WFP/UNICEF DPR KOREA NUTRITION SURVEY SHOWS MARKED

UNCLAS SECTION 01 OF 02 ROME 000791

SIPDIS

AIDAC

FROM U.S. MISSION IN ROME
UNCLASSIFIED

PAGE 02 ROME 00791 01 OF 02 260638Z

STATE FOR A/S KELLY, A/S PRM DEWEY, IO A/S HOLMES, EAP/K
DONG AND BELLER, AND IO/EDA WINNICK
USDA/FAS FOR U/S PENN, MCHAMBLISS AND RTILSWORTH
USAID FOR ADMINISTRATOR NATSIOS, AA/DCHA WINTER, AA/ANE
CHAMBERLAIN, D/DCHA/FFP LLANDIS AND JBRAUSE
NSC FOR JDWORKEN

E.O. 12958: N/A
TAGS: EAID PREL PREF EAGR ECON KN PREL PREF EAGR ECON KN KS UN KS EAID UN
SUBJECT: WFP/UNICEF DPR KOREA NUTRITION SURVEY SHOWS MARKED
DECLINE IN MALNUTRITION RATES AMONG CHILDREN

REF: (A) ROME 00655

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SUMMARY
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1. MALNUTRITION RATES AMONG CHILDREN IN THE DEMOCRATIC
PEOPLE'S REPUBLIC OF KOREA (DPRK) HAVE DECLINED CONSIDERABLY
OVER THE PAST FOUR YEARS, ACCORDING TO THE SURVEY RELEASED
BY WFP AND UNICEF ON FEBRUARY 20, CONJOINTLY WITH THE HOST
GOVERNMENT'S CENTRAL BUREAU OF STATISTICS AND INSTITUTE OF
CHILD NUTRITION. MAJOR FINDINGS OF THE SURVEY ARE: A) THE
PROPORTION OF CHILDREN UNDERWEIGHT (WEIGHT-FOR-AGE) HAS
FALLEN FROM 61 PERCENT IN 1998 TO 21 PERCENT IN 2002; B)
WASTING, OR ACUTE MALNUTRITION (WEIGHT-FOR-HEIGHT),HAS
FALLEN FROM 16 PERCENT TO 9 PERCENT; AND C) STUNTING, OR
CHRONIC MALNUTRITION (HEIGHT-FOR-AGE),HAS DROPPED FROM
62 PERCENT TO 42 PERCENT. THE SURVEY COVERED 6,000 RANDOMLY
UNCLASSIFIED

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SELECTED HOUSEHOLDS LOCATED IN 200 RANDOMLY SELECTED RI
(DISTRICTS) AND DONG (COUNTIES) OF SEVEN PROVINCES (DPRK HAS
NINE PROVINCES),AND THREE CITIES. THE UN AGENCIES CONCLUDED
THAT THESE GAINS COULD BE LOST IF INTERNATIONAL SUPPORT FOR
HUMANITARIAN ASSISTANCE TO THE COUNTRY CONTINUES TO
DIMINISH. END SUMMARY.

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BACKGROUND
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2. THIS NUTRITION ASSESSMENT - THE LARGEST OF ITS KIND EVER
TO BE UNDERTAKEN IN NORTH KOREA - COVERED BOTH CHILD AND
MATERNAL NUTRITION AND WAS CARRIED OUT IN OCTOBER 2002 BY
THE GOVERNMENT'S CENTRAL BUREAU OF STATISTICS (CBS) AND
INSTITUTE OF CHILD NUTRITION (ICN),IN COLLABORATION WITH
UNICEF AND THE WORLD FOOD PROGRAM (WFP). THE SURVEY SAMPLE
INCLUDED 6,000 RANDOMLY SELECTED HOUSEHOLDS LOCATED IN 200
RANDOMLY SELECTED RI AND DONG OF SEVEN PROVINCES (DPRK HAS
NINE PROVINCES),AND IN THREE CITIES. THE HOUSEHOLDS
SELECTED WERE THOSE WITH CHILDREN UNDER SEVEN YEARS OF AGE.
IN EACH HOUSEHOLD SELECTED, THE YOUNGEST CHILD WAS WEIGHED
AND MEASURED, AND INFORMATION COLLECTED ON HOUSEHOLD FOOD
SUPPLIES. IN HOUSEHOLDS WHERE THE CHILD WAS UNDER TWO YEARS
OF AGE, THE MOTHER WAS ALSO INTERVIEWED CONCERNING MATERNAL
AND CHILD HEALTH CARE PRACTICES, INFANT FEEDING PRACTICES,
AND MATERNAL FEEDING PRACTICES. MOTHERS OF CHILDREN UNDER
TWO YEARS OLD CHILDREN WERE ALSO WEIGHED AND MEASURED, AND
INVITED TO UNDERGO A HEMOGLOBIN EXAMINATION.


3. THE NUTRITION ASSESSMENT INVOLVED OVER 100 PROFESSIONALLY
UNCLASSIFIED

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QUALIFIED STAFF - CBS, ICN, WFP AND UNICEF. TWENTY TEAMS OF
FIVE PERSONS FROM THE CENTRAL LEVEL CARRIED OUT DATA
COLLECTION. THEY WERE ASSISTED BY PROVINCIAL LEVEL LOGISTICS
TEAMS THAT ARRANGED FOR LOCAL PREPARATIONS AND SUPPORT IN
THE RI AND DONG, AND BY A PROVINCIAL LEVEL DATA ENTRY AND
QUALITY CONTROL TEAM. UNICEF AND WFP PROVIDED FINANCIAL AND
LOGISTICAL SUPPORT. THE INSTITUTE OF CHILD HEALTH, LONDON
AND THAILAND HEALTH FOUNDATION, BANGKOK, PROVIDED TECHNICAL
ADVICE. CBS WAS DIRECTLY RESPONSIBLE FOR PREPARATION OF
QUESTIONNAIRE, IDENTIFICATION OF SURVEY TARGET HOUSEHOLDS,
ENLISTMENT AND TRAINING OF SURVEY TEAM MEMBERS, ORGANISATION
AND MONITORING OF FIELD SURVEY ACTIVITIES, REVIEW OF
QUESTIONNAIRES AND DATA COLLECTION, DATA ANALYSIS AND REPORT
WRITE-UP.

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FINDINGS
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4. MAJOR FINDINGS OF THE SURVEY ARE:

A) THE PROPORTION OF CHILDREN UNDERWEIGHT (WEIGHT-FOR-AGE)
HAS FALLEN FROM 61 PERCENT IN 1998 TO 21 PERCENT IN 2002;
B) WASTING, OR ACUTE MALNUTRITION (WEIGHT-FOR-HEIGHT),HAS
FALLEN FROM 16 PERCENT TO 9 PERCENT; AND
C) STUNTING, OR CHRONIC MALNUTRITION (HEIGHT-FOR-AGE),HAS

UNCLASSIFIED

UNCLASSIFIED PTQ8202

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ACTION AID-00

INFO LOG-00 NP-00 AGRE-00 AMAD-00 CA-01 CIAE-00 COME-00
USNW-00 DODE-00 DOEE-00 DOTE-00 SRPP-00 DS-00 MEDE-00
EAP-00 EB-00 EUR-00 FAAE-00 FBIE-00 UTED-00 VC-00
H-01 TEDE-00 INR-00 IO-00 L-00 VCE-00 M-00
AC-01 NEA-00 NSAE-00 NSCE-00 OCS-03 OES-00 OIC-02
PA-00 PER-00 PM-00 ACE-00 P-00 SCT-00 SP-00
IRM-00 TEST-00 TRSE-00 T-00 USIE-00 SA-00 R-00
PMB-00 DSCC-00 PRM-00 DRL-01 G-00 NFAT-00 SAS-00
SWCI-00 /009W
-------------- 3B7A29 260639Z /38
P 260546Z FEB 03
FM AMEMBASSY ROME
TO SECSTATE WASHDC PRIORITY 8457
INFO EU MEMBER STATES COLLECTIVE
AMEMBASSY BEIJING
AMEMBASSY SEOUL
AMEMBASSY TOKYO
AMEMBASSY CANBERRA
USEU BRUSSELS 3147
USMISSION GENEVA
USMISSION USUN NEW YORK

UNCLAS SECTION 02 OF 02 ROME 000791

SIPDIS

AIDAC

FROM U.S. MISSION IN ROME
UNCLASSIFIED

PAGE 02 ROME 00791 02 OF 02 260638Z

STATE FOR A/S KELLY, A/S PRM DEWEY, IO A/S HOLMES, EAP/K
DONG AND BELLER, AND IO/EDA WINNICK
USDA/FAS FOR U/S PENN, MCHAMBLISS AND RTILSWORTH
USAID FOR ADMINISTRATOR NATSIOS, AA/DCHA WINTER, AA/ANE
CHAMBERLAIN, D/DCHA/FFP LLANDIS AND JBRAUSE
NSC FOR JDWORKEN

E.O. 12958: N/A
TAGS: EAID PREL PREF EAGR ECON KN PREL PREF EAGR ECON KN KS UN KS EAID UN
SUBJECT: WFP/UNICEF DPR KOREA NUTRITION SURVEY SHOWS MARKED
DECLINE IN MALNUTRITION RATES AMONG CHILDREN

DROPPED FROM 62 PERCENT TO 42 PERCENT.


5. IN GENERAL, CAREFUL REVIEW OF THE RESULTS SUGGESTS THAT
REAL IMPROVEMENTS HAVE OCCURRED. THESE IMPROVEMENTS ARE,
HOWEVER, MUCH MORE PRONOUNCED FOR UNDERWEIGHT GAINS THAN
THEY ARE FOR STUNTING. THE FALL IN UNDERWEIGHT ACROSS THREE
SURVEYS (1998, 2000 AND 2002) - FROM 60 PERCENT TO 28
PERCENT TO 20 PERCENT - SHOWS A CONSISTENT TREND.


6. HOWEVER, THE RATES OF CHILD UNDERWEIGHT AND STUNTING ARE
STILL HIGH AND REQUIRE CONTINUED AND SUSTAINED EFFORTS.
THERE IS EVIDENCE THAT MATERNAL NUTRITION IS FAR FROM
OPTIMAL WITH A THIRD OF MOTHERS MEASURED RECORDING LESS THAN
22.5 CM FOR MUAC. MOREOVER, ABOUT ONE-THIRD OF MOTHERS
COVERED BY THE SURVEY WERE OBSERVED TO BE BOTH MALNOURISHED
AND ANEMIC.


7. THE ASSESSMENT PROVIDED THE FIRST OBJECTIVE ANALYSIS OF
UNCLASSIFIED

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DIFFERING VULNERABILITY ACROSS THE COUNTRY. STUNTING AMONG
CHILDREN IN NAMPO CITY WAS 25 PERCENT, FOR EXAMPLE, COMPARED
TO 48 PERCENT IN SOUTH HAMGYONG PROVINCE. THE WASTING RATE
IN PYONGYANG WAS JUST UNDER 4 PERCENT, AGAINST 12 PERCENT IN
SOUTH HAMGYONG. THE SURVEY FOUND SIMILAR PATTERNS IN FOOD
AVAILABILITY AND THE INCIDENCE OF CHILDHOOD DIARRHEA. UNICEF
AND WFP SAID SUCH PATTERNS CONFIRMED THEIR OBSERVATIONS FROM
FIELD MONITORING THAT THE NORTHEASTERN PROVINCES ARE MORE
VULNERABLE THAN OTHER PARTS OF THE COUNTRY.

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WFP/UNICEF CONCLUSION
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8. THOUGH CHILD MALNUTRITION HAS FALLEN CONSIDERABLY,
ACCORDING TO THE SURVEY, BOTH WFP AND UNICEF COMMENTED THAT
THERE IS STILL "GREAT CAUSE FOR CONCERN." CITING WORLD
HEALTH ORGANIZATION (WHO) CRITERIA, THEY CONCLUDE THAT CHILD-
WASTING RATES ARE STILL HIGH, AND CHILD STUNTING RATES VERY
HIGH. JAMES T. MORRIS, WFP EXECUTIVE DIRECTOR, COMMENTED
THAT: "THE CRISIS IS NOT OVER. IF THE UN CAN'T PROVIDE MORE
MEDICINE AND FOOD - AND QUICKLY - WE WILL SEE MALNUTRITION
RATES RISE AGAIN, UNDOING MUCH OF THE PROGRESS THAT HAS BEEN
MADE." HALL

UNCLASSIFIED

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2003ROME00791 - Classification: UNCLASSIFIED