Housing Inquiry: London housing pipeline analysis initial findings
Cas Initial Findings 16 Feb
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Transcript of Cas Initial Findings 16 Feb
CAMBODIA ANTHROPOMETRICS SURVEY 2008Initial Findings of National Survey
Survey Description Cluster sample survey designed to detect a two
percentage point change in acute malnutrition and to provide provincial estimates of key nutrition indicators; separate domain of informal urban settlements also surveyed, but not analyzed yet
Field work carried out in November, with mop-up activities completed in December
7,600 households selected; interviews completed in 7,495 households (response rate >98%)
Primary objective of the survey is to determine the affect of increased food prices on nutrition
90.0
95.0
100.0
105.0
110.0
115.0
120.0
125.0
130.0
1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12
2005 2006 2007 2008
Relative price of food (food price index/consumer price index) by month in Cambodia from January 2005 to December 2008
Child anthropometry
Section I
05
101520253035404550
JAN FEB MAR APR MAY JUN SEP OCT NOV DEC
Wasting prevalence of children 0-4 years of age by month, CDHS 2000 & 2005
2000
2005
05
101520253035404550
JAN FEB MAR APR MAY JUN SEP OCT NOV DEC
Underweight prevalence of children 0-4 years of age by month, CDHS 2000 & 2005
2000
2005
Standard Deviation of Child Anthropometry
Indicators from CAS 2008HAZ WAZ WHZ
1.8 1.26 1.13
From Mei et al, 2007
16.8
8.4 8.9
Y2000 Y2005 Y2008
Percentage of children under five years classified as acutely malnourished according to Weight for Height, CDHS 2000/5 & CAS 2008
38.4
28.2 28.8
Y2000 Y2005 Y2008
Percentage of children under five years classified as malnourished according to Weight for age, CDHS 2000/5 & CAS 2008
9.4
29.1
6.4
24.2
8.9
28.8
W/H W/A
Expected levels are calculated using the percent decrease from DHS 2000 & 2005 and applying this to November 2005 levels
Comparison of similar months and expected levels of selected child anthropometry indicators
DHS Nov 2005 Expected Nov 2008 CAS 2008
49.7
43.239.5
Y2000 Y2005 Y2008
Percentage of children under five years classified as chronically malnourished according to Height for Age, CDHS
2000/5 & CAS 2008
39.3
32.8
16.9 16.3
28.4 27.2
8.3 8.7
30.4
21.1
9.0 8.5
RURAL URBAN RURAL URBAN
Sum of W/A Sum of W/H
Percentage of underweight and wasted children by place of residence, DHS 2000/5 & CAS 2008
2000 2005 2008
Child disease
Section II
1015202530354045505560
JAN FEB MAR APR MAY JUN JUL SEP OCT NOV DEC
Fever prevalence among children 0-4 years of age, CDHS 2000 & 2005
2000
2005
05
101520253035404550
JAN FEB MAR APR MAY JUN JUL SEP OCT NOV DEC
Diarrhea prevalence among children 0-4 years of age by month, CDHS 2000 & 2005
2000
2005
05
101520253035404550
JAN FEB MAR APR MAY JUN JUL SEP OCT NOV DEC
Prevalence of acute respiratory infection symptoms among children 0-4 years of age by month, CDHS 2000 & 2005
2000
2005
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
ARI Diarrhea Fever
Percent decrease of infectious disease prevalence from 2000 to 2005, CDHS month of February
URBAN
RURAL
21.6 22.1
29.7
2005 NOV 2005 2008
Period prevalence of diarrhea among youngest child 0-4 years of age, CDHS 2005 & CAS 2008
37.1 39.6
58.9
2005 NOV 2005 2008
Period prevalence of fever among youngest child 0-4 years of age, CDHS 2005 & CAS 2008
21.415.8
28.9
2000 2005 2008
Prevalence is calculated using methodology from the DHS 2000. Symptoms include cough and diffi culty breathing
Period prevalence of symptoms of acute respiratory infection among the youngest child 0-4 years of age, DHS 2000/5 & CAS
2008
8.9
15.6
2005 2008
Prevalence calculated using DHS 2005 methodology. Symptoms include cough, diffi culty breathing, and that these are chest related
Period prevalence of symptoms of acute respiratory infection among the youngest child 0-4 years of age, DHS 2005 & CAS
2008
15.88.9
15.48.3
28.9
15.6
ARI 2000 Method. ARI 2005 Method.
The methodology for calculating prevalence differed from 2000 to 2005. 2 symptoms were included in 2000 (cough & difficulty breathing) and a third symptom (chest-related) was
added in 2005
Period prevalence of symptoms of acute respiratory infection among youngest child 0-4 years of age, DHS 2005 & CAS 2008
2005 NOV 2005 2008
37.634.1
22.516.8
9.55.5
61.5
45.6
31.6
20.116.7
9.1
RURAL URBAN RURAL URBAN RURAL URBAN
Fever Diarrhea ARI
Percentage of children under 5 with disease in the two weeks preceding the survey by place of residence, DHS 2005 & CAS 2008
2005 2008
Woman anthropometry and micronutrient deficiency
Section III
7.2%
19.1%
5.2%
0.9%
6.3%
16.1%
3.7%1.5%
< 145 cm Total (<18.5) Moderate + Severe (<17.0) ≥ 30.0
Height Thin Obese
Among Women 15-49 Years of Age with a Child Under-5, Height and Levels of Body Mass Index, CDHS 2005 & CAS 2008
CDHS '05 CAS '08
8
2.2
5.1
1.6
unadjusted adjusted
Adjusted levels of night blindness consider women who also have vision problems during the day to not be suffering from night blindness
Percentage of women who suffered night blindness during last pregnancy, DHS 2005 & CAS 2008
2005 2008
Section IVFood consumption and coping strategies
4.7 4.6 5.4
4.6 4.5 5.2
4.7 4.7 4.8 4.6 4.5 5.2
national rural urban national rural urban
child mother
Mean number of food groups consumed by children and mothers in the day or night preceding the interview, CAS 2008
2005 2008
Question: How many times did [name] eat solid, semi-solid, or soft foods other than liquids yesterday during the day or at night?
71
59
52
43
41
43
7
71
70
60
56
44
52
13
Rely on less preferred and less expensive food
Purchase food on credit, incur debts
Reduce food eaten
Restrict consumption by adults for small children to eat
Mothers and elder sisters eat less than others
Borrow food, or rely on help from friends or relatives
Consume seed stocks
CAS 2008 field work was carried out primarily in November, while the CDRI survey took place during the month of May
Percentage of households using coping strategy related to food at least one time in the previous month, CAS 2008 & CDRI 2008 Survey
CAS CDRI
21
27
20
34
15
10
8
7
8
3
2
2
33
30
25
41
16
17
17
10
9
4
3
4
Increase exploitation of common property resources
Seek alternative or additional jobs
Plant more or new crops
Decrease expenditures for health care
Decrease expenditures for fertiliser, pesticide, etc
Increase migration for work or food
Sell more animals than usual
Sell jewellery
Take children out of school
Sell domestic assets
Sell productive assets
Sell land
CAS 2008 field work was carried out primarily in November, while the CDRI survey took place during the month of May
Percentage of households using coping stategy not related to food at least one time in the previous month, CAS 2008 & CDRI 2008 Survey
CAS CDRI
Section VConclusions
Conclusions 1 Improvements in maternal nutrition are
giving kids a better start, but this improvement is not carrying on through the first 5 years. The malnutrition-infection cycle for children under 5 is worsening and this is likely to have been caused by the increases in food prices
18.6
25.3
35.9
42.7
46.6 45.4
12
18.6
27.9 28.2
35.2 34.4
7.5
15.6
25.4
33.536.2
40.5
0 - 5 6 - 11 12 - 23 24 - 35 36 - 47 48 - 59
Percentage of children underweight by age group, DHS 2000/5 & CAS 2008
2000 2005 2008
0%
10%
20%
30%
40%
50%
60%
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57
Data smoothed with a three month rolling average
Percentage of children underweight by age in months, DHS 2000/5 & CAS 2008
DHS 2000 DHS 2005 CAS 2008
20.9
17.719
17.7
15.3
12.813.8 13.1
8.26.9 7.6
5.3
9.8
11.8
9.8 10.1
7.15.5
0 - 5 6 - 11 12 - 23 24 - 35 36 - 47 48 - 59
Percentage of children wasted by age group, DHS 2000/5 & CAS 2008
2000 2005 2008
Conclusions 2 Infection has increased in both urban and
rural areas, but levels are much higher in rural areas. Consumption of quality food is decreasing in both urban and rural areas, but the decrease is larger in urban areas. Poor urban areas have been affected the most by increased food prices and it can be considered an emergency situation in those areas. Many rural areas and entire provinces are facing crisis levels of acute malnutrition.
9.97.7 9.6 9.69.8 8.9
15.9
7.6
Poor Rich Poor Rich
Rural Urban
Wealth quintiles constructed using a simplified version of DHS methodology. Poor consists of the two lowest quintiles, while rich includes the two highest quintiles
Percentage of wasted children under-5 by place of residence and wealth, DHS 2005 & CAS 2008
2005 2008
Program Implications 1 The malnutrition-infection cycle is not going to
be broken with short-term staple food interventions. Breaking this cycle needs to be the focus.
Community screening for severe malnutrition with supported referral is needed; the immediate need is greatest in poor, urban areas.
The situation should be closely monitored with incidence data that can be disaggregated to the local level.
Program Implications 2 It does not make sense to focus only on
maternal nutrition and nutrition of children under 2. The improvements for both of these groups are keeping national levels of U-5 malnutrition below emergency levels, but these improvements will be erased if we do not react to the worsening nutrition status of older children.
Planned Further Analysis Child anthropometry by additional
background characteristics such as profession
Infant and young child feeding indicators Child and maternal supplementation Informal urban settlements
Future considerations There is not yet evidence that food prices
are going to drop to pre-crisis levels. If prices stay high, the nutrition situation will likely worsen.
The global recession is likely to make it more difficult for many families in Cambodia. As the recession deepens the impact on nutrition will be felt more and more, especially in combination with high food prices.