Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1696588863415.pdf (Vanuatu)
MALNUTRITION IN REMOTE VANUATU: CYCLONE RESPONSE SURVEY MATTHEW J. CORNISH, MD, FAAP VANUATU 2ND HEALTH RESEARCH SYMPOSIUM Holiday Inn, Port Vila 23 – 24 September 2021 INTRODUCTION  April 2020  Borders are closed for COVID-19  TC Harold hits northern SANMA, PENAMA, MALAMPA  No contact with Ambrym VANUATU 2ND HEALTH RESEARCH SYMPOSIUM INTRODUCTION  Initial triage highlighted dehydration superimposed on chronic malnutrition  Continued to support recovery efforts while also defining the extent of nutritional vulnerability VANUATU 2ND HEALTH RESEARCH SYMPOSIUM METHODS VANUATU 2ND HEALTH RESEARCH SYMPOSIUM  Invited all children under to come for review  Difficulties with mid upper arm circumference and length/height measurements with high volume  Focus on weight for age  Low weight for age can indicate acute and chronic malnutrition RESULTS VANUATU 2ND HEALTH RESEARCH SYMPOSIUM  210 children 1-59 months were evaluated, even age distribution  Compared against international growth standards (Z-score 2 to -2)  Weighted Z-score is -1.45 (±0.25)  43% of the children assessed children were underweight or severely underweight RESULTS  The 210 children assessed represents about 38% of the children between 1-59 months in North Ambrym.
 78 underweight+ children were identified.

 Another 129 were likely not captured.

VANUATU 2ND HEALTH RESEARCH SYMPOSIUM RESULTS VANUATU 2ND HEALTH RESEARCH SYMPOSIUM  1.

Nebul – 29% total underweight  2.

Wilit – 22% total underweight  3.
Ranon – 53% total underweight DISCUSSION  Possible causes of malnutrition in rural Vanuatu  Access to healthcare (prematurity/CP, deworming, chronic infections & disease)  Agricultural obstacles (windward facing, soil, seeds, machinery)  Access to protein sources (animal husbandry, fishing, awareness)  Societal factors (inequalities, access, family dynamics, food & water practices) VANUATU 2ND HEALTH RESEARCH SYMPOSIUM DISCUSSION  Impacts of Malnutrition  Stunting  Decreased school performance  Decreased economic stability  Higher rates of NCDs  Shortened life expectancy VANUATU 2ND HEALTH RESEARCH SYMPOSIUM  Increase demand on medical system  Less able to contribute to community  Requires greater resources IMPLICATIONS / RECOMMENDATIONS  Preventing, identifying and treating malnutrition provides massive individual and societal benefits.
 Identifying vulnerable pockets guides resource allocation.

 Collecting anthropometric data from all sources allows improves identification of high risk communities.
 Consider processes to efficiently target high-benefit communities  Implement efficient data collection and analysis VANUATU 2ND HEALTH RESEARCH SYMPOSIUM IMPLICATIONS / RECOMMENDATIONS  Examples of efficient data collection and analysis  Require anthropometric data submission (NGOs, HCWs)  Utilize all data sources and collection opportunities  Automate data analysis  Send feedback to local healthcare workers who can assess underlying causes  Give access to resources that reverse malnutrition when identified VANUATU 2ND HEALTH RESEARCH SYMPOSIUM CONCLUSIONS  Identifying and addressing malnutrition matters  Utilizing all available data sources can strengthen existing approaches VANUATU 2ND HEALTH RESEARCH SYMPOSIUM ACKNOWLEDGEMENTS  Victor Mintu and all our brave rural healthcare workers  Ben Elliot  TC Harold Response Team F  MOH encouragement  The research was self-funded  There are no conflicts of interest VANUATU 2ND HEALTH RESEARCH SYMPOSIUM