Nutrition in times of crisis: Report of the SMART national nutrition survey in Lebanon (August – September 2021) – Lebanon

Strong points

As Lebanon reels from a convergence of crises that have plunged the majority of the population into poverty, the nutrition sector in Lebanon has released the results of a new national nutrition survey on children and women under five by exploiting the malnutrition situation in the country, marked by major food and nutrition insecurity, poor health and nutrition practices and lack of access to quality services.


UNICEF and MoPH, in collaboration with Action Against Hunger Canada’s SMART team, successfully conducted a national survey, which included ten SMART surveys from July to September 2021. The national survey targeted all 8 governorates with a weighted analysis carried out for the national estimates, and two camps of the surveys targeting Syrian refugees residing in informal settlements and Palestinian refugees in camps.

The main objective of the survey was to determine the nutritional and health status of the under-5s and the mother.

The specific objectives of the survey were:

  • To estimate the prevalence of acute malnutrition (weight for height) in children aged 6-59 months.

  • To estimate the prevalence of stunting (height for age) in children aged 6-59 months.

  • To estimate the prevalence of underweight (weight for age) in children aged 6-59 months.

  • Estimate morbidity rates (ARI, acute flaccid paralysis, diarrhoea) in children aged 6 to 59 months; two weeks before the survey.

  • Estimate the proportion of children 0-59 months who have received polio and measles vaccines.

  • Assess selected infant and young child feeding indicators for children 0-24 months; Exclusive Breastfeeding (EBF), Ever Breastfed (EvBF), Mixed Breastfeeding (MixMF), Continuous Breastfeeding (CBF), ISSSF, Minimum Dietary Diversity (MDD), Minimum Meal Frequency (MMF) and Minimum Acceptable Diet (MAD) .

  • Assess the nutritional status of pregnant and lactating women by MUAC.

  • To estimate the prevalence of anemia in children 6-59 months and women of childbearing age.

  • Formulate recommendations to guide nutrition programs in Lebanon.

The SMART method (Standardized Monitoring Assessment for Relief and Transition Method) was used to conduct the surveys.

The methodology is a cross-sectional study design with a 2-stage sampling approach. Stage 1 involved sampling of clusters in each governorate/camp, while Stage 2 involved segmentation of clusters and simple random sampling of households within the selected clusters.

The household was used as the basic sampling unit.
The data collection tools were based on national and global guidelines and approved by the Technical Committee. The standard SMART questionnaire in ODK collection was used in the tablets to collect data in 8 strata while the paper questionnaire was used in two strata (South and El Nabatieh). ENA for SMART was used in the analysis of anthropometric indicators while EPI-Info software was used for the analysis of additional indicators.

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