Community-Based Sub-Component of Ethiopian National

Community-Based Sub-Component of Ethiopian National Nutrition Program

Baseline Survey Report

Prepared by: Addis Continental Institute of Public Health

December 04, 2009

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Table of contents Table of contents .............................................................................................................................. i Acronyms ........................................................................................................................................ ii Summary ........................................................................................................................................ iii 1. Background ............................................................................................................................. 1 2. Objectives of the baseline survey ........................................................................................... 4 3. Methodology ............................................................................................................................... 5

3.2 Baseline survey design .......................................................................................................... 5 3.3 Baseline survey population ................................................................................................... 5 3.4 Sample size and sampling procedure .................................................................................... 6

3.4.1 Primary sampling unit: selection of Enumeration Areas ............................................... 6 3.4.2 Secondary sampling unit: selection of Households ....................................................... 6

3.5 Data Collection ................................................................................................................... 10 3.5.1 Interview of Caregivers/Mothers ................................................................................. 10 3.5.2 Anthropometric Measurements .................................................................................... 11 3.5.3 Iodization Test of Household Salt ................................................................................ 11

3.6 Pre-Test and Piloting........................................................................................................... 11 3.7 Data Quality, Transfer and Storage .................................................................................... 12 3.8 Data Analysis ...................................................................................................................... 13

4. Result ........................................................................................................................................ 14 4.1 Socio demographic characteristics of household heads ...................................................... 14 4.2 Housing characteristics in the study area ............................................................................ 17 4.3 House hold food security level of the study area ................................................................ 19 4.4 Water and sanitary conditions ............................................................................................. 24 4.5 Maternal and new born health conditions ........................................................................... 28 4.7 Diarrheal disease and malaria ............................................................................................. 43 4.8 TSF coverage ...................................................................................................................... 46 4.9 Nutritional status of children .............................................................................................. 48 4.10 Iodization of salt ............................................................................................................... 49 4.11 Important indicators .......................................................................................................... 50

References ..................................................................................................................................... 53 Annexes......................................................................................................................................... 54

Annex 1. Children ever breastfed versus selected determinant factors .................................... 54 Annex 2. Breast feeding initiation period versus selected characteristics ................................ 56 Annex 3. Wasting among children versus selected factors ....................................................... 59 Annex 4. Stunting among children versus selected factors ...................................................... 61 Annex 5. Underweight among children versus selected factors ............................................... 65 Annex 6. Presence of iodine in the HH salt versus selected variables ..................................... 68 Annex 7. Duration of exclusive breast feeding versus selected variables ................................ 70 Annex 8. Colostrum feeding practice versus selected variables ............................................... 72 Annex 9. Maternal night blindness versus selected variables ................................................... 75

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Acronyms CBN- Community Based Nutrition CSA- Central Statistics Agency EHNRI- Ethiopian Health and Nutrition Research Institute GOE – Government Of Ethiopia HAZ- Height for Age Z-score HEWs- Health Extension Workers HH- House Hold HWs- Health Workers MDG- Millennium Development Goals M&E- Monitoring and Evaluation MUAC- Middle Upper Arm Circumference NNP- National Nutrition Program PPS- Population Proportion Sampling PSU- Primary Sampling Units SNNP- Southern Nations Nationalities and Peoples USA- United States of America UNICEF – United Nations International Children’s Emergency Fund VCHP- Volunteer Community Health Promoters WAZ- Weight for Age Z-score

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Summary Children and women are most vulnerable to malnutrition in developing countries because of low dietary intakes, infectious diseases, lack of appropriate care, and inequitable distribution of food within the household. The Ethiopian Demographic Health Survey conducted in 2005 showed that the level of malnutrition in the country among under five year children; 47% stunted, 11 percent wasted, and 38 percent underweight. To this response the Government of Ethiopia (GOE) developed the National Nutrition Program (NNP) in 2008. As a contribution to the NNP, the GOE-UNICEF Country Program Action Plan 2007 -2011 has initiated the implementation of the CBN sub- component in selected woredas in Amhara, Oromia, SNNP and Tigray regions. The objective of this baseline survey is to assess the nutritional status of children, knowledge of mothers/care takers about nutrition and child caring practices, food security situation, and to measure the iodization level of household salt. A cross sectional study was conducted in selected woredas of four Regions: Amhara, Oromia, SNNP and Tigray Regions. The groups of population which were included in the study were children in the age group of 0-35 months and mothers/care takers who have the same group of children. Fresh enumeration of households was conducted in each enumeration area to select 17 households from the enumeration area. A total of 1100 households and 1175 children were included in the baseline survey. Using Household Food Insecurity Access Scale (HFIAS), the food security level was calculated to be 6(0.6%), 42(4.1%), 404(39.9%), and 561(55.4%) of households are food secured, mildly insecure, moderately insecure, and severely insecure respectively. With regard to ANC follow up for the last pregnancy, 544 (47.2%) of the mothers didn’t have any ANC follow up. From those who had attended ANC the majorities, 296(25.5%) went to health centers and 227(19.7%) attended health post. A significant proportion of mothers (88.3%) gave birth to their youngest child at their own home and more than half of mothers (55%) reported that their friends and relatives assisted them at delivery. The breast feeding practice in the study area is estimated to be 98% but breast feeding was initiated within one hour of birth for 50.4% of the children who are ever breastfed. Even though the breast feeding practice is encouraging in the study areas, 26% of the children have been given fluids other than breast milk in the first three days after delivery and it is only 59% of the children who were fed with colostrums. Almost all of the children (98%) who are in the age range of 12-15 months are still on breast feeding and 56% of children aged 6-8 months have started to receive mushy foods. Out of the 1005 children, 53% have participated in nutrition screening program in their locality. And from those who participated on the screening the majorities (75%) are not given ration card. The prevalence of wasting, stunting and underweight among children in the study areas was also found to be 10.0%, 44.5% and 28.4% respectively. As to the use of iodized salt, a significant proportion of HHs (91%) are using salt which is not iodized and only 4.9% and 2.0% of household use salt which is slightly and adequately iodized respectively.

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1. Background The nutritional status of young children and women of reproductive age reflects household, community, and national development. Children and women are most vulnerable to malnutrition in developing countries because of low dietary intakes, infectious diseases, lack of appropriate care, and inequitable distribution of food within the household (1). Nutritional status of children today reflects a healthy and a productive generation in future. Especially for pre-school children, nutritional condition is a critical factor for optimum growth and it should neither be inadequate nor excessive. Improved nutrition and health enhance the learning ability of children. In the long-run it leads to an increase in the strength of the labor force and thereby it contributes positively for the economic growth. Thus, good nutrition is essential for healthy, thriving individuals, families and a nation. Of the nearly 1.9 billion children in the developing world, 31% are stunted (2, 3). Despite the continued progress in all the developing countries, it is still predicted that there will be 128-155 million underweight children by the year 2020 with 35% of these children to be from sub-Saharan Africa (4). Malnutrition has been responsible, directly or indirectly, for 60% of the 10.9 million deaths annually among children under five years of age. Well over two-thirds of these deaths, which are often associated with inappropriate feeding practices, occur during the first year of life (5). Nutrition status in Ethiopia is alarming: almost half of the children are malnourished. The National Demographic Health Survey conducted by Central Statistic Agency (CSA) in Ethiopia in 2005 showed that the level of malnutrition is significant with nearly one in two (47 percent) Ethiopian children under five years of age are stunted (short for their age), 11 percent wasted (thin for their height), and 38 percent underweight (1). A study conducted in North West Ethiopia has reveled also 28.5%, 24% and 17.7% of children in Gumbrit are Underweight, Stunted, and Wasted respectively (6). High rates of malnutrition can be attributed to both intrauterine growth retardation and post natal growth faltering (7). The recent national infant and under-five mortality rate estimates are 77 and 123 deaths per 1,000 live births, respectively. According to the estimates 1 out of 13 children born in Ethiopia dies before celebrating their first birthday, while 1 out of 8 children born in Ethiopia dies before the age of five years (1). Malnutrition is the underlying cause for about 51% of these deaths, and 11% are believed to be associated with HIV infection.

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Though there is a lack of agreement about the relative importance of the factors affecting the nutritional status of children (8), the postnatal growth faltering in Ethiopia is largely caused by high rates of infection, limited household food availability, and poor infant feeding practices leading to inadequate energy and nutrient intakes (9). Family/household income was also reported to be among the major determinant factors for nutritional status of the under five children. Children belonging to the low-income group were at a higher risk of being wasted, underweight and stunted than children of better income families. Low income levels of developing nation limits the kinds and the amounts of food available for consumption. Low income also increases the likelihood of infection through such mechanisms as inadequate personal and environmental hygiene (6). Maternal height and type of weaning food are also found to be significant predictors for childhood malnutrition. A study in Tigray region has revealed that taller mothers had taller children and children from families that used cereal-based complementary foods had statistically higher HAZ and WAZ scores than those who did not (10). In 2008, the Government of Ethiopia (GOE) developed the National Nutrition Program (NNP), which aims to reduce malnutrition and achieve the target 1 and 2 of the Millennium Development Goal (MDG) through a comprehensive approach to address both emergency and preventive measures. NNP places a significant emphasis on the sub-component, called “Community-Based Nutrition (CBN)”. As a contribution to the NNP, the GOE-UNICEF Country Program Action Plan 2007 -2011 has initiated the implementation of the CBN sub- component in selected woredas in Amhara, Oromia, SNNP and Tigray. In order to prevent children from falling into malnutrition, family and community should be the first line of protection. CBN aims to build up communities and families’ capacity and ownership to make informed decisions on child care practices at family and community levels, The major implementation approaches include Growth Monitoring and Promotion, supported by Community Conversation/Triple-A in which community members ASSESS the situation of their own children, ANALYZE causes of malnutrition and other problems, and take ACTIONs for their own children. Community Dialogue provides a forum to bring about appropriate and feasible solutions/actions by learning from each other and helping each other, especially for the most disadvantaged ones. It also provides simple tools to aide community mobilization, problem identification, analysis and problem solving by themselves. Through GOE-UNICEF CPAP, CBN program has been piloted in selected woredas, and it will be initiated in 36 woredas of the four regions in

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the 1st and 2nd Quarters of 2009. The initial training of Health Workers (HWs), Health Extension Workers (HEWs) and Volunteer Community Health Promoters (VCHPs) has been started in April/May 2009. NNP recognizes the importance of sound program evaluation, combining the nationwide NNP baseline and end-line surveys and other special ad hoc surveys as necessary. NNP has identified the evaluation of CBN sub- component as one of the important special surveys to support the overall NNP evaluation. It was agreed that the survey should use the geographical areas that have already started the CBN implementation under GOE/UNICEF CPAP support, and technically assisted by the Tulane University in USA. The entire survey process will be coordinated under the Survey Steering Committee consisting of Federal Ministry of Health, Ethiopia Health and Nutrition Research Institute (EHNRI), UNICEF Nutrition and Food Security Section and UNICEF M&E Section. The program intervention will be introduced in a step wise fashion and the entire evaluation process will be conducted periodically as new intervention areas are included. As presented in the figure below some woredas were targeted by the program at the beginning and for this baseline survey was conducted. After 12 months additional woredas will be included and baseline survey will be conducted for the new sites at the same time comparison will be made between the two groups of woredas (follow up study). This process will be repeated when another third group of woredas are included by the end of second year (End line survey).

Figure 1. Overall design of the impact evaluation

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2. Objectives of the baseline survey The objectives of the baseline survey are:

1. To determine the nutritional of children under three years of age who are residing in CBN implementation woredas.

2. To assess the level of knowledge and practice of good nutrition and health behaviors among families/care takers in CBN Implementation woredas.

3. To determine iodization of salt at a household level.

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3. Methodology 3.1 Study area The baseline survey was conducted in four Regions of Ethiopia: Amhara, Oromia, SNNP and Tigray. From the four regions 51 woredas which are considered to have food security problem and in which GOE-UNICEF start implementing Community Based Nutrition program in 2009 and 2010 were selected for the survey.

3.2 Baseline survey design A cross sectional quantitative study was conducted to obtain a reasonable estimate of the magnitude of malnutrition and for assessing levels of knowledge and practice concerning good nutrition and health behaviors that serves as baseline for future assessment of the same parameters in the intervention areas. Information was gathered through interview of mothers/care takers, anthropometric measurement, and iodine level test of salt.

3.3 Baseline survey population The source populations for the study were children 0-35 months of age and their mothers/care givers who are residing in the selected EAs. The target populations for inclusion in the baseline survey were:

• Under three years children were eligible for the assessment of malnutrition. Children in the age group 0-35 months are eligible for anthropometry assessment including MUAC except for those under 6 months of age. MUAC measurement was not done for children younger than 6 months of age.

• Mothers/caretakers of children under three years of age were selected and interviewed for the assessment of levels of knowledge and practice of good nutrition and health behaviors.

Children who are older than 35 months of age were excluded from the study for two reasons;

1. They will grow older and will be above 5 years old through the duration of the project

2. These children can be already malnourished or survived from malnutrition so that it will be difficult to evaluate the impact based on this.

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3.4 Sample size and sampling procedure

The sample size was calculated to be adequate to determine a reduction in malnutrition prevalence of 1.5 percentage points per year with 95% level of significance and 80% statistical power. Accordingly a sample size of 1000 was derived and the same numbers of households who have children younger than three years of age were included in the baseline survey.

3.4.1 Primary sampling unit: selection of Enumeration Areas

A two-stage cluster design was used to select sample clusters and households based on the estimated sample size to detect changes overtime. The primary sampling units (PSU) for the survey are EAs which are located in the selected woredas. At the beginning 54 woredas were selected purposively from the four regions and 65 clusters/EAs were identified as survey areas. List of all EAs along with the population size in the selected woredas was obtained from Central Statistics Authority of Ethiopia (CSA). Then from these woredas a total of 65 clusters (Enumeration Areas) were selected using probability Proportionate to Population size (PPS) sampling technique. This process was done at the central level (in Addis Ababa) in collaboration with CSA and before the start of field work.

During the sampling process using PPS technique, from the woredas listed by UNICEF four of them (Sankura, Mareko, Damot wayide and Adwa) were excluded because of the small population they have. Table 1 indicates the list of woredas and Enumeration areas selected for the survey.

3.4.2 Secondary sampling unit: selection of Households The secondary sampling units are households within the selected Enumeration Areas (EAs). Seventeen households who are eligible for the study were selected from each EA using systematic random sampling technique. Before selecting households demarcation of the EA and fresh listing was done to get the sampling frame. Then from the total households listed eligible once were selected and seventeen HHs were selected using systematic random sampling technique.

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Table 1. List of selected woredas and EAs by region

S.no Region Woreda Name of rural kebele (EA) 1. Tigiray

Mereb leki Asayime 2. Ahfom (2 EAs) Tahitay Deiriha, Zibenigus 3. Were lakhe Mayikuhili 4. Tanqua abergele Simiret 5. Erob Enidemosa 6. Saesi Tsaedaemba Senikata 7. Ganta Afeshum Bahira seheta 8. Hawzen Digum 9. Atsbi Wenberta Barika adi sibiha 10. Enderta Shibita 11. Alagie Sesat 12. Raya Azobo (2 EAs) Mechare, Bale ulaga 13. Alamata Merewa 14. Ofla Rada bekeda 15. Amhara

Adiarkaye Ziwa 16. Debark Kirar zibizab 17. Dabat (2 EAs) Sebentara, Dafeya 18. W/belessa Menti 19. Misirak belessa Akite iyesus 20. Lay gaint (2 EAs) Akabit, Barozibana titaro 21. Tach gaint Kebele 16 22. Bugna Biris 23. Gubalafto Lasite gerado 24. Ambasel (2 EAs) Hamusit, Milewa 25. Worebabu Gedero 26. Desie zuria (2 EAs) Abaso kotu, Dajole 27. Debresina Holagosh 28. Jamma (2 EAs) Faji, Yedo 29. Wereleilu Kuyu 30. Goncha Gonideweyin baza 31. Enbse (2 EAs) Mekane genet, Adis Alem 32. Machekel Minichina yekesit 33. Sekota (2 EAs) Tsata, Wal 34. Oromia

Mieso Welitane 35. Tulo Gara kufa 36. Habru (2 EAs) Weroni guda, Gerbi teka 37. Kuni Adamuda 38. Gemechis (2 EAs) Homecho sogido, Rukele agemti 39. Gero Getu Biftu diremu 40. Melkabalu (2 EAs) Tokuman kane, Burka Negeya 41. Sebeta Roge atebela 42. Goro Chanicho Soyema

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Table 1. Continued

S.no Region Woreda Name of rural kebele (EA) 43. SNNP

Soro (2 EAs) Sunidusa, Ile 44. Loka Abaya Sodosemita 45. Bona Wetiko wedimo 46. Boloso Sore (2 EAs) Dache Gofera, Dubo 47. Offa Weshe Alidado 48. Kucha (2 EAs) Kasike zulo, Koy lade 49. Zala Uba Male Deboch Bena 50. Maraka Chilish

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Figure 2: Schematic presentation of the two-stage cluster sampling procedure

All Clusters in the 50 CBN Implementation Woredas of the four Regions: Amhara, Oromia, SNNP, and Tigray

PPS Sampling

65 Clusters were selected randomly based on population

proportion

Systematic Random Sampling

17 HH per Cluster, a total of 1105≅1000 HH were selected

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3.5 Data Collection Information was gathered for the baseline survey through three components: interview of caregivers/mothers, anthropometric measurement, and assessment of iodization of household salt. Figure 3 describes the data collection process in three steps.

Figure 3: Data Collection Steps at a Household level

In situations where more than one child aged less than three years and mothers were found in a single household, one household module of questionnaire was filled and child and maternal modules were completed for each of them. Anthropometric measurement was also done for each child in the household.

3.5.1 Interview of Caregivers/Mothers

A structured questionnaire was used to assess the levels of knowledge and practice of nutrition and health behaviors among families in CBN Implementation woredas. Data collection tool which developed by expert panel coordinated by EHNRI and Tulane University and used for the National Nutrition Program was modified and used for this survey. This tool was modified to make some changes and incorporate important questions. First the English version of the questionnaire was revised and once it is finalized the Amharic translation was done accordingly. The questionnaire was designed in a way to gather important information on the following subject areas: Household members’ information, Housing characteristics, food security, water and sanitation, mothers/care givers information, maternal and new born health, child information, breast feeding practices, care given for ill child, malaria occurrence/prevention and TSF coverage. Besides the questionnaire had a section to put the result of household salt iodine level test and anthropometry measurements.

Eligible respondents for interview were mothers/caregivers of children under five years of age. In cases where mother/caregiver were not available any adult (15 years or above) household member who lives with the child was interviewed; priority was given to the person who is reported to be closest to the child care. At

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least two call backs were made before declaring the household unavailable for the study. Trained data collectors interviewed eligible respondents using the questionnaire.

3.5.2 Anthropometric Measurements

In order to determine the nutritional status of the children weight, height and Middle Upper Arm Circumference (MUAC) measurements were taken for each child. WEIGHT MEASUREMENT: Each team was provided with one scale for weighing children. The UNICEF electronic scale for weighing children as well as adults (capacity 150 kilograms) was used. It has a precision of 100 grams and a digital display. LENGTH/HEIGHT MEASUREMENT: Each team had a length/Height board to measure the length or height of the child. Children under 2 years of age were measured lying down (length) and older children were measured standing up (height). For this purpose UNICEF’s recommended model wooden measuring board that accommodates children up to 130 centimetres was used.

3.5.3 Iodization Test of Household Salt

After the interview and anthropometric measurement, a sample of salt was asked from household and tested for iodine content level using Unicef’s recommended test kit. A sample of the salt used to cook the main meal eaten in the household the night before survey was collected and tested using the kit. The test result is recorded as follows:

− ‘1’ if the test is negative (0 parts per million/no color - not iodized); − ‘2’ if the test shows less than 15 parts per million iodine (salt turned light blue during the

test/slightly iodized); − ‘3’ if the test is positive, 15 parts per million or more, (salt turned dark blue during the test/

adequately iodized) − Different codes were also used to indicate other findings: ‘6’ if there is ‘no salt in home’ and ‘7’ if

the salt was present, but not tested for any reason.

3.6 PreTest and Piloting The study procedures and tools were pre-tested in two selected EAs of Butajira woreda (found 130 km from Addis Ababa in SNNPR). All the survey procedures (demarcation, sampling, interview, anthropometry measurement and iodization test) were done in the two EAs. After the pre-test comments were gathered from the field teams and necessary adjustments were done on the study procedures and the questionnaire.

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The measurement standardization (weight, height and MUAC) was also done twice; one in the training room and the other on the field during piloting. The trainers were used as gold standards in taking anthropometric measurements. Each data collector took the measurement for 10 times in the class and at least 15 times on the field after the gold standards did the same measurement. For standardization in the class weighted objects were used and on the field children were measured. Level of agreement between the gold standards and enumerators was calculated and all of them performed well enough.

For the above measurements Cronbach’s Alpha was used in the analysis as a measure of internal consistency. Intra class correlation was as well calculated. Since the main objective of taking anthropometric measurement is to determine the nutritional status of children, classification of the nutritional status of children by the gold standard and the data collectors was analyzed. Cohen’s Kappa measure of agreement was used for this analysis. A Kappa value above 60% was considered as a good level of agreement. Enumerators who performed 60% and above were only included in the actual survey.

3.7 Data Quality, Transfer and Storage Appropriate data quality assurance mechanisms were established to ensure data quality from collection to analysis and reporting. Manual was prepared to guide operation at all levels and provided for each supervisors. Besides, supervision was done at two levels to assure the standard procedures are followed and quality data is gathered. At the first level a field supervisor was assigned in each team to check whether sampling is done according to the manual in each enumeration area and data are collected using the study tools. At the second level the project coordinator and other experts from ACIPH conducted a visit to 11 woredas of the survey sites. At the beginning two teams were assigned in one woreda where there are two EAs to enable the expert supervise both teams. In general, all teams have been supervised at least once mainly during the first week of field work.

The collected data then transferred to ACIPH office by the designated field supervisor as soon as data collection was completed. Manual data editing, double data entry using EPI INFO software was done to minimize errors during data entry. The data entry was made separately for household characteristics, child modules and maternal modules. After completing the double data entry comparison was made between the two entries to check for consistency. When there was a difference between the two entries the questionnaire was referred and correction was made accordingly.

Data cleaning procedure was also developed and data was cleaned before it is transferred to SPSS software for analysis. Finally, the cleaned data was transformed into SPSS statistical program for further

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analysis. Before analysis the three data (household characteristics, child module and maternal modules) were merged. For anthropometry analysis data was transferred to WHO anthro version 2 software.

3.8 Data Analysis Data was analyzed based on the objectives of the evaluation. The impact indicators to measure the contribution are the proportion of children aged under 3 years who are underweight (weight-for-age below 2 standard deviations of the global reference population). Major indicators were also measured according to the recommendation of WHO (11). For the purpose of identifying the diversity of foods consumed by children food types were categorized in to seven groups based on WHO recommendation. Then, frequency was done and only four groups (Legumes, nuts, diary and fruits and vegitables) were found to be frequently consumed. As a result the analysis related to meal diversity and minimum acceptable diets are based on only these groups of food.

With regard to land size, all other measurements were converted to gasha with the assumption of 1 hectar=4 timad and 1 gasha= 10 hectar. Household food security status was also calculated based on HH Food Insecurity Access Scale (HFIAS) recommendation by USAID (12).

Cross tabulation was also done between selected indicators and other variables. Because of inadequate sample size, the result from cross tabulation is meant to give baseline information not for the purpose on making statistical inference.

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4. Result

4.1 Socio demographic characteristics of household heads The baseline survey was conducted in 65 enumeration areas of the four regions of Ethiopia; Amhara, Oromiya, SNNPR and Tigiray. Information was gathered for 1175 children and 1099 mothers. As indicated in Table 2, the majorities of the households (92.9%) are headed by males and among these heads 20.8%, 18.9%, and 14.9% are found in the age groups of 30-34, 35-39, and 25-29 respectively. A significant proportion of heads (93.8%) are married and more than half of them (56.8%) are orthodox by religion. As to the primary occupation, 91.4% of house hold heads are farmers and almost 54% have never attended any form of education. Table 3 describes the socio demographic characteristics of mothers/care takers of children who are younger than three years of age. Almost all of the care takers (99%) are females and the majorities (47.3%) are found in the age group of 25-34 years. As to the marital status of care takers, almost 94% are married. A significant proportion of care takers (75.5%) have never attended any form of education and 57% are orthodox by religion. More than half (54%) of the care takers in the study areas are not employed and the other 37% have reported that farming is their primary occupation (Table 3).

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Table 2. Socio-demographic characteristics of HH head in the study areas (Amhara, Oromia, SNNPR and Tigray), 2009

Characteristics Frequency Percent House hold Head sex

Male Female

Total

1092

83 1175

92.9 7.1

100.0 House hold Head age

15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-60

>60 Total

2

49 175 244 222 161

84 79 44

115 1175

0.2 4.2

14.9 20.8 18.9 13.7 7.1 6.7 3.7 9.8

100.0 House hold Head marital status

Single Married

Separated Divorced Widowed

Total

5

1102 8

29 31

1175

0.4

93.8 0.7 2.5 2.6

100.0 House hold Head religion

Orthodox Protestant

Catholic Muslim Others

Total

666 154

8 342

3 1173

56.8 13.1 0.7

29.2 0.3 100

House hold Head educational status No school

Informal education Primary

Secondary Higher

Total

630 104 339

90 5

1168

53.9 8.9

29.0 7.7 0.4

100.0 House hold Head primary occupation

Student Farmer

Own Business Permanent wage work Occasional wage work

Trade Unemployed

Others Total

4

1069 14 16 5

28 22 12

1170

0.3

91.4 1.2 1.4 0.4 2.4 1.9 1.0

100.0 House hold Family size

2-4 5-6 7-8

More than 8 Total

342 413 299 121

1175

29.1 35.1 25.4 10.3

100.0

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Table 3. Socio-demographic characteristics of care takers of children under three years in the study areas (Amhara, Oromia, SNNPR and Tigray), 2009

Characteristics Frequency Percent Sex

Male Female

Total

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1163 1175

1.0

99.0 100.0

Age 15-24 25-34 35-44 >=45 Total

324 553 200 92

1169

27.7 47.3 17.1 7.9

100.0 Marital status

Single Married

Separated Divorced Widowed

Total

10

1091 10 47 11

1169

0.9

93.9 0.9 4.0 0.9

100.0 Religion

Orthodox Protestant

Catholic Muslim Others

Total

659 153

8 336

3 1159

56.9 13.2 0.7

20.9 0.3

100.0 Educational status

No school Informal education

Preschool Primary

Secondary Higher education

Total

883 24 4

216 41 2

1170

75.5 2.1 0.3

18.5 3.5 0.2

100.0

Occupation Student Farmer

Own business Permanent wage work Occasional wage work

Trade Unemployed

Others Total

6

417 9 2 4

54 609 27

1128

0.5

37.0 0.8 0.2 0.4 4.8

54.0 2.5

100.0

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From all the children included in the study 611 (52%) were males and 564 (48%) were females. 22.2%, 19% and 14.1% of the children were aged 24-29 months, 12-17 months and 30-35 months respectively. Children 0-5 months of age take a relatively a small proportion (14%), (fig. 4).

Fig 4. Age distribution of children younger than three years of age in the study areas, 2009

1175(100.0%)

166(14.1%)261(22.2%)

179(15.2%)224(19%)181(15.4%)164(14%)

0

200

400

600

800

1000

1200

1400

0 to 5 6 to 11 12 to 17 18 to 23 24 to 29 30 to 35 Total

Age in months

No o

f chi

ldre

n

4.2 Housing characteristics in the study area In the studied areas the majority of the houses, 672 (57.2%), have a roof made of grass, and 354 (30.1%) are made of iron sheet. The floor material for the majority of households is made of earth (60.7%) and cow dung (39%) and the wall material is made of wood/mud and stone/mud for 807(68.7%) and 313 (26.6%) of households respectively. More than half of the households (58.6%) have reported that they have separate place for the domestic animals to spend the night. Where as in 28.8% of house holds animals spend the night with members in the same house but separate section. Almost 60% of the households observed don’t have at least one window in the main house (Table 4).

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Table 4. Household characteristics of the study area, 2009

Characteristics Frequency Percent Roofing material

Corrugated iron sheet Thatch or grass Wood and mud Mud and stone

Reed and bamboo Other Total

354 672 69 60 2

18 1175

30.1 57.2 5.9 5.1 .2

1.5 100.0

Floor material

Earth Cow dung

Cement Other Total

713 458

3 1

1175

60.7 39.0 0.3 0.1

100.0 Wall material

Wood and mud Reed and bamboo

Stone and mud Stone & cement

Other (specify) Total

807 15

313 1

39 1175

68.7 1.3

26.6 0.1 3.3

100.0 Place for domestic animals

Same house, same section Same house, separate section

Separate place Other (specify)

Total

103 338 688 45

1174

8.8 28.8 58.6 3.8

100.0 Presence of window

No

Yes Total

640 429

1069

59.9 40.1

100.0

19

4.3 House hold food security level of the study area Respondents of the households were asked for the presence or absence of events in the previous four weeks that are associated with food security. Accordingly, almost 70% have reported to have worried that enough food may not be available in the house during the specified time period. The frequency of not eating preferred food, eating limited variety of foods, eating foods that are not preferred and eating a small amount of food was 72%, 74%, 50% and 71% respectively. Majority of the households (87%) have reported that there was no a day that a household member went without eating anything (Table 5).

Using Household Food Insecurity Access Scale (HFIAS), the food security level was calculated to be 166(14.2%), 42(3.6%), 404(34.4%), and 561(47.8%) of households are food secured, mildly insecure, moderately insecure, and severely insecure respectively. As the strategies to overcome food shortage in the HH eating less, borrowing, selling assets and migration of HH member are used in 197 (35.4%), 178 (32%), 156 (28.1%), and 126 (22.7%) of HHs respectively, (Fig 5.)

20

Table 5. Food security condition of the households in the study area, 2009

Characteristics Frequency Percent Worried for not having enough food

No Yes

Total

357 818

1175

30.4 69.6

100.0 HH not eaten preferred food

No Yes

Total

325 850

1175

27.7 72.3

100.0 HH ate limited variety of food

No Yes

Total

307 867

1174

26.1 73.9

100.0 HH forced to eat food that are not preferred

No Yes

Total

583 591

1174

49.7 50.3

100.0 HH have to eat small amount of food

No Yes

Total

342 833

1175

29.1 70.9

100.0 HH have to eat fewer meals in a day

No Yes

Total

384 791

1175

32.7 67.3

100.0 There were ever no food in the house

No Yes

Total

888 287

1175

75.6 24.4

100.0 HH member slept hungry at night

No Yes

Total

929 246

1175

79.1 20.9

100.0 HH member go the whole day without eating anything

No Yes

Total

1026 149

1175

87.3 12.7

100.0

21

Fig. 5 Food security level of Households in the study areas, 2009

Almost all of the households (96.6%) in the study area have a land to cultivate which is either rented or owned by the household. As described in the table below a significant proportion 941(82.9%) and 191(16.8%) of households cultivate once and twice a year respectively. With regard to food source of HHs the majority 951(81%) gain food from own production and 482 (41.1%) own a vegetable garden. From those who own a vegetable garden the majority 270 (56.5%) use the entire product for HH consumption. (See table 6)

Almost 52% of HHs in the study area benefit from food aid and ration. Among these the majorities 385 (65.5%) are beneficiaries of safety net food ration. More than half of the HHs 669 (57%) has also participated in public work in the last one year. From those who were engaged in public work almost 50% worked for more than one month duration and the remaining 33.1% and 17.2% worked for 3-4 weeks and 1-2 weeks respectively (Table 6).

22

Table 6. Ownership of cultivated land and frequency of cultivation and food security status of households in the study area, 2009

Characteristics Frequency Percent Presence of cultivated land No

Yes Total

40 1135 1175

3.4 96.6

100.0 Size of cultivated land in timad

Less than one timad 1-2.99 timad 3-4.99 timad 5-6.99 timad 7-9.99 timad

10 and more timad Total

45

439 339 141

65 46

1075

4.2

40.8 31.5 13.1 6.0 4.3

100.0 Own land size in timad



52

500 297

96 33 22

1000

5.2

50.0 29.7 9.6 3.3 2.2

100.0 Rented/shared land size in timad



7

205 79 20 6 9

326

2.1

62.9 24.2 6.1 1.8 2.8

100.0 Frequency of cultivation

Once a year Two-times a year

Three-times a year Total

941 191

3 1135

82.9 16.8

.3 100.0

Food source of HH Own production

Purchase Food aid/donation Shared production

Others Total

951 185

21 16 1

1174

81.0 15.8 1.8 1.4

.1 100.0

Source of income to purchase food Salary wage

Own business Sale of livestock

Remittance Sale of agricultural products

Renting land Others

Total

25 47 63 4

38 1

33 211

13.5 25.4 34.1 2.2

20.5 0.5

17.9

23

Table 6. Continued Ownership of garden

No Yes

Total

692 482

1174

58.9 41.1

100.0 Use of vegetable product

Sell all of it Sell part of it

Use all for HH consumption Others Total

15

183 270

10 478

3.1

38.3 56.5 2.1

100.0 Strategy to overcome food shortage

Eating less Borrowing

Food/cash aid Migration

Selling assets Eating wild foods

Others Total

197 178

92 126 156

7 47

803

35.4

32 16.5 22.7 28.1 1.3 8.5

144.5

Table 7. Benefits, participation in public works and supports to household members of the study areas in one year prior to the study, 2009

Characteristics Frequency Percent HH benefit from food aid and ration

No Yes

Total

566 608

1174

48.2 51.8

100.0 Type of benefit

Emergency food ration Safety net food ration

TSF food ration Other programs

Total

94

385 104

5 588

15.6 65.5 17.7 0.9

100.0 HH member participate in public work

No Yes DK

Total

502 669

2 1173

42.8 57.0

.2 100.0

HH member getting direct support No

Yes Total

1070

105 1175

91.1 8.9

100.0 Gratitious benefits for HH members

Food Cash

Food and cash alternatively Total

76 12 16

104

73.1 11.5 15.4

100.0

24

4.4 Water and sanitary conditions The source of drinking water used by 348(29.6%), 211(18.0%), 199(16.9%) and 184(15.7%) of the households are unprotected spring, tube well, public tap and protected spring respectively. Other sources like protected well, surface water and unprotected well are used by few proportion of the households. Almost 29% (338) of households require 16-30 minutes to fetch water from these sources and the other 27% (318) require 31-60 minutes. With regard to treating drinking water in the household the majority (87.3%) do nothing to the water to make it safer to drink. And more than half of the households (52%) have never been told by a health worker about how to make water safe to drink in the HH (Table 8). As shown in Table 8 more than half of the households (52.6%) do not have any kind of toilet facility as a result household members go to bushes or open field for defecation. While the youngest child passed stool for the last time 477(40.6%) of the households rinsed the stool into toilet and the other 385(32.8%) of them left it in the open field (Table 8). A significant proportion of mothers in the study area, 807(72.6%) have a habit of washing hands after using toilet on sometimes basis but the majorities, 481 (80.3%) use only water to wash hands. Almost 80% mothers also wash hands sometimes before feeding children and 399(85.3%) use only water. More than half of these mothers in the study area, 635(54.1%) have been told by the health worker about washing hands with ash and soap (Table 9).

25

Table 8. Water and sanitary condition of households in the study areas, 2009

Characteristics Frequency Percent Source of drinking water

Piped into yard or plot Public tap/standpipe

Tube well/borehole Protected well

Unprotected well Protected spring

Unprotected spring Rainwater collection

Surface water Total

5

199 211 79 51

184 348

1 97

1175

.4

16.9 18.0 6.7 4.3

15.7 29.6

.1 8.3

100.0 Time taken to fetch water

1-15 minutes 16-30 minutes 31-60 minutes more than 1 hr

Total

241 338 318 278

1175

20.5 28.8 27.1 23.7

100.0 HH treats water

No Yes, always

Yes, sometimes Total

1023

91 58

1172

87.3 7.8 4.9

100.0 Method of water treatment

Boiling Using bleach

Straining using cloth Use water filter

Let it stand and settle Use purifying products

Others Total

66 20 42 14 8 9

16 175

37.7 11.4 24.0 8.0 4.6 5.1 9.1

100.0 Told by health worker about treating water

No

Yes DK

Total

610 561

3 1174

52.0 47.8 0.2

100.0

26

Table 8 continued Characteristics Frequency Percent

Type of toilet facility Ventilated Improved Pit latrine (VIP)

Pit latrine without slab / open pit Composting toilet

No facilities or bush or field Disposing on farm

Others No facility

Total

143 104 36

618 41 63

169 1174

12.2 8.9 3.1

52.6 3.5 5.4

14.4 100.0

Method of disposal of HH waste Collected by municipality

buried dumped in street

disposed in the compound dispose on the farm

dumped in river burned others Total

0

143 104 36

618 41 63

169 1174

0.0

12.2 8.9 3.1

52.6 3.5 5.4

14.4 100.0

Disposal of the youngest child’s stool child used toilet rinsed into toilet

rinsed into drain or ditch thrown into garbage

buried left in the open

others 98

Total

11 477 18

131 18

385 133

1 1174

.9 40.6 1.5

11.2 1.5

32.8 11.3

.1 100.0

27

Table 9. Hand and body washing practice of mothers/caretakers in the study areas, 2009

Characteristics Frequency Valid Percent Hand washing after using toilet

No Yes, sometimes

Total

305 807

1112

27.4 72.6

100.0 Materials used to wash hands after toilet

Water only Soap and water

Ash Endod

Total

481 85 3

30 599

80.3 14.2 0.5 5.0

100.0 Hand washing before feeding children

No Yes, sometimes

Total

236 916

1152

20.5 79.5

100.0 Materials used to wash hands before feeding

Water only Soap and water

Ash Endod

Total

399 49 4

16 468

85.3 10.5 0.9 3.4

100.0 Frequency of body bath

In less than a week period

Every week Once in fifteen days

Once a month In more than a month period

Others Total

102 646 211 131 62 23

1175

8.7 55.0 18.0 11.1 5.3 2.0

100.0 Told by health worker about importance of

hand washing

No Yes DK

Total

535 635

3 1173

45.6 54.1 0.3

100.0

28

4.5 Maternal and new born health conditions During the study period 933(81.5%) of the mothers were lactating their children and the other 124(10.8%) were neither pregnant nor lactating. With regard to ANC follow up for the last pregnancy, 544 (47.2%) of the mothers didn’t have any ANC follow up. From those who had attended ANC the majorities, 296(25.5%) went to health centers and 227(19.7%) attended health post. During ANC follow up information was given on family planning, HIV/AIDS and maternal nutrition for 460(75.5%), 421(69.2%), and 403 (66.2%) of the mothers respectively. Besides, blood pressured was measured for 372(61.1%) of mothers and 358(58.8%) were weighed. More than half of the mothers (55.8%) have attended ANC for two to three times during their last pregnancy (Table 10). More than half of mothers in the study areas (69%) didn’t take iron tablets during their last pregnancy. From those who took the tablet, 28%, 1.8% and 0.7% took iron tablets for 1-60 days, more than 90 days and 61-90 days respectively. With regard to immunization and de-worming during pregnancy the majorities (81%) have taken tetanus immunization once and the other 19% were not immunized at all. Besides, the majorities of mothers (88%) never took de-worming tablets during their pregnancy and 64.2% of the mothers have reported food intake during pregnancy to be less than the usual (Table 11). A significant proportion of mothers (88.3%) gave birth to their youngest child at their own home and more than half of mothers (55%) reported that their friends and relatives assisted them at delivery. Another 37% of mothers have also mentioned that traditional birth attendants and community health volunteers were the ones to assist them at birth. Only 22.9% of mothers have got a chance to receive vitamin A supplement after their birth and 7.7% of the children delivered were weighed. More than one fourth (80%) of the mothers were not also visited by health professionals after delivery (Table 12).

29

Table 10. Antenatal care service utilization by mothers during their last pregnancy in the study area, 2009

Characteristics Frequency Percent Status of the mother

Non pregnant and non lactating Pregnant Lactating

Pregnant and lactating 98

Total

124 69

933 18 1

1145

10.8 6.0

81.5 1.6 .1

100.0

Place of ANC for the last pregnancy No Antenatal Care

Government Hospital Private Hospital

Health centre Government clinic

Private clinic Health post

NGO clinic/health centre Others

Total

544

6 2

294 52 6

227 6

16 1153

47.2

.5

.2 25.5 4.5 .5

19.7 .5

1.4 100.0

Type of ANC provider Doctor/nurse

HEW/auxiliary midwife TBA

CHW Others

Total

368 246

1 4 1

620

59.4 39.7 0.2 0.6 0.2

100.0 Services received during antenatal care

Weight measurement Blood pressure measurement

Urine test Blood test

Drugs for malaria Breast feeding information

Family planning information HIV/AIDS information

Maternal nutrition information Total

358 372 82

152 98

311 460 421 403

2657

58.8 61.1 13.5 25.0 16.1 51.1 75.5 69.2 66.2

100.0

No of ANC visit during last pregnancy none once

2-3 times 4 and more times

Total

1 53

340 215 609

.2 8.7

55.8 35.3

100.0

30

Table 11. Immunization and food intake of mothers during their last pregnancy in the study areas,

2009 Characteristics Frequency Percent

Iron intake during pregnancy No

1-60 days 61-90 days

Don’t Know the number of days Total

421 172

4 11

608

69.2 28.3 0.7 1.8

100.0 Tetanus injection during pregnancy

No Once

2-3 times DK

Total

114 489

0 2

605

18.8 80.9

.0 0.3

100.0 De-worming tablet taken

No Yes

Total

1008 141

1149

87.7 12.3

100.0 Food intake during pregnancy

Less than the usual Same as usual

More than usual 98

Total

738 316 94 2

1150

64.2 27.5 8.2 .2

100.0 Reason for eating more

Fetus competes Development of fetus

Health of fetus and mother Others

Total

32 24 41 16

115

27.8 20.9 35.7 13.9

100.0

31

Table 12. Delivery service utilization by mothers during their last pregnancy in the study area, 2009

Characteristics Frequency Percent Place of birth

Own home Mother’s home

Government hospital Government clinic/health center

NGO health facility Other place

Total

1016

97 10 20 1 6

1150

88.3 8.4 0.9 1.7 0.1 0.5

100.0 Assistant at delivery

No one assisted Doctor/nurse/midwife/auxilary MW

HEW TBA/CHV

Relative/friends/others Total

40 36 12

426 635

1149

3.5 3.1 1.0

37.1 55.3

100.0 Visited by health professional after birth

No Yes DK

Total

919 230

1 1150

79.9 20.0 0.1

100.0 Child weighed at birth

No Yes DK

Total

1057

88 3

1148

92.1 7.7 0.3

100.0 Mother received vit A after birth

No Yes DK

Total

882 263

1 1146

77.0 22.9 0.1

100.0 Mother has difficulty of seeing in dim light

No Yes DK

Total

722 423

2 1147

62.9 36.9 0.2

100.0 Mother has difficulty of seeing in day light

No Yes DK

Total

878 263

2 1143

76.8 23.0 0.2

100.0

32

Table 13. Vaccination and growth monitoring services for children in the study area, 2009 Variable Frequency Percent

Ever Received vit A No

Yes DK

Total

178 812

1 991

18.0 81.9

.1 100.0

last vit A dose Less than a month ago

2-3 months ago 4-5 months ago 6+ months ago Never received

Total

568 105 38 84 12

807

70.4 13.0 4.7

10.4 1.5

100.0 De worming tablet given to child

No Yes DK

Total

626 346 10

982

63.7 35.2 1.0

100.0 Growth card of the child

Neither FHC only

Other Growth Card Both

DK Total

603 120 376 67 7

1173

51.4 10.2 32.1 5.7 .6

100.0 Place growth card is kept

In household In clinic Others

Total

530 18 5

553

95.8 3.3 .9

100.0 Child weighted in last 3 month

No Yes DK

Total

1007 162

3 1172

85.9 13.8

.3 100.0

Place of weighing in last 3 month Health facility

Community weighing sessions Both Total

126 33 3

162

77.8 20.4 1.9

100.0 Frequency of weighing

Once 2-3 times

More than 3 times Total

16 16 10 42

38.1 38.1 23.8

100.0 Child weighed in last 1 month

No Yes

Total

66 96

162

40.7 59.3

100.0

33

Table 13 continued Variable Frequency Percent

Place of weighing in 1 last month Health facility

Community weighing sessions Total

64 23 87

73.6 26.4

100.0 Family participation during weighing

Weighing the child Plotting on growth card

Individual counseling Community conversation

Discussion on growth chart Others

Total

43 14 31 33 32 14 96

44.8 14.6 32.3 34.3 33.3 4.3

34

4.6 Feeding practices Overall more than three fourth of the children in the study area (82%) have received vitamin A supplement at least once in their life time. With regard to the timing of vitamin A supplement the majorities (70.4%) took it less than a month ago before the survey; the other 13% took in two to three months before the survey. As to de-worming tablet provision only 35.2% of children were given de-worming tablets in their life time (Table 14). Only 48% of children have either Family Health Card or other growth card and 5.7% of them have both kinds of health cards. Concerning weighing of children in any kind of facilities, 13.8% of the children in the study area had a chance to be weighed in three months before the survey. Out of these 59% were weighed in a one month before the survey. In both cases; in three month and one month weighing health facilities were reported to be the place of weighing for 77.8% and 73.6% of children respectively (Table 14). Knowledge of mothers on the food sources for micronutrients and prevention and treatment of common nutritional and childhood illnesses was assessed during this survey. Accordingly, 93.1% and 99.7% of mothers were not able to mention correctly at least one food source of vitamin A and iron rich foods respectively. In response to the question about the causes of diarrhea, spoiled foods, contaminated water, not washing hands before meals and others like bad spirit, evil eye, and malnutrition were listed as causes 50.4%, 34.2%, 12.4% and 31.1% of the mothers respectively. In addition 48.3%, 32.8%, and 13.8% of the mothers reported prevention strategies to be use of safe foods, drinking safe fluids and washing hands before meals respectively (Table 14)

35

Table 14. Knowledge of mothers/caretakers on nutrition and nutrition related health problems in the study areas, 2009

Characteristics Frequency Percent Knowledge on food sources of vitamin A

Mentioned at least one food source Don’t know

Total

8010721152

6.993.1

100.0Knowledge on food sources of iron

Mentioned at least one food source Don’t know

Total

411681172

0.399.7

100.0Heard of goiter

No Yes

Total

233 941

1174

19.8 80.2

100.0 Causes of goiter

Curse that come through family Not eating iodized salt

Other Total

2

35 229 941

0.2 3.7

24.3

Prevention of goiter Eating sea foods

Eating iodized salt Eating fish

Eating eggs Drinking holy water/tsebel

Tattooing (Nikisat) Other Total

3

46 1 4

15 21

315 405

0.7

11.4 0.2 1.0 3.7 5.2

77.8 100.0

Causes of diarrhea Dirty/contaminated water/liquid

Spoiled, stale food Not washing hands before taking meal

Not washing hands with soap after defecating Not washing hands with ash/mud after

defecating Not using sanitary latrine

Not giving proper immunization Other Total

402 592 145 50 17 38 3

365 1612

34.2 50.4 12.4 4.3 1.4 3.2 0.3

31.1 100.0

Prevention of diarrhea Use of safe foods Use of safe fluids

Washing hands before taking foods Washing hands with soap after defecation

Washing hand with ash/mud after defecation Using sanitary latrine Proper immunization

Other Total

566 385 162 62 17 25 37

312 1172

48.3 32.8 13.8 5.3 1.4 2.1 3.2

26.6 100.0

36

A significant proportion of care givers/mothers (65%) in the study area recommend breast feeding to be initiated with in one hour after delivery and another 11.6% responded that breast feeding should be initiated after one hour. As to the benefits of breast feeding, 69.3%, 45.2% and 37.1% of the caregivers mentioned that it is important for the growth of the child, to be used as a food for the child and for the health of the child respectively. Only 1.1% of respondents mentioned prevention of pregnancy as benefits of breast feeding. Even though majority of mothers know the benefits of breast feeding, only 76% of them suggested exclusive breast feeding duration to be 3-6 months and another 14.5% responded that children should be exclusively breastfed for more than 6 months. Eighty eight percent of mothers in the study area are aware of what colostrums is and almost 62% believe that additional foods should be started to the child at the age of 6 month. As first foods during weaning soft porridge, cow’s milk and gruel were listed by 50.6%, 36.4% and 33.4% of care givers respectively. Almost 39%, 32% and 23% of care givers prefer to feed their children using hand, spoon and cup respectively (Table 15). Table 16 describes access of mothers to nutrition information from Health Extension Workers (HEWs) and Voluntary Community Health Workers (VCHWs). Twenty four percent of care takers have never contacted HEWs in the past six months before the survey. The most commonly mentioned type of information obtained from HEWs by mothers were: family planning (65.7%), child caring practices (55.3%), and complementary feeding (49%). Where as, information provided by VCHWs were family planning (40.4%), child caring practices (34.8%), and complementary feeding (32.8%). The most commonly mentioned event to meet with HEWs is community outreach (52.6%) and for VCHWs is home visit (36.5%), (See Table 16).

37

Table 15. Breast feeding related knowledge of mothers/caretakers in the study areas, 2009

Characteristics Frequency Percent Breast feeding initiation

Less than 1hr After one hr In one day In 2-3 days

In more than 3 days Total

766 136 37

223 12

1174

65.2 11.6 3.2

19.0 1.0

100.0 Duration of exclusive breast feeding

1-2 months 3-6months

more than 6 months DK

Total

104 870 167

9 1150

9.0

75.7 14.5

.8 100.0

Benefits of breast feeding Child growth Child health

Child food Comfort (for not crying)

Mother’s health Preventing pregnancy

Others Total

814 436 531 47 47 13

194 1174

69.3 37.1 45.2 4.0 4.0 1.1

16.6 100.0

Know colostrum No

Yes Total

137

1029 1166

11.7 88.3

100.0 Age to start additional foods

0 to 3 months 4 to 5 months

At 6 months 7 month and more

DK Total

62

117 721 263

5 1168

5.3

10.0 61.7 22.5

.4 100.0

Duration of BF Less than 1 year

1-2 years More than 2 years

DK Total

9

568 590

5 1172

.8

48.5 50.3

.4 100.0

First additional foods to breast feeding Gruel

Soft porridge Cow's milk

Formula milk Others

392 594 406

9 635

33.4 50.6 36.4 0.8

54.1

38

Table 15 continued Characteristics Frequency Percent

Method of feeding Spoon

Cup Hand Bottle

Others DK

Total

372 272 452 68 7 1

1172

31.7 23.2 38.6 5.8 0.6 0.1

100.0 Signs of malnutrition on children

Thin Short

Old man face (monkey face Irritable

Change of hair color Sunken eye ball

Leg edema Other

1042 117 67

460 65 58

150 213

89.0 10.0 5.7

39.2 5.5 4.9

12.8 18.2

39

Table 16. Nutrition information and sources of information for mothers/caretakers in the study area, 2009

Characteristics Frequency Percent Type of nutrition information from HEWs

Child weight/growth Exclusive breast feeding Complementary feeding

Family planning Child caring practices

519

0 574 769 647

44.4

0 49.1 65.7 55.3

Place of meeting with HEWs Health post

Community outreaches House visit

Community conversation Growth monitoring

Family training Others

469 617 511 335 311 202 37

40.0 52.6 43.6 28.6 26.6 17.2 3.2

No of contacts with HEWs no contact

1 to 3 times Total

284 886

1170

24.3 75.7

100.0

Type of nutrition information from VCHWs Child weight/growth

Exclusive breast feeding Complementary feeding

Family planning Child caring practices

others Total

354 366 384 474 408 46

1172

30.2 31.2 32.8 40.4 34.8 3.9

Place of meeting with VCHWs Community outreaches

House visit Community conversation

Growth monitoring Others

Total

406 428 290 246 37

1170

34.7 36.5 24.8 21.0 3.2

40

The breast feeding practice in the study area is estimated to be 98% but breast feeding was initiated only for 50% of the children who are ever breastfed. Even though the breast feeding practice is encouraging in the study areas, 26% of the children have been given fluids other than breast milk in the first three days after delivery and it is only 59% of the children who were fed with colostrums. Fear that colostrums may not be good for the health of the baby was mentioned by 67.2% of the respondents. The most common type of fluids reported to be given to children in the first three days after birth are raw butter (49.7%), sugar and water (20.5%), and tea (12.9%). Almost three fourth of the children in the study area have been exclusively breastfed for 4-6 months (Table 17). Almost 78% of children in the study area were on breast feeding during the study period. But from those who were not on breast feeding during the study period, the majorities (77.6%) have been breastfed for 12-24 months. Only 4.7% of children were fed with a bottle in the previous day before the study and the type of fluids given to the children were; water, solid/semi solid foods and coffee/tea which were given to 85.3%, 71.7% and 31.4% of children. Only 5.1% of children were fed more than 6 times in the previous day and the majorities (39%) were fed 4-6 times. Less than half of children were weaned at the age of 6 months were as the other 25% were weaned when they were older than 6 months (Table 18).

41

Table 17. Breast feeding history of children born in the last three years preceding the survey in the study areas, 2009

Breast feeding history Frequency Percent Children ever breastfed

No Yes

Total

24

1149 1173

2.0

98.0 100.0

BF initiated Immediately

1 to 24 hours 25 to 48 hours

DK Total

580 313 251

6 1150

50.4 27.2 21.8 0.5

100.0 What is done to colostrum

Given to the child Thrown away

Total

674 476

1150

58.6 41.4

100.0 Reason for throwing colostrum

Not good for the baby It was yellow/thick

It is the tradition Told to do so

Others Total

317

5 87 8

55 472

67.2 1.1

18.4 1.7

11.6 100.0

Child given any drink in 3 days after birth No

Yes DK

Total

845 298

5 1148

73.6 26.0

.4 100.0

Fluids/foods given to a child in the first 3 days Milk (other than breast milk)

Plain water Sugar or glucose water

Tea Raw butter

Ersho Abish water

Others Total

20 38 62 39

150 4 2

35 302

6.6 12.6 20.5 12.9 49.7 1.3 0.7

11.6

Reason for giving fluids in the first 3 days Baby is thirsty

More nutritious It is the tradition

Encouraged by someone It is easier than breastfeeding

Others Total

84 30

109 4 1

91 302

27.8 9.9

36.1 1.3 0.3

30.1

Duration of exclusive breastfeeding Less than a month

2-3 months 4-6 months

Total

53

237 859

1149

4.6

20.6 74.8

100.0

42

Table 18. Current feeding practice of children born in the last three years preceding the survey in the study area, 2009

Feeding practice Frequency Percent Children still on BF

No Yes

Total

259 891

1150

22.5 77.5

100.0 Frequency of BF in a day time

1-3 times 4-6 times

7 and more times Total

241 449 200 890

27.1 50.4 22.5

100.0 Frequency of BF in night time

1-3 times More than 3 times

Total

891

0 891

100.0

0.0 100.0

Duration of breast feeding for not currently breastfed

2-6 months 7-12 months

12-24 months Total

15 36

177 228

6.6 15.8 77.6

100.0 Children fed with bottle in the previous night

No Yes

Total

1084 54

1138

95.3 4.7

100.0

Type of foods/fluids child took in the previous day Vitamins, minerals, supplements, medicines

Water Fruit juice, coffee, tea

ORS/Lemlem Infant formula

Powdered milk Cow’s milk

Solid or semi solid food Others

Total

28

1002 369 10 4 2

232 842 69

1175

2.4

85.3 31.4 0.9 0.3 0.2

19.7 71.7 5.9

Frequency of feeding in previous day

Didn't eat 1-3 times 4-6 times

More than 6 times Total

231 421 454 59

1165

19.8 36.1 39.0 5.1

100.0

Age child start additional food Doesn't start 1-3 months 4-5 months

At 6 months More than 6 month

Total

182 54 87

553 296

1172

15.5 4.6 7.4

47.2 25.3

100.0

43

Fig 6. Type of foods mentioned to be given to children in the previous day in the study areas, 2009

42%

8%

20%

2% 3% 1%

24%

0%5%

10%15%20%25%30%35%40%45%

Gra

ins,

root

s an

dtu

bers

Frui

ts a

ndve

gita

bles

Legu

mes

and

nuts

Vit.

A ri

chfo

ods

Egg

s

Fles

hfo

ods

Dia

rypr

oduc

ts

Food groups

Perc

enta

ge

4.7 Diarrheal disease and malaria The prevalence of diarrheal illness in the two weeks prior the study among the study children was 30.8%. The remaining 69% of children were reported to be free of the illness in the specified time period. As to the treatment and care to the children who were sick, only 17.2% and 18.0% were given ORS and home made recommended fluids respectively. Almost 44%, 30% and 25% of sick children has taken fluid which is less than the usual, same as the usual and more than the usual respectively (Table 19). With regard to the occurrence of febrile illnesses among children in the study area, 40.7% of children had some form of fever in the two weeks before the study. Among these 26% of them have been seen at the health facility for this specific compliant and 19.7% had taken some kind of medicine outside of the health facility. Moreover, only 32% of the children slept under mosquito net in the previous night before the study and only 23% of the households reported that they give priority for children to sleep under mosquito net (Table 20).

44

Table 19. Diarrhea occurrence among children and treatment in the study area, 2009

Variable Frequency Percent Had diarrhea in the last 2 weeks

No Yes

Total

811 361

1172

69.2 30.8

100.0 ORS given to the child

No Yes

Total

299 62

361

82.8 17.2

100.0 Home made fluid/Atmit given to the child

No Yes

Total

296 65

361

82.0 18.0

100.0 Fluid intake during diarrhea

Much less or none of usual Same as usual More than usual

DK Total

154 107 88 4

353

43.6 30.3 24.9 1.1

100.0 Food intake during diarrhea

None Much less than usual

Somewhat less than usual The same as usual

More than usual DK

Total

57

196 80 17 6 3

359

15.9 54.6 22.3 4.7 1.7 0.8

100.0

45

Table 20. Malaria occurrence, treatment and prevention among children born in the last three years

preceding the survey in the study areas, 2009

Variable Frequency Percent Fever or malaria

No Yes

Total

695 477

1172

59.3 40.7

100.0 Seen at health facility

No Yes

Total

353 124 477

74.0 26.0

100.0 Took medicine from facility

No Yes

Total

20

105 125

16.0 84.0

100.0 Took medicine outside facility

No Yes

Total

382 94

476

80.3 19.7

100.0 Use mosquito net in the previous day

No Yes

Total

785 373

1158

67.8 32.2

100.0 Source of net

Child health day/EOS Others

DK Total

97

446 22

565

17.2 78.9 3.9

100.0 Priority given to use net

No priority Pregnant mothers

Children Male adults

Others Total

309 78

132 19 28

566

54.6 13.8 23.3 3.4 4.9

100.0

46

4.8 TSF coverage Table 21 shows the coverage of Targeted Supplementary Feeding (TSF) services in the study area. Out of the 1005 children for whom information was provided for this section, 53% have participated on screening program in their locality. And from those who participated on the screening the majorities (75%) are not given ration card. As to the mothers, 24% of the 1001 have participated on screening and almost half (48%) of them have got supplementary feeding support (Table 21).

47

Table 21. TSF coverage for mothers and children born in the last three years preceding the survey in the study areas, 2009

Variable Frequency Percent Participation in screening

No Yes

Refused DK

Total

466 536

1 2

1005

46.4 53.3 0.1 0.2

100.0 Reason for no participation

Did not know about the date/time Caretaker unable to take child

Child sick Migrated

Distance to screening center too far Busy with agricultural activities

Others DK

Total

78 42 5 8 3 4

244 70

454

17.2 9.3 1.1 1.8 0.7 0.9

53.7 15.4

100.0 Ration card

No Yes card not seen

Yes card seen Total

412

51 90

553

74.5 9.2

16.3 100.0

Supplementary feeding No

Yes Total

464

89 553

83.9 16.1

100.0 Frequency of supplementary feeding

1-2 times >= 3 times

Refused Total

24 38 26 88

27.3 43.2 29.5

100.0 Mother participate on screening

No Yes DK

Total

756 237

8 1001

75.5 23.7 0.8

100.0 Mother receive supplementary feeding

No Yes

Total

124 115 239

51.9 48.1

100.0 Mother Breastfed

No Yes

Total

58

939 997

5.8

94.2 100.0

Mother had food ration when child is <=6months No

Yes DK

Total

843 149

8 1000

84.3 14.9 0.8

100.0 Mother received supplementary food when child is > 6 month No

Yes DK

Total

838 148

13 999

83.9 14.8 1.3

100.0

48

4.9 Nutritional status of children Height, weight and mid upper arm circumference of children younger than three years of age was measured to estimate the nutritional status in the study area. Accordingly the prevalence of wasting, stunting and underweight was found to be 10.0%, 44.5% and 28.4% respectively. Based on the WHO classification the level of malnutrition is also presented in Table 22 as mild and sever malnutrition criteria. Based on the MUAC measurement 10.0% of children are also found to be in a state of acute malnutrition measuring less than 12.1 cm (Table 22).

Table 22. Nutritional status of children who are younger than three years of age in the study area, 2009

Characteristics Frequency Percent Wasting

Normal (-2 up to 5 SD) Mild (-3 up to -2.01 SD) Sever (-5 up to -3.01SD)

Total

1017

82 30

1129

90.1 7.3 2.7

100.0 Stunting

Normal (-2 up to 6 SD) Mild (-3 up to -2.01 SD)

Sever (-6 up to -3.01 SD) Total

619 287 208

1114

55.6 25 .8 18.7

100.0 Underweight

Normal (-2 up to 5 SD) Mild (-3 up to -2.01 SD)

Sever (-6 up to -3.01 SD) Total

829 220 109

1158

70.6 19.0 9.4

100.0 MUAC

<= 11 cm 11.1 cm – 12 cm

>=12.1 cm Total

27 79

911 1017

2.7 7.8

89.6 100.0

49

4.10 Iodization of salt Hose hold salt which was used to cook the last meal of the household was tested for the level of iodine. As presented in Table 23 a significant proportion of HHs (91%) are using salt which is not iodized and only 4.9% and 2.0% of household use salt which is slightly and adequately iodized respectively. (See fig .7)

Fig 7. Result of iodine level test of salt used by households to cook last meal before the study in the study area, 2009

50

4.11 Important indicators As shown in Table 23 it is only for half of the children (50.4%) that breast feeding was initiated with in one hour duration after birth. Almost all of the children (98%) who are in the age range of 12-15 months are still on breast feeding and 56% of children aged 6-8 months have started to receive mushy foods. The majority of children at the age of 6-23 months but not on breast feeding are fed with other foods at least four times in a day (Table 23).

51

Table 23. Summary of important indicators

Indicator No of children Frequency Percent Children for whom BF was initiated immediately (with in one hour)[early initiation of breast feeding] 1175

580

50.4

Children under 6 months of age on EXBF [Exclusive breast feeding] 164 9 7.0

Children 12-15 months of age who are on BF[continued breast feeding] 176 171 97.2

Children 6-8 months of age who are receiving solid (mushy) foods[introduction of solid, semi solid or soft food] 81 45 56.3

Children 6-11 months received food from at least four food sources [minimum dietary diversity] 181 12 12.9



Children 6-8 months who are on breast feeding and given food at least two times [minimum meal frequency] 81 43 53.1

Children 9-23 months who are on breast feeding and given food at least three times [minimum meal frequency] 503 275 54.7

Children 6-23 months who are not on breast feeding and given food at least four times [minimum meal frequency] 63 41 65.1

Children who are on breast feeding and are on minimum acceptable diet [minimum acceptable diet] 875 32 3.7

Children who are NOT on breast feeding and are on minimum acceptable diet [minimum acceptable diet] 235 5 2.1

52

Fig 8. IYCF practice among all children 6-23 months (percent) n the study area, 2009

53

References 1. Central Statistics Authority. Ethiopian Demographic and Health Survey. 2005, Ethiopia 2. The State of the World’s Children. A UNICEF REPORT: Childhood under threat, 2005; 2. 3. The State of the World’s Children. A UNICEF Report: Excluded and invisible, 2006; 112-115. 4. Underwood, B.A. Health and nutrition in women, infants and children: Overview of the global

situation and the Asian Enigma. Nutr. Rev. 2002;60(5):S7-S13. 5. WHO. Global strategy for infant and young child feeding, 2003; Geneva 6. Melkie E. Assessment of nutritional status of preschool children of Gumbrit, North West Ethiopia

7. Nita, B., Sarmila, M., Rajiv, B., Jose, M., Robert, E.B., Maharaj, K.B., et al. An educational intervention to promote appropriate complementary feeding practices and physical growth inn infants and young children in rural Haryana, India. J.Nutr. 2004;134:2342-2348.

8. Alemu, M., Nicola, J. and Bekele, T. Tackling child malnutrition in Ethiopia: Do the sustainable development poverty reduction program’s underlying policy assumptions reflect local realities? Young Lives, An International Study of Childhood Poverty, Working paper No. 19, 2005.

9. Getahun, Z., Urga, K., Ganebo, T. and Nigatu, A. Review of the status of Malnutrition and trends in Ethiopia. Ethiop. J. Health Dev. 2001; 15:55-74.

10. Afework M, Fitsum H, Gideon K, Vincent L, Barbara S, Zenebe A, etal. Factors contributing to childhood malnutrition in Tigray. Northern Ethiopia

11. WHO. Indicator for assessing infant and young child practices. 2008 12. USAID. Household Food Insecurity Access Scale for measurement of food access: Indicator guide.

2007

54

Annexes

Annex 1. Children ever breastfed versus selected determinant factors

Ever breastfed Total no yes no

Child Sex

male Count 10 600 610 % within ChildSex_HR4 1.6% 98.4% 100.0% % within Ever breastfed 41.7% 52.2% 52.0%female Count 14 549 563 % within ChildSex_HR4 2.5% 97.5% 100.0% % within Ever breastfed 58.3% 47.8% 48.0%

Caregiver education

no school Count 17 865 882 % within Caregiver education 1.9% 98.1% 100.0% % within Ever breastfed 70.8% 75.6% 75.5%informal education

Count 1 23 24

% within Caregiver education 4.2% 95.8% 100.0% % within Ever breastfed 4.2% 2.0% 2.1%pre school Count 0 4 4 % within Caregiver education .0% 100.0% 100.0% % within Ever breastfed .0% .3% .3%primary Count 6 209 215 % within Caregiver education 2.8% 97.2% 100.0% % within Ever breastfed 25.0% 18.3% 18.4%secondary Count 0 41 41 % within Caregiver education .0% 100.0% 100.0% % within Ever breastfed .0% 3.6% 3.5%higher education Count 0 2 2 % within Caregiver education .0% 100.0% 100.0% % within Ever breastfed .0% .2% .2%

Total HH family size

2-4 Count 5 336 341 % within Total HH family size 1.5% 98.5% 100.0% % within Ever breastfed 20.8% 29.2% 29.1%5-6 Count 4 408 412 % within Total HH family size 1.0% 99.0% 100.0% % within Ever breastfed 16.7% 35.5% 35.1%7-8 Count 9 290 299 % within Total HH family size 3.0% 97.0% 100.0% % within Ever breastfed 37.5% 25.2% 25.5%more than 8 Count 6 115 121 % within Total HH family size 5.0% 95.0% 100.0% % within Ever breastfed 25.0% 10.0% 10.3%

No of ANC visits

No (0) ANC Count 14 529 543 % within No of ANC visits 2.6% 97.4% 100.0%

55

% within Ever breastfed 66.7% 46.8% 47.2%Once Count 1 52 53 % within No of ANC visits 1.9% 98.1% 100.0% % within Ever breastfed 4.8% 4.6% 4.6%2-3 times Count 3 337 340 % within No of ANC visits .9% 99.1% 100.0% % within Ever breastfed 14.3% 29.8% 29.5%More than 3 times

Count 3 212 215

% within No of ANC visits 1.4% 98.6% 100.0% % within Ever breastfed 14.3% 18.8% 18.7%

Information on BF given

No Count 3 294 297 % within Information on BF given 1.0% 99.0% 100.0% % within Ever breastfed 42.9% 48.8% 48.8%Yes Count 4 307 311 % within Information on BF given 1.3% 98.7% 100.0% % within Ever breastfed 57.1% 51.0% 51.1%DK Count 0 1 1 % within Information on BF given .0% 100.0% 100.0% % within Ever breastfed .0% .2% .2%

HH food security status

Food Secured Count 1 164 165 % within HH FOOD SECURITY 0.6% 99.4% 100.0% % within Ever breastfed 4.2% 14.3% 14.1%Mildly insecure Count 0 42 42 % within HH FOOD SECURITY .0% 100.0% 100.0% % within Ever breastfed .0% 3.7% 3.6%Moderately insecure

Count 8 396 404

% within HH FOOD SECURITY 2.7% 97.3% 100.0% % within Ever breastfed 33.3% 34.5% 34.5%Severely insecure

Count 15 545 560

% within HH FOOD INSECURITY 2.7% 97.3% 100.0% % within Ever breastfed 62.5% 47.5% 47.8%

56

Annex 2. Breast feeding initiation period versus selected characteristics

BF initiated for the child

immediately 1-24 hrs more than

24 hrs DK Total Child Sex

male Count 307 152 139 3 601 % within ChildSex_HR4 51.1% 25.3% 23.1% .5% 100.0% % within BF initiated for

the child 52.9% 48.6% 55.4% 50.0% 52.3%

female Count 273 161 112 3 549 % within ChildSex_HR4 49.7% 29.3% 20.4% .5% 100.0% % within BF initiated for

the child 47.1% 51.4% 44.6% 50.0% 47.7%

Caregiver education

no school Count 444 230 188 5 867 % within Caregiver

education 51.2% 26.5% 21.7% .6% 100.0%

% within BF initiation 76.6% 74.0% 75.8% 83.3% 75.7%informal education

Count 10 4 9 0 23

% within Caregiver education 43.5% 17.4% 39.1% .0% 100.0%

% within BF initiated for the child 1.7% 1.3% 3.6% .0% 2.0%

pre school Count 4 0 0 0 4 % within Caregiver

education 100.0% .0% .0% .0% 100.0%

% within BF initiated for the child .7% .0% .0% .0% .3%

primary Count 105 64 40 0 209 % within Caregiver

education 50.2% 30.6% 19.1% .0% 100.0%


secondary Count 16 13 10 1 40 % within Caregiver

education 40.0% 32.5% 25.0% 2.5% 100.0%

% within BF initiated for the child 2.8% 4.2% 4.0% 16.7% 3.5%

higher education

Count 1 0 1 0 2

% within Caregiver education 50.0% .0% 50.0% .0% 100.0%



2-4 Count 157 86 91 2 336 % within Total HH family

size 46.7% 25.6% 27.1% .6% 100.0%

57



size 54.9% 25.5% 18.9% .7% 100.0%



size 50.3% 30.0% 19.3% .3% 100.0%


more than 8 Count 53 36 27 0 116 % within Total HH family

size 45.7% 31.0% 23.3% .0% 100.0%


No of ANC visits

No ANC Count 284 130 115 1 530 % within No of ANC visits 53.6% 24.5% 21.7% .2% 100.0% % within BF initiated for

the child 49.5% 42.1% 46.6% 100.0% 46.9%

Once Count 29 14 9 0 52 % within No of ANC visits 55.8% 26.9% 17.3% .0% 100.0% % within BF initiated for

the child 5.1% 4.5% 3.6% .0% 4.6%

2-3 times Count 158 101 78 0 337 % within No of ANC visits 46.9% 30.0% 23.1% .0% 100.0% % within BF initiated for

the child 27.5% 32.7% 31.6% .0% 29.8%

More than 3 times

Count 103 64 45 0 212

% within No of ANC visits 48.6% 30.2% 21.2% .0% 100.0% % within BF initiated for

the child 17.9% 20.7% 18.2% .0% 18.7%


No Count 125 93 76 0 294 % within Information on

BF given 42.5% 31.6% 25.9% .0% 100.0%


Yes Count 164 86 57 0 307 % within Information on

BF given 53.4% 28.0% 18.6% .0% 100.0%


DK Count 1 0 0 0 1 % within Information on

BF given 100.0% .0% .0% .0% 100.0%


58

No of contacts with HEW

no contact Count 140 76 60 2 278 % within No of contacts

with HEW 50.4% 27.3% 21.6% .7% 100.0%


once Count 260 167 135 1 563 % within No of contacts

with HEW 46.2% 29.7% 24.0% .2% 100.0%


2-3 times Count 172 65 55 3 295 % within No of contacts

with HEW 58.3% 22.0% 18.6% 1.0% 100.0%


HH FOOD SECURITY

Food Secured Count 88 38 38 0 164 % within HH FOOD

SECURITY 53.7% 23.2% 23.2% .0% 100.0%


Mildly in secured

Count 23 11 8 0 42

% within HH FOOD SECURITY 54.8% 26.2% 19.0% .0% 100.0%


Moderately in secured

Count 186 102 105 3 396



Severely in secured

Count 282 161 100 3 546



59

Annex 3. Wasting among children versus selected factors

wasting severely

wasted (-5 up to -

3.01SD)

mildly wasted (-3

up to -2.01SD)

Normal (-2 up to 5SD) Total

Child Sex

male Count 20 58 509 587 % within ChildSex_HR4 3.4% 9.9% 86.7% 100.0% % within wasting 66.7% 70.7% 50.0% 52.0%female Count 10 24 508 542 % within ChildSex_HR4 1.8% 4.4% 93.7% 100.0% % within wasting 33.3% 29.3% 50.0% 48.0%

Child Age

0-5 Count 7 8 116 131 % within Age category

including above 23 5.3% 6.1% 88.5% 100.0%

% within wasting 23.3% 9.8% 11.4% 11.6%6-8 Count 5 8 66 79 % within Age category

including above 23 6.3% 10.1% 83.5% 100.0%


including above 23 4.1% 10.2% 85.7% 100.0%


including above 23 1.4% 10.4% 88.3% 100.0%


including above 23 .0% 3.4% 96.6% 100.0%

% within wasting .0% 7.3% 16.8% 15.7%24-35 Count 11 27 384 422 % within Age category

including above 23 2.6% 6.4% 91.0% 100.0%

% within wasting 36.7% 32.9% 37.8% 37.4%Care giver education

no school Count 26 73 747 846 % within Care giver

education 3.1% 8.6% 88.3% 100.0%

% within wasting 86.7% 89.0% 73.8% 75.3%informal education

Count 0 1 23 24

% within Care giver education .0% 4.2% 95.8% 100.0%

% within wasting .0% 1.2% 2.3% 2.1%pre school Count 0 1 3 4

60

% within Care giver education .0% 25.0% 75.0% 100.0%

% within wasting .0% 1.2% .3% .4%primary Count 4 7 198 209 % within Care giver

education 1.9% 3.3% 94.7% 100.0%

% within wasting 13.3% 8.5% 19.6% 18.6%secondary Count 0 0 39 39 % within Care giver

education .0% .0% 100.0% 100.0%

% within wasting .0% .0% 3.9% 3.5%higher education

Count 0 0 2 2

% within Care giver education .0% .0% 100.0% 100.0%

% within wasting .0% .0% .2% .2%care givers age

15-24 Count 6 22 282 310 % within care givers age 1.9% 7.1% 91.0% 100.0% % within wasting 20.0% 27.2% 27.9% 27.6%25-34 Count 16 43 477 536 % within care givers age 3.0% 8.0% 89.0% 100.0% % within wasting 53.3% 53.1% 47.1% 47.7%35-44 Count 7 7 175 189 % within care givers age 3.7% 3.7% 92.6% 100.0% % within wasting 23.3% 8.6% 17.3% 16.8%above 45 Count 1 9 78 88 % within care givers age 1.1% 10.2% 88.6% 100.0% % within wasting 3.3% 11.1% 7.7% 7.8%


2-4 Count 6 23 303 332 % within Total HH family

size 1.8% 6.9% 91.3% 100.0%

% within wasting 20.0% 28.0% 29.8% 29.4%5-6 Count 13 37 344 394 % within Total HH family

size 3.3% 9.4% 87.3% 100.0%

% within wasting 43.3% 45.1% 33.8% 34.9%7-8 Count 5 17 271 293 % within Total HH family

size 1.7% 5.8% 92.5% 100.0%

% within wasting 16.7% 20.7% 26.6% 26.0%more than 8 Count 6 5 99 110 % within Total HH family

size 5.5% 4.5% 90.0% 100.0%

% within wasting 20.0% 6.1% 9.7% 9.7%child has ration card

No Count 10 16 383 409 % within child has ration

card 2.4% 3.9% 93.6% 100.0%

% within wasting 71.4% 48.5% 76.6% 74.8%Yes card not Count 1 5 43 49

61

seen % within child has ration

card 2.0% 10.2% 87.8% 100.0%

% within wasting 7.1% 15.2% 8.6% 9.0%yes card seen Count 3 12 74 89 % within child has ration

card 3.4% 13.5% 83.1% 100.0%

% within wasting 21.4% 36.4% 14.8% 16.3% HH FOOD INSECURITY

Food Secured Count 4 8 149 161 % within HH FOOD

INSECURITY 2.5% 5.0% 92.5% 100.0%

% within wasting 13.3% 9.8% 14.7% 14.3%Mildly in secured Count 0 5 34 39 % within HH FOOD

INSECURITY .0% 12.8% 87.2% 100.0%

% within wasting .0% 6.1% 3.3% 3.5%Moderately in secured

Count 9 28 355 392

% within HH FOOD INSECURITY 2.3% 7.1% 90.6% 100.0%

% within wasting 30.0% 34.1% 35.0% 34.8%Severely in secured

Count 17 41 477 535


% within wasting 56.7% 50.0% 47.0% 47.5%

62

Annex 4. Stunting among children versus selected factors

stunting severely

stunted (-6 up to -3.01SD)

mildly stunted (-3 up to -2.01SD)


Child Sex

male Count 129 137 311 577 % within

ChildSex_HR4 22.4% 23.7% 53.9% 100.0%

% within stunting 62.0% 47.7% 50.2% 51.8%female Count 79 150 308 537 % within

ChildSex_HR4 14.7% 27.9% 57.4% 100.0%

% within stunting 38.0% 52.3% 49.8% 48.2%Age category including above 23

0-5 Count 11 13 98 122 % within Age

category including above 23

9.0% 10.7% 80.3% 100.0%

% within stunting 5.3% 4.5% 15.8% 11.0%6-8 Count 6 19 54 79 % within Age


7.6% 24.1% 68.4% 100.0%



13.4% 25.8% 60.8% 100.0%



19.0% 23.5% 57.5% 100.0%



24.4% 29.5% 46.0% 100.0%



22.2% 30.1% 47.7% 100.0%

% within stunting 44.7% 43.9% 32.3% 37.6%Care giver education

no school Count 155 219 457 831 % within Caregiver

education 18.7% 26.4% 55.0% 100.0%

% within stunting 74.9% 76.8% 74.1% 74.9%informal education

Count 5 4 15 24

63

% within Caregiver education 20.8% 16.7% 62.5% 100.0%

% within stunting 2.4% 1.4% 2.4% 2.2%pre school Count 0 3 1 4 % within Caregiver

education .0% 75.0% 25.0% 100.0%

% within stunting .0% 1.1% .2% .4%primary Count 46 49 115 210 % within Caregiver

education 21.9% 23.3% 54.8% 100.0%

% within stunting 22.2% 17.2% 18.6% 18.9%secondary Count 1 10 27 38 % within Caregiver

education 2.6% 26.3% 71.1% 100.0%

% within stunting .5% 3.5% 4.4% 3.4%higher education

Count 0 0 2 2

% within Caregiver education .0% .0% 100.0% 100.0%

% within stunting .0% .0% .3% .2%care givers age

15-24 Count 51 77 178 306 % within care givers

age 16.7% 25.2% 58.2% 100.0%

% within stunting 24.5% 27.2% 28.8% 27.6%25-34 Count 104 133 297 534 % within care givers

age 19.5% 24.9% 55.6% 100.0%

% within stunting 50.0% 47.0% 48.1% 48.2%35-44 Count 37 50 98 185 % within care givers

age 20.0% 27.0% 53.0% 100.0%

% within stunting 17.8% 17.7% 15.9% 16.7%above 45 Count 16 23 45 84 % within care givers

age 19.0% 27.4% 53.6% 100.0%

% within stunting 7.7% 8.1% 7.3% 7.6%Total HH family size

2-4 Count 56 88 182 326 % within Total HH

size 17.2% 27.0% 55.8% 100.0%

% within stunting 26.9% 30.7% 29.4% 29.3%5-6 Count 73 100 221 394 % within Total HH

size 18.5% 25.4% 56.1% 100.0%

% within stunting 35.1% 34.8% 35.7% 35.4%7-8 Count 61 71 156 288 % within Total HH

size 21.2% 24.7% 54.2% 100.0%

% within stunting 29.3% 24.7% 25.2% 25.9%more than 8 Count 18 28 60 106 % within Total HH

size 17.0% 26.4% 56.6% 100.0%

64

% within stunting 8.7% 9.8% 9.7% 9.5%child has ration card

No Count 68 123 212 403 % within child has

ration card 16.9% 30.5% 52.6% 100.0%

% within stunting 60.7% 71.1% 83.1% 74.6%Yes card not seen

Count 11 20 19 50

% within child has ration card 22.0% 40.0% 38.0% 100.0%

% within stunting 9.8% 11.6% 7.5% 9.3%yes card seen Count 33 30 24 87 % within child has

ration card 37.9% 34.5% 27.6% 100.0%

% within stunting 29.5% 17.3% 9.4% 16.1%HH FOOD INSECURITY


INSECURITY 18.9% 24.5% 56.6% 100.0%

% within stunting 14.4% 13.7% 14.5% 14.3%Mildly insecured

Count 8 9 22 39


% within stunting 3.8% 3.2% 3.6% 3.5%Moderately insecured

Count 81 99 206 386


% within stunting 38.9% 34.7% 33.3% 34.7%Severely insecured

Count 89 138 301 528


% within stunting 42.8% 48.4% 48.6% 47.5%

65

Annex 5. Underweight among children versus selected factors

underweight severely

underweight (-6 up to -3.01SD)

mildly underweight (-3 up to -2.01SD)


Child Sex

male Count 68 126 409 603 % within Child Sex 11.3% 20.9% 67.8% 100.0% % within underweight 62.4% 57.3% 49.3% 52.1%female Count 41 94 420 555 % within Child Sex 7.4% 16.9% 75.7% 100.0% % within underweight 37.6% 42.7% 50.7% 47.9%

Child Age

0-5 Count 8 8 139 155 % within Age category

including above 23 5.2% 5.2% 89.7% 100.0%

% within underweight 7.3% 3.6% 16.8% 13.4%6-8 Count 8 13 60 81 % within Age category

including above 23 9.9% 16.0% 74.1% 100.0%


including above 23 10.2% 27.6% 62.2% 100.0%


including above 23 10.4% 21.2% 68.5% 100.0%


including above 23 5.6% 21.9% 72.5% 100.0%


including above 23 11.8% 20.3% 67.9% 100.0%

% within underweight 45.9% 39.1% 34.7% 36.6% % within underweight 14.7% 14.2% 17.9% 16.9%

Care giver education

no school Count 89 180 601 870 % within Caregiver

education 10.2% 20.7% 69.1% 100.0%

% within underweight 82.4% 81.8% 72.8% 75.5%informal education Count 1 5 18 24 % within Caregiver

education 4.2% 20.8% 75.0% 100.0%

% within underweight .9% 2.3% 2.2% 2.1%pre school Count 0 2 2 4

66

% within Caregiver education .0% 50.0% 50.0% 100.0%

% within underweight .0% .9% .2% .3%primary Count 16 31 167 214 % within Caregiver

education 7.5% 14.5% 78.0% 100.0%

% within underweight 14.8% 14.1% 20.2% 18.6%secondary Count 2 2 35 39 % within Caregiver

education 5.1% 5.1% 89.7% 100.0%

% within underweight 1.9% .9% 4.2% 3.4%higher education Count 0 0 2 2 % within Caregiver

education .0% .0% 100.0% 100.0%

% within underweight .0% .0% .2% .2%care givers age

15-24 Count 26 49 244 319 % within care givers

age 8.2% 15.4% 76.5% 100.0%

% within underweight 24.1% 22.4% 29.6% 27.7%25-34 Count 55 118 376 549 % within care givers

age 10.0% 21.5% 68.5% 100.0%

% within underweight 50.9% 53.9% 45.6% 47.7%35-44 Count 20 33 141 194 % within care givers

age 10.3% 17.0% 72.7% 100.0%

% within underweight 18.5% 15.1% 17.1% 16.8%above 45 Count 7 19 64 90 % within care givers

age 7.8% 21.1% 71.1% 100.0%

% within underweight 6.5% 8.7% 7.8% 7.8%Total HH family size

2-4 Count 28 60 250 338 % within Total HH

size 8.3% 17.8% 74.0% 100.0%

% within underweight 25.7% 27.3% 30.2% 29.2%5-6 Count 44 74 287 405 % within Total HH

size 10.9% 18.3% 70.9% 100.0%

% within underweight 40.4% 33.6% 34.6% 35.0%7-8 Count 24 71 202 297 % within Total HH

size 8.1% 23.9% 68.0% 100.0%

% within underweight 22.0% 32.3% 24.4% 25.6%more than 8 Count 13 15 90 118 % within Total HH

size 11.0% 12.7% 76.3% 100.0%

% within underweight 11.9% 6.8% 10.9% 10.2%child has ration card

No Count 30 71 307 408 % within child has

ration card 7.4% 17.4% 75.2% 100.0%

% within underweight 49.2% 59.2% 83.9% 74.6%

67

Yes card not seen Count 6 20 24 50 % within child has

ration card 12.0% 40.0% 48.0% 100.0%

% within underweight 9.8% 16.7% 6.6% 9.1%yes card seen Count 25 29 35 89 % within child has

ration card 28.1% 32.6% 39.3% 100.0%

% within underweight 41.0% 24.2% 9.6% 16.3%HH FOOD INSECURITY


INSECURITY 9.0% 13.9% 77.1% 100.0%

% within underweight 13.8% 10.5% 15.5% 14.4%Mildly insecured Count 6 5 31 42 % within HH FOOD

INSECURITY 14.3% 11.9% 73.8% 100.0%

% within underweight 5.5% 2.3% 3.7% 3.6%Moderately insecured

Count 37 82 275 394


% within underweight 33.9% 37.4% 33.2% 34.1%Severely insecured

Count 51 109 394 554


% within underweight 46.8% 49.8% 47.6% 47.9%

68

Annex 6. Presence of iodine in the HH salt versus selected variables

Maternal knowledge on

causes of goiter

Don't mention iodine

Mentioned iodine

Total Result of iodine level test on HH salt

Non iodated Count 821 0 821 % within Result of iodine

level test on HH salt 100.0% 0.0% 100.0%

% within Maternal knowledge on causes of goiter

90.5% 0.0%

90.5%

iodated, week color Count 51 0 51 % within Result of iodine



5.6% 0.0%

5.6%

iodated, strong color Count 21 0 21 % within Result of iodine



2.3% 0.0%

2.3%

difficult to judge Count 5 0 5 % within Result of iodine



.6% 0.0%

.6%

salt not available Count 9 0 9 % within Result of iodine



1.0% 0.0%

1.0%

Result of iodine level test on HH salt

Non iodated Count 845 3 848 % within Result of iodine

level test on HH salt 99.6% .4% 100.0%

% within Maternal knowledge on prevention of goiter

90.2% 100.0% 90.2%

iodated, week color Count 55 0 55 % within Result of iodine



5.9% .0% 5.9%

iodated, strong color Count 22 0 22 % within Result of iodine


69


2.3% .0% 2.3%

difficult to judge Count 6 0 6 % within Result of iodine



.6% .0% .6%

salt not available Count 9 0 9 % within Result of iodine



1.0% .0% 1.0%

70

Annex 7. Duration of exclusive breast feeding versus selected variables

Duration of EXBF less than a month 2-3 months 4-6 months Total

Child Sex

male Count 31 112 458 601 % within Child Sex 5.2% 18.6% 76.2% 100.0% % within Duration of EXBF 58.5% 47.3% 53.3% 52.3%female Count 22 125 401 548 % within Child Sex 4.0% 22.8% 73.2% 100.0% % within Duration of EXBF 41.5% 52.7% 46.7% 47.7%

Care giver education

no school Count 47 160 659 866 % within Caregiver education 5.4% 18.5% 76.1% 100.0% % within Duration of EXBF 88.7% 67.8% 77.1% 75.7%informal education

Count 0 8 15 23

% within Caregiver education .0% 34.8% 65.2% 100.0% % within Duration of EXBF .0% 3.4% 1.8% 2.0%pre school Count 0 0 4 4 % within Caregiver education .0% .0% 100.0% 100.0% % within Duration of EXBF .0% .0% .5% .3%primary Count 6 62 140 208 % within Caregiver education 2.9% 29.8% 67.3% 100.0% % within Duration of EXBF 11.3% 26.3% 16.4% 18.2%secondary Count 0 5 36 41 % within Caregiver education .0% 12.2% 87.8% 100.0% % within Duration of EXBF .0% 2.1% 4.2% 3.6%higher education

Count 0 1 1 2

% within Caregiver education .0% 50.0% 50.0% 100.0% % within Duration of EXBF .0% .4% .1% .2%


2-4 Count 15 65 257 337 % within Total HH family size 4.5% 19.3% 76.3% 100.0% % within Duration of EXBF 28.3% 27.4% 29.9% 29.3%5-6 Count 17 86 304 407 % within Total HH family size 4.2% 21.1% 74.7% 100.0% % within Duration of EXBF 32.1% 36.3% 35.4% 35.4%7-8 Count 12 66 212 290 % within Total HH family size 4.1% 22.8% 73.1% 100.0% % within Duration of EXBF 22.6% 27.8% 24.7% 25.2%more than 8 Count 9 20 86 115 % within Total HH family size

7.8% 17.4% 74.8% 100.0%

% within Duration of EXBF 17.0% 8.4% 10.0% 10.0%ANC service none Count 31 115 404 550

71

provider

% within ANC service provider 5.6% 20.9% 73.5% 100.0%

% within Duration of EXBF 58.5% 48.7% 47.2% 48.0%doctor/nurse/MW/HEW

Count 22 119 451 592

% within ANC service provider 3.7% 20.1% 76.2% 100.0%

% within Duration of EXBF 41.5% 50.4% 52.7% 51.7%TBA/CHW Count 0 2 1 3 % within ANC service provider .0% 66.7% 33.3% 100.0%

% within Duration of EXBF .0% .8% .1% .3%No of ANC visits

No ANC Count 31 113 385 529 % within No of ANC visits 5.9% 21.4% 72.8% 100.0% % within Duration of EXBF 58.5% 47.9% 45.8% 46.8%Once Count 3 13 36 52 % within No of ANC visits 5.8% 25.0% 69.2% 100.0% % within Duration of EXBF 5.7% 5.5% 4.3% 4.6%2-3 times Count 12 68 257 337 % within No of ANC visits 3.6% 20.2% 76.3% 100.0% % within Duration of EXBF 22.6% 28.8% 30.6% 29.8%More than 3 times

Count 7 42 163 212

% within No of ANC visits 3.3% 19.8% 76.9% 100.0% % within Duration of EXBF 13.2% 17.8% 19.4% 18.8%


No Count 17 64 213 294 % within Information on BF given 5.8% 21.8% 72.4% 100.0% % within Duration of EXBF 77.3% 52.0% 46.6% 48.8%Yes Count 5 59 243 307 % within Information on BF given

1.6% 19.2% 79.2% 100.0%

% within Duration of EXBF 22.7% 48.0% 53.2% 51.0%DK Count 0 0 1 1 % within Information on BF given .0% .0% 100.0% 100.0%

HH FOOD INSECURITY

Food Secured Count 7 38 118 163 % within HH FOOD INSECURITY

4.3% 23.3% 72.4% 100.0%

% within Duration of EXBF 13.5% 16.0% 13.8% 14.2%Mildly insecured

Count 4 8 30 42

% within HH FOOD INSECURITY 9.5% 19.0% 71.4% 100.0% % within Duration of EXBF 7.7% 3.4% 3.5% 3.7%Moderately insecured

Count 17 84 295 396

% within HH FOOD INSECURITY 4.3% 21.2% 74.5% 100.0% % within Duration of EXBF 32.7% 35.4% 34.4% 34.5%Severely insecured

Count 24 107 415 546

% within HH FOOD INSECURITY 4.4% 19.6% 76.0% 100.0% % within Duration of EXBF 46.2% 45.1% 48.4% 47.6%

72

Annex 8. Colostrum feeding practice versus selected variables

Colostrum Given to the child Thrown away Total

Child Sex

male Count 345 256 601 % within Child Sex 57.4% 42.6% 100.0% % within Colostrum 51.2% 53.8% 52.3%female Count 329 220 549 % within ChildSex4 59.9% 40.1% 100.0% % within Colostrum 48.8% 46.2% 47.7%

Caregiver education

no school Count 519 347 866 % within Caregiver

education 59.9% 40.1% 100.0%

% within Colostrum 77.3% 73.2% 75.6%informal education

Count 16 7 23

% within Caregiver education 69.6% 30.4% 100.0%

% within Colostrum 2.4% 1.5% 2.0%pre school Count 2 2 4 % within Caregiver

education 50.0% 50.0% 100.0%

% within Colostrum .3% .4% .3%primary Count 110 99 209 % within Caregiver

education 52.6% 47.4% 100.0%

% within Colostrum 16.4% 20.9% 18.3%secondary Count 23 18 41 % within Caregiver

education 56.1% 43.9% 100.0%

% within Colostrum 3.4% 3.8% 3.6%higher education

Count 1 1 2

% within Caregiver education 50.0% 50.0% 100.0%

% within Colostrum .1% .2% .2%Mothers’ knowledge on Colostrum

No Count 72 61 133 % within know Colostrum 54.1% 45.9% 100.0% % within Colostrum 10.7% 12.8% 11.6%Yes, First yellow milk

Count 595 414 1009

% within know Colostrum 59.0% 41.0% 100.0% % within Colostrum 88.3% 87.0% 87.7%Others Count 7 1 8 % within know Colostrum 87.5% 12.5% 100.0%

73

% within Colostrum 1.0% .2% .7%No of ANC visits

No ANC Count 321 209 530 % within No of ANC visits 60.6% 39.4% 100.0% % within Colostrum 48.3% 44.8% 46.9%Once Count 44 8 52 % within No of ANC visits 84.6% 15.4% 100.0% % within Colostrum 6.6% 1.7% 4.6%2-3 times Count 180 157 337 % within No of ANC visits 53.4% 46.6% 100.0% % within Colostrum 27.1% 33.6% 29.8%More than 3 times

Count 119 93 212

% within No of ANC visits 56.1% 43.9% 100.0% % within Colostrum 17.9% 19.9% 18.7%


No Count 155 139 294 % within Information on BF

given 52.7% 47.3% 100.0%

% within Colostrum 45.2% 53.7% 48.8%Yes Count 187 120 307 % within Information on BF

given 60.9% 39.1% 100.0%

% within Colostrum 54.5% 46.3% 51.0%DK Count 1 0 1 % within Information on BF

given 100.0% .0% 100.0%

% within Colostrum .3% .0% .2%Assistant at delivery

No one assisted

Count 22 16 38

% within Assistant at delivery 57.9% 42.1% 100.0%

% within colostrums 3.3% 3.4% 3.4%Doctor/nurse/midwife/auxilary MW

Count 26 8 34


% within Colostrum 3.9% 1.7% 3.0%HEW Count 5 7 12 % within Assistant at

delivery 41.7% 58.3% 100.0%

% within Colostrum .8% 1.5% 1.1%TBA/CHV Count 268 155 423 % within Assistant at

delivery 63.4% 36.6% 100.0%

% within Colostrum 40.4% 33.2% 37.4%Relative/friends/others

Count 343 281 624


74

% within Colostrum 51.7% 60.2% 55.2%place of birth

own home Count 593 408 1001 % within place of birth 59.2% 40.8% 100.0% % within Colostrum 89.3% 87.2% 88.4%mothers home Count 45 51 96 % within place of birth 46.9% 53.1% 100.0% % within Colostrum 6.8% 10.9% 8.5%gov't hospital Count 7 1 8 % within place of birth 87.5% 12.5% 100.0% % within Colostrum 1.1% .2% .7%govt clinic/health center

Count 13 7 20

% within place of birth 65.0% 35.0% 100.0% % within Colostrum 2.0% 1.5% 1.8%NGO health facility

Count 1 0 1

% within place of birth 100.0% .0% 100.0% % within Colostrum .2% .0% .1%Other place Count 5 1 6 % within place of birth 83.3% 16.7% 100.0% % within Colostrum .8% .2% .5%

visit by health professional (PNC)

No Count 524 380 904 % within visit by health

professional 58.0% 42.0% 100.0%

% within Colostrum 78.9% 81.2% 79.9%Yes Count 140 87 227 % within visit by health

professional 61.7% 38.3% 100.0%

% within Colostrum 21.1% 18.6% 20.1%DK Count 0 1 1 % within visit by health

professional .0% 100.0% 100.0%

% within Colostrum .0% .2% .1%

75

Annex 9. Maternal night blindness versus selected variables

Difficulty of seeing in dim light

No Yes DK Total care givers age

15-24 Count 205 118 0 323 % within care givers age 63.5% 36.5% .0% 100.0% % within Difficulty of seeing in

dim light 28.5% 28.0% .0% 28.3%


dim light 48.1% 47.7% .0% 47.9%


dim light 17.4% 16.4% 50.0% 17.1%

above 45 Count 43 33 1 77 % within care givers age 55.8% 42.9% 1.3% 100.0% % within Difficulty of seeing in

dim light 6.0% 7.8% 50.0% 6.7%

Food intake during pregnancy

Less than the usual Count 440 295 0 735 % within Food intake during

pregnancy 59.9% 40.1% .0% 100.0%

% within Difficulty of seeing in dim light 60.9% 69.7% .0% 64.1%

Same as usual Count 218 96 2 316 % within Food intake during

pregnancy 69.0% 30.4% .6% 100.0%

% within Difficulty of seeing in dim light 30.2% 22.7% 100.0

% 27.6%

More than usual Count 62 32 0 94 % within Food intake during

pregnancy 66.0% 34.0% .0% 100.0%


DK Count 2 0 0 2 % within Food intake during

pregnancy 100.0% .0% .0% 100.0%

% within Difficulty of seeing in dim light .3% .0% .0% .2%

maternal knowledge on vit A rich foods

Didn't mention at least one type of food

Count 139 77 0 216

% within maternal knowledge on vit A rich foods 64.4% 35.6% .0% 100.0%


76

mentioned at least one type of food

Count 55 25 0 80

% within maternal knowledge on vit A rich foods 68.8% 31.3% .0% 100.0%


Post natal vit A supplement given

No Count 555 325 2 882 % within Post natal vit A

supplement 62.9% 36.8% .2% 100.0%


% 77.1%

Yes Count 164 97 0 261 % within Post natal vit A

supplement 62.8% 37.2% .0% 100.0%


DK Count 1 0 0 1 % within Post natal vit A

supplement 100.0% .0% .0% 100.0%

% within Difficulty of seeing in dim light .1% .0% .0% .1%


% 55.3%

Information on maternal nutrition given

No Count 114 92 0 206 % within Information on

maternal nutrition given 55.3% 44.7% .0% 100.0%


Yes Count 265 135 400 % within Information on

maternal nutrition given 66.3% 33.8% 100.0%

% within Difficulty of seeing in dim light 69.9% 59.5% 66.0%

HH FOOD INSECURITY


INSECURITY 77.9% 22.1% .0% 100.0%


Mildly insecured Count 36 6 0 42 % within HH FOOD

INSECURITY 85.7% 14.3% .0% 100.0%


Moderately insecured Count 256 138 0 394 % within HH FOOD

INSECURITY 65.0% 35.0% .0% 100.0%


Severely insecured Count 303 241 2 546 % within HH FOOD

INSECURITY 55.5% 44.1% .4% 100.0%


% 47.7%

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