Standardized Expanded Nutrition Survey Final Report Tanzania Refugee Camps (Nyarugusu, Nduta and Mtendeli), Kigoma Region, October 2019
Demographic and Health Survey [hh/dhs]
The UNHCR standardized expanded nutrition surveys (SENS) were conducted in the three refugee camps located in Kigoma region, the western part of Tanzania. The region has been receiving waves of refugees usually fleeing their countries particularly Burundi and the Republic Democratic of Congo (DRC) for decades now. During the surveys, Kigoma region was mainly hosting 260,906 refugees including; 58,077 Congolese in Nyarugusu old camp, 84,028 Burundians in Nyarugusu new camp, 84,691 Burundians in Nduta and 34,110 Burundians in Mtendeli camp. The under-five population was 54,395 in total including; 11,118 in Nyarugusu old camp, 16,861 in Nyarugusu new camp, 18,649 in Nduta and 7,767 in Mtendeli. Camps are located closer to host communities and to some extent the ethnical characteristics resembles especially between Burundians and the ethnic group of “Waha”, the majority in Kasulu and Kibondo districts. Unlike in previous years, the upgraded UNHCR SENS from version 2 (2013) to version 3 (2019) was piloted for the first time in Kigoma region, Tanzania between September and October 2019. In this version, seven modules were considered namely; Demography, Anthropometry and Health, Anaemia, Infant and Young Child Feeding (IYCF), Food Security, Mosquito Net Coverage and Water, Sanitation and Hygiene (WASH).
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Individuals and households
Children between 6-59 months: Demographic profiling, nutritional status, anthropometry, health and anaemia
Children between 0-23 months: Nutritional status, breastfeeding conditions
Women between 15-49 years: anthropometry, health and anaemia
Households: food security, WASH, mosquito net coverage, demographic profiling.
Health and Nutrition
Water Sanitation Hygiene
Domestic Needs/Household Support
All refugee camps in Kigoma: Nyarugusu, Mtendeli, Nduta.
All household members, all women between 15-49 years resident in the household, all children under 5 resident in the household.
Producers and sponsors
TANZANIA RED CROSS SOCIETY
MEDECINS SANS FRONTIERES
MINISTRY OF HEALTH
In each camp, a cross-sectional household survey was conducted using a two-stage cluster sampling. Four independent samples were drawn separately for Nyarugusu New camp, Nyarugusu Old camp, Nduta camp and Mtendeli camp using the cluster sampling methodology.
Deviations from the Sample Design
If the household members were not present, the survey team had to ask from neighbor of the residents' whereabouts. If they were expected to return before the survey team leaves the village/cluster, the survey team had to return to administer the questionnaire on the same day where possible. This household had an ID, even if the survey team could not able to revisit them. The survey team continued with the survey by choosing the next household according to the selection method described above and this household was not replaced. A household was considered “absent” when its members slept there last night and went out for the whole day of the survey.
If a participant or an entire household refused to participate then it was considered a refusal and the individual or the household was not replaced with another. The refusal was recorded in the data collection control sheet.
Households without children U5 and/or without women
In households with no children aged 0-59 months and/or women between 15 and 49 years, the survey team had to complete the Demography questionnaire and the Household questionnaire (Food security, mosquito net and WASH) if this household was selected for the Household questionnaire (administered in every other household). In the data collection control sheet, the team leader wrote the household's number and indicated that no children between the ages of 0 and 59 months and/or no women between the ages of 15 and 49 years belonged to the household.
The team leader asked the reason of the children's/women's absence. If the child/woman (or children or women) is close to the home, someone should be sent to bring them back. If the child/woman was expected to return before the survey team leaves the village/cluster, then the survey team had to return before the end of the day to take the measurements. If the child/woman could not be found before the team leaves the village/cluster, the child/woman available information (age, sex, etc.) were recorded in the questionnaire and the child/woman was marked as “absent” in the data collection control sheet.
Disabled children were included in the survey. If a physical deformity prevents the measurement of child's weight, height or MUAC, the data were recorded as missing and the remaining data were collected. This information was recorded in the data collection control sheet.
Children in a medical/nutrition centre
Children in a medical/nutrition centre were included in the survey. Where feasible, the team had to go to the centre. If it was not possible to visit the centre, the child was given an ID number and considered as absent and not replaced. If the child was too weak to be measured, the anthropometric data were recorded as missing and the remaining data were collected. This information was also recorded in the data collection control sheet.
Sample weights were calculated for each of the data files.
Sample weights for the household data were computed as the inverse of the probability of selection of the household, computed at the sampling domain level (urban/rural within each region). The household weights were adjusted for non-response at the domain level, and were then normalized by a constant factor so that the total weighted number of households equals the total unweighted number of households.
Dates of Data Collection
Data Collection Mode
Data Collection Notes
Data were collected using mobile phones operated by the Android operating system (LG) and the ODK application. During supervision in the field and at the end of each day, the survey consultant and the supervisors manually check the phone questionnaires for completeness, consistency and accuracy. This check also used to provide feedback to the teams to improve data collection as the surveys progressed. Children data were downloaded and analysed on a daily basis with the ENA software (ENA for SMART 2011, July 9th, 2015). The SMART plausibility report was generated daily in order to identify any problems with anthropometric data collection such as flags and digit preference for age, height and weight, to improve the quality of the anthropometric data collected as the survey was on-going.
A quick check on Haemoglobin concentration among children and non-pregnant women was conducted during quality check. This was done by checking the disparities of number of subjects with low Hb level amongst the teams and feedback was provided for necessary correction among blood sample takers where applicable.
The SENS modules include standardized questionnaires, analysis guidance, reporting format and standard
4 questionnaires were included in this version:
1. Household demographics
2. Household mosquito nets, food security and WASH
3. Individuals, children under 5
4. Individuals, women between 15-49
All data files were reviewed before analysis. Anthropometric data for children 6-59 months were analysed using ENA for SMART software. The nutritional indices were cleaned using flexible criterion (+/- 3 SD from the observed mean; also known as SMART flags in the ENA for SMART software).
The nutrition results were presented in the standard format following the report template from the ENA software (ENA for SMART 2011, July 9th, 2015). This format includes GAM, SAM, Stunting, Underweight and Overweight with 95% confidence intervals. The report has estimates of malnutrition calculated with the WHO 2006 growth references.
All other data were analysed in Epi-Info 7. Primary data and secondary information related to health and nutrition were also gathered through interviews, observations and various records. In the secondary data review; the UNHCR Health Information System (HIS) data, UNHCR and partners weekly and monthly reports and past nutritional survey reports were used for the final analysis.
Data was anonymized through decoding and local suppression.
Miata Tubee Johnson
Office of the High Commissioner for Refugees. Tanzania - Standardized Expanded Nutrition Survey Final Report Tanzania Refugee Camps (Nyarugusu, Nduta and Mtendeli), Kigoma Region, October 2019. Anonymized for Public Use. Geneva: UNHCR (October 2019), Ref. UNHCR_TZN_2019_SENS. Dataset downloaded from https://microdata.unhcr.org on [date].