Tanzania is prone to refugee influxes, often of long duration. Despite facing its own economic challenges, for decades Tanzania has welcomed thousands of refugees fleeing conflicts in neighboring countries of Great Lakes Region. The counties geographic proximity to the strifetorn Congo Basin is responsible in part for the ease access of displaced populations. As well Tanzania was an early signatory in the region to international agreements on the rights and welfare of refugee and asylum seekers As of December, 2018, Tanzania host some 284,300 camp-based refugees, 77% of who are children and woman, in Nduta, Nyarugusu and Mtendeli Refugee Camps in Kigoma region in Northwest Tanzania. About 74% are from Burundi, and the remaining 26% are primarily from Democratic republic of Congo.
Following a Tripartite Commission meeting in August 2017, the governments of Tanzania,
Burundi, and UNHCR agreed to assist refugees who wish to voluntarily repatriate from Tanzania to Burundi. A subsequent meeting in March 2018 reaffirmed the commitment of both governments and UNHCR to uphold the principle of voluntariness, and noted that while some refugees may opt to return, others will continue to be in need of international protection. The March 2018 Tripartite meeting also produced a work plan entailing the repatriation of approximately 2,000 refugees per week from 5 April to 31 December 2018. As from January to 30th September 2018, a total of 52,260 refugees were assisted to voluntarily repatriate to Burundi from Tanzania in 88 Convoys; bringing the total repatriated from September 2017 to 57,865 of which 57.2% are children.
This is the 5th SENS survey among the refugees in Nyarugusu since the first survey in September 2012 second in September 2014. Assessments in 2016, 2017 and 2018 covered all the three camps of Nyarugusu (old & New Camp), Nduta and Mtendeli. The current survey was conducted as from 16th September to October 13th 2018, with a total of 4 assessments.
UNHCR coordinated the survey in collaboration with WFP, UNICEF, WVI, Tanzania Red-cross Society (TRCS), MSF as well as Tanzania Ministry of Health, Community Development, Gender,
Elderly and Children (MOHCDGEC). Funding was shared between UNHCR, WFP and UNICEF.
UNHCR and WFP were in charge of logistics and daily operations.
The survey objectives are as outlined below:
• To determine the prevalence of acute malnutrition in children aged 6-59 months.
• To determine the prevalence of stunting in children aged 6-59 months.
• To determine the coverage of measles vaccination among children aged 9-59 months.
• To determine the coverage of vitamin A supplementation received during the last 6 months among children aged 6-59 months.
• To assess the two-week period prevalence of diarrhoea among children aged 6- 59 months.
• To measure the prevalence of anaemia in children aged 6-59 months and in nonpregnant women of reproductive age (15-49 years).
• To investigate IYCF practices among children aged 0-23 months.
• To determine the coverage of ration cards and the duration of the general food ration lasts for recipient households.
• To determine the extent to which negative coping strategies are used by households.
• To assess household dietary diversity.
• To determine the population’s access to, and use of, improved water, sanitation and hygiene facilities.
• To determine the ownership of mosquito nets (all types and LLINs) in households.
• To determine the utilisation of mosquito nets (all types and LLINs) by the total population, children 0-59 months and pregnant women.
• To establish recommendations on actions to be taken to address the situation in Mtendeli, Nduta and Nyarugusu Refugee Camps.
• To determine the enrolment coverage of therapeutic feeding and targeted supplementary feeding programmes for children 6-59 months.
• To determine enrolment into Antenatal Care clinic and coverage of iron-folic acid supplementation in pregnant women.
The surveys were conducted using the UNHCR Standardised Expanded Nutrition Survey (SENS) version 2 (2013), www.sens.unhcr.org and the Standardised Monitoring and Assessments of Relief and Transitions (SMART) guidelines www.smartmethodology.org. Two stage cluster sampling was used to identify the survey respondents, the first stage involved identifying clusters and the second stage was to identify the households. The Emergency Nutrition Assessment (ENA) software version July 9th, 2015 which uses Probability Proportion to Sample Size (PPS) was used to calculate the sample size and to select the clusters. To select households for participation in the survey from the clusters, Simple random sampling was used. The parameters that were used to calculate the sample size are summarized in Table 3 .
The survey had a total of 6 modules, 3 individual level questionnaires and 3 household level questionnaires. The modules are;
• Anthropometry and health; targeting all children (6 to 59 months) in all the sampled households;
• Infant and Young Child Feeding (IYCF); targeting all children 0 to 23 months in all the sampled households • Anaemia; targeting all children 6 to 59 months and all non-pregnant women 15 to 49 years in every other sampled households;
• Food security; targeting every other sample households • Water, Sanitation and Hygiene (WASH); targeting all the sampled households.
• Mosquito net coverage; targeting every other sampled households;
Data was collected using smart mobile phones with the ODK application by 6 teams of 6 members per team; each team had two phones configured for household and individual level questionnaires respectively.