Nutritional Status Of Young Children And Risk Factors Among Refugees And Host Population In Bidi Bidi Settlement, Yumbe District, Uganda.

Abstract

About 25.4 million people worldwide are living as refugees of whom 1.36 million are resident in Uganda. Uganda is the largest refugee host in Africa and third globally. The burden of refugees’ presence on the host population is rarely discussed by funding and development agencies. Despite continuous relief food interventons in refugee settlements in Uganda, the nutritional status of Bidi Bidi was high at 11.8%. The main objective of this study was to determine the nutritional status of children in the refugee settlement and to elucidate the risk factors that contribute to poor nutritional status of children in the settlement in order to illuminate strengths or weaknesses of the host population. Using analytical cross-sectional design, host and refugee populations were compared with emphasis on the nutritional status of children under the age five years. The sample size determination used 11.8% prevalence of wasting for the refugees to yield a simple random sample of 340 mother-child dyads. Using digital questionnaire, mothers provided data in Open Data Kit. The data included demographic and socio-economic characteristics, health-seeking behaviour, immunization status, child-feeding practices, anthropometric measurements, mother’s nutritional knowledge, attitude and practices. Data were analyzed using SPSS version 20.0 and Python version 3.7.3. The overall prevalence of underweight for the two groups was 14.1% (p=0.5) while global acute malnutrition (GAM) was 3.9% (p=0.9). GAM was 4.1% and 3.6% (p=0.9) for the host and refugee populations, while stunting was 27.0% and 22.4% (p=0.5), respectively. In ascending order, five factors contributed to poor nutritional status; size of household with large or medium being most affected (Adjusted Odds Ratio (ORa) =1.34 or 1.92), experience of illness episode in the 14 days prior to the study (wasting, stunting and underweight) (ORa=1.47, 1.49 and 1.97), being part of host population (wasting and stunting) (ORa=1.81 and 1.36), deworming status (lack of it) and anemia (ORa=3.2 and 2.13), respectively. Even though the host had relatively better nutrient intake, they were worse off compared to the refugees in Bidi Bidi; the refugee children had better nutritional status and better vitamin A intake. Therefore, the host should be equally targeted for nutritional interventions while strengthening family planning programmes to moderate household size for both groups. The government of Uganda should thereby formulate xviii and enforce policies based on the principle of non-discrimination that allow the host to benefit equally from food relief during emergencies. Lastly, livelihood programmes involving animal rearing should be promoted in Bidi Bidi and the host population.