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Integrated Smart Nutrition Baseline Survey - Dhaka Urban Slums, May-June 2022

Countries
Bangladesh
Sources
ACF
Publication date

EXECUTIVE SUMMARY

Background and Objectives

In Bangladesh, the urban context has its unique characteristics and complexities. Considering the basic causes and underlying causes of malnutrition, there would be differences between children residing in rural households compared to a household in congested slums or on a pavement. The malnutrition levels among children and PLW living in extreme poor households in urban slums are expected to be high. Meanwhile, the Covid-19 pandemic not only affected the health situation, but will also had a profound impact on many spheres: political, social, human, environmental, economic and infrastructural. There is a high risk of further deterioration of health and nutrition situation, access to health and nutrition services because of the COVID-19 pandemic and increased cost of living and the potiential impact on food security and nutrtion.

However, there is a lack of nutritional data for children under five and pregnant and lactating women (PLW) living in the urban slums. Previous national level surveys also focused on rural and urban areas; hence, there is data paucity specifically for urban slums

Therefore, it was essential to evaluate its adverse effect on health and nutrition that will support the identification of a potential deterioration of access to and / or coverage of nutrition services, and deterioration of nutrition outcomes due to specific factors linked to Covid-19 epidemics.

In May-June 2022, the Action Against Hunger Bangladesh in partnership with Concern Worldwide and World Food Programme conducted two independent integrated nutrition surveys in Dhaka North City Corporation (DNCC) and South City Cooperation (DSCC) slums. National Nutrition Services (NNS), the Institute of Public Health Nutrition (IPHN), MoHFW and respective City Corporations authorized these assessments.

The main objective of these assessments was to determine nutrition status (e.g. wasting/acute malnutrition, stunting and underweight) of children of 5 years of age, pregnant and lactating women (PLWs). The study also aimed to determine possible causal factors for better understanding of the malnutrition situation in the slums that might have deteriorated due to the impact of COVID-19. The collected data included: household demography, anthropometry, morbidity, mortality, infant and young child feeding practices (IYCF), vitamin A, measles vaccination, and deworming coverage among children, access to antenatal care (ANC) and iron supplementation among pregnant women including ANC and post-natal care (PNC) checkups during the last pregnancy, food security, and Water Sanitation and Hygiene (WASH).

The assessment findings and recommendations will inform timely and effective multi-sectoral interventions as well as support stakeholders for necessary changes in their programme policies or interventions.

Methodology:

Two population representative cross-sectional household surveys following SMART methodology was conducted which included two-stage cluster sampling (e.g. stage 1: selection of cluster using PPS sampling; stage 2: random selection of households) to achieve the desired outcomes of the survey.

The sample size in number of children was calculated using ENA software [version January 11th, 2020] which was then converted into number of households to provide a representative sample for the anthropometric and mortality indicators in DSCC [Children-387, households-1336] and DNCC [Children-387, households- 1336].

A total of 56 clusters for each corporation were selected using PPS method using the ENA software. Each selected cluster included 24 households and measured all eligible children for anthropometric measurements. The study finally surveyed all targeted clusters covering minimum number of households and children 6-59 months of age.1