Proposal Description

Research/Project 1: This report presents evidence-based findings from the SMART Nutrition and Retrospective Mortality survey conducted in Nigeria as a follow-up to the baseline survey in Borno State, initiated in November 2017. According to the previous SMART survey conducted in 2017, the prevalence of Global Acute Malnutrition (GAM) was 12.4% (10.0-15.2, 95% CI), with Severe Acute Malnutrition (SAM) prevalence of 2.6% (1.6-4.1, 95% CI), while CDR and U5MR were 1.8/10,000pp/day (1.03-3.11, 95% CI) and 4.36/10,000pp/day (1.90-9.64, 95% CI), respectively. The survey’s overall objective was to determine the magnitude and severity of malnutrition and retrospective mortality rates among under-five children in Bolori-II, Borno State, Nigeria. Its specific activities were to determine the prevalence of acute malnutrition among children 0 to 59 months of age using WHZ, MUAC, and bilateral oedema; determine the prevalence of wasting, chronic malnutrition, and underweight among children 0 to 59 months of age; estimate retrospective mortality rates, including crude mortality rates (CMR) and under-five mortality rates (U5MR), in the target population; estimate retrospective morbidity among children under five years; determine measles vaccination coverage among children 12-59 months of age; determine morbidity among children 0-59 months of age; determine Vitamin A supplementation coverage among children 6-59 months of age and deworming among children 12-59 months of age in the six months prior to the study; assess infant and young child feeding practices among households with children under two years of age in the target population; and draw conclusions and recommendations to address identified gaps and support advocacy, planning, decision-making, and monitoring. Data processing and analysis for the nutrition and mortality questionnaires were done using ENA for SMART software (July 2015), and the results are based on WHO 2006 growth standards. Research/Project 2: Underweight is a nutritional status of toddlers characterized by low weight based on the anthropometric index weight-for-age (WFA). In Indonesia, this index is recorded on a Card Towards Health called KMS (Kartu Menuju Sehat), which refers to the WHO–2005 Standard Growth Charts (WHO–2005 SGC). The samples used to design the WHO–2005 SGC were toddlers from Brazil, Ghana, India, Norway, Oman, and the USA, who are physically different from Indonesian toddlers, especially those from East Java. This study aimed to design Percentile Standard Growth Charts (Percentile SGC) of WFA based on toddler samples from East Java by using both least square spline (LS-spline) and local linear estimators of a multi-response semiparametric regression (MSR) model. Those Percentile SGC were used to assess the nutritional status of toddlers in East Java by comparing them with the WHO–2005 SGC. Results show that these Percentile SGC based on both LS-spline and local linear estimators give a lower reference than the WHO–2005 SGC, so the percentages of malnutrition and less-nutrition status categories provided by these Percentile SGC are also lower than those provided by the WHO–2005 SGC. In general, the Percentile SGC of WFA for boy and girl toddlers in East Java has an evaluator standard and a lower standard than the WHO–2005 SGC.