BINGA - INCREASED PREVALENCE OF MALNUTRITION AMONG

UNCLAS SECTION 01 OF 02 HARARE 000485

SIPDIS

NSC FOR SENIOR AFRICA DIRECTOR J. FRAZER
LONDON FOR C. GURNEY
PARIS FOR C. NEARY
NAIROBI FOR T. PFLAUMER
USAID/W FOR DCHA/OFDA FOR HAJJAR, KHANDAGLE AND MARX,
DCHA/FFP FOR LANDIS, BRAUSE, SKORIC AND PETERSEN,
AFR/SA FOR POE AND COPSON, AFR/SD FOR ISALROW AND WHELAN
PRETORIA FOR FFP DISKIN AND OFDA BRYAN
NAIROBI FOR DCHA/OFDA/ARO FOR RILEY, MYER AND SMITH,
REDSO/ESA/FFP FOR SENYKORR
ROME PLEASE PASS TO FODAG

E.O. 12958: N/A
TAGS: PHUM KHIV ZI
SUBJECT: BINGA - INCREASED PREVALENCE OF MALNUTRITION AMONG
CHILDREN

REF: A. 02 HARARE 2337

B. 02 HARARE 2871

C. 02 HARARE 2472


1. Summary: On February 11, Save the Children-UK (SCF) issued
its third Binga District Nutrition Survey in which they
reported a slight increase in the prevalence of acute
malnutrition among children aged
6 -59 months. The increase was not enough for malnutrition
among pre-school aged children in the district to reach
emergency levels. Mortality rates for both children under the
age of five and the total population were within acceptable
levels, contradicting numerous reports of death by starvation
throughout the district over the last several months. The
survey does show how HIV/AIDS has negatively affected the
community over the last year and increased food insecurity
among the vulnerable population. End Summary.

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Worsening Nutrition
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2. On February 11, Save the Children-UK (SCF) issued its
third Binga District Nutrition Survey (the first was
conducted in December 2001 and the second in April 2002) in
which they reported a slight increase in the prevalence of
acute malnutrition among children aged 6 - 59 months. The
objective of the survey was to estimate the prevalence of
acute malnutrition and assess the changes in malnutrition
levels. The survey covered all 21 wards in Binga and
presented weight and height measurement data on 933 randomly
selected children.


3. Binga is one of the most isolated and least developed
districts in Zimbabwe and was the site of heated discussions
between the Government and SCF about food aid politicization
last October. Food deliveries in Binga were blocked on two
separate occasions, leaving the district without general food
distribution for two months, although the Catholic church
school feeding program continued. On October, 4 local
authorities ordered Save the Children U.K. to halt food
distribution, five months after previously having forced the
Catholic Commission for Justice and Peace (CCJP) to stop
distribution efforts in the same town. (The Catholic church
feeding program was later resumed by a different church
entity in advance of SCF's problems. See Reftels)


4. As reported in ReftelB, SCF was just resuming food
distributions in December, after a Government of Zimbabwe
imposed, two and a half month suspension, and was preparing
to feed the entire population of Binga (120,000 people
according to the 2002 census results). Catholic Development
Commission (CADEC) was providing supplementary feeding to
63,000 children aged 6 months to 12 years and 2000 pregnant
women.


5. Global acute malnutrition among pre-school aged children,
measured by a decrease in the weight for height index and the
presence of edema, worsened from April 2002 from 3.5 percent
to 4.2 percent but was still within the acceptable range for
malnutrition. Chronic malnutrition or stunting increased to
33.2 percent from 29.5 percent indicating that one-third of
children are subjected to prolonged food deficits resulting
in compromised physical development. Children not receiving
SCF general food rations were 3.4 times more likely to be
acutely malnourished.

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HIV/AIDS Likely Cause of Deaths
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6. The crude mortality rate and the mortality rate for
children under five were considered normal, debunking
speculation that Binga had suffered widespread deaths by
starvation. After an examination of the demographic
characteristics of the sampled households, one can infer that
the primary causes of death during the three months preceding
the survey were malaria and HIV/AIDS-related illnesses.
(Note: The survey period coincided with the beginning of
malaria season. End Note.)


7. The demographic composition of the survey sample was
consistent with a community suffering from high levels of
HIV/AIDS infection. Orphans were 8.2 percent of the surveyed
children, up from 4.8 percent in April. Of this 8.2 percent,
2.3 percent had lost a mother only and 5.6 percent a father.
There was a decrease in the percentage of female-headed
households from 22.9 to 14.4 percent, which could be
attributed to a decline in male migrational labor. There was
one child-headed household, whereas the previous survey
reported none. Households headed by an elderly person
comprised 28 percent of respondents and households with
either a chronically ill decision maker or other adult male
comprised two percent of respondents.


8. Comment: This nutrition survey is a good assessment of
the effect of SCF program on children aged 6 - 59 months.
The sample selection appears to have been random and
relatively free of bias and thus is a good representation of
pre-school aged children. The results show that although
malnutrition levels have increased, those receiving SCF food
aid are doing much better than those who do not, even though
94 percent of children under five are also receiving CADEC
supplementary food. The survey is also good in that it
provides a snapshot of how disease is affecting this
chronically food insecure community. SCF will conduct
another survey to assess ongoing needs during the upcoming
April/May harvest.


9. Comment continued: Unfortunately, one cannot extrapolate
the results of this survey to the larger population receiving
SCF food because the sample size does not reflect the
population being fed by SCF. A growing body of literature is
recognizing that using pre-school aged children as proxy
indicators for the nutritional status for the entire
population does not provide an accurate picture of
malnutrition in a community. School-age children and adults
could well exhibit higher levels of malnutrition because they
are not receiving CADEC supplementary food in addition to the
SCF rations. Also, adults, particularly mothers, may be
forfeiting some of their food to ensure that their children
are getting enough to eat. End Comment.




SULLIVAN