Standardized Expanded Nutrition Survey (SENS) in Kigoma Refugee Camps (Nyarugusu, Nduta and Mtendeli) - October 2019 - Tanzania

Abstract
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The UNHCR standardized expanded nutrition surveys (SENS) were conducted in the three refugee camps located in Kigoma region, the western part of Tanzania. The region has been receiving waves of refugees usually fleeing their countries particularly Burundi and the Republic Democratic of Congo (DRC) for decades now. During the surveys, Kigoma region was mainly hosting 260,906 refugees including; 58,077 Congolese in Nyarugusu old camp, 84,028 Burundians in Nyarugusu new camp, 84,691 Burundians in Nduta and 34,110 Burundians in Mtendeli camp. The under-five population was 54,395 in total including; 11,118 in Nyarugusu old camp, 16,861 in Nyarugusu new camp, 18,649 in Nduta and 7,767 in Mtendeli. Camps are located closer to host communities and to some extent the ethnical characteristics resembles especially between Burundians and the ethnic group of “Waha”, the majority in Kasulu and Kibondo districts. Unlike in previous years, the upgraded UNHCR SENS from version 2 (2013) to version 3 (2019) was piloted for the first time in Kigoma region, Tanzania between September and October 2019. In this version, seven modules were considered namely; Demography, Anthropometry and Health, Anaemia, Infant and Young Child Feeding (IYCF), Food Security, Mosquito Net Coverage and Water, Sanitation and Hygiene (WASH).

Geographic coverage
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All refugee camps in Kigoma: Nyarugusu, Mtendeli, Nduta.

Analysis unit
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Individuals and households

Universe
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All household members, all women between 15-49 years resident in the household, all children under 5 resident in the household.

Kind of data
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Sample survey data [ssd]

Sampling procedure
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In each camp, a cross-sectional household survey was conducted using a two-stage cluster sampling. Four independent samples were drawn separately for Nyarugusu New camp, Nyarugusu Old camp, Nduta camp and Mtendeli camp using the cluster sampling methodology.

Sampling deviation
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Absent Household
If the household members were not present, the survey team had to ask from neighbor of the residents' whereabouts. If they were expected to return before the survey team leaves the village/cluster, the survey team had to return to administer the questionnaire on the same day where possible. This household had an ID, even if the survey team could not able to revisit them. The survey team continued with the survey by choosing the next household according to the selection method described above and this household was not replaced. A household was considered “absent” when its members slept there last night and went out for the whole day of the survey.

Refusal
If a participant or an entire household refused to participate then it was considered a refusal and the individual or the household was not replaced with another. The refusal was recorded in the data collection control sheet.

Households without children U5 and/or without women
In households with no children aged 0-59 months and/or women between 15 and 49 years, the survey team had to complete the Demography questionnaire and the Household questionnaire (Food security, mosquito net and WASH) if this household was selected for the Household questionnaire (administered in every other household). In the data collection control sheet, the team leader wrote the household's number and indicated that no children between the ages of 0 and 59 months and/or no women between the ages of 15 and 49 years belonged to the household.

Absent Children/Women
The team leader asked the reason of the children's/women's absence. If the child/woman (or children or women) is close to the home, someone should be sent to bring them back. If the child/woman was expected to return before the survey team leaves the village/cluster, then the survey team had to return before the end of the day to take the measurements. If the child/woman could not be found before the team leaves the village/cluster, the child/woman available information (age, sex, etc.) were recorded in the questionnaire and the child/woman was marked as “absent” in the data collection control sheet.

Disabled Children
Disabled children were included in the survey. If a physical deformity prevents the measurement of child's weight, height or MUAC, the data were recorded as missing and the remaining data were collected. This information was recorded in the data collection control sheet.

Children in a medical/nutrition centre
Children in a medical/nutrition centre were included in the survey. Where feasible, the team had to go to the centre. If it was not possible to visit the centre, the child was given an ID number and considered as absent and not replaced. If the child was too weak to be measured, the anthropometric data were recorded as missing and the remaining data were collected. This information was also recorded in the data collection control sheet.

Mode of data collection
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Face-to-face [f2f]

Research instrument
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The SENS modules include standardized questionnaires, analysis guidance, reporting format and standard
analysis procedures.
4 questionnaires were included in this version:
1. Household demographics
2. Household mosquito nets, food security and WASH
3. Individuals, children under 5
4. Individuals, women between 15-49

Cleaning operations
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All data files were reviewed before analysis. Anthropometric data for children 6-59 months were analysed using ENA for SMART software. The nutritional indices were cleaned using flexible criterion (+/- 3 SD from the observed mean; also known as SMART flags in the ENA for SMART software).
The nutrition results were presented in the standard format following the report template from the ENA software (ENA for SMART 2011, July 9th, 2015). This format includes GAM, SAM, Stunting, Underweight and Overweight with 95% confidence intervals. The report has estimates of malnutrition calculated with the WHO 2006 growth references.

All other data were analysed in Epi-Info 7. Primary data and secondary information related to health and nutrition were also gathered through interviews, observations and various records. In the secondary data review; the UNHCR Health Information System (HIS) data, UNHCR and partners weekly and monthly reports and past nutritional survey reports were used for the final analysis.

Data was anonymized through decoding and local suppression.

摘要
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联合国难民署标准化扩展营养调查（SENS）在坦桑尼亚基戈马地区三个难民营地中进行。该地区数十年来一直接收来自各国尤其是布隆迪和刚果民主共和国（DRC）的难民潮。在调查期间，基戈马地区主要接待了260,906名难民，包括：Nyarugusu老营地58,077名刚果难民，Nyarugusu新营地84,028名布隆迪难民，Nduta营地84,691名布隆迪难民，以及Mtendeli营地34,110名布隆迪难民。五岁以下儿童总数为54,395人，包括：Nyarugusu老营地11,118人，Nyarugusu新营地16,861人，Nduta营地18,649人，以及Mtendeli营地7,767人。营地靠近东道社区，并在一定程度上，布隆迪人与“瓦哈”族群（卡苏卢和基邦多区的主体族群）的族群特征相似。与往年不同，升级后的联合国难民署SENS从2013年的第2版到2019年的第3版，首次在2019年9月至10月间在坦桑尼亚基戈马地区进行试点。在该版本中，考虑了七个模块，即：人口统计学、人体测量学和健康、贫血、婴幼儿喂养（IYCF）、食品安全、蚊帐覆盖率和水资源、卫生和清洁（WASH）。
地理覆盖范围
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基戈马地区所有难民营地：Nyarugusu、Mtendeli、Nduta。
分析单元
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个人和家庭
总体
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所有家庭成员，所有居住在户内的15-49岁女性，所有居住在户内的五岁以下儿童。
数据类型
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样本调查数据 [ssd]
抽样程序
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在每个营地，采用两阶段集群抽样法进行横断面家庭调查。分别针对Nyarugusu新营地、Nyarugusu老营地、Nduta营地和Mtendeli营地独立抽取四个样本。
抽样偏差
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缺席家庭
如果家庭成员不在场，调查团队需要向居民邻居询问其下落。如果预计他们在调查团队离开村庄/集群之前返回，调查团队应尽可能在当天返回进行问卷。即使调查团队无法再次访问，该家庭也有一个ID。调查团队继续进行调查，根据上述选择方法选择下一个家庭，该家庭不会被替换。如果一个家庭的成员在调查当天整日外出，该家庭被视为“缺席”。
拒绝
如果参与者或整个家庭拒绝参与，则视为拒绝，且不替换为其他人或家庭。拒绝在数据收集控制表中记录。
无5岁以下儿童和/或无女性的家庭
在无0-59个月儿童和/或15-49岁女性的家庭中，如果该家庭被选为家庭问卷（每户轮流进行），调查团队必须完成人口统计学问卷和家庭问卷（食品安全、蚊帐和WASH）。在数据收集控制表中，团队领导写下家庭的编号，并指出家庭中没有0至59个月之间的儿童和/或没有15至49岁之间的女性。
缺席的儿童/女性
团队领导询问儿童/女性缺席的原因。如果儿童/女性（或儿童或女性）靠近家中，应派人将其带回。如果预计儿童/女性在调查团队离开村庄/集群之前返回，则调查团队必须在当天结束前返回进行测量。如果在团队离开村庄/集群之前找不到儿童/女性，则在问卷中记录儿童/女性可用的信息（年龄、性别等），并在数据收集控制表中将该儿童/女性标记为“缺席”。
残疾儿童
残疾儿童包括在调查中。如果身体畸形妨碍了对儿童体重、身高或MUAC的测量，则记录为缺失数据，并收集剩余数据。此信息在数据收集控制表中记录。
医疗/营养中心的儿童
医疗/营养中心的儿童包括在调查中。如果可能，团队必须前往该中心。如果无法访问中心，则给儿童一个ID号码，视为缺席且不替换。如果儿童过于虚弱无法测量，则记录人体测量数据为缺失，并收集剩余数据。此信息也在数据收集控制表中记录。
数据收集方式
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面对面 [f2f]
研究工具
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SENS模块包括标准化问卷、分析指南、报告格式和标准分析程序。
本版本包含4份问卷：
1. 家庭人口统计学
2. 家庭蚊帐、食品安全和WASH
3. 个人，5岁以下儿童
4. 个人，15-49岁女性
数据清洗操作
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在分析之前，所有数据文件都经过了审查。使用ENA for SMART软件分析6-59个月儿童的人体测量数据。使用灵活标准（观察均值加减3个标准差；也称为ENA for SMART软件中的SMART标志）清洗营养指数。
营养结果按照ENA软件（ENA for SMART 2011，2015年7月9日）报告模板的标准格式呈现。该格式包括GAM、SAM、生长迟缓、体重不足和超重，以及95%置信区间。报告使用世界卫生组织2006年生长参考计算营养不良的估计值。
所有其他数据均使用Epi-Info 7进行分析。通过访谈、观察和各类记录收集有关健康和营养的初级数据和次级信息。在次级数据审查中，使用了联合国难民署健康信息系统（HIS）数据、联合国难民署及其合作伙伴的每周和月度报告以及过去营养调查报告，用于最终分析。
通过解码和本地抑制对数据进行匿名化。