UNICEF/CDC/WHO Elderly Assessment in … and Food Insecurity Nutrition ... Assistance Project III (FANTA)2 1. Guidelines for Measuring Household and Individual Dietary Diversity

UNICEF/CDC/WHOElderly Assessment

in Government Controlled Areas of Donetsk and Luhansk oblasts and Non-Government controlled areas of Donetsk

April 2016

Nutrition Sub-Cluster of the Health and Nutrition Cluster Кластерная группа по питанию Кластера здравоохранения и питания

https://www.humanitarianresponse.info/operations/ukraine/nutrition

Introduction

• Previous assessments in Donbass region have shown older people:• Make up the largest percentage of people affected by the conflict

• Are one of the most vulnerable groups

• Humanitarian response has been slow to identify and address their needs

• A recent assessment by HelpAge International in the Donbass region suggested there may be cases of malnutrition in older persons and difficulties for older persons to access healthcare services and medications for non-communicable diseases

• No comprehensive assessments done of older people’s health and dietary needs

Assessment Goal

• Collect information on health and nutrition in order to help design and inform emergency interventions of the key partner agencies working in the health and nutrition sectors.

• Specifically, provide advice on the requirements for adapted and targeted assistance for older men and women >60 years living in the government controlled areas (GCAs) of Donetsk and Luhansk oblasts and non-government controlled areas (NGCAs) of Donetsk oblast and to monitor the degree to which these groups are accessing such services.

Methods

• Quantitative (NGCAs and GCAs)• Cross-sectional household survey

• Qualitative (GCAs only)• Focus group discussions

• This was presented in a previous presentation and will not be discussed here

NGCA Sampling Frame

• Electoral precincts with population data in non-government controlled areas (NGCAs) of Donetsk oblast• Last updated October 2015

NGCA Sample Selection

Multi-stage sampling procedure1) Cluster randomized sample

• Electoral precincts were primary sampling units

• Clusters selected probability proportional to size (PPS)

• 25 clusters were selected

NGCA Sample Selection

Multi-stage sampling procedure2) Systematic random sampling to choose households

• Chose 2 random starting points in the cluster, conducted ½ of the interviews for that cluster from each starting point

• Apartment buildings• Apartment building randomly selected

• Apartment unit randomly selected as starting point using a random number

• Chose every other apartment

• Private houses• Private house randomly selected as starting point

• Chose every other house after random starting point

Inclusion Criteria

1) Person > 60 years at the time of the survey2) Current resident of one of the randomly selected clusters

and households3) Consented to participate in the survey

NOTE: Included all elderly persons, not only internally displaced persons (IDPs)

Survey Administration

GCASample Size of 750 elderly persons

• 31 Clusters of 24 Households• 24 Clusters in Donetsk oblast, 7

clusters in Luhansk oblast

Data collection was conducted from 30 January to 13 February 2016

• 9 trained data collectors

NGCASample Size of 418 elderly persons

• 25 Clusters of 16 Households

Data collection was conducted from 21 February to 5 March 2016

• 5 trained data collectors

Survey Topics

• Questions• Household and individual demographics, income• Access to humanitarian assistance• Chronic diseases and access to medications• Food intake and food insecurity• Dependency (Ability to perform daily activities)• Psychological distress

• Anthropometry Measurements• Body Mass Index• Mid-upper arm circumference

Questionnaire-Demographics and Income

• Education

• Age

• Sex

• Living situation

• IDP status

• Number of people in household

• Pension

• Total income

• Registered to receive assistance

• Receipt of aid• Cash/Vouchers

• Food

• Non-food

• Transportation assistance

Questionnaire-Humanitarian Assistance

Questionnaire-Health and Healthcare Seeking

Chronic Diseases• Hypertension

• Diabetes

• Cardiovascular diseases

• Chronic lung diseases

• Taking medications regularly

Acute Respiratory Infection• Sought care

• Reason for not seeking care

Questionnaire-Nutrition and Food Insecurity

Nutrition• Foods eaten yesterday

• Number of meals eaten yesterday

• Number of times food group eaten in past week

• Individual dietary diversity• Calculated based on the Women’s Dietary Diversity Score (WDDS) developed by the Food

and Agriculture Organization (FAO) of the United Nations1

Food Insecurity• Household Hunger Scale developed by the Food and Nutrition Technical

Assistance Project III (FANTA) 2

1. Guidelines for Measuring Household and Individual Dietary Diversity. FAO. 20132. Household Hunger Scale: Indicator Definition and Measurement Guide. FANTA III. 2011

Questionnaire-Dependency• Help with bathing• Help getting dressed• Help using the toilet• Help with moving from bed to chair• Incontinence• Help with eating• Someone to care for you• Classified as independent, moderately dependent, and severely

dependent• Katz Index of Independence in Activities of Daily Living1-3

1. Katz S, Ford A, Moskowitz R, et al. Studies of illness and the aged. The Index of ADL: A standardized measure of biological and psychosocial function. JAMA, 185(12), 1963.2. Katz S, Down T, Cash H, et al. Progress in the development of the index of ADL. The Gerontologist. 10(10), 1970.3. Katz S. Assessing self-maintenance: Activities of daily living, mobility, and instrumental activities of daily living. JAGS. 31(12) 1983.

Questionnaire-Psychological Condition

• Nervous

• Hopeless

• Restless or fidgety

• Depressed

• Everything is an effort

• Worthless

• Kessler K6 Psychological Distress Scale1-2

• Scale previously pilot tested and validated in Ukraine

1. Kessler R, Andrews G, Colpe L, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine. 32(60), 2002.2. Kessler R, Barker P, Colpe L, et al. Screening for serious mental illness in the general population. Archives of General Psychiatry. 60(20), 2003.

Questionnaire-Anthropometry

• Arm-demi span (as proxy for height) and weight used to calculate body mass index (BMI)

• Mid-upper arm circumference (MUAC)

Household Survey Results

Demographic Characteristics GCA

(N=758)

NGCA

(N=418)

Gender n (%) n (%)

Male 266 (35.1) 140 (33.5)

Female 492 (64.9) 278 (66.5)

Age (years)

60-70 371 (48.9) 181 (43.3)

>70 387 (51.1) 237 (56.7)

Mean (SD) 71.8 (8.2) 72.7 (8.3)

Median (IQR) 70.4 (64.5-78.1) 73.4 (65.1-78.4)

Respondent

Self 695 (92.7) 390 (93.3)

Proxy 63 (8.3) 28 (6.7)

Education level

Incomplete secondary school 177 (23.4) 100 (23.9)

Complete secondary school 177 (23.4) 143 (34.2)

Professional secondary education 285 (37.6) 133 (31.8)

Incomplete or complete higher education or

above119 (15.7) 42 (10.1)

Demographic Characteristics GCA

(N=758)

NGCA

(N=418)

Living situation (n, %)

Own house or apartment (no fee) 740 (97.6) 400 (95.7)

Other 18 (2.4) 18 (4.3)

Total # of people in household

Mean (SD) 2.1 (1.1) 2.1 (1.1)

Median (IQR) 2 (1-2) 2 (1-2)

Total # of people >60 years in household (n, %)

1 386 (50.9) 201 (48.1)

2 361 (47.6) 202 (48.3)

3 11 (1.5) 15 (3.6)

Living Situation

Living alone 238 (31.4) 123 (29.4)

Living only with another person(s) over 60 308 (40.6) 172 (41.2)

Living with people under 60 212 (28.0) 123 (29.4)

Socioeconomic Characteristics GCA Donetsk

(N=592)

GCA Luhansk

(N=166)

GCA Total

(N=758)

NGCA

(N=418)

Ukrainian Government Pension Eligibility

Registered to receive pension from

Ukrainian Government, n (%)

592 (100) 166 (100) 758 (100) 372 (89.0)

N=592 N=166 N=758 N=372

Received pension last month from


590 (99.7) 166 (100) 756 (99.7) 80 (21.5)

Amount of pension received last month from

Ukrainian Government (UAH)

N=590 N=166 N=756 N=60

Mean (SD) 1676.0 (784.3) 1549.1 (533.0) 1647.3 (736.9) 1985.5 (1093.9)

Median (IQR) 1350 (1230-1800) 1300 (1228-1700) 1342 (1230-1800) 1500 (1200-2750)


(N=592)

GCA Luhansk

(N=166)

GCA Total

(N=758)

NGCA

(N=418)




592 (100) 166 (100) 758 (100) 372 (89.0)

N=592 N=166 N=758 N=372



590 (99.7) 166 (100) 756 (99.7) 80 (21.5)



N=590 N=166 N=756 N=60

Mean (SD) 1676.0 (784.3) 1549.1 (533.0) 1647.3 (736.9) 1985.5 (1093.9)

Median (IQR) 1350 (1230-1800) 1300 (1228-1700) 1342 (1230-1800) 1500 (1200-2750)


(N=592)

GCA Luhansk

(N=166)

GCA Total

(N=758)

NGCA

(N=418)




592 (100) 166 (100) 758 (100) 372 (89.0)

N=592 N=166 N=758 N=372



590 (99.7) 166 (100) 756 (99.7) 80 (21.5)



N=590 N=166 N=756 N=60

Mean (SD) 1676.0 (784.3) 1549.1 (533.0) 1647.3 (736.9) 1985.5 (1093.9)

Median (IQR) 1350 (1230-1800) 1300 (1228-1700) 1342 (1230-1800) 1500 (1200-2750)

Socioeconomic CharacteristicsNGCA

(N=418)

DNR Pension Eligibility

Registered to receive pension, n (%) N=418409 (97.9)

Received pension last month, n (%) N=409402 (98.3)

Amount of pension received last month from DNR

N=356

Mean (SD) 1244.5 (707.5) UAH

3360.1 (1910.2) RUB*

Median (IQR) 930 (815-1407) UAH

2512 (2200-3800) RUB*

Received pension from Ukrainian government and DNR

last month, n (%) 77 (18.4)*Exchange Rate 2.7:1

Socioeconomic CharacteristicsGCA Donetsk

(N=592)

GCA Luhansk

(N=166)

GCA Total

(N=758)

NGCA

(N=418)

Resident of household currently working,

n (%) 155 (26.2) 34 (20.5) 189 (24.9) 72 (17.2)

Total amount of household income N=529

(UAH)

N=140

(UAH)

N=669

(UAH)N=339

Mean (SD)3090.7 (1768.8) 2661.9 (1216.5) 3000.8 (1677.5)

2713.5 (2049.2) UAH

7326.5 (5532.9) RUB*

Median (IQR)2723 (1500-4000) 2500 (1470-3400) 2650 (1500-3813)

2222 (1185-3498) UAH

6000 (3200-9444) RUB*

Total household income per capita (UAH)

Mean (SD)1663.6 (734.1) 1530.6 (565.3) 1635.7 (704.2)

1474.8 (1087.6) UAH

3982.0 (2936.5) RUB*

Median (IQR)1450 (1250-2000) 1325 (1210-1770) 1400 (1250-1953)

1111 (852-1675)

3000 (2300-4522) RUB*

*Exchange Rate 2.7:1


(N=528)

n (%)

GCA Luhansk

(N=140)

n (%)

GCA Total

(N=668)

n (%)

NGCA Total

(N=339)

n (%) Household income per capita ($/day)

<$2/day280 (53.0) 86 (61.4) 366 (54.8) 228 (67.3)

$2-$3/day162 (30.7) 37 (26.4) 199 (29.8) 69 (20.4)

$3-$4/day57 (10.8) 15 (10.7) 72 (10.8) 16 (4.7)

>$4/day29 (5.5) 2 (1.4) 31 (4.6) 26 (7.7)

Household income per capita in $/day


(N=528)

n (%)

GCA Luhansk

(N=140)

n (%)

GCA Total

(N=668)

n (%)

NGCA Total

(N=339)


<$2/day280 (53.0) 86 (61.4) 366 (54.8) 228 (67.3)

$2-$3/day162 (30.7) 37 (26.4) 199 (29.8) 69 (20.4)

$3-$4/day57 (10.8) 15 (10.7) 72 (10.8) 16 (4.7)

>$4/day29 (5.5) 2 (1.4) 31 (4.6) 26 (7.7)



(N=528)

n (%)

GCA Luhansk

(N=140)

n (%)

GCA Total

(N=668)

n (%)

NGCA Total

(N=339)


<$2/day280 (53.0) 86 (61.4) 366 (54.8) 228 (67.3)

$2-$3/day162 (30.7) 37 (26.4) 199 (29.8) 69 (20.4)

$3-$4/day57 (10.8) 15 (10.7) 72 (10.8) 16 (4.7)

>$4/day29 (5.5) 2 (1.4) 31 (4.6) 26 (7.7)


IDP Status GCA Total

(N=758)

NGCA Total

(N=418)

Displaced due to conflict (n, %) 13 (1.7) 8 (1.9)

Permanent residence left from (n, %) N=13 N=8

Donetsk oblast 8 (61.5) 8 (100)

Luhansk oblast 2 (15.4) 0 (0)

Other/Don’t know 3 (23.1) 0 (0)

Length of displacement, months

Mean (SD) 16.2 (5.6) 15 (4.6)

Median (IQR) 19 (12-19) 14 (12-19)

IDP Status GCA Total

(N=758)

NGCA Total

(N=418)

Displaced due to conflict (n, %) 13 (1.7) 8 (1.9)

Permanent residence left from (n, %) N=13 N=8

Donetsk oblast 8 (61.5) 8 (100)

Luhansk oblast 2 (15.4) 0 (0)

Other/Don’t know 3 (23.1) 0 (0)

Length of displacement, months

Mean (SD) 16.2 (5.6) 15 (4.6)

Median (IQR) 19 (12-19) 14 (12-19)

Assistance Donetsk LuhanskGCA

TotalNGCA

Registered to receive additional

assistance from the state, humanitarian

or volunteer organizationsn/N (%) n/N (%) n/N (%) n/N (%)

All respondents 33/592 (5.6) 43/166 (25.9) 76/758 (10.0) 359/418 (85.9)

IDPs 4/11 (36.4) 2/2 (100) 6/13 (46.2) 4/8 (50.0)

Received humanitarian assistance in the

last 3 months, all respondentsN=592

n (%)

N=166

n (%)

N=758

n (%)

N=418

n (%)

Any kind of assistance 17 (2.9) 32 (19.3) 49 (6.5) 347 (83.0)

Cash vouchers/coupons 2 (0.3) 1 (0.6) 3 (0.4) 1 (0.2)

Food assistance 12 (2.0) 30 (18.1) 42 (5.5) 347 (83.0)

Non-food assistance 6 (1.0) 3 (1.8) 9 (1.2) 4 (1.0)

Transportation 0 (0) 0 (0) 0 (0) 1 (0.2)


TotalNGCA




All respondents 33/592 (5.6) 43/166 (25.9) 76/758 (10.0) 359/418 (85.9)

IDPs 4/11 (36.4) 2/2 (100) 6/13 (46.2) 4/8 (50.0)



n (%)

N=166

n (%)

N=758

n (%)

N=418

n (%)



Food assistance 12 (2.0) 30 (18.1) 42 (5.5) 347 (83.0)


Transportation 0 (0) 0 (0) 0 (0) 1 (0.2)


TotalNGCA




All respondents 33/592 (5.6) 43/166 (25.9) 76/758 (10.0) 359/418 (85.9)

IDPs 4/11 (36.4) 2/2 (100) 6/13 (46.2) 4/8 (50.0)



n (%)

N=166

n (%)

N=758

n (%)

N=418

n (%)



Food assistance 12 (2.0) 30 (18.1) 42 (5.5) 347 (83.0)


Transportation 0 (0) 0 (0) 0 (0) 1 (0.2)

Organizations Providing NGCA with Food Assistance (N=347)

n %

Akhmetov Foundation340 98.0

Red Cross7 2.0

Russian Government6 1.7

Church1 0.3

Other3 0.9

Health and Healthcare Seeking

Prevalence of Chronic Disease

0

10

20

30

40

50

60

70

80

90

100

Any ChronicDisease

Hypertension Diabetes Cardiovascular Chronic Lung

Perc

enta

ge

Chronic Disease

GCA NGCA

Prevalence of Chronic Disease by Sex

010

203040

5060

70

8090

100

Perc

enta

ge

Chronic Disease

GCA

Men Women

010

203040

5060

70

8090

100

Perc

enta

ge

Chronic Disease

NGCA

Men Women

Prevalence of Chronic Disease by Age

0

1020304050

60708090

100

Perc

enta

ge

Chronic Disease

GCA

60-70 Years >70 Years

0

1020304050

60708090

100

Perc

enta

ge

Chronic Disease

NGCA

60-70 Years >70 Years

60-70 Years >70 Years Total

Men

(N=153)

Women

(N=218)

Men

(N=113)

Women

(N=274)

Men

(N=266)

Women

(N=492)

Prevalence of chronic diseases

Any chronic condition 83 (54.3) 161 (73.9) 65 (57.5) 205 (74.8) 148 (55.6) 366 (74.4)

Hypertension 57 (37.3) 127 (58.3) 43 (38.1) 161 (58.8) 100 (37.6) 288 (58.5)

Diabetes 11 (7.2) 20 (9.2) 5 (4.4) 33 (12.0) 16 (6.0) 53 (10.8)

Cardiovascular disease 51 (33.3) 115 (52.8) 49 (43.4) 158 (57.7) 100 (37.6) 273 (55.5)

Chronic lung disease 13 (8.5) 20 (9.2) 14 (12.4) 13 (4.7) 27 (10.2) 33 (6.7)

GCA Prevalence of Chronic Disease by Age and Sex


Men

(N=153)

Women

(N=218)

Men

(N=113)

Women

(N=274)

Men

(N=266)

Women

(N=492)



Hypertension 57 (37.3) 127 (58.3) 43 (38.1) 161 (58.8) 100 (37.6) 288 (58.5)

Diabetes 11 (7.2) 20 (9.2) 5 (4.4) 33 (12.0) 16 (6.0) 53 (10.8)



GCA Prevalence of Chronic Disease by Age and Sex


Men

(N=69)

Women

(N=112)

Men

(N=71)

Women

(N=274)

Men

(N=140)

Women

(N=278)



Hypertension 24 (34.8) 71 (63.4) 34 (47.9) 114 (68.7) 58 (41.4) 185 (66.6)

Diabetes 5 (7.3) 11 (9.8) 8 (11.3) 15 (9.0) 13 (9.3) 26 (9.4)



NGCA Prevalence of Chronic Disease by Age and Sex


Men

(N=69)

Women

(N=112)

Men

(N=71)

Women

(N=274)

Men

(N=140)

Women

(N=278)



Hypertension 24 (34.8) 71 (63.4) 34 (47.9) 114 (68.7) 58 (41.4) 185 (66.6)

Diabetes 5 (7.3) 11 (9.8) 8 (11.3) 15 (9.0) 13 (9.3) 26 (9.4)



NGCA Prevalence of Chronic Disease by Age and Sex

Use of Medications Donetsk

N=592

Luhansk

N=166

GCA Total

N=758

NGCA Total

N=418

n/N (%) n/N (%) n/N (%) n/N (%)

Regular use of medications

Any chronic conditions 287/392 (73.2) 118/122 (96.7) 405/514 (78.8) 206/309 (66.7)

Hypertension 219/292 (75.0) 93/96 (96.9) 312/388 (80.4) 166/238 (69.8)

Diabetes 38/55 (69.1) 13/14 (92.9) 51/69 (73.9) 25/37 (67.6)

Cardiovascular disease 180/266 (67.7 92/107 (86.0) 272/373 (72.9) 138/221 (62.4)

Chronic lung disease 21/39 (53.9) 11/21 (52.4) 32/60 (53.3) 5/16 (31.3)

Primary Reason for not taking medications

regularly, any condition

N=151

n (%)

N=25

n (%)

N=176

n (%)

N=142

n (%)

Not prescribed to take regularly 32 (21.2) 5 (20.0) 37 (21.0) 29 (20.4)

Can’t access pharmacy 0 (0) 1 (4.0) 1 (0.6) 1 (0.7)

Availability of medication at pharmacy 1 (0.7) 0 (0) 1 (0.6) 0 (0)

Cost of medication 62 (41.1) 6 (24.0) 68 (38.6) 85 (59.9)

Other 62 (41.1) 15 (60.0) 77 (43.8) 37 (26.1)

Unknown 2 (1.3) 0 (0) 2 (1.1) 0 (0)


N=592

Luhansk

N=166

GCA Total

N=758

NGCA Total

N=418

n/N (%) n/N (%) n/N (%) n/N (%)



Hypertension 219/292 (75.0) 93/96 (96.9) 312/388 (80.4) 166/238 (69.8)

Diabetes 38/55 (69.1) 13/14 (92.9) 51/69 (73.9) 25/37 (67.6)





N=151

n (%)

N=25

n (%)

N=176

n (%)

N=142

n (%)





Other 62 (41.1) 15 (60.0) 77 (43.8) 37 (26.1)

Unknown 2 (1.3) 0 (0) 2 (1.1) 0 (0)


N=592

Luhansk

N=166

GCA Total

N=758

NGCA Total

N=418

n/N (%) n/N (%) n/N (%) n/N (%)



Hypertension 219/292 (75.0) 93/96 (96.9) 312/388 (80.4) 166/238 (69.8)

Diabetes 38/55 (69.1) 13/14 (92.9) 51/69 (73.9) 25/37 (67.6)





N=151

n (%)

N=25

n (%)

N=176

n (%)

N=142

n (%)





Other 62 (41.1) 15 (60.0) 77 (43.8) 37 (26.1)

Unknown 2 (1.3) 0 (0) 2 (1.1) 0 (0)

Using medications regularly

for all conditions; n/N (%)

Not using medications for

any condition because

too expensive; n/N (%)

Not using medications for

any condition for other

reasons; n/N (%)

GCA NGCA GCA NGCA GCA NGCA

Household income per

capita ($/day)

<$2/day 162/252 (64.3) 83/166 (50.0) 41/252 (16.3) 51/166 (30.7) 49/252 (19.4) 32/166 (19.3)

$2-$3/day 99/139 (71.2) 33/51 (64.7) 13/139 (9.4) 7/51 (13.7) 27/139 (19.4) 11/51 (21.6)

$3-$4/day 28/45 (62.2) 5/10 (50.0) 5/45 (11.1) 4/10 (40.0) 12/45 (26.7) 1/10 (10.0)

>$4/day 12/19 (63.2) 11/20 (55.0) 2/19 (10.5) 5/20 (25.0) 5/19 (26.3) 4/20 (20.0)

Living Situation

Living alone 107/170 (62.9) 43/97 (44.3) 26/170 (38.2) 36/97 (37.1) 37/170 (34.3) 18/97 (18.6)

Living only with another

person(s) over 60 149/207 (72.0) 72/122 (59.0) 18/207 (8.7) 23/122 (18.9) 40/207 (19.3) 27/122 (22.1)

Living with people

under 6082/137 (59.9) 52/90 (57.8) 24/137 (17.5) 26/90 (28.9) 31/137 (22.6) 12/90 (13.3)

Health Care SeekingDonetsk

N=592

Luhansk

N=166

GCA Total

N=758

NGCA

N=418

n (%) n (%) n (%) n (%)

Acute respiratory disease two week

prevalence129 (21.8) 30 (18.1) 159 (21.0) 55 (13.1)

Among those with acute respiratory disease,

sought care at a health clinicn/N

(%)

n/N

(%)

n/N

(%)

n/N

(%)

All respondents 29/129

(16.5)

13/30

(43.3)

42/159

(26.4)

11/55

(20.0)

Respondents with one or more chronic

conditions22/94

(23.4)

13/26

(34.6)

35/120

(29.2)

9/44

(20.5)

Primary Reason for not seeking care, acute

respiratoryN=100 N=17 N=117 N=44

Can’t access the clinic 4 (4.0) 2 (11.8) 6 (5.1) 1 (2.3)

Cost of clinic visit 11 (11.0) 1 (5.9) 12 (10.3) 6 (13.6)

Didn’t feel it was necessary 29 (29.0) 9 (52.9) 38 (32.5) 13 (29.6)

Other/Don’t know 56 (56.0) 5 (29.4) 61 (52.1) 24 (54.5)


N=592

Luhansk

N=166

GCA Total

N=758

NGCA

N=418

n (%) n (%) n (%) n (%)


prevalence129 (21.8) 30 (18.1) 159 (21.0) 55 (13.1)



(%)

n/N

(%)

n/N

(%)

n/N

(%)


(16.5)

13/30

(43.3)

42/159

(26.4)

11/55

(20.0)


conditions22/94

(23.4)

13/26

(34.6)

35/120

(29.2)

9/44

(20.5)






Other/Don’t know 56 (56.0) 5 (29.4) 61 (52.1) 24 (54.5)


N=592

Luhansk

N=166

GCA Total

N=758

NGCA

N=418

n (%) n (%) n (%) n (%)


prevalence129 (21.8) 30 (18.1) 159 (21.0) 55 (13.1)



(%)

n/N

(%)

n/N

(%)

n/N

(%)


(16.5)

13/30

(43.3)

42/159

(26.4)

11/55

(20.0)


conditions22/94

(23.4)

13/26

(34.6)

35/120

(29.2)

9/44

(20.5)






Other/Don’t know 56 (56.0) 5 (29.4) 61 (52.1) 24 (54.5)


N=592

Luhansk

N=166

GCA Total

N=758

NGCA

N=418

n (%) n (%) n (%) n (%)


prevalence129 (21.8) 30 (18.1) 159 (21.0) 55 (13.1)



(%)

n/N

(%)

n/N

(%)

n/N

(%)


(16.5)

13/30

(43.3)

42/159

(26.4)

11/55

(20.0)


conditions22/94

(23.4)

13/26

(34.6)

35/120

(29.2)

9/44

(20.5)






Other/Don’t know 56 (56.0) 5 (29.4) 61 (52.1) 24 (54.5)

Nutrition

Types of Foods Eaten Yesterday

0

20

40

60

80

100

Perc

enta

ge

Type of Food

GCA NGCA

GCA

(N=758)

NGCA

(N=418)Number of food groups

consumed yesterday

Mean (SD) 4.5 (1.2) 4.5 (1.3)

Median (IQR) 5 (4-5) 5 (4-5)

Consumption of iron-

rich foods yesterday, n

(%)

596 (78.6) 298 (71.3)

Consumption of

Vitamin A rich foods

yesterday, n (%)

699 (92.2) 396 (94.7)

Dietary Diversity

Days Ate Food in Past WeekGCA (N=758) NGCA (N=418)

Mean (SD) Median (IQR) Mean (SD) Median (IQR)

Cereals6.8 (0.9) 7 (7-7) 6.9 (0.6) 7 (7-7)

White/yellow potatoes5.9 (1.7) 7 (5-7) 6.1 (1.5) 7 (5-7)

Vegetables5.8 (1.7) 7 (5-7) 5.8 (1.5) 7 (5-7)

Fruits2.1 (2.3) 2 (0-3) 1.7 (2.1) 1 (0-3)

Eggs1.7 (1.7) 1 (0-3) 1.9 (1.7) 2 (1-3)

Meat/fish3.4 (2.4) 3 (2-6) 3.2 (2.3) 3 (1-5)

Milk/milk products2.8 (2.6) 2 (0-5) 2.3 (2.2) 2 (0-3)

Peas/beans1.1 (1.7) 0 (0-2) 1.3 (1.5) 1 (0-2)

Days Ate Food in Past WeekGCA (N=758) NGCA (N=418)


Cereals6.8 (0.9) 7 (7-7) 6.9 (0.6) 7 (7-7)

White/yellow potatoes5.9 (1.7) 7 (5-7) 6.1 (1.5) 7 (5-7)

Vegetables5.8 (1.7) 7 (5-7) 5.8 (1.5) 7 (5-7)

Fruits2.1 (2.3) 2 (0-3) 1.7 (2.1) 1 (0-3)

Eggs1.7 (1.7) 1 (0-3) 1.9 (1.7) 2 (1-3)

Meat/fish3.4 (2.4) 3 (2-6) 3.2 (2.3) 3 (1-5)

Milk/milk products2.8 (2.6) 2 (0-5) 2.3 (2.2) 2 (0-3)

Peas/beans1.1 (1.7) 0 (0-2) 1.3 (1.5) 1 (0-2)

Mean Number of Days Foods Eaten in Past Week

0

1

2

3

4

5

6

7

Cereals White/yellowpotatoes

Vegetables Fruits Eggs Meat/fish Milk/milkproducts

Peas/beans

Nu

mb

er

of

Day

s

Type of Food

GCA NGCA

Household income per capita in $/day<$2/day $2-$3/day $3-$4/day >$4/day Total

GCA

(N=366)

NGCA

(N=228)

GCA

(N=199)

NGCA

(N=69)

GCA

(N=72)

NGCA

(N=16)

GCA

(N=31)

NGCA

(N=26)

GCA

(N=668)

NGCA

(N=339)

Number of food groups

consumed yesterday,

mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)



(%)

251

(68.6)

150

(65.8)

176

(88.4)

69

(79.7)

61

(84.7)

11

(68.8)

30

(96.8)

25

(96.2)

518

(77.5)

241

(71.1)

Consumption of


yesterday, n (%)

327

(89.3)

217

(95.2)

190

(95.5)

64

(92.3)

70

(97.2)

15

(93.4)

30

(96.8)

26

(100)

617

(92.4)

322

(95.0)

Days eaten in past

week, mean (SD)

Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)

Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)

Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)

Dietary Diversity by Household Income per capita in $/Day


GCA

(N=366)

NGCA

(N=228)

GCA

(N=199)

NGCA

(N=69)

GCA

(N=72)

NGCA

(N=16)

GCA

(N=31)

NGCA

(N=26)

GCA

(N=668)

NGCA

(N=339)


consumed yesterday,

mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)



(%)

251

(68.6)

150

(65.8)

176

(88.4)

69

(79.7)

61

(84.7)

11

(68.8)

30

(96.8)

25

(96.2)

518

(77.5)

241

(71.1)

Consumption of


yesterday, n (%)

327

(89.3)

217

(95.2)

190

(95.5)

64

(92.3)

70

(97.2)

15

(93.4)

30

(96.8)

26

(100)

617

(92.4)

322

(95.0)

Days eaten in past

week, mean (SD)

Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)

Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)

Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)



GCA

(N=366)

NGCA

(N=228)

GCA

(N=199)

NGCA

(N=69)

GCA

(N=72)

NGCA

(N=16)

GCA

(N=31)

NGCA

(N=26)

GCA

(N=668)

NGCA

(N=339)


consumed yesterday,

mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)



(%)

251

(68.6)

150

(65.8)

176

(88.4)

69

(79.7)

61

(84.7)

11

(68.8)

30

(96.8)

25

(96.2)

518

(77.5)

241

(71.1)

Consumption of


yesterday, n (%)

327

(89.3)

217

(95.2)

190

(95.5)

64

(92.3)

70

(97.2)

15

(93.4)

30

(96.8)

26

(100)

617

(92.4)

322

(95.0)

Days eaten in past

week, mean (SD)

Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)

Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)

Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)



GCA

(N=366)

NGCA

(N=228)

GCA

(N=199)

NGCA

(N=69)

GCA

(N=72)

NGCA

(N=16)

GCA

(N=31)

NGCA

(N=26)

GCA

(N=668)

NGCA

(N=339)


consumed yesterday,

mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)



(%)

251

(68.6)

150

(65.8)

176

(88.4)

69

(79.7)

61

(84.7)

11

(68.8)

30

(96.8)

25

(96.2)

518

(77.5)

241

(71.1)

Consumption of


yesterday, n (%)

327

(89.3)

217

(95.2)

190

(95.5)

64

(92.3)

70

(97.2)

15

(93.4)

30

(96.8)

26

(100)

617

(92.4)

322

(95.0)

Days eaten in past

week, mean (SD)

Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)

Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)

Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)



GCA

(N=366)

NGCA

(N=228)

GCA

(N=199)

NGCA

(N=69)

GCA

(N=72)

NGCA

(N=16)

GCA

(N=31)

NGCA

(N=26)

GCA

(N=668)

NGCA

(N=339)


consumed yesterday,

mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)



(%)

251

(68.6)

150

(65.8)

176

(88.4)

69

(79.7)

61

(84.7)

11

(68.8)

30

(96.8)

25

(96.2)

518

(77.5)

241

(71.1)

Consumption of


yesterday, n (%)

327

(89.3)

217

(95.2)

190

(95.5)

64

(92.3)

70

(97.2)

15

(93.4)

30

(96.8)

26

(100)

617

(92.4)

322

(95.0)

Days eaten in past

week, mean (SD)

Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)

Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)

Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)



GCA

(N=366)

NGCA

(N=228)

GCA

(N=199)

NGCA

(N=69)

GCA

(N=72)

NGCA

(N=16)

GCA

(N=31)

NGCA

(N=26)

GCA

(N=668)

NGCA

(N=339)


consumed yesterday,

mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)



(%)

251

(68.6)

150

(65.8)

176

(88.4)

69

(79.7)

61

(84.7)

11

(68.8)

30

(96.8)

25

(96.2)

518

(77.5)

241

(71.1)

Consumption of


yesterday, n (%)

327

(89.3)

217

(95.2)

190

(95.5)

64

(92.3)

70

(97.2)

15

(93.4)

30

(96.8)

26

(100)

617

(92.4)

322

(95.0)

Days eaten in past

week, mean (SD)

Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)

Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)

Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)


GCA

(N=758)

NGCA

(N=418)

Food insecurity in

past 30 days

n (%) (95%CI) n (%) (95%CI)

Little or no hunger 740 (97.6) 95.1-98.9 416 (99.5) 98.0-99.9

Moderate hunger 16 (2.1) 1.0-4.6 2 (0.5) 0.1-2.0

Severe hunger 2 (0.3) 0.0-1.1 0 N/A

Mean (SD) Median

(IQR)

Mean (SD) Median

(IQR)

Number of meals

eaten yesterday

3.4 (1.0) 3 (3-4) 3.4 (0.9) 3 (3-4)

Food Security

GCA

(N=758)

NGCA

(N=418)

Food insecurity in

past 30 days

n (%) (95%CI) n (%) (95%CI)

Little or no hunger 740 (97.6) 95.1-98.9 416 (99.5) 98.0-99.9

Moderate hunger 16 (2.1) 1.0-4.6 2 (0.5) 0.1-2.0

Severe hunger 2 (0.3) 0.0-1.1 0 N/A

Mean (SD) Median

(IQR)

Mean (SD) Median

(IQR)

Number of meals

eaten yesterday

3.4 (1.0) 3 (3-4) 3.4 (0.9) 3 (3-4)

Food Security

Moderate or Severe HungerGCA (N=18) NGCA (N=2)

n % n %

Income per capita ($/day) N=14 N=2

<$2/day 13 92.9 1 50.0

$2-$3/day 1 7.1 1 50.0

$3-$4/day 0 0 0 0

>$4/day 0 0 0 0

Living Situation N=18 N=2

Living alone 7 38.9 1 50.0

Living only with another person(s) over

608 44.4 0 0

Living with people under 60 3 16.7 1 50.0

Number of food groups consumed

yesterday1, mean (SD)

3.4 (1.5) 3 (0)

Days eaten in past week, mean (SD)

Fruits 1.7 (2.9) 0

Meat 1 (1.1) 4.5 (4.5)

Milk 0.8 (1.4) 0

BMI, mean (SD) 28.5 (4.9) 39.1 (1.2)

Moderate or Severe HungerGCA (N=18) NGCA (N=2)

n % n %

Income per capita ($/day) N=14 N=2

<$2/day 13 92.9 1 50.0

$2-$3/day 1 7.1 1 50.0

$3-$4/day 0 0 0 0

>$4/day 0 0 0 0

Living Situation N=18 N=2

Living alone 7 38.9 1 50.0

Living only with another person(s) over

608 44.4 0 0

Living with people under 60 3 16.7 1 50.0

Number of food groups consumed

yesterday1, mean (SD)

3.4 (1.5) 3 (0)

Days eaten in past week, mean (SD)

Fruits 1.7 (2.9) 0

Meat 1 (1.1) 4.5 (4.5)

Milk 0.8 (1.4) 0

BMI, mean (SD) 28.5 (4.9) 39.1 (1.2)

Dependency/Activities of Daily Living

DependencyGCA (N=758) NGCA (N=418)

Requires help with activities n (%) 95%CI n (%) 95%CI

Bathing 111 (14.6) 12.0-17.8 85 (20.3) 15.8-25.7

Getting dressed 62 (8.2) 6.6-10.2 57 (13.6) 11.0-16.8

Going to the toilet 46 (6.1) 4.6-7.9 51 (12.2) 9.5-15.5

Moving from bed to chair 44 (5.8) 4.3-7.9 46 (11.0) 8.0-15.0

Leak urine or feces 139 (18.3) 14.4-23.0 98 (23.4) 19.1-28.4

Eating 20 (2.6) 1.7-4.1 30 (7.2) 4.6-11.1

Dependency

Independent 664 (87.6) 84.6-90.1 345 (82.7) 79.1-85.8

Moderate dependency 48 (6.3) 4.4-9.0 25 (6.0) 4.0-8.9

Severe dependency 46 (6.1) 4.6-8.0 47 (11.3) 8.6-14.6

DependencyGCA (N=758) NGCA (N=418)

Requires help with activities n (%) 95%CI n (%) 95%CI

Bathing 111 (14.6) 12.0-17.8 85 (20.3) 15.8-25.7

Getting dressed 62 (8.2) 6.6-10.2 57 (13.6) 11.0-16.8

Going to the toilet 46 (6.1) 4.6-7.9 51 (12.2) 9.5-15.5

Moving from bed to chair 44 (5.8) 4.3-7.9 46 (11.0) 8.0-15.0

Leak urine or feces 139 (18.3) 14.4-23.0 98 (23.4) 19.1-28.4

Eating 20 (2.6) 1.7-4.1 30 (7.2) 4.6-11.1

Dependency

Independent 664 (87.6) 84.6-90.1 345 (82.7) 79.1-85.8

Moderate dependency 48 (6.3) 4.4-9.0 25 (6.0) 4.0-8.9

Severe dependency 46 (6.1) 4.6-8.0 47 (11.3) 8.6-14.6

Dependency

Someone to help if person

needs help with 1 or more

activities

GCA (N=186) NGCA (N=130)

n (%) 95%CI n (%) 95%CI

No31 (16.7) 11.5-23.6 32 (24.6) 15.6-36.6

Yes, but not every day55 (29.6) 24.3-35.4 16 (12.3) 7.9-18.6

Yes, every day, part of the

time18 (9.7) 6.0-15.3 10 (7.7) 3.6-15.6

Yes, every day, all of the

time82 (44.1) 37.2-51.2 71 (54.6) 43.4-65.4

Dependency

Someone to help if person

needs help with 1 or more

activities

GCA (N=186) NGCA (N=130)

n (%) 95%CI n (%) 95%CI

No31 (16.7) 11.5-23.6 32 (24.6) 15.6-36.6

Yes, but not every day55 (29.6) 24.3-35.4 16 (12.3) 7.9-18.6

Yes, every day, part of the

time18 (9.7) 6.0-15.3 10 (7.7) 3.6-15.6

Yes, every day, all of the

time82 (44.1) 37.2-51.2 71 (54.6) 43.4-65.4

Prevalence of Dependency by Age

0

5

10

15

20

25

30

60-70 Years >70 Years 60-70 Years >70 Years

Perc

enta

ge

Severe dependency

Moderate dependency

GCA NGCA

Prevalence of Dependency by Sex

0

2

4

6

8

10

12

14

16

18

20

Male Female Male Female

Perc

enta

ge

Severe dependency

Moderate dependency

GCA NGCA

Psychological Distress

Psychological Distress GCA (N=711) NGCA (N=396)n (%) 95%CI n (%) 95%CI

Felt most or all of the time in past

30 days

Nervous 286 (40.2) 35.3-45.4 162 (40.9) 34.1-48.1

Hopeless 170 (23.9) 20.4-27.9 137 (34.6) 28.5-41.2

Restless/Fidgety 252 (35.4) 29.2-42.2 178 (44.9) 37.6-52.6

Depressed 233 (32.8) 27.0-39.2 139 (35.1) 29.8-40.8

Everything is an effort 245 (34.5) 28.7-40.7 158 (39.9) 33.3-46.8

Worthless 151 (21.2) 17.1-26.0 89 (22.5) 18.0-27.6

Suffers from serious psychological

distress

239 (33.6) 28.0-39.7 168 (42.5) 36.1-49.2


Kessler K6 Score 9.7 (6.7) 8 (4-15) 11.4 (6.8) 12 (6-16)

Psychological Distress GCA (N=711) NGCA (N=396)n (%) 95%CI n (%) 95%CI

Felt most or all of the time in past

30 days

Nervous 286 (40.2) 35.3-45.4 162 (40.9) 34.1-48.1

Hopeless 170 (23.9) 20.4-27.9 137 (34.6) 28.5-41.2

Restless/Fidgety 252 (35.4) 29.2-42.2 178 (44.9) 37.6-52.6

Depressed 233 (32.8) 27.0-39.2 139 (35.1) 29.8-40.8

Everything is an effort 245 (34.5) 28.7-40.7 158 (39.9) 33.3-46.8

Worthless 151 (21.2) 17.1-26.0 89 (22.5) 18.0-27.6

Suffers from serious psychological

distress

239 (33.6) 28.0-39.7 168 (42.5) 36.1-49.2


Kessler K6 Score 9.7 (6.7) 8 (4-15) 11.4 (6.8) 12 (6-16)

Psychological DistressGCA NGCA

n/N % n/N %

Income per capita ($/day)

<$2/day 130/344 37.8 92/216 42.6

$2-$3/day 56/185 30.3 29/67 43.3

$3-$4/day 24/72 33.3 8/16 50.0

>$4/day 6/30 20.0 10/25 40.0

Living Situation

Lives alone 84/234 35.9 63/123 51.2

Lives with people >60 only 85/289 29.4 60/163 36.8

Lives with people <60 70/188 37.2 45/109 41.3

Dependency

Independent 191/642 29.8 125/341 36.7

Moderately Dependent 27/41 65.9 15/22 68.2

Severely Dependent 21/28 75.0 28/32 87.5

BMI, mean (SD) (N=158) 29.0 (6.2) 30.5 (6.8)

Psychological DistressGCA NGCA

n/N % n/N %

Income per capita ($/day)

<$2/day 130/344 37.8 92/216 42.6

$2-$3/day 56/185 30.3 29/67 43.3

$3-$4/day 24/72 33.3 8/16 50.0

>$4/day 6/30 20.0 10/25 40.0

Living Situation

Lives alone 84/234 35.9 63/123 51.2

Lives with people >60 only 85/289 29.4 60/163 36.8

Lives with people <60 70/188 37.2 45/109 41.3

Dependency

Independent 191/642 29.8 125/341 36.7

Moderately Dependent 27/41 65.9 15/22 68.2

Severely Dependent 21/28 75.0 28/32 87.5

BMI, mean (SD) (N=158) 29.0 (6.2) 30.5 (6.8)

Anthropometry

BMI (kg/m2) Total

GCA (N=488) NGCA (N=305)

n (%) 95%CI n (%) 95%CI

Underweight (<18.5) 7 (1.4) 0.6-3.2 2 (0.7) 0.0-5.1

Normal (18.5-24.99) 123 (25.2) 20.9-30.0 55 (18.0) 14.6-22.1

Overweight (25-

29.99)

162 (33.2) 29.5-37.2 107 (35.1) 30.0-52.4

Obese (>30) 196 (40.2) 35.8-44.7 141 (46.2) 40.1-52.4

Mean (SD)

(95%CI)

29.1 (5.8)

(28.5-29.6)

29.8 (6.0)

(29.2-30.5)

Median (IQR) 28.8

(24.8-33.0)

29.4(26.0-33.1)

BMI (kg/m2) Total

GCA (N=488) NGCA (N=305)

n (%) 95%CI n (%) 95%CI

Underweight (<18.5) 7 (1.4) 0.6-3.2 2 (0.7) 0.0-5.1

Normal (18.5-24.99) 123 (25.2) 20.9-30.0 55 (18.0) 14.6-22.1

Overweight (25-

29.99)

162 (33.2) 29.5-37.2 107 (35.1) 30.0-52.4

Obese (>30) 196 (40.2) 35.8-44.7 141 (46.2) 40.1-52.4

Mean (SD)

(95%CI)

29.1 (5.8)

(28.5-29.6)

29.8 (6.0)

(29.2-30.5)

Median (IQR) 28.8

(24.8-33.0)

29.4(26.0-33.1)

BMI (kg/m2) Total

GCA (N=488) NGCA (N=305)

n (%) 95%CI n (%) 95%CI

Underweight (<18.5) 7 (1.4) 0.6-3.2 2 (0.7) 0.0-5.1

Normal (18.5-24.99) 123 (25.2) 20.9-30.0 55 (18.0) 14.6-22.1

Overweight (25-

29.99)

162 (33.2) 29.5-37.2 107 (35.1) 30.0-52.4

Obese (>30) 196 (40.2) 35.8-44.7 141 (46.2) 40.1-52.4

Mean (SD)

(95%CI)

29.1 (5.8)

(28.5-29.6)

29.8 (6.0)

(29.2-30.5)

Median (IQR) 28.8

(24.8-33.0)

29.4(26.0-33.1)

BMI (kg/m2) Total

GCA (N=488) NGCA (N=305)

n (%) 95%CI n (%) 95%CI

Underweight (<18.5) 7 (1.4) 0.6-3.2 2 (0.7) 0.0-5.1

Normal (18.5-24.99) 123 (25.2) 20.9-30.0 55 (18.0) 14.6-22.1

Overweight (25-

29.99)

162 (33.2) 29.5-37.2 107 (35.1) 30.0-52.4

Obese (>30) 196 (40.2) 35.8-44.7 141 (46.2) 40.1-52.4

Mean (SD)

(95%CI)

29.1 (5.8)

(28.5-29.6)

29.8 (6.0)

(29.2-30.5)

Median (IQR) 28.8

(24.8-33.0)

29.4(26.0-33.1)

BMI (kg/m2) Male

GCA (N=169) NGCA (N=88)

n (%) 95%CI n (%) 95%CI

Underweight (<18.5) 1 (0.6) 0.0-4.5 1 (1.1) 0.2-8.2

Normal (18.5-24.99) 58 (34.3) 27.8-41.5 22 (25.0) 19.0-32.2

Overweight (25-

29.99)

67 (39.7) 33.1-46.6 33 (37.5) 28.4-47.6

Obese (>30) 43 (25.4) 19.4-32.6 32 (36.4) 27.4-46.4

Mean (SD)

(95%CI)

27.2 (4.7)

(26.5-27.9)

38.0 (5.2)

(27.0-29.1)

Median (IQR) 26.7

(24.0-30.1)

27.8(24.9-31.1)

BMI (kg/m2) Male

GCA (N=169) NGCA (N=88)

n (%) 95%CI n (%) 95%CI

Underweight (<18.5) 1 (0.6) 0.0-4.5 1 (1.1) 0.2-8.2

Normal (18.5-24.99) 58 (34.3) 27.8-41.5 22 (25.0) 19.0-32.2

Overweight (25-

29.99)

67 (39.7) 33.1-46.6 33 (37.5) 28.4-47.6

Obese (>30) 43 (25.4) 19.4-32.6 32 (36.4) 27.4-46.4

Mean (SD)

(95%CI)

27.2 (4.7)

(26.5-27.9)

38.0 (5.2)

(27.0-29.1)

Median (IQR) 26.7

(24.0-30.1)

27.8(24.9-31.1)

BMI (kg/m2) Female

GCA (N=319) NGCA (N=217)

n (%) 95%CI n (%) 95%CI

Underweight (<18.5) 6 (1.9) 0.8-4.6 1 (0.5) 0.0-3.7

Normal (18.5-24.99) 65 (20.4) 15.2-26.7 33 (15.2) 10.9-20.8

Overweight (25-

29.99)

95 (29.8) 25.1-35.0 74 (34.1) 27.2-41.8

Obese (>30) 153 (47.9) 42.2-53.7 109 (50.2) 42.2-58.2

Mean (SD)

(95%CI)

30.0 (6.0)

(29.3- 30.8)

30.6 (6.2)

(29.6-31.5)

Median (IQR) 29.8

(25.6-33.7)

30.1(26.8-33.9)

BMI (kg/m2) Female

GCA (N=319) NGCA (N=217)

n (%) 95%CI n (%) 95%CI

Underweight (<18.5) 6 (1.9) 0.8-4.6 1 (0.5) 0.0-3.7

Normal (18.5-24.99) 65 (20.4) 15.2-26.7 33 (15.2) 10.9-20.8

Overweight (25-

29.99)

95 (29.8) 25.1-35.0 74 (34.1) 27.2-41.8

Obese (>30) 153 (47.9) 42.2-53.7 109 (50.2) 42.2-58.2

Mean (SD)

(95%CI)

30.0 (6.0)

(29.3- 30.8)

30.6 (6.2)

(29.6-31.5)

Median (IQR) 29.8

(25.6-33.7)

30.1(26.8-33.9)

Conclusions and Recommendations

Discussion-Demographics/Income

• In both GCA and NGCA about 2/3 of the sample were female and 1/3 of the sample were males• Life expectancy 66 years for males vs. 76 years for females

• About half of the sample was 60-70 years and half was >70 years• Slightly larger proportion of people >70 years in NGCA areas (57% vs. 51%)

• Many people living in poverty• 55% of people in GCA and 67% of people in NGCA living on <$2/day• 85% of people in GCA and 88% of people in NGCA living on <$3/day• Only 22% of people in NGCA who are registered to receive Ukrainian pension

received it in the month preceding the survey, however almost all received DNR pension

• About 1/3 of the population (31% GCA and 29% NGCA) live alone

Discussion-Assistance

• Few households (about 10%) in GCA are registered to receive humanitarian assistance• 5.6% of individuals in Donetsk, 25.9% in Luhansk

• Only 6.5% of households have received assistance in 3 months preceding survey

• Majority of households (about 86%) in NGCA are registered to receive humanitarian assistance• 83% of households have received assistance in 3 months preceding survey

• All households (83%) that have received assistance received food assistance• 98% received food assistance from Akhmetov Foundation

• Only 1 household received cash or voucher assistance, 4 households received non-food assistance and 1 household received transportation assistance

• Low proportion of IDPs in both samples (<2% of the sample in GCA and NGCA)

Discussion-Nutrition• Most common foods eaten are cereals/grains and white/yellow

potatoes, and vegetables• Mean number of food groups eaten in day preceding survey was 4.5 in GCA

and NGCA

• 79% of people in GCA and 71% of people in NGCA consumed iron-rich foods in the day preceding the survey

• People living on <$2/day ate less fruits, milk, and meat

• About 2% of people in GCA and 0.5% of people in NGCA experienced moderate or severe hunger in the 30 days preceding the survey• 93% of these people in GCA live on <$2/day

• 100% of people in both areas live on <$3/day

• Only 2 people in NGCA. One person had received food assistance.

• Around 70% of respondents have some type of chronic disease in both areas• Women have higher prevalence of hypertension and cardiovascular disease

• About 79% of respondents in GCA and 67% in NGCA with a chronic condition take medications regularly for at least one condition• Out of those who don’t take medications for at least one chronic condition,

about 40% in GCA and 60% in NGCA reported this was due to cost

• Most people do not have problems accessing healthcare• 21% in GCA and 13% in NGCA reported an acute illness

• 26% in GCA and 20% in NGCA of those of those with an acute illness sought care

• Only 15% listed cost of care or access to the clinic as reasons for not seeking care in both areas

Discussion-Health

• About 12% of the sample in GCA and 17% of sample in NGCA had moderate or severe dependency• People of older ages have a higher prevalence of dependency than those of

younger ages

• In GCA about 46% of people and in NGCA about 37% of people who may need help with daily activities do not receive any help or do not receive help every day

Discussion-Dependency

• 33% of people in GCA and 43% of people in NGCA reported suffering from severe psychological distress

• 70% of people in GCA and 80% of people in NGCA with moderate or severe dependency reported suffering from severe psychological distress

Discussion-Psychological Distress

• Undernutrition is not a major problem in this population• Only 7 individuals in GCA (1.7%) and 2 individuals in NGCA (0.7%) had a BMI

<18.5 kg/m2

• Only 25% of individuals in GCA and 18% of individuals in NGCA were in the normal BMI range• 34% of men in GCA and 35% of men in NGCA had a normal BMI; compared to

20% of women in GCA and 15% of women in NGCA• 75% of people in GCA and 81% of people in NGCA are overweight or obese

• Obesity is a major problem in this older population• About 40% of people in GCA and 46% of people in NGCA are considered

obese• About 50% of women in both areas are considered obese

Discussion-Nutritional Status

Recommendations1. Provide psychosocial support services to all older individuals living in

both areas if needed

2. Identify the people who are suffering from extreme hunger for targeted assistance• 93% of those with moderate or severe hunger in GCA live on <$2/day• 100% of those with moderate or severe hunger in both areas live on <$3/day

3. Modify food and voucher assistance in both areas to encourage healthier diets • Distribution of food vouchers for people to buy fresh fruits and vegetables, meat,

milk products, etc.

4. Engage in promotional activities on health and healthy diets in both areas• Specifically targeting older women

Recommendations

5. Identify people who are not taking medications for chronic diseases regularly for targeted assistance

6. Identify and provide assistance to those who are moderately and severely dependent without everyday help

7. Do not limit humanitarian assistance in GCA areas to only internally displaced persons

8. Consider including cash/voucher assistance for purchasing medications for chronic diseases as part of humanitarian aid

Questions

MUAC (mm) GCA Total

N=408

NGCA Total

N=303

n (%) 95%CI n (%) 95%CI

< 185 0 0 0 0

185-210 1 (0.3) 0.0-1.8 1 (0.3) 0.0-2.6

> 210 407 (99.8) 98.2-99.9 302 (99.7) 97.5-99.9

Mean (95%CI) 313.6

(309.2-318.0)

307.0

(302.7-311.4)

Median (IQR) 310

(286-344)

304(282-329)

MUAC (mm) GCA Male

N=143

GCA Male

N=88

n (%) 95%CI n (%) 95%CI

< 185 0 0 0 0

185-210 0 0 0 0

> 210 143 100 88 100

Mean (95%CI) 305.4

(298.5-312.4)

300.3

(293.5-307.1)

Median (IQR) 304

(286-328)

299(281-321)

MUAC (mm) GCA Female

N=265

NGCA Female

N=215

n (%) 95%CI n (%) 95%CI

< 185 0 0 0 0

185-210 1 (0.4) 0.0-2.8 1 (0.5) (0.0-3.5)

> 210 264 (99.6) 97.2-99.9 214 (99.5) (96.5-99.9)

Mean (95%CI) 317.9

(312.6-323.3)

309.7

(303.7-315.8)

Median (IQR) 314

(288-350)

308(282-332)

Response Rate Donetsk Luhansk GCA Total NGCA

Total Households N=1,914 N=611 N=2,525 N=1,324

Absent 809 (42.3%) 355 (58.1%) 1164 (46.1%) 701 (52.9%)

Refused 47 (2.5%) 62 (10.2%) 109 (4.3%) 14 (1.1%)

No one over 60 523 (27.3%) 58 (9.5%) 581 (23.0%) 299 (22.6%)

Consented 535 (28.0%) 136 (22.3%) 671 (26.6%) 310 (23.4%)

Total Respondents over 60 in

Consenting Households N=690 N=196 N=886 N=423

Absent 47 (6.8%) 5 (2.6%) 52 (5.9%) 4 (0.9%)

Refused 57 (8.3%) 23 (11.7%) 80 (9.0%) 1 (0.2%)

Interviewed 592 (85.8%) 166 (84.7%) 758 (85.6%) 418 (98.8%)

Measured MUAC 352 (51.0%) 56 (28.6%) 408 (46.0%) 303 (71.6%)

Measured Weight and Demi-

span388 (56.2%) 100 (51.0%) 488 (55.1%) 305 (72.1%)

Documents

UNICEF/CDC/WHO Elderly Assessment in … and Food Insecurity Nutrition ... Assistance Project III (FANTA)2 1. Guidelines for Measuring Household and Individual Dietary Diversity