Food insecurity, malnutrition and mortality in Maewo and Ambae islands, Vanuatu.

This study reports on findings from the ex post evaluation of the Maewo Capacity Building project in Vanuatu which was funded by World Vision Australia. The objective of the evaluation was to examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security, and health and nutritional outcomes in Maewo island, using Ambae island as a comparator The household food security of 817 households selected by a two stage cluster sampling method was assessed using a modified version of the Radimer-Comell hunger scale and the US National Measure of food security. Anthropometric measurement in children (6-59 months) and mortality data were also obtained. The prevalence of food insecurity without hunger was estimated at 15.3% (95%CI: 12.1% to 19.2%) in Maewo versus 38.2% (95%CI: 33.6% to 43.0%) in Ambae while food insecurity with hunger in children did not vary by location. After controlling for age, gender and household food security status, children aged 6-59 months in Maewo were less likely to be underweight than children of the same age in Ambae (OR: 0.66, 95%CI 0.38 to 0.99). No difference was detected between the two locations in terms of stunting and wasting prevalence. The crude mortality rate (CMR) was lower in Maewo (CTvIIR=0.47/10,000/day, 95%CI: 0.39 to 0.55) than Ambae (CMR= 0.59/10,000/day, 95%CI: 0.51 to 0.67) but no difference existed in mortality in children under five years old. The major causes of death were similar in both locations and the causes frequently reported were malaria, acute respiratory infection and dianheal diseases. The evaluation found that Maewo had better health and nutrition outcomes but the infrastructure left behind by the project and the livelihood system may have been weakened by cyclone Ivy that devastated the region from 25 to 27 February 2004.