تقرير المسح الأولي وزارة الصحة والسكان محافظة أرخبيل سقطرى بدعم اليونسيف 24 – 30 2019

Executive Summary Between 24 and 30 July 2019 a total of 630 households in Socotra Governorate were visited for the survey with absence and refusal rate of 0.0%. There is two villages has been excluded due to poeople migrated after Makuno cyclone but no others for security reasons or access difficulties. There was no IDP settlements in the Governorate. The Governorate is calm and there is no conflict in progress. Seven teams were able to access the planned (core) 42 clusters in 7 days. One Team for Abd-alkuri island

Executive Summary The selection of clusters followed PPS. Primary sampling units in the sampling frames are villages in in rural settings and Haras in cities as previously presented in the survey protocol The planned number of households per cluster is 15 HHs. The selection of households at the cluster level followed the SRS method after households listing. Segmentation was considered for large clusters. The selection of sample segments were made randomly using PPS. Final draft report is expected within five weeks.

Summary of Key Anthropometric Findings Number of children in the surveyed HHs was 776 children distributed as the following: 91 children aged 0 to less than 6 months. all of them were measured for their weight. 692 children aged 6 to less than 60 months. all of them were measured for their height and weight. 12 child aged above 60 months but was not measured for his height and weight. Levels of GAM and SAM based on Weight-for-Height and the presence of bilateral oedema among children aged 6 – 59 months were found as 11.6%(8.9 - 15.0 95% C.I.) and 1.2% (0.6 - 2.2 95% C.I.) respectively. No Oedema cases were found

Summary of Key Anthropometric Findings Levels of GAM and SAM based on MUAC and the presence of bilateral oedema among children aged 6 – 59 months were found as 2.7% (1.8 - 4.2 95% C.I.) and 0.4% (0.1 - 1.3 95% C.I.) respectively. No Oedema cases were found

Summary of Key Anthropometric Findings levels stunting and severe stunting among children aged 6 – 59 months were found as 41.3% (36.1 - 46.7 95% C.I.) and 11.8% (9.3 - 15.0 95% C.I.) respectively. Levels of underweight and severe underweight among children aged 0 – 59 months were found as 32.2% (27.4 - 37.3 95% C.I.)and 6.8%(4.8 - 9.5 95% C.I.) respectively. Summary findings have excluded extreme values (SMART Flags +/- 3SD from the observed mean). Interpretation of measurements is based on WHO Growth Standards 2006.

Overall and specific objectives Overall Objective: The overall objective of the survey was to assess the current nutrition situation in Soqatra Governorate and key determinants Specific Objectives: To assess levels of acute malnutrition by WHZ criteria among children aged 6 to 59 months in Soqatra Governorate. To assess levels of acute malnutrition by MUAC criteria among children aged 6 to 59 months in Soqatra Governorate. To determine the combined acute malnutrition in children aged 6 to 59 months in Soqatra Governorate. To assess levels of stunting among children aged 6 to 59 months in Soqatra Governorate. To assess levels of underweight among children aged 0 to 59 months in Soqatra Governorate. Note:

Overall and specific objectives Overall Objective: The overall objective of the survey was to assess the current nutrition situation in Soqatra Governorate and key determinants Specific Objectives: To assess the routine polio vaccination coverage among children aged 3 to 59 months, measles vaccination coverage among children aged 9 to 59 months and vitamin A supplementation coverage within the last 6 months prior to survey among children aged 6 to 59 months in Soqatra Governorate. To assess the level of acute malnutrition among women at child bearing age (15 to 49 years) in Soqatra Governorate. To assess the food consumption scoring (FCS) in past 7 days in Soqatra Governorate. Note:

Overall and specific objectives Overall Objective: The overall objective of the survey was to assess the current nutrition situation in Soqatra Governorate and key determinants Specific Objectives: To assess the mean coping strategy index (CSI) of households in Soqatra Governorate. To assess the household practice of a set of stress, crisis and emergency coping strategies in Soqatra Governorate. To assess the household head losing of income sources in Soqatra Governorate due to the current conflict crisis. To assess the monthly household expenditure of households in Soqatra Governorate. Note:

Overall and specific objectives Overall Objective: The overall objective of the survey was to assess the current nutrition situation in Soqatra Governorate and key determinants Specific Objectives: To assess the education level of household caregivers in Soqatra Governorate. To assess the main household drinking water source, the quality classification of the water sources and the cleanness of drinking water storage in Soqatra Governorate. To assess the household latrine type and the quality classification of sanitation facilities in Soqatra Governorate. To assess the practice of handwashing with water and soap (or soap alternatives) by household care giver after toilet and before the meal in Soqatra Governorate. Note:

Overall and specific objectives Overall Objective: The overall objective of the survey was to assess the current nutrition situation in Soqatra Governorate and key determinants Specific Objectives: To assess the crude and under-five mortality rates in Soqatra Governorate using the recall period of 118 days. Note:

Sample Size: Soqatra Governorate Number of HH planned Number of HH surveyed % surveyed /planned Number of children 6-59 months planned Number of children 6-59 months surveyed 604 630 104% 863 689 (all measured) 80% Number of clusters planned Number of clusters surveyed % clusters/ planned 41 42 102%

Plausibility check for:  Standard/Reference used for z-score calculation: WHO standards 2006 (If it is not mentioned, flagged data is included in the evaluation. Some parts of this plausibility report are more for advanced users and can be skipped for a standard evaluation)   Overall data quality  Criteria Flags* Unit Excel. Good Accept Problematic Score  Flagged data Incl % 0-2.5 >2.5-5.0 >5.0-7.5 >7.5 (% of out of range subjects) 0 5 10 20 0 (0.6 %)  Overall Sex ratio Incl p >0.1 >0.05 >0.001 <=0.001 (Significant chi square) 0 2 4 10 0 (p=0.356)  Age ratio(6-29 vs 30-59) Incl p >0.1 >0.05 >0.001 <=0.001 (Significant chi square) 0 2 4 10 0 (p=0.155)  Dig pref score - weight Incl # 0-7 8-12 13-20 > 20 0 2 4 10 0 (4)  Dig pref score - height Incl # 0-7 8-12 13-20 > 20 0 2 4 10 0 (7)  Dig pref score - MUAC Incl # 0-7 8-12 13-20 > 20 0 2 4 10 0 (5)  Standard Dev WHZ Excl SD <1.1 <1.15 <1.20 >=1.20 . and and and or . Excl SD >0.9 >0.85 >0.80 <=0.80 0 5 10 20 0 (0.94)  Skewness WHZ Excl # <±0.2 <±0.4 <±0.6 >=±0.6 0 1 3 5 0 (0.01)  Kurtosis WHZ Excl # <±0.2 <±0.4 <±0.6 >=±0.6 0 1 3 5 0 (0.02)   Poisson dist WHZ-2 Excl p >0.05 >0.01 >0.001 <=0.001 0 1 3 5 3 (p=0.010) OVERALL SCORE WHZ = 0-9 10-14 15-24 >25 3 %  The overall score of this survey is 3 %, this is excellent.   There were no duplicate entries detected.  

Acute malnutrition by WHZ (Table 3.2)   All n = 685 Boys n = 330 Girls n = 353 Prevalence of global malnutrition (<-2 z-score and/or oedema) (80) 11.6 % (8.9 - 15.0 95% C.I.) (48) 14.5 % (10.8 - 19.2 95% C.I.) (32) 8.9 % (6.0 - 13.0 95% C.I.) Prevalence of moderate malnutrition (<-2 z-score and >=-3 z-score, no oedema) (72) 10.4 % (7.9 - 13.7 95% C.I.) (43) 13.0 % (9.3 - 17.9 95% C.I.) (29) 8.1 % (5.4 - 11.9 95% C.I.) Prevalence of severe malnutrition (<-3 z-score and/or oedema) (8) 1.2 % (0.6 - 2.2 95% C.I.) (5) 1.5 % (0.6 - 3.6 95% C.I.) (3) 0.8 % (0.3 - 2.5 95% C.I.)

Acute malnutrition by MUAC (Table 3.5)   All n = 698 Boys n = 334 Girls n = 364 Prevalence of global malnutrition (< 125 mm and/or oedema) (19) 2.7 % (1.8 - 4.2 95% C.I.) (9) 2.7 % (1.4 - 5.1 95% C.I.) 10) 2.7 % (1.6 - 4.7 95% C.I.) Prevalence of moderate malnutrition (< 125 mm and >= 115 mm, no oedema) (16) 2.3 % (1.5 - 3.6 95% C.I.) (7) 2.1 % (1.0 - 4.5 95% C.I.) (9) 2.5 % (1.4 - 4.4 95% C.I.) Prevalence of severe malnutrition (< 115 mm and/or oedema) (3) 0.4 % (0.1 - 1.3 95% C.I.) (2) 0.6 % (0.1 - 2.5 95% C.I.) (1) 0.3 % (0.0 - 2.0 95% C.I.)

Underweight Z-scores (Table 3.7)   All n =780 Boys n = 371 Girls n =409 Prevalence of underweight (<-2 z-score) (251) 32.2 % (27.4 - 37.3 95% C.I.) (136) 36.7 % (29.8 - 44.1 95% C.I.) (115) 28.1 % (23.2 - 33.6 95% C.I.) Prevalence of moderate underweight (<-2 z-score and >=-3 z-score) (198) 25.4 % (22.0 - 29.1 95% C.I.) (108) 29.1 % (23.1 - 35.9 95% C.I.) (90) 22.0 % (18.1 - 26.5 95% C.I.) Prevalence of severe underweight (<-3 z-score) (53) 6.8 % (4.8 - 9.5 95% C.I.) (28) 7.5 % (5.1 - 11.0 95% C.I.) (25) 6.1 % (4.0 - 9.3 95% C.I.)

Stunting Z-scores (Table 3.9)   All n =692 Boys n = 332 Girls n = 360 Prevalence of stunting (<-2 z-score) (286) 41.3 % (36.1 - 46.7 95% C.I.) (144) 43.4 % (36.2 - 50.8 95% C.I.) (142) 39.4 % (33.9 - 45.3 95% C.I.) Prevalence of moderate stunting (<-2 z-score and >=-3 z-score) (204) 29.5 % (26.2 - 33.0 95% C.I.) (99) 29.8 % (23.9 - 36.5 95% C.I.) (105) 29.2 % (25.3 - 33.3 95% C.I.) Prevalence of severe stunting (<-3 z-score) (82) 11.8 % (9.3 - 15.0 95% C.I.) (45) 13.6 % (10.0 - 18.2 95% C.I.) (37) 10.3 % (7.7 - 13.6 95% C.I.)

Mortality Results: Parameter Result Number of deaths during recall period Recall period (days) 116 days CMR (total deaths/10,000 people / day): 0.00(0.00-0.00) U5MR (deaths in children under five/10,000 children under five / day) 0.00 (0.00-0.00) Mean household size 4.7