnutrition require an understanding (knowledge) of the determinants of acute malnutrition. Therefore, the aim of this study is to identify factors associated with acute malnutrition among south Sudanese children aged 6-59 months in Longechuk. This is crucial for UNHCR, governmental and others nongovernmental organizations (NGOs) working on internal displaced people and refugees health, nutrition & food security to redesign their implementation of nutrition intervention strategies.
Knowing the determinants of acute malnutrition has significant advantage in improving the effectiveness and efficiency of the intervention. Therefore this study will help these agents, to consider factors influencing acute malnutrition and it will provide way out to design new strategies and intervention.
Choice of the malnutrition thematic:
Malnutrition is a universal issue holding back development with unacceptable human consequences. Under nutrition, particularly in children, is a vice locked around humanity, preventing individuals and even whole societies from achieving their full potential. Acute malnutrition is not only a condition that kills but also has a long term health and developmental consequences among recovered children. Malnutrition is one of the main health problems facing children under five age group in South Sudan, and particularly in Longechuk County.
The population in Upper Nile is highly reliant on natural resource-based livelihoods, including agriculture and livestock rearing, which have been significantly disrupted by conflict, displacement, cattle raids and climate shocks. Since early 2018 and accelerating after the Revitalized Peace Agreement (RPA) in September 2018, spontaneous returnees have put increasing pressure on already-depleted host community resources.
For instance, according to an Inter-Agency Multi-Sectoral Needs Assessment led by Relief International in December 2018, the population of Longechuk was reported to have increased by approximately 200% between July 2017, when a major battle displaced much of the population, and December 2018. Stability after the RPA has led to slight improvements in food security, though significant portions of the population continue to face serious food insecurity.
Objective: The aim of this study is to assess factors associated with acute malnutrition among children aged between 6 months to 59 months old in Longechuk.
Methods: A cross sectional study will be conducted for children aged 6-59 months. Secondary data from the nutrition therapeutic program will be analyzed and the study result will be generalized to the entire population of the study.