Standardised_Expanded_Nutrition_Survey__SENS_ DDI_BGD_2024_SENS_CXB_v01_M_v01_A_ESS_FAO United Nations High Commissioner for Refugees Statistics Division Nesstar Publisher Standardised Expanded Nutrition Survey (SENS) - 2024 - Cox’s Bazar BGD_2024_SENS_CXB_v01_M_v01_A_ESS United Nations High Commissioner for Refugees (UNHCR) National Nutrition Services (NNS) World Food Programme (WFP) United Nations Children's Fund (UNICEF) Action Against Hunger (ACF, Action contre la Faim) Gonoshasthaya Kendra (GK) Society for Health Extension and Development (SHED) World Vision (WV) Save the Children International (SCI) Concern Worldwide (CWW) CartONG Community Health and Nutrition Workers Nesstar Publisher Curation team Sample Frame, Households [sf/hh] The Standardised Expanded Nutrition Survey (SENS) is a series of survey methodologies developed by the United Nations High Commissioner for Refugees (UNHCR) and specifically designed to consider the factors that are most relevant to refugees. SENS measures not only nutritional status data but also measures relevant other data related to household composition, anaemia, measles vaccination, vitamin A supplementation, diarrhoea and other health-related indicators, infant and young child feeding (IYCF), food availability, water, sanitation and hygiene (WASH), latrine usage and mosquito nets at the household-level. By collecting all this data, SENS studies provide a detailed snapshot of the nutritional health of a refugee population at a given point in time. Health and Nutrition Water Sanitation Hygiene Malaria Prevention and Control Food Consumption The Standardized Expanded Nutrition Survey (SENS) 2024 was conducted among Rohingya refugee households residing in Cox’s Bazar, Bangladesh, between 1 and 21 December 2024. The survey aimed to assess the nutritional and public health status of refugees living in 33 camps and to inform evidence-based programming across health, nutrition, water, sanitation and hygiene (WASH), and food security sectors. Using two-stage cluster sampling, 672 households were selected from 48 clusters with representation across both the Kutupalong Mega Camps and registered camps (Kutupalong RC and Nayapara RC). The sampling frame was based on UNHCR population estimates as of 30 September 2024. The assessment collected data across multiple modules, including household demographics, child and maternal nutrition, water and sanitation practices, mosquito net coverage, food security, and coping strategies. Results indicated a medium level of global acute malnutrition (cGAM) among children under five (9.1 percent), persistent stunting (40.7 percent), and maternal malnutrition. Improvements were noted in complementary feeding practices and health program coverage, though challenges remain in dietary diversity, exclusive breastfeeding, and malaria prevention. Households reported high access to protected water sources and soap, with average water collection per person per day reaching 29.9 liters, above the UNHCR post-emergency standard. However, only 59.2 percent of households met the standard using protected containers and treated sources exclusively. Bangladesh The study covered the Kutupalong Mega Camps, Kutupalong Registered Camp, and Nayapara Registered Camp which are refugee camps located in Cox's Bazar, Chittagong Division, Bangladesh. Household All Rohingya refugee households residing in the 33 camps of Cox's Bazar as of 30 September 2024, including Mega Camps and registered camps (Kutupalong RC and Nayapara RC). Sample survey data [ssd] United Nations High Commissioner for Refugees (UNHCR) Concern Worldwide (CWW) National Nutrition Services (NNS) World Food Programme (WFP) United Nations Children's Fund (UNICEF) BRAC Gonoshasthaya Kendra (GK) Training and Management International (RTMI) Friendship The survey was conducted using two-stage cluster sampling. In the first stage, 48 clusters were selected from blocks across all 33 camps using probability proportional to size (PPS) sampling based on UNHCR September 2024 population estimates. In the second stage, 14 households were randomly selected from updated household lists in each cluster, yielding a total of 672 households to be surveyed. Face-to-face [f2f] The standard version 3 of the SENS questionnaires was used, which includes demographic, health, nutrition, food security, infant and young child feeding (IYCF), mosquito net, and water, sanitation and hygiene (WASH) modules. Data collection was conducted using face-to-face interviews with electronic tablets running the ODK application. The standard SENS version 3 questionnaire was used, adapted with technical support from CartONG. Community Health and Nutrition Workers supported the identification of sampled households. Enumerators received daily feedback and supervision, and anthropometric data were validated using the Emergency Nutrition Assessment (ENA) software for SMART. United Nations High Commissioner for Refugees (UNHCR), National Nutrition Services (NNS), World Food Programme (WFP), UNICEF, Action contre la Faim (ACF), Gonoshasthaya Kendra (GK), SHED, World Vision (WV), Save the Children International (SCI), CWW (2025). Bangladesh: Standardised Expanded Nutrition Survey (SENS). Accessed from: https://microdata.unhcr.org Children module.NSDstat This file contains the children module data dictionary. 0 107 Nesstar 200801 Demographics & Mortality.NSDstat This file contains the Demographics & Mortality module data dictionary. 0 27 Nesstar 200801 Food Security, Mosquito Net & WASH.NSDstat This file contains the Food Security, Mosquito Net & WASH module data dictionary. 0 68 Nesstar 200801 Women Module.NSDstat This file contains the women module data dictionary. 0 27 Nesstar 200801 ID 0 0 Camp name 0 0 Survey Date 0 0 Cluster 0 0 Sex of ${CHNAME}: 0 0 1 f 2 m Age of child in months 0 0 2 1 3 2 4 3 5 4 6 5 7 6 8 7 9 8 10 9 11 10 12 11 13 12 14 13 15 14 16 15 17 16 18 17 19 18 20 19 21 20 22 21 23 22 24 23 25 24 26 25 27 26 28 27 29 28 30 29 31 30 32 31 33 32 34 33 35 34 36 35 37 36 38 37 39 38 40 39 41 40 42 41 43 42 44 43 45 44 46 45 47 46 48 47 49 48 50 49 51 50 52 51 53 52 54 53 55 54 56 55 57 56 58 57 59 58 60 59 61 60 Weight in kg 0 0 Presence of bilateral pitting oedema 0 0 Do you have an official age documentation for ${CHNAME}? 0 0 Is ${CHNAME} currently present in the household? 0 0 CLOTHES 0 0 1 TRUE MEASURE 0 0 1 TRUE Is ${CHNAME} currently being treated in [SC, OTP and TSFP-local name- pusti khana] for malnutrition? Verify by card and empty packet, 0 0 1 TRUE Is ${CHNAME} currently enrolled in the BSFP? 0 0 1 TRUE Has ${CHNAME} been vaccinated against measles? 0 0 Was ${CHNAME} given any drug for intestinal worms in the last six months? 0 0 Diarrhea 0 0 Fever 0 0 Rash 0 0 Cough 0 0 Rapid breathing/difficulties in breathing 0 0 Skin disease 0 0 Did you give ORS sachets to ${CHNAME} when s/he had diarrhoea? 0 0 Did you give zinc tablets or syrup to ${CHNAME} when s/he had diarrhea? 0 0 Child body cleanliness observations 0 0 1 TRUE Does the child have a clean face and hands? 0 0 Does a child have clean clothes? 0 0 Does a child look like it has been recently washed? 0 0 Now I would like to ask you some QUESTIONS ABOUT CURRENT BREAST- AND BOTTLE FEEDING of your child(ren) Feel free to ask any question you may have. THESE QUESTIONS NEED TO BE ASKED TO THE MOTHER OR THE MAIN CAREGIVER WHO IS RESPONSIBLE FOR FEEDING THE CHILD. 0 0 1 TRUE Has ${CHNAME} ever been breastfed? 0 0 How long after birth did you first put ${CHNAME} to the breast? 0 0 Why your child was not put to the breast immediately or within one hour? 0 0 In the first 2 days after delivery, was ${CHNAME} given anything to drink or eat other than breastmilk ? 0 0 What was ${CHNAME} given in the first two days? 0 0 What was ${CHNAME} given in the first two days?/Milk (other than breastmilk) 0 0 What was ${CHNAME} given in the first two days?/Plain water 0 0 What was ${CHNAME} given in the first two days?/Sugar/Glucose water 0 0 What was ${CHNAME} given in the first two days?/Honey 0 0 What was ${CHNAME} given in the first two days?/Dates 0 0 What was ${CHNAME} given in the first two days?/Mustard oil 0 0 What was ${CHNAME} given in the first two days?/Cocoa 0 0 What was ${CHNAME} given in the first two days?/Gripe water 0 0 What was ${CHNAME} given in the first two days?/Fruit juice 0 0 What was ${CHNAME} given in the first two days?/Infant formula 0 0 What was ${CHNAME} given in the first two days?/Animal fat 0 0 What was ${CHNAME} given in the first two days?/Local herbs 0 0 What was ${CHNAME} given in the first two days?/Don’t know 0 0 In the first two days after delivery, why ${CHNAME} was given anything other than breast milk to eat or drink? 0 0 What did you do for the first Milk (Colostrum) after the birth of the baby? 0 0 If yes, why did you mainly squeeze out and throw away the first milk (Colostrum)? 0 0 Was ${CHNAME} breastfed yesterday during the day or at night? 0 0 Why was ${CHNAME} not breastfed yesterday during the day or at night? 0 0 1 TRUE Did ${CHNAME} drink anything from a bottle with a teat yesterday during the day or at night? 0 0 If bottle-feeding is yes, why ${CHNAME} drink anything from a bottle with a teat? 0 0 4B. Infant formula such as Myboy, Lactogen, Biomeal, Enfomeal, Prima, etc. 0 0 4C. Milk such as tinned, powdered e.g. Nido, fresh, Pran, or fresh animal milk, packages milk e.g. Arong, Fresh, Milk Vita, Pran etc. 0 0 If "Yes" How many times did ${CHNAME} drink Milk? If 7 or more, record "7" If numer of times not known, record "88" 0 0 4E. Clear broth or clear soup 0 0 4F. Semi solid/thick Yogurt other than drinks such as home made or bought from markets e.g. Arong, Pran, Milk Vita etc. 0 0 If “yes”: How many times did ${CHNAME} eat yogurt? If 7 or more, record “7” If number of times not known, record “88”. ”. 0 0 1 TRUE If "Yes": Was the yogurt or were any of these yogurts sweetened or flavored? 0 0 1 TRUE Homemade yogurt drinks or bought from market e.g. Pran, Matha, Gol Dowi, Labang, Lachi etc. 0 0 If "Yes" How many times did ${CHNAME} drink yogurt? If 7 or more, record "7" if number of times not known, record "88" 0 0 4G. Any type of thin porridge, for example made with WSB+, WSB++, rice powder, suji, cerelac or cerelac type other food etc. 0 0 Sodas, malt drinks, sports drinks, or energy drinks? 0 0 Tea, coffee or herbal drinks? 0 0 If "Yes": Was the drinks / were any of these drinks sweetened? 0 0 Chocolate-flavored drinks including those made from syrups or powders e.g. Ruh afza, Api tank, Espi, Foster Clark etc. 0 0 If "Yes": Was the drink or were any of these drinks sweetened? 0 0 Any specialized therapeutic or supplementary foods? 0 0 Any specialized therapeutic or supplementary foods?/No 0 0 Any specialized therapeutic or supplementary foods?/Therapeutic Milk e.g. F-75, F-100 0 0 Any specialized therapeutic or supplementary foods?/Don’t know 0 0 Yesterday, during the day or at night, did ${CHNAME} eat solid or semi-solid (soft, mushy) food? 0 0 How many times did ${CHNAME} eat solid or semi solid foods other than liquids yesterday? 0 0 If No, why ${CHNAME} didn’t t eat solid or semi solid foods other than liquids yesterday? 0 0 Cereals/Grains, roots, tubers (maize, nan, chapatti, parata, bread, rice, potato, cassava, yams) 0 0 Pulses, Legumes or Nuts (Lentils, Beans, Green Grams, Dried Peas, Seeds) 0 0 7A. Any meat, fish and poultry, such as beef, lamb, goat, chicken, liver, kidney, heart, or other organ meats, fresh or dried fish, sardines, seafood (e.g. shrimp), etc. 0 0 Eggs 0 0 Fruits and Vegetables rich in Vitamin A (e.g. carrot, pumpkin, red, yellow and orange sweet potato, mango, papaya, spinach, dark green leafy vegetables, long beans, red sweet capsicum, deep yellow and orange color squash etc.) 0 0 Other fruit and vegetables (e.g. banana, apples, pineapple, watermelon, eggplant, onion, cucumbers, tomatoes, onion) 0 0 Sweet foods such as chocolates, candies, pastries, cakes, biscuits, or frozen treats like ice cream and popsicles, or other commonly consumed sentinel sweet foods 0 0 Sweet foods such as chocolates, candies, pastries, cakes, biscuits, or frozen treats like ice cream and popsicles, or other commonly consumed sentinel sweet foods/No 0 0 Sweet foods such as chocolates, candies, pastries, cakes, biscuits, or frozen treats like ice cream and popsicles, or other commonly consumed sentinel sweet foods/Chocolates 0 0 Sweet foods such as chocolates, candies, pastries, cakes, biscuits, or frozen treats like ice cream and popsicles, or other commonly consumed sentinel sweet foods/Candies 0 0 Sweet foods such as chocolates, candies, pastries, cakes, biscuits, or frozen treats like ice cream and popsicles, or other commonly consumed sentinel sweet foods/Pastries 0 0 Sweet foods such as chocolates, candies, pastries, cakes, biscuits, or frozen treats like ice cream and popsicles, or other commonly consumed sentinel sweet foods/Cakes, Biscuits 0 0 Sweet foods such as chocolates, candies, pastries, cakes, biscuits, or frozen treats like ice cream and popsicles, or other commonly consumed sentinel sweet foods/Frozen treats like Ice Cream and Popsicles 0 0 Sweet foods such as chocolates, candies, pastries, cakes, biscuits, or frozen treats like ice cream and popsicles, or other commonly consumed sentinel sweet foods/Other 0 0 Sweet foods such as chocolates, candies, pastries, cakes, biscuits, or frozen treats like ice cream and popsicles, or other commonly consumed sentinel sweet foods/Don’t know 0 0 Salty or fried foods e.g. chips, crisps, puffs, french fries, fried dough, instant noodles or other commonly consumed sentinel fried and salty foods 0 0 Salty or fried foods e.g. chips, crisps, puffs, french fries, fried dough, instant noodles or other commonly consumed sentinel fried and salty foods/No 0 0 Salty or fried foods e.g. chips, crisps, puffs, french fries, fried dough, instant noodles or other commonly consumed sentinel fried and salty foods/Any Chips, Crisps, Puffs etc 0 0 Salty or fried foods e.g. chips, crisps, puffs, french fries, fried dough, instant noodles or other commonly consumed sentinel fried and salty foods/French Fries 0 0 Salty or fried foods e.g. chips, crisps, puffs, french fries, fried dough, instant noodles or other commonly consumed sentinel fried and salty foods/Fried Dough 0 0 Salty or fried foods e.g. chips, crisps, puffs, french fries, fried dough, instant noodles or other commonly consumed sentinel fried and salty foods/Instant Noodles 0 0 Salty or fried foods e.g. chips, crisps, puffs, french fries, fried dough, instant noodles or other commonly consumed sentinel fried and salty foods/Other 0 0 Salty or fried foods e.g. chips, crisps, puffs, french fries, fried dough, instant noodles or other commonly consumed sentinel fried and salty foods/Don’t know 0 0 7C.WSB++ 0 0 7D. Plumpy’Nut® (RUTF) 0 0 Caregiver observations 0 0 1 TRUE Caregiver tends to keep the child within visual range and looks at the child quite often 0 0 Caregiver talks to the child during the course of the visit 0 0 Caregiver interacts with child to promote development and learning 0 0 Caregiver smiles at the child, laughs with the child, caresses, kisses or hugs the child 0 0 Caregiver spanked or hit the child during the visit, or shouted or yelled at him/her 0 0 ID 0 0 Camp name 0 0 Cluster number 0 0 Survey date 0 0 Household Size 0 0 Ratio of children under 5 to household size 0 0 Ratio of women to household size 0 0 Ratio of pregnant women to household size 0 0 Ratio of females under 2 to household size 0 0 Ratio of males under 2 to household size 0 0 Ratio of children under 2 to household size 0 0 Ratio of females under 5 to household size 0 0 Ratio of males under 5 to household size 0 0 Ratio of females aged 5–14 to household size 0 0 Ratio of males aged 5–14 to household size 0 0 Ratio of children aged 5–14 to household size 0 0 Ratio of females under 15 to household size 0 0 Ratio of males under 15 to household size 0 0 Ratio of individuals under 15 to household size 0 0 Ratio of females aged 15–64 to household size 0 0 Ratio of males aged 15–64 to household size 0 0 Ratio of individuals aged 15–64 to household size 0 0 Ratio of females aged 65 and older to household size 0 0 Ratio of males aged 65 and older to household size 0 0 Ratio of individuals aged 65 and older to household size 0 0 Ratio of household females to total household size 0 0 Ratio of household males to total household size 0 0 ID 0 0 Camp name 0 0 Cluster number 0 0 1 1 2 10 3 11 4 12 5 13 6 14 7 15 8 16 9 17 10 18 11 19 12 2 13 21 14 22 15 23 16 24 17 25 18 26 19 27 20 28 21 29 22 3 23 30 24 31 25 32 26 33 27 34 28 35 29 36 30 37 31 38 32 39 33 4 34 40 35 41 36 42 37 43 38 44 39 45 40 46 41 47 42 48 43 5 44 6 45 7 46 8 47 9 Survey date 0 0 Does the household have a 6-59 months child? 0 0 Apart from aid, do you have access to any additional sources of income in the household? 0 0 Apart from aid, do you have access to any additional sources of income in the household?/Wage labor (including agriculture) 0 0 Apart from aid, do you have access to any additional sources of income in the household?/Paid volunteer (e.g. CNHW, CNV, GBV, teacher, etc) 0 0 Apart from aid, do you have access to any additional sources of income in the household?/Petty trading/small scale business 0 0 Apart from aid, do you have access to any additional sources of income in the household?/Remittance 0 0 Apart from aid, do you have access to any additional sources of income in the household?/Others 0 0 Apart from aid, do you have access to any additional sources of income in the household?/No additional source of aid 0 0 Environment observations 0 0 1 TRUE Are there animals in the child's play area? 0 0 Is there food left uncovered, on the ground or on table? 0 0 Do free range animals such as chicken, dogs… entering the house and/or kitchen? 0 0 Do you see organic waste (kitchen refuse, food…) left on the ground at a distance of less than 10 meters from the kitchen? 0 0 What is your household's assistance category? 0 0 Which of your household’s basic needs can you not meet? 0 0 Which of your household’s basic needs can you not meet?/Food 0 0 Which of your household’s basic needs can you not meet?/Water 0 0 Which of your household’s basic needs can you not meet?/Hygiene items, clothes, shoes 0 0 Which of your household’s basic needs can you not meet?/Health costs (including medicines) 0 0 Which of your household’s basic needs can you not meet?/Rent, shelter repair, household items (e.g. mattress, blanket, jerrycan), utilities and bills (e.g. electricity, water bills, phone calling credit) 0 0 Which of your household’s basic needs can you not meet?/Firewood/fuel for cooking or heating 0 0 Which of your household’s basic needs can you not meet?/Assets for a livelihood activity (e.g. seeds, tools, farming, fishing, petty trade, etc.) 0 0 Which of your household’s basic needs can you not meet?/Debt repayment 0 0 Which of your household’s basic needs can you not meet?/Save some money or support other family members, relatives, friends 0 0 Which of your household’s basic needs can you not meet?/Education (e.g. school fees, uniform, books) 0 0 Which of your household’s basic needs can you not meet?/Security 0 0 Which of your household’s basic needs can you not meet?/Other 0 0 Which of your household’s basic needs can you not meet?/All basic needs are met 0 0 Which of your household’s basic needs can you not meet?/Don’t know 0 0 What cooking fuel does your household usually use? 0 0 Does your household receive cooking fuel assistance? 0 0 How many days did the fuel from the LPG distribution received in October last? 0 0 In the past 4 weeks, have you or anyone in your household needed to skip meals due to cooking fuel shortage? 0 0 In the past 4 weeks, have you or anyone in your household needed to take out new loans or borrowed money? 0 0 In the past 7 days, how many days did your household rely on less preferred and/or less expensive food due to lack of food or money to buy food? 0 0 In the past 7 days, how many days did your household borrow food or rely on help from a friend or relative due to lack of food or money to buy food? 0 0 In the past 7 days, how many days did your household reduce the number of meals eaten in a day due to lack of food or money to buy food? 0 0 In the past 7 days, how many days did your household limit portion sizes at mealtime due to lack of food or money to buy food? 0 0 In the past 7 days, how many days did your household reduce consumption by adults so children could eat, due to lack of food or money to buy food? 0 0 reduced Coping Strategy Index 0 0 What is the total number of household members? 0 0 You entered more children below 60 months (${TOTCH}) and pregnant women (${TOTPW}) than people that actually slept in the household last night (${TOTHH}) . Please review. 0 0 Did you have your house sprayed with insecticide in an indoor residual spray campaign in the past 6 months? 0 0 1 TRUE What is the principal source of drinking water for members of your household? 0 0 Where do you and your household members (excluding children under 5) usually go to defecate? 0 0 Where do children under-5 living in this household usually go to defecate? 0 0 For the children under 5 that don’t use the latrine, what is done with their faeces? 0 0 Please show me the soap you have in the household. 0 0 How many containers do you have to collect or store water for domestic purposes for your house? Please show me all of them one by one. 0 0 Ratio of children in household to household size 0 0 Ratio of pregnant women to household size 0 0 Ratio of LLIN mosquito nets to household size 0 0 Ratio of observed nets to household size 0 0 Ratio of household members who slept under any net to household size 0 0 Ratio of household members who slept under LLIN to household size 0 0 Ratio of children under 5 who slept under any net to household size 0 0 Ratio of children under 5 who slept under LLIN to household size 0 0 Ratio of pregnant women who slept under any net to household size 0 0 Ratio of pregnant women who slept under LLIN to household size 0 0 Ratio of children under 5 (cross-checked value) to household size 0 0 Ratio of pregnant women (cross-checked value) to household size 0 0 Ratio of number of children to household size 0 0 Average liters of water collected per person per day 0 0 Total liters of water collected per household per day 0 0 ID 0 0 Camp name (WASH module) 0 0 Survey date (WASH module) 0 0 Cluster number (WASH module) 0 0 Household number (WASH module) 0 0 1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 10 10 Age of female respondent (WASH module) 0 0 1 15-19 2 20-24 3 25-29 4 30-34 5 35-39 6 40-44 7 45-49 Presence of children aged 6–59 months 0 0 Number of children aged 6–59 months 0 0 Presence of children outside 6–59 months 0 0 Months gap between the youngest children 6–59m 0 0 Respondent arrival date 0 0 Education level of respondent 0 0 Mood question intro 0 0 1 TRUE Felt cheerful and in good spirits 0 0 Felt calm and relaxed 0 0 Felt active and vigorous 0 0 Woke up feeling fresh and rested 0 0 Felt interest in daily activities 0 0 Workload self-perception 0 0 Decision-making intro 0 0 1 TRUE Decision on household matters 0 0 Decision on money use 0 0 Decision on own healthcare 0 0 Decision on child medical care 0 0 Received ANC during last pregnancy 0 0 Last delivery was a live birth 0 0 Currently breastfeeding 0 0