Zimbabwe Nutrition Survey 2010 Report

7/14/2019 Zimbabwe Nutrition Survey 2010 Report

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Zimbabwe National

Nutrition Survey - 2010



ZIMBABWE NATIONAL NUTRITION SURVEY – 2010

Background

In 2008, the FNC hosted a meeting to review the

nutrition surveillance system

National Nutrition Surveillance and Assessment(NaNSA) Task Force recommended a large scale

nutrition survey

To disaggregated at the district level.

Designed to serve as a baseline for future surveillanceefforts.




Survey Objectives

Determine the nutritional status of children 6-59

months of age in each District

Explore the prevalence and distribution of underlyingdeterminants of malnutrition among children 0-59

months of age in each district

Provide platform for recommendations for action atdistrict and national level




Survey Design

Conceptual Framework




Findings:

Explain various indices

Stunting or Chronic Malnutrition Underweight Wasting or Acute Malnutrition

Height for Age Weight for Age Weight for Height or

Mid-Upper Arm Circumference




Results: National Prevalence

Malnutrition (1)

IndicatorWHO

Standard (%)

NCHS

Reference

(%)

Rating Per

Global

Thresholds5

Stunting (Chronic Malnutrition)1 33.8%(N = 35,323)

27.1%(N = 35,914)

High

Underweight 2 9.9%(N = 35,285)

14.5%(N = 35,812)

Medium

Wasting (Acute Malnutrition)3 2.1%

(N = 35,069)

2.1%

(N = 35,695)

Low

Overweight4 3.1%(N = 35,295)

1.3%

(N = 35,266)Medium

4Children 6-59 months >+2 SD Weight for Height5WHO TRS No. 854, Geneva, 1995: WHO Global

Database on Child Growth and Malnutrition

1Children 6-59 months < - 2 SD Height for Age2Children 6-59 months <-2 SD Weight for Age3Children 6-59 months <-2 SD Weight for Height

Figure 5: Prevalence of malnutrition at national level with global threshold rank


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Under nutrition (Z-Scores)

By Age

-2

-1.5

-1

-0.5

0

0.5

6-11 12-17 18-23 24-35 36-47 48-59

M e a n Z - S c o r e

Age in Months

Stunting Wasting Underweight Stunting andunderweight beginprior to the age of six

monthsStunting andunderweight peak at 24months and there islittle recoverythereafter

Wasting appearsbetter than thestandard population –we need further workto understand why

Figure 12: Mean z-score by age and nutrition index


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Under nutrition (Z-Scores)

By Age

Figure 12: Mean z-score by age and nutrition index

Pregnancy to 24

months is often

referred to as the

“window of

opportunity”

Interventions

targeted at these

age groups will have

the greatest impact

at population level-2

-1.5

-1

-0.5

0

0.5

6-11 12-17 18-23 24-35 36-47 48-59

M e a n Z - S c o r e

Age in Months

Stunting Wasting Underweight




Prevalence of Stunting

By District

Figure 9: Percent children 6-59 months of age below -2 SD Height for Age (WHO)

33.8% of children between

6-59 months of age are

stunted

National figures obscure

wide variation between

districts

Rates of stunting in 24districts are above 35% -

high according to global

thresholds

Hwange

Binga

Chiredzi

Hurungwe

Mwenezi

Gutu

Insiza

Bubi

Lupane

Gwanda

Beitbridge

Kariba

Makoni

Kwekwe

Matobo

Bikita

Makonde

Gweru

Gokwe South

Nkayi

Mbire

Bulilima

Zvimba

Mutare

Nyanga

Buhera

Umguza

Masvingo

Chivi

Tsholotsho

Mudzi

Mangwe

Chikomba

Zaka

Chegutu

Chipinge

Gokwe NorthMutoko

Mazowe

Seke

Mberengwa

Centenary

Guruve

Shurugwi

Murehwa

Chirumhanzu

Mutasa

Mt Darwin

Shamva

Marondera

Bindura

Kadoma

Rushinga

Umzingwane

Harare Urban

Hwange Urban

Plumtree

Mutare Urban

Beitbridge Urban

Victoria Falls

Kariba Urban

Karoi Urban

UMP

Chimanimani

Bulawayo Urban

Zvishavane

Hwedza

Goromonzi

N

30.0% - 34.9%

Legend

35.0% - 47.8%

Figure 1.1a Prevalence of stunting in children 6-59 months of age, by district (WHO)

20.0 - 29.9%

0% - 19.9%

Districts with lower than expected samp le size




Exclusive Breastfeeding

By Province

Percent children under 6 months of age exclusively breastfed, by province

5.8 % of children areexclusively breastfedthrough 6 months of age

Rates are lower thanthose previouslyreported – possibly dueto different indicatordefinitions

Rates of EBF are

extremely low and highlyconcerning

EBF is the foundation of child survivalprogramming

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%




Minimum Acceptable Diet

By District

Hwange

Binga

Chiredzi

Hurungwe

Mwenezi

Gutu

Insiza

Bubi

Lupane

Gwanda

Beitbridge

Kariba

Makoni

Kwekwe

Matobo

Bikita

Makonde

Gweru

Gokwe South

Nkayi

Mbire

Bulil ima

Zvimba

Mutare

Nyanga

Buhera

Umguza

Masvingo

Chivi

Tsholotsho

Mudzi

Mangwe

Chikomba

Zaka

Chegutu

Chipinge

Gokwe Nor thMutoko

Mazowe

Seke

Mberengwa

Centenary

Guruve

Shurugwi

Murehwa

Chi rumhanzu

Mutasa

Mt Darwin

Shamva

Marondera

Bindura

Kadoma

Rushinga

Umzingwane

Harare Urban

Hwange Urban

Plumtree

Mutare Urban

Beitbridge Urban

Victoria Falls

Kariba Urban

Karoi Urban

UM P

Chiman iman i

Bulawayo Urban

Zvishavane

Hwedza

Goromonzi

N

5.0% - 9.9%

Legend

0.5% - 4.9%

Figure 2.9 Percentage of children between 6-23 months of age receiving a minimum acceptable diet, by district

10.0% - 14.9%

15.0% - 20.8%

Districts with lower than e xpected sample size

Minimum acceptable dietis a composite of mealfrequency and dietary

diversity and considersbreastfeeding

8.4% of children between6-23 months of agereceived a minimumacceptable diet (just 1 in

10 children) National figures obscure

wide variation betweendistricts - in 14 districtsless than 5% of childrenreceived an acceptable

diet

Figure 17: Percent children 6-23 months of age who received a minimum acceptable diet

according to age and breastfeeding status( meal frequency + minimum dietary diversity)




HH Food Consumption

National

Low

12%

Moderate

21%

High67%

12% of children between

0-59 months resided in

households with a “low”food consumption score




Prevalence of Diarrhea,

Fever and Coughs

By District

Hwange

Binga

Chiredzi

Hurungwe

Mwenezi

Gutu

Insiza

Bubi

Lupane

Gwanda

Beitbridge

Kariba

Makoni

Kwekwe

Matobo

Bikita

Makonde

Gweru

Gokwe South

Nkayi

Mbire

Bulilima

Zvimba

Mutare

Nyanga

Buhera

Umguza

Masvingo

Chivi

Tsholotsho

Mudzi

Mangwe

Chikomba

Zaka

Chegutu

Chipinge

Gokwe NorthMutoko

Mazowe

Seke

Mberengwa

Centenary

Guruve

Shurugwi

Murehwa

Chirumhanzu

Mutasa

Mt Darwin

Shamva

Marondera

Bindura

Kadoma

Rushinga

Umzingwane

Harare Urban

Hwange Urban

Plumtree

Mutare Urban

BeitbridgeUrb an

Victoria Falls

Kariba Urban

KaroiUrban

UMP

Chimanimani

Bulawayo Urban

Zvishavane

Hwedza

Goromonzi

N

12.9% - 17.1%

Legend

17.2% - 23.3%

Figure 4.2 Prevalence of diarrhoea in children between 0-59 months of age, by district

8.0% - 12.8%

2.7% - 7.9%

Districts with lower than expected sample size

Hwange

Binga

Chiredzi

Hurungwe

Mwenezi

Gutu

Insiza

Bubi

Lupane

Gwanda

Beitbridge

Kariba

Makoni

Kwekwe

Matobo

Bikita

Makonde

Gweru

Gokwe South

Nkayi

Mbire

Bulilima

Zvimba

Mutare

Nyanga

Buhera

Umguza

Masvingo

Chivi

Tsholotsho

Mudzi

Mangwe

Chikomba

Zaka

Chegutu

Chipinge

Gokwe NorthMutoko

Mazowe

Seke

Mberengwa

Centenary

Guruve

Shurugwi

Murehwa

Chirumhanzu

Mutasa

Mt Darwin

Shamva

Marondera

Bindura

Kadoma

Rushinga

Umzingwane

Harare Urban

Hwange Urban

Plumtree

Mutare Urban

Beitbridge Urban

Victoria Falls

Kariba Urban

Karoi Urban

UMP

Chimanimani

Bulawayo Urban

Zvishavane

Hwedza

Goromonzi

N

16.4% - 20.4%

Legend

20.5% - 34.5%

Figure 4.3a Prevalence of cough in children between 0-59 months of age, by distr

9.6% - 16.3%

2.4% - 9.5%


Hwange

Binga

Chiredzi

Hurungwe

Mwenezi

Gutu

Insiza

Bubi

Lupane

Gwanda

Beitbridge

Kariba

Makoni

Kwekwe

Matobo

Bikita

Makonde

Gweru

Gokwe South

Nkayi

Mbire

Bulilima

Zvimba

Mutare

Nyanga

Buhera

Umguza

Masvingo

Chivi

Tsholotsho

Mudzi

Mangwe

Chikomba

Zaka

Chegutu

Chipinge

Gokwe NorthMutoko

Mazowe

Seke

Mberengwa

Centenary

Guruve

Shurugwi

Murehwa

Chirumhanzu

Mutasa

Mt Darwin

Shamva

Marondera

Bindura

Kadoma

Rushinga

Umzingwane

Harare Urban

Hwange Urban

Plumtree

Mutare Urban

BeitbridgeU rban

Victoria Falls

Kariba Urban

KaroiUrban

UMP

Chimanimani

Bulawayo Urban

Zvishavane

Hwedza

Goromonzi

N

13.3% - 18.8%

Legend

18.9% - 28.0%

Figure 4.3b Prevalence of fever in children between 0-59 months of age, by district

7.6% - 13.2%

2.4% - 7.5%


Figure 18: Percent children 0-59 months of age who had diarrhea , fever and cough in

the two weeks preceding the survey

Diarrhea cough

fever




Results: Access to nutrition

services, water and

Sanitation

Only 25.2% of new mothers received a Vitamin Asupplement within 8 weeks of their last delivery

Only 27.8 % of women received iron/folatesupplements during their pregnancies

86.4% children 6 – 59 months received vitamin Ain children

About a third of the children live in householdswith un safe water resources and/or in householdsthat practice unsafe disposal of children's stools




Conclusion

At 33.8% chronic malnutrition remains unacceptably high in

Zimbabwe. This means that 1 in every 3 children who are

chronically malnourished, are more susceptible to disease,

may suffer cognitive impairment, have poorer educationaloutcomes and are likely to experience reduced productivity.

Zimbabwe is not on target for achieving both MDG 1

(underweight) and Target 4 (<5 mortality). It is estimated that

12, 000 (preventable) child deaths per year are attributable tounder nutrition in Zimbabwe

Scaling up nutrition in Zimbabwe will be critical towards

reversing these trends.




Implication of Malnutrition

on Progress Towards MDG 1

13

17

13

17

15

7

4

6

8

10

12

14

16

18

1988 1994 1999 2006 2010 2015

P e r c e n t C h i l d r e n

Year of Survey

Figure 7: Percent underweight children by year of survey including MDG 1 Target

MDG 1 – Significantly off target

Source: MDG Mid-term Review, Government of Zimbabwe, 2008. All rates ruse the NCHS reference population




Implication of Malnutrition

on Progress Towards MDG 4

102

82 86

34

0

20

40

60

80

100

120

1999 2006 2009 2015

D

e a t h s p e r 1 0 0 0 L i v

e B i r t h s

Year of Survey

MDG 4 – Significantly off target

35%attributable

to

malnutrition

Source: MDG Mid-term Review, Government of Zimbabwe, 2008

Figure 8: Under-five mortality rate by year of survey including MDG 4 Target




Conclusion contd.

Infants under 6 months of age are not beingexclusively breastfed. Young children are notgenerally being provided with adequate

complementary foods, in terms of frequency andquality.

There are major gaps in key interventions such aspost-partum Vitamin A and iron/folate

Malnutrition levels appear to be exacerbated byunderlying causes such as lack of access toimproved water and sanitation and episodes of illness.




Recommendations

Chronic malnutrition should be considered a developmentpriority for Zimbabwe.

Interventions to prevent chronic malnutrition should be guidedby sound, evidence based policies and strategies of anintersectoral nature.

Resources should be made available to scale-up high impactinterventions such as (behavior change):

Exclusive breastfeeding from birth to 6months

Appropriate complementary feeding from 6-23monthsMaternal nutrition (supplementation and BCC)

Improving the child’s health and sanitary environment

Treatment of acute malnutrition



Thank you

Tatenda

Siyabonga

Documents

Zimbabwe Nutrition Survey 2010 Report