The cumulative effect of the Oil for Food Programme implementation has supported significant changes in improving the nutritional status of children under five years of age in northern Iraq. As part of the regular nutrition survey carried out every year, a household nutritional status survey was conducted in the three Governorates (Dohuk, Erbil and Suleimanyiah) with a total sample of 2,745 children under five years of age between 30 June and 12 July 2001.
Purpose / Objective
The main objectives of the survey were to assess the current health and nutrition status of children and their mothers, to assess feeding practices and to identify risk groups for future interventions.
The sample for the current survey was based on a systematic random sampling technique (WHO methodology) where 30 clusters each of 30 children with specific age groups were selected in each of the three Governorates based on the 1996 population data. Using random start and direction, consecutive households were selected within the cluster until the 30th child was reached. A total of 2,745 under five children were measured during the survey.
Key Findings and Conclusions
The survey results show that 10.7% of children under five are underweight for their age, 3.0% are acutely malnourished and 11.4% suffer from chronic malnutrition (World Health Organisation - WHO - classification). These results indicate significant improvements in chronic malnutrition compared to the 1996 (26.3%) and 1994 data (37.3%). The assumption is that this is related to the cumulative effect of improved household food security due to the distribution of food rations, health inputs and the overall improvement of the local economy. There was also an improvement in underweight prevalence compared to the 1994 (25.2%) and 1996 (19.3%) data. The current high prevalence of acute malnutrition has to be seen in relation to the summer season where diarrhoea prevalence is high and the cumulative effect of low rain level in the last three years, which have had negative effects on the harvest.
There is a high rate of bottle-feeding of infants (56%), which will remain a potent cause of diarrhoea, ill health and increased infant and child morbidity and mortality risk. This is linked to the large amount of infant milk formula in the food rations (3.6 kg/month) compared to complementary foods (0.9 kg/month). The prevalence of breast-feeding is 78% during infancy and 38% during the second year. Exclusive breast-feeding is low with 5.4% for infants aged 0-5 months. There is an urgent need to continue advocating for an increase of complementary foods in the monthly food rations with a corresponding reduction in infant formula. There is also a pressing need to continue the high-risk group in terms of inadequate breast-feeding and high use of infant formula. Incidence of diarrhoea (25%) and acute respiratory infections (18%) were high during the past two weeks of the survey. Some (about 14%) of these children had both, diarrhoea and ARI.
More than half of the mothers (53%) interviewed were illiterate. This was highest (59%) in Dohuk and higher in rural/settlement areas as compared to urban areas. More than half of the mothers (53%) reported that they delivered at home. Home deliveries were less in Dohuk (40%), in urban areas (42%) and in literate women (42%).
Family use of adequately iodised salt was high (89.1%) at 15 parts per million and above, while 6.8% use inadequately iodised salt below 15 PPM, and only 4.2% of the families used salt without iodine. This is mainly attributed to the provision of potassium iodate to the salt iodization plants under the oil-for-food programme. This represents an improvement from the 72% reported in 1996, especially in Dohuk.
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ECD - Health