A Review of Vitamin A Supplementation in South Sudan: Successes, Challenges, and Opportunities for the Way Forward.

Aim: To identify vitamin A supplementation (VAS) trends in South Sudan and provide insights to refocus VAS programming vis a vis polio eradication campaigns recently phased out while access to health care, land, food, and markets remain challenging.

Method: Review of data from survey and coverage reports; review of policy and program documents; key informant responses; general literature search.

Results: Vitamin A deficiency (VAD) is likely a severe public health problem among preschool-aged children in South Sudan based on a high under-5 mortality rate (96.

Childhood Stunting and Wasting Following Independence in South Sudan.

Background: South Sudan has experienced ongoing civil and environmental problems since gaining independence in 2011 that may influence childhood nutritional status.

Objective: To estimate the prevalence of undernutrition among children in South Sudan in 2018 and 2019 compared to the prevalence in 2010.

Methods: Data on height and weight were collected using a 2-stage stratified sample framework in which households were randomly selected at the county level and nutritional status was calculated for all children under 5 years of age to determine height-for-age, weight-for-height, and weight-for-age Z-scores (HAZ, WHZ, and WAZ) and the prevalence of stunting, wasting, and underweight.

Can we predict the burden of acute malnutrition in crisis-affected countries? Findings from Somalia and South Sudan.

Background: Sample surveys are the mainstay of surveillance for acute malnutrition in settings affected by crises but are burdensome and have limited geographical coverage due to insecurity and other access issues. As a possible complement to surveys, we explored a statistical approach to predict the prevalent burden of acute malnutrition for small population strata in two crisis-affected countries, Somalia (2014-2018) and South Sudan (2015-2018).

Methods: For each country, we sourced datasets generated by humanitarian actors or other entities on insecurity, displacement, food insecurity, access to services, epidemic occurrence and other factors on the causal pathway to malnutrition.

Assessing the Impact of Integrated Community-Based Management of Severe Wasting Programs in Conflict-Stricken South Sudan: A Multi-Dimensional Approach to Scalability of Nutrition Emergency Response Programs.

Community-based management of severe wasting (CMSW) programs have solely focused on exit outcome indicators, often omitting data on nutrition emergency preparedness and scalability. This study aimed to document good practices and generate evidence on the effectiveness and scalability of CMSW programs to guide future nutrition interventions in South Sudan. A total of 69 CMSW program implementation documents and policies were authenticated and retained for analysis, complemented with the analyses of aggregated secondary data obtained over five (2016-2020 for CMSW program performance) to six (wasting prevention) years (2014-2019).

Assessment of the effectiveness of a small quantity lipid-based nutrient supplement on reducing anaemia and stunting in refugee populations in the Horn of Africa: Secondary data analysis.

Stunting and micronutrient malnutrition are persistent public health problems in refugee populations. UNHCR and its partner organisations implement blanket supplementary feeding programmes using a range of special nutritional products as one approach to address these issues. The evidence base for the efficacy and effectiveness of a small quantity lipid-based nutrient supplement, Nutributter®, in reducing stunting and anaemia is limited.

Operational guidance on the use of special nutritional products in refugee populations.

Background: Stunting, acute malnutrition, and micronutrient malnutrition are persistent public health problems in refugee populations worldwide. In recent years there has been an increase in the availability and use of special nutritional products in emergency and development contexts to help address inadequate nutrient intakes from low-diversity diets. The availability of new special nutritional products, and the decision by the United Nations High Commissioner for Refugees (UNHCR) to use blanket supplementary feeding programs to prevent stunting and anemia, raised new challenges for designing, monitoring, and evaluating nutritional programs.

Iodine intake in Somalia is excessive and associated with the source of household drinking water.

Few data on iodine status in Somalia are available, but it is assumed that deficiency is a public health problem due to the limited access to iodized salt. We aimed to describe the iodine status of the population of Somalia and to investigate possible determinants of iodine status. A national 2-stage, stratified household cluster survey was conducted in 2009 in the Northwest, Northeast, and South Central Zones of Somalia.

Excessive iodine intake during pregnancy in Somali refugees.

Iodine deficiency and excess are both associated with adverse health consequences, with fetuses, children and pregnant women being most vulnerable to the devastating effects of severe deficiency. It is often assumed that the iodine status of a population if displaced or in a remote or emergency situation is low. However, there is little evidence available to support this assumption, especially among long-term food-aid-dependent pregnant women.

Maize meal fortification is associated with improved vitamin A and iron status in adolescents and reduced childhood anaemia in a food aid-dependent refugee population.

Objective: To assess changes in the Fe and vitamin A status of the population of Nangweshi refugee camp associated with the introduction of maize meal fortification.

Design: Pre- and post-intervention study using a longitudinal cohort.

Setting: Nangweshi refugee camp, Zambia.