DOI: 10.3886/e108684v1
title: Assessment of nutritional status of children of pastoralists in a humanitarian setting: A Cross-sectional Standardized Monitoring and Assessment of Relief and Transitions Survey

description: The AVSI
Foundation in collaboration with the South Sudan Nutrition Cluster conducted a
SMART nutrition and mortality survey covering all the eight Payams of the
former Ikwoto County in the former Eastern Equitoria State. The main objective
of the survey was to assess the current prevalence of acute malnutrition and
retrospective mortality rates in the County. 

The Standardized
Methodology for Assessment in Relief and Transitions (SMART) which applies a
two-stage cluster sampling was used. A total of 623 children aged 6-59 months
from 532 households in 36 clusters were sampled for anthropometric
measurements. The mortality assessment was conducted concurrently in all 532
households. 

Additional information on Infant and Young Child
Feeding practices (IYCF) was collected in the 532 households visited to provide
more insight into possible risk factors associated with the high acute
malnutrition prevalence.  

The prevalence of Global Acute Malnutrition (GAM) defined
as Weight-for-Height 80%. Another 76.2% of children (0-23.9 months) were initiated
to breastfeeding within one hour after delivery. Introduction of solid,
semi-solid or soft foods among children aged 6 to 8.9 months was low (51.5%).
Findings indicated suboptimal IYCF practices.
description: Response Rates: Survey contains a total of 96% response rate on average on all questions
description: face-to-face interview~~
description: Children of pastoralists in South SudanSmallest Geographic Unit: Payam (Villages)
description: 1.1      Sampling methodology

The survey applied a two-stage
cluster sampling based on the SMART methodology with clusters being selected
using probability proportional to population size (PPS). 

2.4.1 First stage sampling

The first stage involved the
assignment of the smallest sampling unit called clusters which in this case
were villages. A sampling frame for clusters was prepared with assistance from
the County Health Department and the
survey enumerators because they were familiar with the area. All accessible
villages along with their respective populations were entered into the ENA for
SMART software. 

Random selection of clusters
from the total number of villages in the County was done using the planning screen
of ENA for SMART software based on probability proportional to population size
(PPS). Clusters were defined as villages within Bomas in all the Payams of the
County. 

A total of 36 clusters were
selected from the sampling frame generated from the list of all villages in the
County.

2.4.2
Second stage sampling

Simple
random sampling was used to select 15 households per cluster to be surveyed.
The household heads in the villages were listed with the support of the village
Chiefs. Once a complete list of household heads was obtained, enumerators used
ENA generated random numbers tables to select the households from the sampling
frame (household list). 

2.4.3 Number of
households per cluster

The
number of households to be completed per day was determined according to the
time the team could spend in the field excluding transportation, other
procedures and break times. The details below were taken into consideration
when performing this calculation based on the given context:

1.    
Departure from office at 8:00 am and back at 6:00 pm.

2.    
Average travel time (to and from the field): 3 hours.

3.    
Duration for initial introduction and selection
of households: 1 hour.

4.    
Breaks: 1 lunch break of 1hour.

The
above considerations gave an average of 5 hours of
working time in each cluster.  If on
average teams spent 10 minutes in each HH and 10 min traveling
from one HH to another, each team could comfortably reach 15 HH per day.  One day in each
area (cluster) was assumed. 

The
total number of households in the sample was then divided by the number of
households to be completed in one day to determine the number of clusters to be
included in the survey.  

528
HH/15 HH per day = 35.2 clusters (when rounded up gives 36 clusters).

Based
on this calculation 36 clusters were selected to be included in the survey. 

All
the selected clusters were surveyed and no replacements were done.