UNDERNUTRITION IN MYANMAR · PDF file Executive Summary The multi-donor Livelihoods and Food...

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Transcript of UNDERNUTRITION IN MYANMAR · PDF file Executive Summary The multi-donor Livelihoods and Food...

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    UNDERNUTRITION IN MYANMAR Part 2: A Secondary Analysis of LIFT 2013 Household Survey Data March 2016

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    This report was prepared by Zaw Win and Jennifer Cashin for the Leveraging Essential Nutrition Actions to Reduce Malnutrition (LEARN) programme, funded by Livelihoods and Food Security Trust Fund (LIFT).

    About the Leveraging Essential Nutrition Actions to Reduce Malnutrition (LEARN)

    In 2012, LIFT funded the LEARN consortium of Save the Children, Action Contre la Faim (ACF) and Helen Keller International (HKI) to support non-government organisations to implement more nutri- tion-sensitive programmes.

    Our goal is to increase the capacity of LIFT implementing partners to deliver a more comprehensive approach to food security that includes all three food security pillars: Availability, Access and Utilisa- tion.

    Our objectives are: • Increase capacity of LIFT implementing partners to deliver nutrition-related activities in their target communities; • Integrate nutrition into current and forthcoming LIFT funded food security and livelihood programmes; and, • Support implementing partners in collecting nutrition-related data and to contribute in building the evidence base in LIFT project areas.

    Funded By:

    A Consortium Of:

    Published March 2016 Cover photo: Cooking sessions ensure mothers learn better cooking methods and practices, as well as dietary diversity in Kywe Boke, Mag- way Region, Myanmar. Photo Credit: Lynette Lim/Save the Children

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    Acronyms

    ACF Action Contre la Faim BMI Body mass index FCS Food consumption score FSL Food security and livelihoods HAZ Height-for-age z-score HDDS Household dietary diversity score HKI Helen Keller International IDDS Individual dietary diversity score IP Implementing partner IYCF Infant and young child feeding LEARN Leveraging Essential Nutrition Actions to Reduce Malnutrition MDD Minimum dietary diversity RHC Rural health center SCI Save the Children International WASH Water, sanitation and hygiene WAZ Weight-for-age z-score WHZ Weight-for-height z-score

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    Contents Part II: Secondary Analysis of LIFT 2013 Household Survey 1 Executive Summary .................................................................................................................................................. 7 Methodology ............................................................................................................................................. 7 Summary of Findings ............................................................................................................................... 7 Immediate causes of undernutrition: Inadequate dietary intake and disease ............................. 8 Underlying causes of undernutrition: food, care and environment ............................................... 8 Basic causes of undernutrition .............................................................................................................. 9 Areas for further research ...................................................................................................................10 1. Introduction .........................................................................................................................................................11 2. Methodology ........................................................................................................................................................11 2.1. LIFT 2013 Household Survey Datasets .....................................................................................11 2.2. Dependent variables ......................................................................................................................12 2.3. Independent variables ....................................................................................................................13 2.4. Wealth indexing ...............................................................................................................................14 2.5. Weights ..............................................................................................................................................14 2.6. Analysis of risk factors ...................................................................................................................15 2.7. Study limitations..............................................................................................................................15 3. Results ...................................................................................................................................................................15 3.1. Prevalence of undernutrition in LIFT program areas .............................................................16 3.1.1. Stunting ................................................................................................................................17 3.1.2. Wasting ................................................................................................................................19 3.1.3. Underweight .......................................................................................................................21 3.1.4. Diarrhea ..............................................................................................................................23 3.1.5. Dietary diversity ................................................................................................................25 3.2. Uplands .............................................................................................................................................27 3.2.1. Risk factors for undernutrition in the Uplands ..........................................................28 3.2.2. Risk factors for diarrhea in the Uplands ......................................................................30 3.2.3. Contributing factors to minimum dietary diversity in the Uplands ......................30 3.3. Dry Zone..........................................................................................................................................31 3.3.1. Risk factors for undernutrition in the Dry Zone ......................................................33 3.3.2. Risk factors for diarrhea in the Dry Zone ..................................................................37 3.3.3. Contributing factors to minimum dietary diversity in the Dry Zone ...................38 3.4. Coastal/Delta Zone ........................................................................................................................39 3.4.1. Risk factors for undernutrition in the Coastal/Delta Zone ....................................40 3.4.2. Risk factors for diarrhea in the Coastal/Delta Zone ................................................42 3.4.3. Contributing factors to minimum dietary diversity in the Coastal/Delta Zone .42 4. Discussion and Recommendations .................................................................................................................43 4.1. Undernutrition in LIFT program areas ......................................................................................43 4.1.1. Immediate causes: Inadequate dietary intake and disease .......................................44 4.1.2. Underlying causes: Food, care, environment ...............................................................46 4.1.3. Basic causes ........................................................................................................................47 4.2. Areas for additional research .......................................................................................................48 4.3. Recommendations for future surveys ........................................................................................48 References ................................................................................................................................................................49 ANNEX 1: Summary Prevalence Tables .............................................................................................................50 ANNEX 2: Results of multiple logistic regression ...........................................................................................75

    Left: Thein Thein Kwye nurses her 9 month old son in Mon Kan Village, Yaynanchaung Township, Dry Zone. Photo Credit: Elizabeth Whelan/ LEARN

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    Executive Summary

    The multi-donor Livelihoods and Food Security Trust Fund (LIFT) commenced operations in Myanmar in 2010, supporting implementing partners (IPs) to assist poor families to increase their food availability and incomes in three of the country‘s main agro-ecological zones: the Uplands, Dry Zone, and Delta Zone. LIFT programming was later initiated in Rakhine State in the Coastal Zone. LIFT has funded a consortium of Save the Children (SCI), Action Contre la Faim (ACF) and Helen Keller International, to implement the LEARN project. The goal of this three-year project (December 2012 – December 2015) is to build the capacity of IPs and to provide technical support to LIFT to maximize the nutritional impact of their food security and livelihoods (FSL) programming throughout the country.

    In 2013, LIFT contracted ICF International, Inc., which worked with Myanmar Survey Research, to carry out its second household survey that included 2,400 LIFT house- holds and 800 comparison households in 200 villages. In order to better understand the contributing factors of undernutrition in LIFT program areas and the links between child nutritional status and independent variables of programmatic