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ASSESSMENT ON INTERNALLY DISPLACED
PERSONS (IDP) STATUS IN KHYBER PAKHTUNKHWA AND
FEDERALLY ADMINISTERED TRIBAL AREAS
Nutrition Cluster
Submitted to UNOCHA
KP Nutrition Cluster
Aien Khan
2
1. INTRODUCTION 1.1 Background
The current existing displacement of caseload is estimated about one million IDPs (159,609
families; 957,654 individuals – 54 per cent men/46 per cent women),1who fled between
2008 to 2013 due to insecurity related to armed non-state entities, security operations and
sectarian violence in various Agencies of FATA. Almost four cent of this population is living in
the three IDP camps, including 4,682 IDP families in Jalozai (KP), 1,157 families in Togh Sarai
(KP)and 732 in New Durrani (FATA) IDP camps. The remaining 96 per cent are residing in
host communities, mostly in the adjoining districts in KP and safer areas in FATA. So far
517,133 Children displaced and over 1 million in IDPs in KP and FATA. As of may 20 2014,
824 registered families returned to Tirah Valley, Khyber Agency in the on-going Phase II of
Tirah IDPs return, which started on 7 May 2014.2
1.2 The rational for theIDP Assessment
This assessment was planned in response to OCHA request to carry outIDP assessment by
the respective clusters on the Internally Displaced persons (IDP) within Khyber Pakhtunkhwa
(KP) and Federally Administered tribal areas (FATA).The main objective of the assessment is
to identify and estimate the humanitarian needs of the IDPs community and prepare
response based on the facts in the targeted areas. Thus, theassessment wasdesignedbased
on UNHCR IDP official figure that was shared to the clusters during the technical working
group meeting. This assessment was believed to fill the lack of updated information on IDP
status and provide basis for IDP humanitarian response planning in areas of Nutrition and
other sectors through: Promote a shared vision of needs and priorities; Establish the priority
needs from an integrated perspective and use resources more efficiently; Obtain a more
comprehensive picture of needs for better guide donor funding; Allow clusters to analyze
and decide on the most appropriate strategies to support IDPs; Serve as a foundation for
planning for IDP response; and Reduce duplication of effort and promote inter-cluster
learning.
Therefore, the nutrition cluster decided to coordinate with implementing partners (IPs) in order to conduct the assessment in their own operational area using simple random sampling. Almost all who are renting the house are living within the host community. In terms of place origin, the IDPs came from different parts of the province. The highest origin was reported from Alihera for Kurram agency followed by Tirah, slaarzai for other districts. This assessment was conducted in DI Khan, Hangu, Nowshera, Khot,Kurram, Nowshera, Peshawar,Tank of KP districts, Bajour, Mohmand, Kurram agencies of FATA and three camps Jalozai in Nowshera, Togh Sarai in Hangu, New Durrani in Kurram camps in KP and FATA.
1UNHCRIDP statistics as of 30 April 2014 2 Situation Report Complex Emergency in KP and FATA Monthly Sitrep # 29
3
1.3 Objectives of the Study
The cluster developed tool and harmonize it to come up simple tool for IDP assessment. The
assessment specifically will look into;
The prevalence of malnutrition among children aged 6-59 months in the IDP households.
Determine of measles coverage and illness among children in the IDP population
Assess the Infant and young child feeding practice among the IDP population
2. METHODOLOGY
2.1 Sample size calculation
Simple random sampling was used as indicated on Table1. The sample size for nutrition
cluster was derived using the formula:
𝑁 = D ⌈t2(p×q)
𝑑2⌉ The parameters are tabulated as follows:
Table 1: Parameters used in calculation of sample size calculation IDP assessment
Parameter Definition value
N Sample size:
𝑁 = 2 ⌈t2(p × q)
𝑑2⌉
𝑁 = ⌈1.962(0.5 × 0.5)
0.052⌉
=384.16 rounded up to 384
t Error risk. t=1.96 at 95% confidence interval
p Expected prevalence Used 50% corresponding to p=0.5 as proportion
q 1-p Thus q=1-0.5=0.5
d Degree of accuracy (5% for each survey) and given as 0.05 proportion
D Design effect 1 because we are using random sampling
Simple random sampling is always used for small populations that contain more than 1000 sampling units (or households). The assessment team was requested to prepare the list of IDP households up on arrival in each selected village for purpose of sampling.
Table 2. IDP sampling by district with in KP/FATA
S/N
District Total population
Total under five @ 12.1%
Total IDPs
Total Returnees
OCHA IDPs Sample
OCHA Sample Returnees
Actual Sample 3
1 Peshawar 2,020,463 244476 71469 382 384 2 DI Khan 705,403 85354 25331 378 384 3 Kohat 554,750 67125 21670 377 384 4 Tank 360,539 43625 11684 372 384 5 Nowshera 671,328 81231 9304 369 384 6 Hangu 373,520 45196 1205 291 384 7 Kurram 649,287 78564 9770 10263 370 370 384 8 Khyber 973,330 117773 2082 6187 324 362 384 9 SWA 574,270 69487 ??? 1900 320 384 10 Bajaur 1124141 136021 ??? 559 228 384 11 Mohmand 627,120 75882 ??? 186 126 384 8,634,151 1044732
3 Sample was taken at confidence interval (CI) of 95%, desired precision of 5% if the prevalence of malnutrition is 50%
4
Figure 1: ENA Random Number Generator
Since in most contexts the number of basic sampling units (BSU) is large, simple random
sampling procedure was conducted by numbering each basic sampling unit i.e IDP
households and then choosing the desired number IDPs households randomly using the
random number table as presented on Figure 2Error! Reference source not found..
Assessment was then be taken based on these IDP households only. For instance we have
71469 IDP households in Peshawar and our total sample is 382 (OCHA sample). Therefore, in
order to select 386 IDP households randomly in Peshawar the team usedrandom table
generated from ENA software as follow.
2.2 Sampling procedure
Option 1:Using simple random sampling methodology.
In order to select the specific IDPs Households from village after listing that is 386 IDP households from the total IDP list in each district, the following optionwas given to the team
o Number each of the 71469 IDPs of Peshawar from 1 to 71469.
o Enter 1 in the box named Range from and 71469 in the box named To (Figure 1Error! Reference source not found.).
o Enter the number of IDPs you need for your sample (386) in the box named Numbers.
o Click on the Generate Table button.
o A word file will open displaying the 386numbers selected randomly (Figure 2).
5
2.3.Data Analysis, Management and Process
2.3.1Data quality management and clearance
One day a partner meeting was organized by nutrition cluster and the pretest of the questioner
was carried out with partners. The review and daily editing of the questionnaires was carried
out on daily basis by the district supervisors in order to identify errors, omissions and
inconsistencies. This quality checking was not done daily after data collection and feedbacks
wasnot given before the next data collection measure as a result the anthropometric data
quality was affected. That means the consistency of data wasn’t assessed by plausibility check
on digit preference in height and weight measurements, overall sex ratio, and standard
deviation for weight for height. Therefore, the analysis of this report was based on the MUAC
finding.
2.3.2Data Analysis SPSS version 16 was used for data cleaning, outliers checking and analysis of contextual or
non-anthropometric data analysis. Moreover, anthropometry Data entry and analysis was
done using ENA for SMART software.
2.3.3 Ethical Considerations
Clearance for the assessment was collected from the respective mandated offices and verbal
consents were obtained from each assessment participants. The participants were briefed
about the objectives and importance of the assessment before the commencement of
interviews and all interviews was conducted in areas where the privacy of the study
participants was maintained.
Figure 2: List of random IDP numbers in a Word document generated by
ENA software
6
3. RESULT
3.1 Resident status of the IDP household
According the findings 4,576 IDP households were visited both within the host community
of eight districts and three camps. The mean household size was 7.27 +3.75 standard
deviation. A total of 3549 children were visited in the assessment and 52.2% of them were
male. The majority of the IDPs in the host community of Hangu, Kohat, Nowshera, Peshawar
and Tank are living within rented houses whereas the IDPs in the camps reported they have
been living within the camp. The situation in Bajour, Mohmand and Kurram is different
where the majority IDPs live in their own house.
Figure 3: percentage of IDPs by types of resident
Out of the total 4574 households, 41.1% are living in rented house while 24.3% and 25.9%
of them were living in IDP camps and own house respectively.
Figure 4: Resident status of in the overall respondents
9.4 11.2 14.1 14.6
6.9 4.1
11.814.9 13.0
6.5 4.3
14.6 9.1 7.6
18.9
7.612.1
8.8 10.6
15.4 12.8
4.46.0
13.6
25.0
9.26.2 7.4
33.3 35.131.6
0.05.0
10.015.020.025.030.035.040.0
Housing conditiong of IDPs
Rented house Living with relatives Owner of the house
In IDP camp Linear (Living with relatives)
41.10%
8.70%
25.90%
24.30%
Resident status of IDPs households
Rented house Living with relatives Owner of the house In IDP Camp
7
3.2 The number of children per household
Except in Hangu and Togh Sarai camp in Hangu where more than 75 of the households
reported they haveonly1 to 2 children, the rest of the IDPs households in the other districts
reported they have more than 3 to 4 more children.
Figure 5: Number of children per household
3.4 IDP Household Income source Casual labor and skilled labor are accounting for 50 %of the income source for IDPs population
Figure 6: The source of income for households
40% 29% 25%
78% 86%
26% 32% 32% 26% 27% 21% 18%
50%
29% 30%
18% 6%
31% 28% 35%25% 27% 30% 43%
10%
24%16%
2%
22% 24%24%
23% 26% 28%27%
11%15%
1%7%
12% 7%15% 13% 15%
12%1% 9% 1% 8% 12%
1% 1% 3% 3% 4%
0%
20%
40%
60%
80%
100%
120%
The number of children in Household
1 to 2 3 to 4 5 to 6 7 to 8 9 to 10 more than 10
0.4
4.3
3.2
2.8
1.7
42.2
16.7
9.1
1.3
5.7
12.5
0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0
No income
Sale of crops
Sale of livestock and animals
Sale of Natural Resources
Sale of Food Aid
Casual labour
Skilled Labour
Salaried work
Petty trading
Family support
Other
Source of income%
8
3.5 Frequency of meal in 24 hours.
The majority of the households consumed three times except in Tank where 73.3 of the
households consumed food twice a day.
Figure 7: Meal frequency in 24 hours recall
3.6 Assistances received 52.8 % of the IDP households mainly from host community didn’t receive any form of
assistance in the past three months. Most households who reported they received FGD for
the last three month, they have also confirmed they received supplementary food in
addition.
Table 3 Type of assistance by District District None GFD Supplementary
food Seeds and tools
Cash assitance
Total
Kurram Camp 100 0 0 0 370
Bajour 96.8 2.6 1.0 0.8 0.3 386
DI Khan 49.7 19.7 28.9 1.3 0.3 380
Hangu 76.8 10.9 8.0 2.1 2.1 375
Hangu Camp 3.6 90.3 5.9 0.0 0.3 390
Jalozai IDPs Camp 21.2 61.0 1.0 0.0 16.8 387
Khot 60.8 21.9 14.1 2.7 0.5 375
Kurram 55.5 36.1 5.7 1.6 1.1 366
Mohmand 1 89.8 1.2 3.7 3.0 2.2 403
Nowshera 48.9 40.8 7.9 1.3 1.1 380
Peshawar 55.1 30.8 9.2 1.8 3.1 390
Tank 76.2 17.9 0.3 0.5 5.1 374
Total 2420 1645 327 58 126 4576
46.4
53.4
10.9 5.4 3.716.3 12.6 9.7 4.5
20.3
73.3
100.0
50.543.4
71.784.6
48.2
79.5 82.5
64.675.8
66.4
26.7
3.1 3.217.4
10.0
48.2
4.3 4.9
25.719.7
13.30.0
0.0
20.0
40.0
60.0
80.0
100.0
120.0
Meal frequncy in 24 hurs
2 times 3 times 4 times
9
3.7 Donation of Infant feeding supplies
Out of the total households, 83.3% of the total households reported there was no donation of infant feeding supplies Table 4: Types of infant feeding donation District No
distribution %
Bottles %
Dry milk
%
Infant formula
%
Liquid milk
%
Teats %
Dont know
%
Others %
Kurram Camp 100 0 0 0 0 0 0 0 370
Bajour 94.6 0.8 2.8 0 0.3 0.5 0.5 0.5 386
DI Khan 81.1 0.3 0 0 0.3 0.3 2.4 15.8 380
Hangu 83.5 0 2.1 6.4 0.5 0 3.5 4 375
Hangu Camp 21.3 0 39.7 18.5 5.4 0 2.8 12.3 390
Jalozai IDPs Camp
98.7 0.5 0.3 0 0 0 0.52 0 387
Khot 84.5 0.27 1.3 2.1 0 0 2.9 8.8 375
Kurram 93.7 1.09 0 2.2 0.55 0 1.6 0.82 366
Mohmand 1 78.7 2.7 5.5 2.2 1.2 0.0 5.7 4.0 403
Nowshera 88.7 0.5 0 0 0.5 0.0 1.8 8.4 380
Peshawar 81.5 0 3.8 1.0 0.5 0 1.0 12.1 390
Tank 84.0 0 0.53 0 0 0 14.7 0.8 374
Total 3767 24 219 125 36 3 143 259 4576
3.8 Shock faced
The price of food commodities is reported as the primary challenge for IDP households followed by insecurity. Figure 8: Shocked faced by IDP households
None, 105, 2%
Insecurity, 784, 17%
Food too expensive, 1770, 39%
Lack of free access, 192, 4%
Livestock disease, 154, 3%
Floods, 41, 1%
Human sickness, 490, 11%
IDP living with HH, 91, 2%late food
distribution, 192, 4%
Social event, 115, 3%
Delay of rains, 34, 1%
weeds or Pest, 27, 1%Others, 525, 12%
10
3.2 Infant and young child feeding practice 3.2.1 Ever breast feeding
The ever breastfeeding coverage is higher as expected for all the districts and camps.
Table 5: Ever breast feeding Districts No Yes %
Kurram Camp 0 265 100.0 265
Bajour 0 234 100.0 234
DI Khan 0 262 100.0 262
Hangu 0 282 100.0 282
Hangu Camp 2 253 99.2 255
Jalozai IDPs Camp 2 176 98.9 178
Kohat 3 252 98.8 255
Kurram 0 246 100.0 246
Mohmand 1 12 246 95.3 258
Nowshera 1 243 99.6 244
Peshawar 2 291 99.3 293
Tank 0 366 100.0 366
22 3116 3138
3.2.2 Initiation of breastfeeding More than half (56.7%) of the mothers initiated breastfeeding within one hour as per the
recommendation.
Table 6: Initiation of breastfeeding among mothers of children under two years Districts Immediately
in 1 hr % In first
day % After first
day % Total under
two children
Kurram Camp 223 84.2 42 15.8 0 0.0 265
Bajour 78 33.6 111 47.8 43 18.5 232
DI Khan 143 54.6 75 28.6 44 16.8 262
Hangu 83 29.4 111 39.4 88 31.2 282
Hangu Camp 58 22.7 98 38.4 99 38.8 255
Jalozai IDPs Camp 153 86.0 17 9.6 8 4.5 178
Kohat 101 39.6 62 24.3 92 36.1 255
Kurram 168 68.3 55 22.4 23 9.3 246
Mohmand 1 100 38.8 63 24.4 95 36.8 258
Nowshera 148 60.7 45 18.4 51 20.9 244
Peshawar 177 60.4 48 16.4 68 23.2 293
Tank 346 94.5 14 3.8 6 1.6 366
1778 56.7 741.0 23.6 617.0 19.7 3136
3.2.3 Colostrum feeding The colostrum feeding was reported highest in Hangu(68.6%) and Jalozai(62.9%)camps whereas New Durrani camp in Kurram shows the lowest of all surveyed areas.
11
Table 7: Colostrum feeding District No % yes % Total under Two
Kurram Camp 157 59.2 108 40.8 265
Bajour 151 64.5 83 35.5 234
DI Khan 133 50.8 129 49.2 262
Hangu 141 50.0 141 50.0 282
Hangu Camp 80 31.4 175 68.6 255
Jalozai IDPs Camp 66 37.1 112 62.9 178
Kohat 122 47.8 133 52.2 255
Kurram 117 47.6 129 52.4 246
Mohmand 1 111 43.0 147 57.0 258
Nowshera 131 53.7 113 46.3 244
Peshawar 165 56.3 128 43.7 293
Tank 216 59.0 150 41.0 366
1433 45.7 1705 54.3 3138
3.2.3 Continued breast feeding two years Similarly, the camps have shown higher proportion of continued breastfeeding.
Table 8:Continue breastfeeding Districts No Yes
Kurram Camp 20 7.55 245 92.5 265
Bajour 63 26.92 171 73.1 234
DI Khan 62 23.66 200 76.3 262
Hangu 61 21.63 221 78.4 282
Hangu Camp 37 14.51 218 85.5 255
Jalozai IDPs Camp 14 7.87 164 92.1 178
Kohat 56 21.96 199 78.0 255
Kurram 28 11.38 218 88.6 246
Mohmand 1 72 27.91 186 72.1 258
Nowshera 56 22.95 188 77.0 244
Peshawar 38 12.97 255 87.0 293
Tank 60 16.39 306 83.6 366
567 18.07 2571 81.9 3138
The analyses for continued breastfeeding at 1 year also showed higher level of children are still breastfed.
12
Table 9: Continued breastfeeding at age 1 year. No % Yes %
Kurram Camp 0 0.0 42 100.0 42
Bajour 8 20.0 32 80.0 40
DI Khan 9 19.1 38 80.9 47
Hangu 4 10.5 34 89.5 38
Hangu Camp 0 0.0 35 100.0 35
Jalozai IDPs Camp 4 16.0 21 84.0 25
Kohat 13 29.5 31 70.5 44
Kurram 7 14.9 40 85.1 47
Mohmand 1 7 15.2 39 84.8 46
Nowshera 4 11.4 31 88.6 35
Peshawar 10 18.5 44 81.5 54
Tank 4 6.3 60 93.8 64
70 13.5 447 86.5 517
3.2.4 Exclusive breast feeding at age 6 months
The overall exclusive rate was at 45.9% whereas the highest was reported in Tank district at
70.6 even though the number of children in the Tank district sample was found very few.
Table 10: The exclusive breast feeding none
other than
breast Milk
EBF Powder or
animal milk
Cereals based diet
Plain water
Fruit Juice
sugar water
Vegetables
Green tea
Total
Kurram Camp 56 50.0 0 54 0 0 0 0 2 112
Bajour 20 40.0 14 0 3 0 0 1 12 50
DI Khan 19 48.7 6 0 1 0 0 0 13 39
Hangu 25 26.0 7 0 12 0 34 0 18 96
Hangu Camp 17 17.5 3 0 14 1 52 1 9 97
JalozaiCamp 26 59.1 2 10 1 0 0 0 5 44
Khot 21 48.8 3 6 2 2 4 0 5 43
Kurram 24 55.8 1 8 0 0 0 0 10 43
Mohmand 1 37 62.7 9 4 3 0 0 4 2 59
Nowshera 38 64.4 9 1 0 1 1 1 8 59
Peshawar 30 61.2 8 0 0 1 0 1 9 49
Tank 12 70.6 1 0 1 0 0 0 3 17
325 45.9 63 83 37 5 91 8 96 708
13
3.2.6 Child Feeding during Diarrhea The large proportion (56.68%) of mothers’ provided less or same feeding amount for their
children during diarrhea against the recommendation of more feeding. Only 14.5 of the
mothers reported more feeding was given to the children during diarrhea.
Table 11: Child feeding practice during illness Nothing was
given less than
usual same as
usual More than
usual Never had diarrhoea
Kurram Camp 0 0 43.2 0 56.8 229
Bajour 20.9 12.4 37.8 9.8 19.1 225
DI Khan 16.9 25.10 46.7 7.06 4.3 255
Hangu 5.5 19.9 48.9 18.75 7.0 272
Hangu Camp 3.3 27.5 47.5 20.9 0.8 244
Jalozai IDPs Camp 17.0 28.5 24.2 26.1 4.2 165
Khot 16.9 0.3 29.8 7.3 15.3 248
Kurram 17.9 19.7 44.4 3.0 15.0 234
Mohmand 1 32.0 32.0 26.4 7.2 2.4 250
Nowshera 14.5 13.7 56.0 12.4 3.4 234
Peshawar 25.5 28.4 28.0 5.0 13.1 282
Tank 8.6 5.8 16.3 45.4 23.8 361
Total 442 595 1105 435 422 2999
3.3 Child Nutrition, immunization and Morbidity status 3.3.1 Sex pyramid of the children
The Bajour sex male to female ratio reveled there was biases in selection of the children.
Figure 10: Sex pyramid by district
47.3
74.3
45.9
50.8
50.8
48.0
50.5
52.9
53.7
52.3
51.2
48.2
52.2
52.7
25.7
54.1
49.2
49.2
52.0
49.5
47.1
46.3
47.7
48.8
51.8
47.8
0.0 20.0 40.0 60.0 80.0 100.0 120.0
KURRAM CAMP
BAJOUR
DI KHAN
HANGU
HANGU CAMP
JALOZAI IDPS CAMP
KHOT
KURRAM
MOHMAND 1
NOWSHERA
PESHAWAR
TANK
Children sex
Male Female
14
3.3.2 Nutritional service
Quite number of children 382 were severely and moderately malnourished however the
service provision wasn’t able to address these children.
Table 12: Beneficiaries by program and gap
In OTP program
In SFP treated by the program
malnourished not in program
Kurram Camp 0 0 83 39
Bajour 5 1 0 78
DI Khan 4 14 0 6
Hangu 6 7 5 20
Hangu Camp 4 32 4 4
JalozaiCamp 5 26 38 6
Khot 17 45 3 19
Kurram 13 23 5 51
Mohmand 1 3 5 0 31
Nowshera 7 7 2 7
Peshawar 19 36 13 13
Tank 46 53 1 108
129 249 154 382
3.3.3 Child morbidity
As the red part of the char highlights the percentage of sick children for past two weeks was very high. Except in Hangu district where the percentage of sick children was reported low at 20.8% as compared to the rest of the areas, almost half of the study children were sick two weeks prior to the assessment with the highest reported figure at 72.8% in Kohat district. Diarrhea is the first major cause of sickness followed by fever and cough respectively.
60.0 52.346.1 75.7
39.119.4 23.7
46.2 41.7 47.929.7
56.4 44.7
40.046.4 48.9
20.8
54.8
38.0
72.852.7 58.3
46.3 68.743.0 49.4
0.0
20.0
40.0
60.0
80.0
100.0
120.0
Child Morbidty
No Yes
15
Table 12 Type of illness Not
Sick fever Cough Diarrhea Skin
Infections Eye
infections Other
Kurram Camp 222 25 35 36 12 5 0
Bajour 202 65 46 53 7 6 2
DI Khan 175 69 21 77 4 2 13
Hangu 284 45 9 19 3 0 2
Hangu Camp 166 112 20 81 11 2 4
JalozaiCamp 75 41 17 75 8 2 4
Khot 89 113 38 98 10 2 11
Kurram 169 42 30 86 18 14 3
Mohmand 1 168 75 41 79 25 4 11
Nowshera 182 68 22 62 9 3 11
Peshawar 116 74 28 142 5 0 18
Tank 211 49 39 45 9 12 7
2059 778 346 853 121 52 86
3.3.4 Child Nutritional status results for MUAC
Table 13. The prevalence of Malnutrition using MUAC and analyzed using ENA software. Prevalence of global acute malnutrition: MUAC < 125 mm or edema
Prevalence of moderate acute malnutrition: MUAC < 125 and MUAC >= 115 mm
Prevalence of severe acute malnutrition : MUAC < 115 mm or edema
All (3422): (635) 18.6% (16.7-19.2 95% CI) Boys (1794): (311) 17.3% (15.2-18.6 95% CI) Girls (1628): (324) 19.9% (17.3-21.0 95% CI)
All (3422): (454) 13.3% (11.7-13.9 95% CI) Boys (1794): (228) 12.7% (10.9-13.9 95% CI) Girls (1628): (226) 13.9% (11.8-15.0 95% CI
All (3422): (181) 5.3% (4.4- 5.9 95% CI) Boys (1794): (83) 4.6% (3.6- 5.5 95% CI) Girls (1628): (98) 6.0% ( 4.8- 7.0 95% CI)
3.3.5 Measles vaccination coverage Measles vaccination was the lowest in Mohmand followed by DI Khan, Tank and Hangu. No % Yes with EPI
with card % Yes recall %
Kurram Camp 1 0.4 170 68.5 77 31.0 248
Bajour 37 14.5 333 130.1 0 0.0 256
DI Khan 177 73.8 109 45.4 32 13.3 240
Hangu 151 62.4 88 36.4 78 32.2 242
Hangu Camp 24 10.0 182 75.8 173 72.1 240
Jalozai Camp 9 3.6 108 43.0 97 38.6 251
Kohat 144 55.8 168 65.1 26 10.1 258
Kurram 65 28.8 181 80.1 41 18.1 226
Mohmand 1 225 88.6 129 50.8 44 17.3 254
Nowshera 98 38.7 235 92.9 5 2.0 253
Peshawar 104 41.4 212 84.5 24 9.6 251
Tank 143 64.4 83 37.4 39 17.6 222
1178 40.1 1998 67.9 636 21.6 2941
*167 of the children were found under nine months.
16
4. Conclusion and recommendation
The prevalence both Severe and moderate acute malnutrition is at critical level even though
MUAC is sensitive measurement and it is a proxy indicative deepening on the type of
population measured.Therefore, the nutrition cluster response need to consider the
following recommendations.
In addition to the high SAM prevalence in this assessment there has always been
high rate of MAM with low coverage of SFP interventions attributes to the high rate
of SAM beneficiaries. It is therefore necessary to have an SFP to run a long side the
already existing OTPs to avert the situation where children deteriorate to severe
malnutrition.
Close follow up of the nutrition situation and giving special attention to areas with
very high SAM and GAM rates and possibly increasing outreach sites to cater for the
IDPs household that travel from far areas for OTP services.
Up scaling the nutrition interventions in the most affected areas. Community
mobilization activities to be increased and continued creation of community
awareness of malnutrition since some cases seem to be reporting at a later stage
when the child is extremely malnourished and in some cases getting a child in the
community with MUAC less than 10cm. Furthermore, most households are food
insecure as reflected by overreliance on food aid and food purchase in the face of
high market food prices hence need for initiation of SFP to run alongside the
operational OTP.
There is need for continued and more intensive health and nutrition education
focusing on: importance appropriate IYCF feeding practices with special focus on the
value and duration of exclusive breastfeeding and the importance of timely
introduction of complementary feeding, dietary diversity and appropriate frequency
of feeding;
Promote income generation on households and community level to increase market
dynamics and service provision, and households’ purchasing power. Establish and
promote an active hunger safety net facilitated through cash or in kind, to support
vulnerable households during the cultivation period to prevent depletion of
productive assets or consumption of seed material;
Explore the possibility of shelter provision for the IDPs as the majority are living in
the rented household.
Promote immunization activities and prevention of communicable disease that
directly impact the nutritional status of children
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