Authors :
Pidor Riek Koang
Volume/Issue :
Volume 11 - 2026, Issue 8 - August
Google Scholar :
https://tinyurl.com/35wdxmc9
Scribd :
https://tinyurl.com/bdzzp46v
DOI :
https://doi.org/10.38124/ijisrt/26aug096
Note : A published paper may take 4-5
working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and
ResearchGate.
Abstract :
Background:
Severe Acute Malnutrition (SAM) remains a critical public health emergency in South Sudan, particularly in conflictaffected zones like Leer County. Despite humanitarian interventions, prevalence rates remain persistently high. This study
analyzed the immediate and underlying determinants of SAM among children aged 6–59 months in Leer County, Unity
State.
Methodology:
A cross-sectional mixed-methods study design was employed. Quantitative data was collected from 339 caregivers using
a structured questionnaire based on SMART methodology, achieving a 100% response rate. Qualitative data was gathered
from 23 health facilities and 12 community leaders through key informant interviews. Bivariate analysis using Fisher’s Exact
Test was used to determine associations, alongside descriptive statistics.
Keywords :
Severe Acute Malnutrition, Leer County, WASH, Conflict, Diarrhea.
References :
- Abdelhadi, I. H., Ali, Y. E. K., Alghamdi, A. A., & Aljohani, B. F. (2024). Addressing Malnutrition in Conflict Zones: Designing Effective Data Collection Instruments for Vulnerable Populations. Journal of Public Health and Epidemiology, 16(2), 55–69.
- ACF International. (2020). SMART Methodology Implementation in High-Risk Settings: Guidelines for Data Collection and Survey Design. Action Against Hunger.
- Al-Awlaqi, M. A., Al-Musawa, H. R., & Al-Tawfiq, J. A. (2024). The Impact of Prolonged Conflict and Economic Collapse on Food Security and Malnutrition Rates in Yemen. The Lancet Global Health, 12(4), e430–e438.
- Ali, O. I., Elamin, I. M., & Ibrahim, M. S. (2024). Protracted Conflict and Mass Displacement: Structural Determinants of Health Crises in South Sudan. Conflict and Health, 18(1), 25.
- Amenu, S., Kassa, B., & Shiferaw, S. (2023). Determinants of Acute Malnutrition Among Children Aged 6–59 Months in Conflict-Affected Regions of Ethiopia: A Case-Control Study. Nutrition and Health, 12(3), 722–735.
- Concern Worldwide. (2024). Integrated health and nutrition services for disaster-affected populations in Unity State, South Sudan [Infographic].https://admin.concern.net/sites/default/files/documents/2024-08/South%20Sudan%20ECHO%20Infographic.pdf
- Conflict Sensitivity Resource Facility. (2020). Leer County profile, Unity State, South Sudan. https://csrf-southsudan.org/county_profile/leer/
- Elsayed, M. K., Hassan, N. H., & Musa, A. A. (2024). Psychological Trauma and Caregiver Agency: Assessing Coping Mechanisms Among Internally Displaced Persons in Sudan. International Journal of Social Psychiatry, 70(8), 1083–1095.
- FAO. (2024). The State of Food Security and Nutrition in Conflict-Affected Regions: A Global Overview. Food and Agriculture Organization of the United Nations.
- International Medical Corps. (2024). Suboptimal Infant and Young Child Feeding Practices in Conflict Settings: The Impact of Unregulated Formula Distribution. Maternal & Child Nutrition, 20(4), e13627.
- Ismail, H., Sano, Y., & Abe, T. (2025). The Interplay of Conflict and Climate Change on Household Food Security and Malnutrition in Sub-Saharan Africa. International Journal of Environmental Research and Public Health, 22(1), 302–315.
- Ismail, M. A., Shaker, H. Y., & El-Hassan, M. A. (2024). Dietary Diversity and Hunger Scores as Independent Predictors of Acute Malnutrition in Crisis-Affected Populations. Public Health Nutrition, 27(5), 1007–1016.
- IPC. (2024). South Sudan acute food insecurity and nutrition analysis (July 2024–March 2025). https://www.ipcinfo.org/fileadmin/user_upload/ipcinfo/docs/IPC_South_Sudan_Acute_Food_Insecurity_Malnutrition_Sep2024_July2025_Report.pdf
- King, J. D. (2020). Political Ecology of Health in Fragile States: Understanding Chronic Malnutrition Beyond Proximate Causes. Social Science & Medicine, 266, 113401.
- Lauby-Secretan, B., Taba, M., & Baan, R. (2022). Health in Conflict Settings: The Political Economy of Environmental and Health System Collapse. The Lancet Global Health, 10(10), e1458–e1467.
- Nussbaum, M. C. (2020). The Capability Approach in Practice: Development, Ethics, and Gender. Cambridge University Press.
- Schweiger, A., & Graf, L. (2021). Applying the Capability Approach in Humanitarian Settings: Ethical Considerations for Research and Intervention. Journal of International Humanitarian Action, 6(1), 1–12.
- Siziya, S., Muula, A. S., & Ngoma, A. (2024). Correlates of Severe Acute Malnutrition Among Pediatric Patients in a Low-Resource Setting: An Analytical Cross-Sectional Study. Paediatrics and International Child Health, 44(3), 395–403.
- Tufts FIC. (2025). Nutrition in Africa's Drylands: A Conceptual Framework for Addressing Acute Malnutrition. Tufts University Friedman School of Nutrition Science and Policy.
- UNICEF. (2020). UNICEF Conceptual Framework on the Determinants of Maternal and Child Nutrition. United Nations Children's Fund.
- Wikipedia. (2025). Leer County. https://en.wikipedia.org/wiki/Leer_County
- WHO. (2020). Guidance on the Management of Children with Severe Acute Malnutrition. World Health Organization.
- WHO. (2023). Global Nutrition Report 2023: Malnutrition in All Its Forms. World Health Organization.
- Wang, H., Zhang, A., & Chen, L. (2023). The Capability Approach to Food Insecurity: Conversion Factors and Agency in Achieving Nutritional Well-being. Sustainability, 15(8), 6545.
Background:
Severe Acute Malnutrition (SAM) remains a critical public health emergency in South Sudan, particularly in conflictaffected zones like Leer County. Despite humanitarian interventions, prevalence rates remain persistently high. This study
analyzed the immediate and underlying determinants of SAM among children aged 6–59 months in Leer County, Unity
State.
Methodology:
A cross-sectional mixed-methods study design was employed. Quantitative data was collected from 339 caregivers using
a structured questionnaire based on SMART methodology, achieving a 100% response rate. Qualitative data was gathered
from 23 health facilities and 12 community leaders through key informant interviews. Bivariate analysis using Fisher’s Exact
Test was used to determine associations, alongside descriptive statistics.
Keywords :
Severe Acute Malnutrition, Leer County, WASH, Conflict, Diarrhea.