The UNHCR Standardized Expanded Nutrition Surveys (SENS) provide regular nutrition data that plays a key role in delivering effective and timely interventions to ensure good nutritional outcomes among populations affected by forced displacement.
The refugee complex of Dadaab is home to an estimate of 208,000 registered refugees of which the vast majority are Somalis who fled conflict and drought in their home country several decades ago. The Dadaab refugee complex is situated in northeastern Kenya, near the border with Somalia. Dadaab was established in the year 1991 following the beginning of the civil war in Somalia. Somalis were forced to flee as the war worsened, leaving to neighbouring countries including Kenya, Ethiopia and Sudan. Today, Dadaab is home to refugees from many countries in eastern and central Africa, including South Sudan, Burundi, Congo, Ethiopia, Eritrea and Somalia. Somali refugees make up more than 90% of the population. Until early 2017, it consisted of five refugee camps. However, one of the camps, Kambioos, which was also the newest, was closed in March 2017 as refugees began returning to Somalia and the few remaining moved into the other camps. Ifo 2 camp was closed in May 2018 in line with the cam consolidation approach, with refugees either moving to the other camps or being repatriated voluntarily. Refugees live in mud-walled houses with iron sheeting roofs, while some, especially new arrivals, live in tents.
The Standardised Expanded Nutrition Survey (SENS) was conducted between 20 August and 8 September 2018 in the 3 Dadaab refugee camps (Dagahaley, Ifo and Hagadera) to assess the magnitude and severity of malnutrition, assess trends by comparison with previous years and support programmatic decisions.
The weighted prevalence of global acutemalnutrition, the most important indicator, was 8.0% overall, falling within the POOR category (5-9%). However, there was a marked improvement from 9.7% in 2017. Only Ifo camp was within the SERIOUS category (10-14%). The high prevalence of anaemia remains a major concern, as shown by the anaemia prevalence among children which remained above the 40% critical threshold, despite having decreased. Anaemia prevalence among non-pregnant women jumped to 48.9% overall, from 43.6% in 2017 and was above the 40% threshold for all camps. Some improvement was recorded in terms of infant and young chid feeding indicators, although there is still room for improvement. The access to safe drinking water also continued to be satisfactory, while gaps were still observed in terms of sanitation. The duration of the food ration and dietary diversity basically reflect what has been observed in recent surveys.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
Children 0-23 months
Children 6-59 months
Women 15-49 years
- v2.1: Edited, anonymous dataset for licensed distribution.
- Children 0-23 months: feeding practices
- Children 6-59 months: prevalence of acute malnutrition, underweight, stunting and anaemia, coverage of vit A supplementation, and prevalence of diarrhoea
- Women 15-49 years: prevalence of anaemia
- Households: food security; WASH knowledge, attitudes and practices
Health and Nutrition
Water Sanitation Hygiene
Dadaab Refugee Camps (Ifo, Dagahaley and Hagadera), in Northern Kenya
Children 0-59 months
Women 15-49 years
Producers and sponsors
Kenyan Red Cross
Medicins sans Frontieres
A two-stage cluster survey with probability proportion to size sampling was employed in this survey.
Standardized Monitoring and Assessment of Relief and Transitions (SMART) methodology to collect and analyse data on child anthropometry and UNHCR's Standardised Expanded Nutrition Survey (SENS) Guidelines for Refugee Populations was used to guide data collection for other indicators.
The same households sampled by SMART were used in all indicators. Anaemia sample was drawn from the SMART sample size, as recommended by the UNHCR Standardised Expanded Nutrition Survey (SENS) Guidelines.
For each of the indicators used, households and individuals were sampled as follows:
- WASH: every household
- Food Security: every other household
- Mosquito net: every other household
- Children 0-59 months: all eligible children in all households were assessed (based on the above calculations)
- Women 15-49: all eligible women in every other household were assessed.
The 2-stage cluster sampling method was used to select 30 clusters from each of the 3 camps. At the first stage, a list of blocks was made before the required number were selected using sampling with probability proportional to size (PPS) using ENA softwareIn nearly all cases, a cluster was the equivalent of a block. However, there were exceptions where, for some larger blocks, more than 1 cluster was selected. In this case, the blocks were split further to cater for more than one cluster. In the event that a selected block had more than 250 households, according to SMART guidance, segmentation was done, after which one of the segments was randomly selected to be the cluster.
All households in the selected clusters were labelled before data collection. At the second stage, the required number of households were selected using systematic random sampling from a list of households. A random number was selected between 1 and the sampling interval, which was calculated by dividing the total number of households in the cluster with the required number of households. The selected number became the first household to be surveyed. Subsequent households were selected by adding the sampling interval until the required number of households were completed. All eligible children below 5 years of age from all selected households were surveyed for the Child Anthropometry and Health, and Infant and Young Child Feeding (IYCF), and WASH. Half of the selected households were selected for the Food Security and Women questionnaire. The survey respondents were the primary caretakers of children below 5 years. Abandoned households were not included in the sampling frame. Absent households or households where children were absent were re-visited before the end of the day. If they were found to be empty, they were recorded as missing and were not replaced. Children who were in health centres at the time of the survey were recorded as absent
Dates of Data Collection
Data Collection Mode
Face-to-face interview: Mobile
Data Collection Notes
A household was defined as: a group of people who live together and routinely eat out of the
same pot. Where two families share the same pot, they were assessed as one household even if
they lived in the same compound.
Kenyan Red Cross
Medicins Sans Frontieres
1) Children 6-59 months (SENS Modules 1-2): Anthropometric status, oedema, enrolment in selective feeding programmes and blanket feeding programmes (CSB++), immunisation (measles), vitamin A supplementation in last six months, de-worming, morbidity from diarrhoea in past two weeks, haemoglobin assessment.
2) Children 0-23 months (SENS Module 3): Questions on infant and young children feeding practices.
3) Women 15-49 years (SENS Module 2): Pregnancy status, coverage of iron-folic acid pills and post-natal vitamin A supplementation, MUAC measurements for pregnant and lactating women (PLW), and haemoglobin assessment for non-pregnant women.
4) Food Security (SENS Module 4): Access and use of the general food ration (GFR), coping mechanisms when the GFR ran out ahead of time and household food dietary diversity using the food consumption score.
5) WASH (SENS Module 5): Water, sanitation and hygiene- Questions on quality and quantity of drinking water,
satisfaction with the drinking water supply, and sanitation facilities
UNHCR (2021). Kenya: SENS in Dadaab Refugee Camps 2018. Accessed from https://microdata.unhcr.org