Kakuma Nutrition Survey November 2012

1. Kakuma Nutrition SurveyNovember 2012 Training Day 2

2. Today’s schedule • Recap day 1 • Team roles • Household visits • Household member listing • Food security section • WASH section • Anaemia section • Mosquito net section • Sampling procedure • Survey logistics (to come later)

3. Team roles PHONE PHONE WEIGHT HEIGHT ASSISTANT MEASURER HB CHILD IYCF WOMAN WASH MALARIA FOOD SECURITY Team of 5 One team leader (not phone holder)

4. Team household visits Household questions WASH WASH WASH PHONE MALARIA FOOD SECURITY MALARIA FOOD SECURITY Individual questions WOMAN WOMAN + equipment CHILD IYCF CHILD IYCF CHILD IYCF

5. Household member listing • To keep track of household members • Name, age, gender • Use birth certificates, events calendar and other relevant documents • Tick off when household member has been investigated

6. Food security • To investigate: • Access to food distribution and duration of the general food ration • Use of negative coping strategies • Level of household dietary diversity • Logistics: • Interview the person who is most involved in food preparation in the household • Really important to word questions exactly as they are written – even if you have to repeat it • When was the last full (i.e. completed) cycle of the GFD ration?

7. Food security – key information • Ask about ALL foods eaten and beverage consumed, inside or outside house, during previous day and night by ANY member of the HH • Includes all meals and snacks • All foods in mixed dishes should be recalled individually (apart from e.g. bread and other basic foods) • Foods consumed by only one member of the household and not by the others are still recorded. • No need to set minimum quantities for foods (e.g. small piece of meat)

8. Food security – common errors • Respondents feel embarrassed to answer questions • Respondents do not understand the questions or the information is too difficult to report • Confusion around the cycle being discussed • Respondent is uncomfortable with questions on coping strategies Take the time to be clear, patient and reaffirm the confidentiality of the survey

9. Food security • Role play exercise 1 • In individual teams with a coordinator • Please practice the dietary recall questionnaire and recording answers • Role play exercise 2 • Two paired interview teams • Please go through the questionnaire according to scenarios given by the coordinator

10. Food security – training test

11. Food security – training test ANSWERS

12. WASH • Objective: • To investigate water and sanitation activities • Use of an adequate quantity of water • Access to an improved drinking water source • Safe excreta disposal practices • Logistics: • Interview the mothers or the main caretaker of young children (and look at the facilities yourself if necessary) • Please ask questions exactly as written! • Take care to be polite when asking where drinking water is stored • Administered to the household even if there is no child for the nutrition survey • Every household to be surveyed for WASH

13. WASH – on the spot question • What is the capacity of the following? A B C D (Big and small one)

14. WASH: Answers A 200 litres Large: 20 litres Small: 10litres B 10 litres C D 15 litres 15 litres

15. WASH – role play • Role play 1 • Coordinator = respondent • Teams to ask questions to the respondent • Role play 2 • Take in turns between teams to be the respondent and the surveyor • Take notes on potential problem areas and give feedback to your colleagues

16. Anaemia • 6-59 and non-pregnant women (including lactating) • Referrals for severely anaemic cases • 6-59: <7.0 g/dl • Women: <8.0 g/dl

17. HemoCue BELOW: HemoCue Hb 301 Analyser, microcuvettes, carry case, and safety lancets

18. Anaemia – most common errors

19. BREAK

20. Referral exercise – 15 mins • Exercise

21. Mosquito net • Objective: • To assess the level of ownership and utilisation of mosquito nets amongst all household members, including children under 5 and pregnant women • Logistics: • Interview the head of household (male or female) or a responsible adult in absence • Make a list of the number of mosquito nets available for sleeping under and the household members who normally sleep there.   • The type of mosquito net (LLIN, conventional) is determined by observation of the net and its brand name and manufacturer on the tag.

22. These are some of the tags you might see. • In addition you might see: • SUPANET • NETTO • others?

23. Mosquito - Questions

24. Mosquito – Answers (1)

25. Mosquito – Answers (2)

26. SAMPLING

27. Review of sampling procedure • Two stage cluster sampling • X blocks are preselected as clusters • Within each block, X households will be randomly selected by survey team on the day of data collection • Sampling • EPI method • Path method • Household list etc

28. Sampling procedure - EPI method Cluster Location X 2 1 5 3 4 = 5 houses

29. EPI method Randomly select one house to start at by lottery Choose others by proximity; visit every house to the LEFT until sample household number is reached

30. Sampling procedure – path method • After arrival in block, walk around the edge of the block while counting all the roads leading into the block. Give each road a number: 1, 2, 3, etc. • When you are back at where you started you randomly select one of the roads leading into the block. For this, put number notes in a container and randomly pick one note. • Start where the selected road number starts at the edge of the block. Walk into the block counting every household on both sides of the road and give them a number. When road ends, randomly select one number using same method as before. • Start your survey at the selected household number. • For the next households, always choose the nearest door to your LEFT when exiting the current household.