WEST POKOT COUNTY

1. WEST POKOT COUNTY SMART SURVEY PRELIMINARY FINDINGS MAY,2012

2. OBJECTIVES OF WEST POKOT SMART SURVEY OVERAL OBJECTIVE:To determine the rates of acute malnutrition amongst children aged 6-59 months in West Pokot County. Specific survey objectives • Determine the prevalence of acute malnutrition in the children aged 6-59months. • Determine the Crude and under five mortality rates of the entire population • Determine the morbidity rates in children aged 0-59 months. • Estimate the coverage of immunization (measles, OPV1&3), and micronutrient supplementation amongst children aged 0-59 months. • Estimate the coverage of women supplemented with iron folate for 90 days in their last pregnancy • Assess household food security, Maternal Child Health care and WASH practices. • To develop capacity amongst focal government ministries and community members on how to undertake SMART surveys

3. SURVEY AREA COVERED • The survey was conducted in 3 districts and 14 divisions across the county: • DISTRICTS:West Pokot, Central Pokot, and Pokot North • DIVISIONS:Kapenguria, Kongelai, Sook, Chepararia, Lelan, Sigor, Tapach, Chesegon, Alale, Kacheliba, Kasei, Konyao, Kiwawa, & Batei • The identified areas had slight difference in their livelihood zones as follows; • West Pokot- Mixed Farming • Central Pokot- Agro-Pastoral • Pokot North- Pastoral • SURVEY FINDINGS:39 villages were randomly sampled based on PPS. However, 10.0% of these were inaccessible prompting the team to move into the RC’s (4) as per SMART methodology guidelines. • Design effect of 1.21 unveiled

4. SAMPLING DESIGN TWO STAGE CLUSTER SAMPLING (PPS) FIRST STAGE: Clusters selected using PPS sampling methodology • Obtain population of the survey sites was obtained to the smallest geographical unit, being a village. • Enter data into the ENA software alongside the planning information. Based on the desired precision, prevalence and design effect • Cluster assignment proportion to population size. SECOND STAGE-households/children: (12HH/cluster)through simple random sampling • Obtain a list of HH from village elder • Randomly select 12 households through simple random sampling

5. PLAUSIBILITY CHECK

6. Plausibility check continued…. One confirmed oedema case reported in Naruoro, Alale. Case referred.

7. DEMOGRAPHIC CHARACTERISTICS

8. MALNUTRITION RATE TRENDS No statistical significance in malnutrition rates above when compared to 2011

9. NUTRITION STATUS BY MUAC

10. Nutrition Status of caregivers of <5 year old children

11. Main cause of deaths in 2011 as per Nutrition survey were malaria, diarrhea and vomiting MORTALITY RESULTS GENERAL FINDINGS: Only 3 facilities (Kacheliba, Kapenguria and Sigor facilities have documented deaths) Deaths outside facility are rarely reported

12. Short Rain Assessment 2012: West Pokot reported an increase in diarrhea and dysentery cases among children under five attributable to poor hygienic practices MORBIDITY RATES AMONGST 0-59MONTHS; 2011-2012 • 72.1% of HH had children who had been sick two weeks to the survey

13. Management of Diarrhea Disease (%) Shortage in supplies KEMSA kit

14. Immunization and Vitamin A supplementation coverage • Defaulter rates seem to increase as the children grow older. • Vitamin A supplementation below target with most cases being reported in places like Naruoro, Narochichi, Chesikiro, Kamayech and Katuda villages • Issues reported during Malezi bora: • Planting season; Mothers have competing activities hindering attendance to medical services • Had to reach areas because of terrain and heavy rains • Poor documentation at facility level reported during brainstorming sessions Attributed to supplementation during illness

15. MEASLES IMMUNIZATION COVERAGE No statistical difference

16. High Impact Nutrition Intervention INDICATORS Not comparable as indicator for last year was based on 1 year old • Iron out of stock for quite sometime, only folic available • Combined iron folate brought in February 2012 • DHIS record indicate a 1.0% coverage in iron supplementation in MAY 2012, documentation????

17. INFANT AND YOUNG CHILD FEEDING PRACTICES EBF & Dietary diversity score below target

18. IYCN Continued............

19. WASH SOURCES OF DRINKING WATER (%)

20. WATER TREATMENT 31.5% Safe sources; 68.5% Unsafe sources 31.5% Safe sources; 68.5% Unsafe sources

21. ACCESS TO LATRINE 42 ODF Villages CLTS trainings

22. HAND WASHING AT CRITICAL TIMES

23. GENERAL HAND WASHING PRACTICES (%)

24. Households Mosquito bed net ownership and utilization High ownership attributed to mass distribution in Sep-Oct 2011 • High bed net ownership but low utilization. Observations during survey indicate that bed nets • Used in grain store • Used to cage chicken from eating flowering beans/legumes • Making children’s undergarments

25. FSL: MAIN SOURCES OF LIVELIHOOD 83.3% of households own Livestock

26. HOUSEHOLD FOOD SOURCES

27. HOUSEHOLD DIETARY DIVERSITY SCORE (HDDS)

28. Household Dietary Diversity by Food Groups

29. SUMMARY OF GENERAL FINDINGS • There is no significant difference in GAM 12.3 % (9.3-16.0) and SAM 1.5% (0.1-3.2) rates • There is no significant difference in the stunting 43.2% (38.5-48.0) and wasting levels 36.1% (31.6-40.9) amongst children aged 6-59 months . • There is a significant drop in mortality levels i.e. both crude rates 0.23 %(0.11-0.49) and amongst under-fives 0.58% (0.19-1.78) • There is a significant increase in diarrhoeal incidences (51.3%) • Exclusive breast- feeding rates (36.2%) are below national target of 50 %. • There is a slight increase in Zinc supplementation (1.5%) but below national target of 50%. (KDHS Report 2008-9-0.0%) • Iron supplementation amongst pregnant women (47.8%) noted a significant decrease below national targets of 50%. • Low Household Dietary Diversity (45.2%)

30. RECOMMENDATIONS FOR DISCUSSION

31. RECOMMENDATIONS Cont.........

32. LETS DISCUSS………….