Malnutrition trends in Rohingya children aged 6–59 months residing in informal settlements in Cox’s Bazar District, Bangladesh: An analysis of cross-sectional, population-representative surveys

Eva Leidman, Md. Lalan Miah, Alexa Humphreys, Leonie Toroitich-van Mil, Caroline Wilkinson, Mary Chelang'at Koech, Henry Sebuliba, Muhammad Abu Bakr Siddique, and Oleg Bilukha

Review

This paper estimates malnutrition rates among Rohingya refugee children in Bangladesh. Since April 2017, more than 700,000 Rohingya refugees have fled violence in Myanmar, settling in makeshift settlements in Cox’s Bazar District, Bangladesh.

The analysis is based on three cross-sectional population-representative cluster surveys covering all informal settlements of Rohingya refugees in the Ukhia and Teknaf Upazilas of Cox’s Bazar District. The first round was conducted during the acute phase of the humanitarian response (October–November 2017), and the second and third rounds were conducted 6 months (April–May 2018) and 12 months (October–November 2018) later. Anthropometric indices (weight, height, mid-upper arm circumference, oedema) and hemoglobin were measured in children aged 6–59 months.

Main findings:

  • The prevalence of global acute malnutrition (GAM) as assessed by weight for height declined from 19 percent in round 1 to 12 percent in round 2 and 11 percent in round 3.
  • The prevalence of anemia significantly declined between the first two rounds from 48 percent to 32 percent. Prevalence increased significantly to 40 percent during round 3 but remained below the round 1 level.
  • Reported receipt of both fortified blended foods (13 percent) and micronutrient powders (10 percent) were low during round 1 but increased significantly within the first 6 months to 50 percent and 30 percent, respectively.
  • Although findings demonstrate improvement in anthropometric indicators during a period in which nutrition program coverage increased, causation cannot be determined from the cross-sectional design.

In the acute phase of the humanitarian crisis, the nutritional status of Rohingya children in makeshift settlements of Cox’s Bazar District, Bangladesh, exceeded the World Health Organization (WHO) global emergency thresholds for both wasting and anemia. In the period 6-12 months after the initial assessment, there were significant improvements in both acute and micronutrient malnutrition. These improvements coincide with a scaleup of humanitarian interventions, including those to prevent and treat cases of malnutrition. Ongoing activities to improve access to nutritional services may facilitate further reductions in malnutrition levels to sustained below-crisis levels.