unicef/cdc/who elderly assessment in … and food insecurity nutrition ... assistance project iii...
TRANSCRIPT
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UNICEF/CDC/WHOElderly Assessment
in Government Controlled Areas of Donetsk and Luhansk oblasts and Non-Government controlled areas of Donetsk
April 2016
Nutrition Sub-Cluster of the Health and Nutrition Cluster Кластерная группа по питанию Кластера здравоохранения и питания
https://www.humanitarianresponse.info/operations/ukraine/nutrition
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Introduction
• Previous assessments in Donbass region have shown older people:• Make up the largest percentage of people affected by the conflict
• Are one of the most vulnerable groups
• Humanitarian response has been slow to identify and address their needs
• A recent assessment by HelpAge International in the Donbass region suggested there may be cases of malnutrition in older persons and difficulties for older persons to access healthcare services and medications for non-communicable diseases
• No comprehensive assessments done of older people’s health and dietary needs
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Assessment Goal
• Collect information on health and nutrition in order to help design and inform emergency interventions of the key partner agencies working in the health and nutrition sectors.
• Specifically, provide advice on the requirements for adapted and targeted assistance for older men and women >60 years living in the government controlled areas (GCAs) of Donetsk and Luhansk oblasts and non-government controlled areas (NGCAs) of Donetsk oblast and to monitor the degree to which these groups are accessing such services.
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Methods
• Quantitative (NGCAs and GCAs)• Cross-sectional household survey
• Qualitative (GCAs only)• Focus group discussions
• This was presented in a previous presentation and will not be discussed here
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NGCA Sampling Frame
• Electoral precincts with population data in non-government controlled areas (NGCAs) of Donetsk oblast• Last updated October 2015
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NGCA Sample Selection
Multi-stage sampling procedure1) Cluster randomized sample
• Electoral precincts were primary sampling units
• Clusters selected probability proportional to size (PPS)
• 25 clusters were selected
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NGCA Sample Selection
Multi-stage sampling procedure2) Systematic random sampling to choose households
• Chose 2 random starting points in the cluster, conducted ½ of the interviews for that cluster from each starting point
• Apartment buildings• Apartment building randomly selected
• Apartment unit randomly selected as starting point using a random number
• Chose every other apartment
• Private houses• Private house randomly selected as starting point
• Chose every other house after random starting point
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Inclusion Criteria
1) Person > 60 years at the time of the survey2) Current resident of one of the randomly selected clusters
and households3) Consented to participate in the survey
NOTE: Included all elderly persons, not only internally displaced persons (IDPs)
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Survey Administration
GCASample Size of 750 elderly persons
• 31 Clusters of 24 Households• 24 Clusters in Donetsk oblast, 7
clusters in Luhansk oblast
Data collection was conducted from 30 January to 13 February 2016
• 9 trained data collectors
NGCASample Size of 418 elderly persons
• 25 Clusters of 16 Households
Data collection was conducted from 21 February to 5 March 2016
• 5 trained data collectors
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Survey Topics
• Questions• Household and individual demographics, income• Access to humanitarian assistance• Chronic diseases and access to medications• Food intake and food insecurity• Dependency (Ability to perform daily activities)• Psychological distress
• Anthropometry Measurements• Body Mass Index• Mid-upper arm circumference
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Questionnaire-Demographics and Income
• Education
• Age
• Sex
• Living situation
• IDP status
• Number of people in household
• Pension
• Total income
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• Registered to receive assistance
• Receipt of aid• Cash/Vouchers
• Food
• Non-food
• Transportation assistance
Questionnaire-Humanitarian Assistance
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Questionnaire-Health and Healthcare Seeking
Chronic Diseases• Hypertension
• Diabetes
• Cardiovascular diseases
• Chronic lung diseases
• Taking medications regularly
Acute Respiratory Infection• Sought care
• Reason for not seeking care
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Questionnaire-Nutrition and Food Insecurity
Nutrition• Foods eaten yesterday
• Number of meals eaten yesterday
• Number of times food group eaten in past week
• Individual dietary diversity• Calculated based on the Women’s Dietary Diversity Score (WDDS) developed by the Food
and Agriculture Organization (FAO) of the United Nations1
Food Insecurity• Household Hunger Scale developed by the Food and Nutrition Technical
Assistance Project III (FANTA) 2
1. Guidelines for Measuring Household and Individual Dietary Diversity. FAO. 20132. Household Hunger Scale: Indicator Definition and Measurement Guide. FANTA III. 2011
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Questionnaire-Dependency• Help with bathing• Help getting dressed• Help using the toilet• Help with moving from bed to chair• Incontinence• Help with eating• Someone to care for you• Classified as independent, moderately dependent, and severely
dependent• Katz Index of Independence in Activities of Daily Living1-3
1. Katz S, Ford A, Moskowitz R, et al. Studies of illness and the aged. The Index of ADL: A standardized measure of biological and psychosocial function. JAMA, 185(12), 1963.2. Katz S, Down T, Cash H, et al. Progress in the development of the index of ADL. The Gerontologist. 10(10), 1970.3. Katz S. Assessing self-maintenance: Activities of daily living, mobility, and instrumental activities of daily living. JAGS. 31(12) 1983.
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Questionnaire-Psychological Condition
• Nervous
• Hopeless
• Restless or fidgety
• Depressed
• Everything is an effort
• Worthless
• Kessler K6 Psychological Distress Scale1-2
• Scale previously pilot tested and validated in Ukraine
1. Kessler R, Andrews G, Colpe L, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine. 32(60), 2002.2. Kessler R, Barker P, Colpe L, et al. Screening for serious mental illness in the general population. Archives of General Psychiatry. 60(20), 2003.
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Questionnaire-Anthropometry
• Arm-demi span (as proxy for height) and weight used to calculate body mass index (BMI)
• Mid-upper arm circumference (MUAC)
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Household Survey Results
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Demographic Characteristics GCA
(N=758)
NGCA
(N=418)
Gender n (%) n (%)
Male 266 (35.1) 140 (33.5)
Female 492 (64.9) 278 (66.5)
Age (years)
60-70 371 (48.9) 181 (43.3)
>70 387 (51.1) 237 (56.7)
Mean (SD) 71.8 (8.2) 72.7 (8.3)
Median (IQR) 70.4 (64.5-78.1) 73.4 (65.1-78.4)
Respondent
Self 695 (92.7) 390 (93.3)
Proxy 63 (8.3) 28 (6.7)
Education level
Incomplete secondary school 177 (23.4) 100 (23.9)
Complete secondary school 177 (23.4) 143 (34.2)
Professional secondary education 285 (37.6) 133 (31.8)
Incomplete or complete higher education or
above119 (15.7) 42 (10.1)
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Demographic Characteristics GCA
(N=758)
NGCA
(N=418)
Living situation (n, %)
Own house or apartment (no fee) 740 (97.6) 400 (95.7)
Other 18 (2.4) 18 (4.3)
Total # of people in household
Mean (SD) 2.1 (1.1) 2.1 (1.1)
Median (IQR) 2 (1-2) 2 (1-2)
Total # of people >60 years in household (n, %)
1 386 (50.9) 201 (48.1)
2 361 (47.6) 202 (48.3)
3 11 (1.5) 15 (3.6)
Living Situation
Living alone 238 (31.4) 123 (29.4)
Living only with another person(s) over 60 308 (40.6) 172 (41.2)
Living with people under 60 212 (28.0) 123 (29.4)
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Socioeconomic Characteristics GCA Donetsk
(N=592)
GCA Luhansk
(N=166)
GCA Total
(N=758)
NGCA
(N=418)
Ukrainian Government Pension Eligibility
Registered to receive pension from
Ukrainian Government, n (%)
592 (100) 166 (100) 758 (100) 372 (89.0)
N=592 N=166 N=758 N=372
Received pension last month from
Ukrainian Government, n (%)
590 (99.7) 166 (100) 756 (99.7) 80 (21.5)
Amount of pension received last month from
Ukrainian Government (UAH)
N=590 N=166 N=756 N=60
Mean (SD) 1676.0 (784.3) 1549.1 (533.0) 1647.3 (736.9) 1985.5 (1093.9)
Median (IQR) 1350 (1230-1800) 1300 (1228-1700) 1342 (1230-1800) 1500 (1200-2750)
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Socioeconomic Characteristics GCA Donetsk
(N=592)
GCA Luhansk
(N=166)
GCA Total
(N=758)
NGCA
(N=418)
Ukrainian Government Pension Eligibility
Registered to receive pension from
Ukrainian Government, n (%)
592 (100) 166 (100) 758 (100) 372 (89.0)
N=592 N=166 N=758 N=372
Received pension last month from
Ukrainian Government, n (%)
590 (99.7) 166 (100) 756 (99.7) 80 (21.5)
Amount of pension received last month from
Ukrainian Government (UAH)
N=590 N=166 N=756 N=60
Mean (SD) 1676.0 (784.3) 1549.1 (533.0) 1647.3 (736.9) 1985.5 (1093.9)
Median (IQR) 1350 (1230-1800) 1300 (1228-1700) 1342 (1230-1800) 1500 (1200-2750)
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Socioeconomic Characteristics GCA Donetsk
(N=592)
GCA Luhansk
(N=166)
GCA Total
(N=758)
NGCA
(N=418)
Ukrainian Government Pension Eligibility
Registered to receive pension from
Ukrainian Government, n (%)
592 (100) 166 (100) 758 (100) 372 (89.0)
N=592 N=166 N=758 N=372
Received pension last month from
Ukrainian Government, n (%)
590 (99.7) 166 (100) 756 (99.7) 80 (21.5)
Amount of pension received last month from
Ukrainian Government (UAH)
N=590 N=166 N=756 N=60
Mean (SD) 1676.0 (784.3) 1549.1 (533.0) 1647.3 (736.9) 1985.5 (1093.9)
Median (IQR) 1350 (1230-1800) 1300 (1228-1700) 1342 (1230-1800) 1500 (1200-2750)
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Socioeconomic CharacteristicsNGCA
(N=418)
DNR Pension Eligibility
Registered to receive pension, n (%) N=418409 (97.9)
Received pension last month, n (%) N=409402 (98.3)
Amount of pension received last month from DNR
N=356
Mean (SD) 1244.5 (707.5) UAH
3360.1 (1910.2) RUB*
Median (IQR) 930 (815-1407) UAH
2512 (2200-3800) RUB*
Received pension from Ukrainian government and DNR
last month, n (%) 77 (18.4)*Exchange Rate 2.7:1
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Socioeconomic CharacteristicsGCA Donetsk
(N=592)
GCA Luhansk
(N=166)
GCA Total
(N=758)
NGCA
(N=418)
Resident of household currently working,
n (%) 155 (26.2) 34 (20.5) 189 (24.9) 72 (17.2)
Total amount of household income N=529
(UAH)
N=140
(UAH)
N=669
(UAH)N=339
Mean (SD)3090.7 (1768.8) 2661.9 (1216.5) 3000.8 (1677.5)
2713.5 (2049.2) UAH
7326.5 (5532.9) RUB*
Median (IQR)2723 (1500-4000) 2500 (1470-3400) 2650 (1500-3813)
2222 (1185-3498) UAH
6000 (3200-9444) RUB*
Total household income per capita (UAH)
Mean (SD)1663.6 (734.1) 1530.6 (565.3) 1635.7 (704.2)
1474.8 (1087.6) UAH
3982.0 (2936.5) RUB*
Median (IQR)1450 (1250-2000) 1325 (1210-1770) 1400 (1250-1953)
1111 (852-1675)
3000 (2300-4522) RUB*
*Exchange Rate 2.7:1
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Socioeconomic Characteristics GCA Donetsk
(N=528)
n (%)
GCA Luhansk
(N=140)
n (%)
GCA Total
(N=668)
n (%)
NGCA Total
(N=339)
n (%) Household income per capita ($/day)
<$2/day280 (53.0) 86 (61.4) 366 (54.8) 228 (67.3)
$2-$3/day162 (30.7) 37 (26.4) 199 (29.8) 69 (20.4)
$3-$4/day57 (10.8) 15 (10.7) 72 (10.8) 16 (4.7)
>$4/day29 (5.5) 2 (1.4) 31 (4.6) 26 (7.7)
Household income per capita in $/day
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Socioeconomic Characteristics GCA Donetsk
(N=528)
n (%)
GCA Luhansk
(N=140)
n (%)
GCA Total
(N=668)
n (%)
NGCA Total
(N=339)
n (%) Household income per capita ($/day)
<$2/day280 (53.0) 86 (61.4) 366 (54.8) 228 (67.3)
$2-$3/day162 (30.7) 37 (26.4) 199 (29.8) 69 (20.4)
$3-$4/day57 (10.8) 15 (10.7) 72 (10.8) 16 (4.7)
>$4/day29 (5.5) 2 (1.4) 31 (4.6) 26 (7.7)
Household income per capita in $/day
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Socioeconomic Characteristics GCA Donetsk
(N=528)
n (%)
GCA Luhansk
(N=140)
n (%)
GCA Total
(N=668)
n (%)
NGCA Total
(N=339)
n (%) Household income per capita ($/day)
<$2/day280 (53.0) 86 (61.4) 366 (54.8) 228 (67.3)
$2-$3/day162 (30.7) 37 (26.4) 199 (29.8) 69 (20.4)
$3-$4/day57 (10.8) 15 (10.7) 72 (10.8) 16 (4.7)
>$4/day29 (5.5) 2 (1.4) 31 (4.6) 26 (7.7)
Household income per capita in $/day
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IDP Status GCA Total
(N=758)
NGCA Total
(N=418)
Displaced due to conflict (n, %) 13 (1.7) 8 (1.9)
Permanent residence left from (n, %) N=13 N=8
Donetsk oblast 8 (61.5) 8 (100)
Luhansk oblast 2 (15.4) 0 (0)
Other/Don’t know 3 (23.1) 0 (0)
Length of displacement, months
Mean (SD) 16.2 (5.6) 15 (4.6)
Median (IQR) 19 (12-19) 14 (12-19)
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IDP Status GCA Total
(N=758)
NGCA Total
(N=418)
Displaced due to conflict (n, %) 13 (1.7) 8 (1.9)
Permanent residence left from (n, %) N=13 N=8
Donetsk oblast 8 (61.5) 8 (100)
Luhansk oblast 2 (15.4) 0 (0)
Other/Don’t know 3 (23.1) 0 (0)
Length of displacement, months
Mean (SD) 16.2 (5.6) 15 (4.6)
Median (IQR) 19 (12-19) 14 (12-19)
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Assistance Donetsk LuhanskGCA
TotalNGCA
Registered to receive additional
assistance from the state, humanitarian
or volunteer organizationsn/N (%) n/N (%) n/N (%) n/N (%)
All respondents 33/592 (5.6) 43/166 (25.9) 76/758 (10.0) 359/418 (85.9)
IDPs 4/11 (36.4) 2/2 (100) 6/13 (46.2) 4/8 (50.0)
Received humanitarian assistance in the
last 3 months, all respondentsN=592
n (%)
N=166
n (%)
N=758
n (%)
N=418
n (%)
Any kind of assistance 17 (2.9) 32 (19.3) 49 (6.5) 347 (83.0)
Cash vouchers/coupons 2 (0.3) 1 (0.6) 3 (0.4) 1 (0.2)
Food assistance 12 (2.0) 30 (18.1) 42 (5.5) 347 (83.0)
Non-food assistance 6 (1.0) 3 (1.8) 9 (1.2) 4 (1.0)
Transportation 0 (0) 0 (0) 0 (0) 1 (0.2)
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Assistance Donetsk LuhanskGCA
TotalNGCA
Registered to receive additional
assistance from the state, humanitarian
or volunteer organizationsn/N (%) n/N (%) n/N (%) n/N (%)
All respondents 33/592 (5.6) 43/166 (25.9) 76/758 (10.0) 359/418 (85.9)
IDPs 4/11 (36.4) 2/2 (100) 6/13 (46.2) 4/8 (50.0)
Received humanitarian assistance in the
last 3 months, all respondentsN=592
n (%)
N=166
n (%)
N=758
n (%)
N=418
n (%)
Any kind of assistance 17 (2.9) 32 (19.3) 49 (6.5) 347 (83.0)
Cash vouchers/coupons 2 (0.3) 1 (0.6) 3 (0.4) 1 (0.2)
Food assistance 12 (2.0) 30 (18.1) 42 (5.5) 347 (83.0)
Non-food assistance 6 (1.0) 3 (1.8) 9 (1.2) 4 (1.0)
Transportation 0 (0) 0 (0) 0 (0) 1 (0.2)
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Assistance Donetsk LuhanskGCA
TotalNGCA
Registered to receive additional
assistance from the state, humanitarian
or volunteer organizationsn/N (%) n/N (%) n/N (%) n/N (%)
All respondents 33/592 (5.6) 43/166 (25.9) 76/758 (10.0) 359/418 (85.9)
IDPs 4/11 (36.4) 2/2 (100) 6/13 (46.2) 4/8 (50.0)
Received humanitarian assistance in the
last 3 months, all respondentsN=592
n (%)
N=166
n (%)
N=758
n (%)
N=418
n (%)
Any kind of assistance 17 (2.9) 32 (19.3) 49 (6.5) 347 (83.0)
Cash vouchers/coupons 2 (0.3) 1 (0.6) 3 (0.4) 1 (0.2)
Food assistance 12 (2.0) 30 (18.1) 42 (5.5) 347 (83.0)
Non-food assistance 6 (1.0) 3 (1.8) 9 (1.2) 4 (1.0)
Transportation 0 (0) 0 (0) 0 (0) 1 (0.2)
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Organizations Providing NGCA with Food Assistance (N=347)
n %
Akhmetov Foundation340 98.0
Red Cross7 2.0
Russian Government6 1.7
Church1 0.3
Other3 0.9
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Health and Healthcare Seeking
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Prevalence of Chronic Disease
0
10
20
30
40
50
60
70
80
90
100
Any ChronicDisease
Hypertension Diabetes Cardiovascular Chronic Lung
Perc
enta
ge
Chronic Disease
GCA NGCA
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Prevalence of Chronic Disease by Sex
010
203040
5060
70
8090
100
Perc
enta
ge
Chronic Disease
GCA
Men Women
010
203040
5060
70
8090
100
Perc
enta
ge
Chronic Disease
NGCA
Men Women
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Prevalence of Chronic Disease by Age
0
1020304050
60708090
100
Perc
enta
ge
Chronic Disease
GCA
60-70 Years >70 Years
0
1020304050
60708090
100
Perc
enta
ge
Chronic Disease
NGCA
60-70 Years >70 Years
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60-70 Years >70 Years Total
Men
(N=153)
Women
(N=218)
Men
(N=113)
Women
(N=274)
Men
(N=266)
Women
(N=492)
Prevalence of chronic diseases
Any chronic condition 83 (54.3) 161 (73.9) 65 (57.5) 205 (74.8) 148 (55.6) 366 (74.4)
Hypertension 57 (37.3) 127 (58.3) 43 (38.1) 161 (58.8) 100 (37.6) 288 (58.5)
Diabetes 11 (7.2) 20 (9.2) 5 (4.4) 33 (12.0) 16 (6.0) 53 (10.8)
Cardiovascular disease 51 (33.3) 115 (52.8) 49 (43.4) 158 (57.7) 100 (37.6) 273 (55.5)
Chronic lung disease 13 (8.5) 20 (9.2) 14 (12.4) 13 (4.7) 27 (10.2) 33 (6.7)
GCA Prevalence of Chronic Disease by Age and Sex
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60-70 Years >70 Years Total
Men
(N=153)
Women
(N=218)
Men
(N=113)
Women
(N=274)
Men
(N=266)
Women
(N=492)
Prevalence of chronic diseases
Any chronic condition 83 (54.3) 161 (73.9) 65 (57.5) 205 (74.8) 148 (55.6) 366 (74.4)
Hypertension 57 (37.3) 127 (58.3) 43 (38.1) 161 (58.8) 100 (37.6) 288 (58.5)
Diabetes 11 (7.2) 20 (9.2) 5 (4.4) 33 (12.0) 16 (6.0) 53 (10.8)
Cardiovascular disease 51 (33.3) 115 (52.8) 49 (43.4) 158 (57.7) 100 (37.6) 273 (55.5)
Chronic lung disease 13 (8.5) 20 (9.2) 14 (12.4) 13 (4.7) 27 (10.2) 33 (6.7)
GCA Prevalence of Chronic Disease by Age and Sex
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60-70 Years >70 Years Total
Men
(N=69)
Women
(N=112)
Men
(N=71)
Women
(N=274)
Men
(N=140)
Women
(N=278)
Prevalence of chronic diseases
Any chronic condition 39 (56.5) 85 (75.9) 48 (67.6) 137 (82.5) 87 (62.1) 222 (79.9)
Hypertension 24 (34.8) 71 (63.4) 34 (47.9) 114 (68.7) 58 (41.4) 185 (66.6)
Diabetes 5 (7.3) 11 (9.8) 8 (11.3) 15 (9.0) 13 (9.3) 26 (9.4)
Cardiovascular disease 23 (33.3) 63 (56.3) 39 (54.9) 114 (68.7) 62 (44.3) 177 (63.7)
Chronic lung disease 6 (8.7) 5 (4.5) 5 (7.0) 10 (6.0) 11 (7.9) 15 (5.4)
NGCA Prevalence of Chronic Disease by Age and Sex
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60-70 Years >70 Years Total
Men
(N=69)
Women
(N=112)
Men
(N=71)
Women
(N=274)
Men
(N=140)
Women
(N=278)
Prevalence of chronic diseases
Any chronic condition 39 (56.5) 85 (75.9) 48 (67.6) 137 (82.5) 87 (62.1) 222 (79.9)
Hypertension 24 (34.8) 71 (63.4) 34 (47.9) 114 (68.7) 58 (41.4) 185 (66.6)
Diabetes 5 (7.3) 11 (9.8) 8 (11.3) 15 (9.0) 13 (9.3) 26 (9.4)
Cardiovascular disease 23 (33.3) 63 (56.3) 39 (54.9) 114 (68.7) 62 (44.3) 177 (63.7)
Chronic lung disease 6 (8.7) 5 (4.5) 5 (7.0) 10 (6.0) 11 (7.9) 15 (5.4)
NGCA Prevalence of Chronic Disease by Age and Sex
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Use of Medications Donetsk
N=592
Luhansk
N=166
GCA Total
N=758
NGCA Total
N=418
n/N (%) n/N (%) n/N (%) n/N (%)
Regular use of medications
Any chronic conditions 287/392 (73.2) 118/122 (96.7) 405/514 (78.8) 206/309 (66.7)
Hypertension 219/292 (75.0) 93/96 (96.9) 312/388 (80.4) 166/238 (69.8)
Diabetes 38/55 (69.1) 13/14 (92.9) 51/69 (73.9) 25/37 (67.6)
Cardiovascular disease 180/266 (67.7 92/107 (86.0) 272/373 (72.9) 138/221 (62.4)
Chronic lung disease 21/39 (53.9) 11/21 (52.4) 32/60 (53.3) 5/16 (31.3)
Primary Reason for not taking medications
regularly, any condition
N=151
n (%)
N=25
n (%)
N=176
n (%)
N=142
n (%)
Not prescribed to take regularly 32 (21.2) 5 (20.0) 37 (21.0) 29 (20.4)
Can’t access pharmacy 0 (0) 1 (4.0) 1 (0.6) 1 (0.7)
Availability of medication at pharmacy 1 (0.7) 0 (0) 1 (0.6) 0 (0)
Cost of medication 62 (41.1) 6 (24.0) 68 (38.6) 85 (59.9)
Other 62 (41.1) 15 (60.0) 77 (43.8) 37 (26.1)
Unknown 2 (1.3) 0 (0) 2 (1.1) 0 (0)
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Use of Medications Donetsk
N=592
Luhansk
N=166
GCA Total
N=758
NGCA Total
N=418
n/N (%) n/N (%) n/N (%) n/N (%)
Regular use of medications
Any chronic conditions 287/392 (73.2) 118/122 (96.7) 405/514 (78.8) 206/309 (66.7)
Hypertension 219/292 (75.0) 93/96 (96.9) 312/388 (80.4) 166/238 (69.8)
Diabetes 38/55 (69.1) 13/14 (92.9) 51/69 (73.9) 25/37 (67.6)
Cardiovascular disease 180/266 (67.7 92/107 (86.0) 272/373 (72.9) 138/221 (62.4)
Chronic lung disease 21/39 (53.9) 11/21 (52.4) 32/60 (53.3) 5/16 (31.3)
Primary Reason for not taking medications
regularly, any condition
N=151
n (%)
N=25
n (%)
N=176
n (%)
N=142
n (%)
Not prescribed to take regularly 32 (21.2) 5 (20.0) 37 (21.0) 29 (20.4)
Can’t access pharmacy 0 (0) 1 (4.0) 1 (0.6) 1 (0.7)
Availability of medication at pharmacy 1 (0.7) 0 (0) 1 (0.6) 0 (0)
Cost of medication 62 (41.1) 6 (24.0) 68 (38.6) 85 (59.9)
Other 62 (41.1) 15 (60.0) 77 (43.8) 37 (26.1)
Unknown 2 (1.3) 0 (0) 2 (1.1) 0 (0)
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Use of Medications Donetsk
N=592
Luhansk
N=166
GCA Total
N=758
NGCA Total
N=418
n/N (%) n/N (%) n/N (%) n/N (%)
Regular use of medications
Any chronic conditions 287/392 (73.2) 118/122 (96.7) 405/514 (78.8) 206/309 (66.7)
Hypertension 219/292 (75.0) 93/96 (96.9) 312/388 (80.4) 166/238 (69.8)
Diabetes 38/55 (69.1) 13/14 (92.9) 51/69 (73.9) 25/37 (67.6)
Cardiovascular disease 180/266 (67.7 92/107 (86.0) 272/373 (72.9) 138/221 (62.4)
Chronic lung disease 21/39 (53.9) 11/21 (52.4) 32/60 (53.3) 5/16 (31.3)
Primary Reason for not taking medications
regularly, any condition
N=151
n (%)
N=25
n (%)
N=176
n (%)
N=142
n (%)
Not prescribed to take regularly 32 (21.2) 5 (20.0) 37 (21.0) 29 (20.4)
Can’t access pharmacy 0 (0) 1 (4.0) 1 (0.6) 1 (0.7)
Availability of medication at pharmacy 1 (0.7) 0 (0) 1 (0.6) 0 (0)
Cost of medication 62 (41.1) 6 (24.0) 68 (38.6) 85 (59.9)
Other 62 (41.1) 15 (60.0) 77 (43.8) 37 (26.1)
Unknown 2 (1.3) 0 (0) 2 (1.1) 0 (0)
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Using medications regularly
for all conditions; n/N (%)
Not using medications for
any condition because
too expensive; n/N (%)
Not using medications for
any condition for other
reasons; n/N (%)
GCA NGCA GCA NGCA GCA NGCA
Household income per
capita ($/day)
<$2/day 162/252 (64.3) 83/166 (50.0) 41/252 (16.3) 51/166 (30.7) 49/252 (19.4) 32/166 (19.3)
$2-$3/day 99/139 (71.2) 33/51 (64.7) 13/139 (9.4) 7/51 (13.7) 27/139 (19.4) 11/51 (21.6)
$3-$4/day 28/45 (62.2) 5/10 (50.0) 5/45 (11.1) 4/10 (40.0) 12/45 (26.7) 1/10 (10.0)
>$4/day 12/19 (63.2) 11/20 (55.0) 2/19 (10.5) 5/20 (25.0) 5/19 (26.3) 4/20 (20.0)
Living Situation
Living alone 107/170 (62.9) 43/97 (44.3) 26/170 (38.2) 36/97 (37.1) 37/170 (34.3) 18/97 (18.6)
Living only with another
person(s) over 60 149/207 (72.0) 72/122 (59.0) 18/207 (8.7) 23/122 (18.9) 40/207 (19.3) 27/122 (22.1)
Living with people
under 6082/137 (59.9) 52/90 (57.8) 24/137 (17.5) 26/90 (28.9) 31/137 (22.6) 12/90 (13.3)
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Health Care SeekingDonetsk
N=592
Luhansk
N=166
GCA Total
N=758
NGCA
N=418
n (%) n (%) n (%) n (%)
Acute respiratory disease two week
prevalence129 (21.8) 30 (18.1) 159 (21.0) 55 (13.1)
Among those with acute respiratory disease,
sought care at a health clinicn/N
(%)
n/N
(%)
n/N
(%)
n/N
(%)
All respondents 29/129
(16.5)
13/30
(43.3)
42/159
(26.4)
11/55
(20.0)
Respondents with one or more chronic
conditions22/94
(23.4)
13/26
(34.6)
35/120
(29.2)
9/44
(20.5)
Primary Reason for not seeking care, acute
respiratoryN=100 N=17 N=117 N=44
Can’t access the clinic 4 (4.0) 2 (11.8) 6 (5.1) 1 (2.3)
Cost of clinic visit 11 (11.0) 1 (5.9) 12 (10.3) 6 (13.6)
Didn’t feel it was necessary 29 (29.0) 9 (52.9) 38 (32.5) 13 (29.6)
Other/Don’t know 56 (56.0) 5 (29.4) 61 (52.1) 24 (54.5)
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Health Care SeekingDonetsk
N=592
Luhansk
N=166
GCA Total
N=758
NGCA
N=418
n (%) n (%) n (%) n (%)
Acute respiratory disease two week
prevalence129 (21.8) 30 (18.1) 159 (21.0) 55 (13.1)
Among those with acute respiratory disease,
sought care at a health clinicn/N
(%)
n/N
(%)
n/N
(%)
n/N
(%)
All respondents 29/129
(16.5)
13/30
(43.3)
42/159
(26.4)
11/55
(20.0)
Respondents with one or more chronic
conditions22/94
(23.4)
13/26
(34.6)
35/120
(29.2)
9/44
(20.5)
Primary Reason for not seeking care, acute
respiratoryN=100 N=17 N=117 N=44
Can’t access the clinic 4 (4.0) 2 (11.8) 6 (5.1) 1 (2.3)
Cost of clinic visit 11 (11.0) 1 (5.9) 12 (10.3) 6 (13.6)
Didn’t feel it was necessary 29 (29.0) 9 (52.9) 38 (32.5) 13 (29.6)
Other/Don’t know 56 (56.0) 5 (29.4) 61 (52.1) 24 (54.5)
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Health Care SeekingDonetsk
N=592
Luhansk
N=166
GCA Total
N=758
NGCA
N=418
n (%) n (%) n (%) n (%)
Acute respiratory disease two week
prevalence129 (21.8) 30 (18.1) 159 (21.0) 55 (13.1)
Among those with acute respiratory disease,
sought care at a health clinicn/N
(%)
n/N
(%)
n/N
(%)
n/N
(%)
All respondents 29/129
(16.5)
13/30
(43.3)
42/159
(26.4)
11/55
(20.0)
Respondents with one or more chronic
conditions22/94
(23.4)
13/26
(34.6)
35/120
(29.2)
9/44
(20.5)
Primary Reason for not seeking care, acute
respiratoryN=100 N=17 N=117 N=44
Can’t access the clinic 4 (4.0) 2 (11.8) 6 (5.1) 1 (2.3)
Cost of clinic visit 11 (11.0) 1 (5.9) 12 (10.3) 6 (13.6)
Didn’t feel it was necessary 29 (29.0) 9 (52.9) 38 (32.5) 13 (29.6)
Other/Don’t know 56 (56.0) 5 (29.4) 61 (52.1) 24 (54.5)
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Health Care SeekingDonetsk
N=592
Luhansk
N=166
GCA Total
N=758
NGCA
N=418
n (%) n (%) n (%) n (%)
Acute respiratory disease two week
prevalence129 (21.8) 30 (18.1) 159 (21.0) 55 (13.1)
Among those with acute respiratory disease,
sought care at a health clinicn/N
(%)
n/N
(%)
n/N
(%)
n/N
(%)
All respondents 29/129
(16.5)
13/30
(43.3)
42/159
(26.4)
11/55
(20.0)
Respondents with one or more chronic
conditions22/94
(23.4)
13/26
(34.6)
35/120
(29.2)
9/44
(20.5)
Primary Reason for not seeking care, acute
respiratoryN=100 N=17 N=117 N=44
Can’t access the clinic 4 (4.0) 2 (11.8) 6 (5.1) 1 (2.3)
Cost of clinic visit 11 (11.0) 1 (5.9) 12 (10.3) 6 (13.6)
Didn’t feel it was necessary 29 (29.0) 9 (52.9) 38 (32.5) 13 (29.6)
Other/Don’t know 56 (56.0) 5 (29.4) 61 (52.1) 24 (54.5)
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Nutrition
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Types of Foods Eaten Yesterday
0
20
40
60
80
100
Perc
enta
ge
Type of Food
GCA NGCA
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GCA
(N=758)
NGCA
(N=418)Number of food groups
consumed yesterday
Mean (SD) 4.5 (1.2) 4.5 (1.3)
Median (IQR) 5 (4-5) 5 (4-5)
Consumption of iron-
rich foods yesterday, n
(%)
596 (78.6) 298 (71.3)
Consumption of
Vitamin A rich foods
yesterday, n (%)
699 (92.2) 396 (94.7)
Dietary Diversity
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Days Ate Food in Past WeekGCA (N=758) NGCA (N=418)
Mean (SD) Median (IQR) Mean (SD) Median (IQR)
Cereals6.8 (0.9) 7 (7-7) 6.9 (0.6) 7 (7-7)
White/yellow potatoes5.9 (1.7) 7 (5-7) 6.1 (1.5) 7 (5-7)
Vegetables5.8 (1.7) 7 (5-7) 5.8 (1.5) 7 (5-7)
Fruits2.1 (2.3) 2 (0-3) 1.7 (2.1) 1 (0-3)
Eggs1.7 (1.7) 1 (0-3) 1.9 (1.7) 2 (1-3)
Meat/fish3.4 (2.4) 3 (2-6) 3.2 (2.3) 3 (1-5)
Milk/milk products2.8 (2.6) 2 (0-5) 2.3 (2.2) 2 (0-3)
Peas/beans1.1 (1.7) 0 (0-2) 1.3 (1.5) 1 (0-2)
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Days Ate Food in Past WeekGCA (N=758) NGCA (N=418)
Mean (SD) Median (IQR) Mean (SD) Median (IQR)
Cereals6.8 (0.9) 7 (7-7) 6.9 (0.6) 7 (7-7)
White/yellow potatoes5.9 (1.7) 7 (5-7) 6.1 (1.5) 7 (5-7)
Vegetables5.8 (1.7) 7 (5-7) 5.8 (1.5) 7 (5-7)
Fruits2.1 (2.3) 2 (0-3) 1.7 (2.1) 1 (0-3)
Eggs1.7 (1.7) 1 (0-3) 1.9 (1.7) 2 (1-3)
Meat/fish3.4 (2.4) 3 (2-6) 3.2 (2.3) 3 (1-5)
Milk/milk products2.8 (2.6) 2 (0-5) 2.3 (2.2) 2 (0-3)
Peas/beans1.1 (1.7) 0 (0-2) 1.3 (1.5) 1 (0-2)
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Mean Number of Days Foods Eaten in Past Week
0
1
2
3
4
5
6
7
Cereals White/yellowpotatoes
Vegetables Fruits Eggs Meat/fish Milk/milkproducts
Peas/beans
Nu
mb
er
of
Day
s
Type of Food
GCA NGCA
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Household income per capita in $/day<$2/day $2-$3/day $3-$4/day >$4/day Total
GCA
(N=366)
NGCA
(N=228)
GCA
(N=199)
NGCA
(N=69)
GCA
(N=72)
NGCA
(N=16)
GCA
(N=31)
NGCA
(N=26)
GCA
(N=668)
NGCA
(N=339)
Number of food groups
consumed yesterday,
mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)
Consumption of iron-
rich foods yesterday, n
(%)
251
(68.6)
150
(65.8)
176
(88.4)
69
(79.7)
61
(84.7)
11
(68.8)
30
(96.8)
25
(96.2)
518
(77.5)
241
(71.1)
Consumption of
Vitamin A rich foods
yesterday, n (%)
327
(89.3)
217
(95.2)
190
(95.5)
64
(92.3)
70
(97.2)
15
(93.4)
30
(96.8)
26
(100)
617
(92.4)
322
(95.0)
Days eaten in past
week, mean (SD)
Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)
Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)
Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)
Dietary Diversity by Household Income per capita in $/Day
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Household income per capita in $/day<$2/day $2-$3/day $3-$4/day >$4/day Total
GCA
(N=366)
NGCA
(N=228)
GCA
(N=199)
NGCA
(N=69)
GCA
(N=72)
NGCA
(N=16)
GCA
(N=31)
NGCA
(N=26)
GCA
(N=668)
NGCA
(N=339)
Number of food groups
consumed yesterday,
mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)
Consumption of iron-
rich foods yesterday, n
(%)
251
(68.6)
150
(65.8)
176
(88.4)
69
(79.7)
61
(84.7)
11
(68.8)
30
(96.8)
25
(96.2)
518
(77.5)
241
(71.1)
Consumption of
Vitamin A rich foods
yesterday, n (%)
327
(89.3)
217
(95.2)
190
(95.5)
64
(92.3)
70
(97.2)
15
(93.4)
30
(96.8)
26
(100)
617
(92.4)
322
(95.0)
Days eaten in past
week, mean (SD)
Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)
Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)
Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)
Dietary Diversity by Household Income per capita in $/Day
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Household income per capita in $/day<$2/day $2-$3/day $3-$4/day >$4/day Total
GCA
(N=366)
NGCA
(N=228)
GCA
(N=199)
NGCA
(N=69)
GCA
(N=72)
NGCA
(N=16)
GCA
(N=31)
NGCA
(N=26)
GCA
(N=668)
NGCA
(N=339)
Number of food groups
consumed yesterday,
mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)
Consumption of iron-
rich foods yesterday, n
(%)
251
(68.6)
150
(65.8)
176
(88.4)
69
(79.7)
61
(84.7)
11
(68.8)
30
(96.8)
25
(96.2)
518
(77.5)
241
(71.1)
Consumption of
Vitamin A rich foods
yesterday, n (%)
327
(89.3)
217
(95.2)
190
(95.5)
64
(92.3)
70
(97.2)
15
(93.4)
30
(96.8)
26
(100)
617
(92.4)
322
(95.0)
Days eaten in past
week, mean (SD)
Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)
Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)
Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)
Dietary Diversity by Household Income per capita in $/Day
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Household income per capita in $/day<$2/day $2-$3/day $3-$4/day >$4/day Total
GCA
(N=366)
NGCA
(N=228)
GCA
(N=199)
NGCA
(N=69)
GCA
(N=72)
NGCA
(N=16)
GCA
(N=31)
NGCA
(N=26)
GCA
(N=668)
NGCA
(N=339)
Number of food groups
consumed yesterday,
mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)
Consumption of iron-
rich foods yesterday, n
(%)
251
(68.6)
150
(65.8)
176
(88.4)
69
(79.7)
61
(84.7)
11
(68.8)
30
(96.8)
25
(96.2)
518
(77.5)
241
(71.1)
Consumption of
Vitamin A rich foods
yesterday, n (%)
327
(89.3)
217
(95.2)
190
(95.5)
64
(92.3)
70
(97.2)
15
(93.4)
30
(96.8)
26
(100)
617
(92.4)
322
(95.0)
Days eaten in past
week, mean (SD)
Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)
Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)
Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)
Dietary Diversity by Household Income per capita in $/Day
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Household income per capita in $/day<$2/day $2-$3/day $3-$4/day >$4/day Total
GCA
(N=366)
NGCA
(N=228)
GCA
(N=199)
NGCA
(N=69)
GCA
(N=72)
NGCA
(N=16)
GCA
(N=31)
NGCA
(N=26)
GCA
(N=668)
NGCA
(N=339)
Number of food groups
consumed yesterday,
mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)
Consumption of iron-
rich foods yesterday, n
(%)
251
(68.6)
150
(65.8)
176
(88.4)
69
(79.7)
61
(84.7)
11
(68.8)
30
(96.8)
25
(96.2)
518
(77.5)
241
(71.1)
Consumption of
Vitamin A rich foods
yesterday, n (%)
327
(89.3)
217
(95.2)
190
(95.5)
64
(92.3)
70
(97.2)
15
(93.4)
30
(96.8)
26
(100)
617
(92.4)
322
(95.0)
Days eaten in past
week, mean (SD)
Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)
Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)
Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)
Dietary Diversity by Household Income per capita in $/Day
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Household income per capita in $/day<$2/day $2-$3/day $3-$4/day >$4/day Total
GCA
(N=366)
NGCA
(N=228)
GCA
(N=199)
NGCA
(N=69)
GCA
(N=72)
NGCA
(N=16)
GCA
(N=31)
NGCA
(N=26)
GCA
(N=668)
NGCA
(N=339)
Number of food groups
consumed yesterday,
mean (SD)4.2 (1.3) 4.3 (1.2) 4.7 (1.1) 4.6 (1.1) 4.8 (1.1) 4.5 (1.2) 5.4 (1.0) 5.6 (1.0) 4.5 (1.2) 4.5 (1.2)
Consumption of iron-
rich foods yesterday, n
(%)
251
(68.6)
150
(65.8)
176
(88.4)
69
(79.7)
61
(84.7)
11
(68.8)
30
(96.8)
25
(96.2)
518
(77.5)
241
(71.1)
Consumption of
Vitamin A rich foods
yesterday, n (%)
327
(89.3)
217
(95.2)
190
(95.5)
64
(92.3)
70
(97.2)
15
(93.4)
30
(96.8)
26
(100)
617
(92.4)
322
(95.0)
Days eaten in past
week, mean (SD)
Fruits 1.8 (2.4) 1.6 (2.4) 2.9 (2.7) 1.8 (2.1) 2.5 (2.4) 2.1 (2.3) 3.7 (2.6) 3.5 (2.7) 2.3 (2.5) 1.8 (2.5)
Meat 3.1 (2.4) 3.1 (2.5) 3.9 (2.3) 3.2 (2.1) 3.8 (2.6) 3.7 (2.3) 5.5 (2.1) 5.0 (2.0) 3.5 (2.4) 3.3 (2.4)
Milk 2.4 (2.6) 1.8 (1.9) 3.6 (2.7) 2.9(2.5) 3.1 (2.2) 1.7 (1.8) 3.1 (2.5) 3.5 (2.3) 2.9 (2.6) 2.1 (2.1)
Dietary Diversity by Household Income per capita in $/Day
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GCA
(N=758)
NGCA
(N=418)
Food insecurity in
past 30 days
n (%) (95%CI) n (%) (95%CI)
Little or no hunger 740 (97.6) 95.1-98.9 416 (99.5) 98.0-99.9
Moderate hunger 16 (2.1) 1.0-4.6 2 (0.5) 0.1-2.0
Severe hunger 2 (0.3) 0.0-1.1 0 N/A
Mean (SD) Median
(IQR)
Mean (SD) Median
(IQR)
Number of meals
eaten yesterday
3.4 (1.0) 3 (3-4) 3.4 (0.9) 3 (3-4)
Food Security
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GCA
(N=758)
NGCA
(N=418)
Food insecurity in
past 30 days
n (%) (95%CI) n (%) (95%CI)
Little or no hunger 740 (97.6) 95.1-98.9 416 (99.5) 98.0-99.9
Moderate hunger 16 (2.1) 1.0-4.6 2 (0.5) 0.1-2.0
Severe hunger 2 (0.3) 0.0-1.1 0 N/A
Mean (SD) Median
(IQR)
Mean (SD) Median
(IQR)
Number of meals
eaten yesterday
3.4 (1.0) 3 (3-4) 3.4 (0.9) 3 (3-4)
Food Security
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Moderate or Severe HungerGCA (N=18) NGCA (N=2)
n % n %
Income per capita ($/day) N=14 N=2
<$2/day 13 92.9 1 50.0
$2-$3/day 1 7.1 1 50.0
$3-$4/day 0 0 0 0
>$4/day 0 0 0 0
Living Situation N=18 N=2
Living alone 7 38.9 1 50.0
Living only with another person(s) over
608 44.4 0 0
Living with people under 60 3 16.7 1 50.0
Number of food groups consumed
yesterday1, mean (SD)
3.4 (1.5) 3 (0)
Days eaten in past week, mean (SD)
Fruits 1.7 (2.9) 0
Meat 1 (1.1) 4.5 (4.5)
Milk 0.8 (1.4) 0
BMI, mean (SD) 28.5 (4.9) 39.1 (1.2)
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Moderate or Severe HungerGCA (N=18) NGCA (N=2)
n % n %
Income per capita ($/day) N=14 N=2
<$2/day 13 92.9 1 50.0
$2-$3/day 1 7.1 1 50.0
$3-$4/day 0 0 0 0
>$4/day 0 0 0 0
Living Situation N=18 N=2
Living alone 7 38.9 1 50.0
Living only with another person(s) over
608 44.4 0 0
Living with people under 60 3 16.7 1 50.0
Number of food groups consumed
yesterday1, mean (SD)
3.4 (1.5) 3 (0)
Days eaten in past week, mean (SD)
Fruits 1.7 (2.9) 0
Meat 1 (1.1) 4.5 (4.5)
Milk 0.8 (1.4) 0
BMI, mean (SD) 28.5 (4.9) 39.1 (1.2)
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Dependency/Activities of Daily Living
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DependencyGCA (N=758) NGCA (N=418)
Requires help with activities n (%) 95%CI n (%) 95%CI
Bathing 111 (14.6) 12.0-17.8 85 (20.3) 15.8-25.7
Getting dressed 62 (8.2) 6.6-10.2 57 (13.6) 11.0-16.8
Going to the toilet 46 (6.1) 4.6-7.9 51 (12.2) 9.5-15.5
Moving from bed to chair 44 (5.8) 4.3-7.9 46 (11.0) 8.0-15.0
Leak urine or feces 139 (18.3) 14.4-23.0 98 (23.4) 19.1-28.4
Eating 20 (2.6) 1.7-4.1 30 (7.2) 4.6-11.1
Dependency
Independent 664 (87.6) 84.6-90.1 345 (82.7) 79.1-85.8
Moderate dependency 48 (6.3) 4.4-9.0 25 (6.0) 4.0-8.9
Severe dependency 46 (6.1) 4.6-8.0 47 (11.3) 8.6-14.6
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DependencyGCA (N=758) NGCA (N=418)
Requires help with activities n (%) 95%CI n (%) 95%CI
Bathing 111 (14.6) 12.0-17.8 85 (20.3) 15.8-25.7
Getting dressed 62 (8.2) 6.6-10.2 57 (13.6) 11.0-16.8
Going to the toilet 46 (6.1) 4.6-7.9 51 (12.2) 9.5-15.5
Moving from bed to chair 44 (5.8) 4.3-7.9 46 (11.0) 8.0-15.0
Leak urine or feces 139 (18.3) 14.4-23.0 98 (23.4) 19.1-28.4
Eating 20 (2.6) 1.7-4.1 30 (7.2) 4.6-11.1
Dependency
Independent 664 (87.6) 84.6-90.1 345 (82.7) 79.1-85.8
Moderate dependency 48 (6.3) 4.4-9.0 25 (6.0) 4.0-8.9
Severe dependency 46 (6.1) 4.6-8.0 47 (11.3) 8.6-14.6
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Dependency
Someone to help if person
needs help with 1 or more
activities
GCA (N=186) NGCA (N=130)
n (%) 95%CI n (%) 95%CI
No31 (16.7) 11.5-23.6 32 (24.6) 15.6-36.6
Yes, but not every day55 (29.6) 24.3-35.4 16 (12.3) 7.9-18.6
Yes, every day, part of the
time18 (9.7) 6.0-15.3 10 (7.7) 3.6-15.6
Yes, every day, all of the
time82 (44.1) 37.2-51.2 71 (54.6) 43.4-65.4
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Dependency
Someone to help if person
needs help with 1 or more
activities
GCA (N=186) NGCA (N=130)
n (%) 95%CI n (%) 95%CI
No31 (16.7) 11.5-23.6 32 (24.6) 15.6-36.6
Yes, but not every day55 (29.6) 24.3-35.4 16 (12.3) 7.9-18.6
Yes, every day, part of the
time18 (9.7) 6.0-15.3 10 (7.7) 3.6-15.6
Yes, every day, all of the
time82 (44.1) 37.2-51.2 71 (54.6) 43.4-65.4
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Prevalence of Dependency by Age
0
5
10
15
20
25
30
60-70 Years >70 Years 60-70 Years >70 Years
Perc
enta
ge
Severe dependency
Moderate dependency
GCA NGCA
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Prevalence of Dependency by Sex
0
2
4
6
8
10
12
14
16
18
20
Male Female Male Female
Perc
enta
ge
Severe dependency
Moderate dependency
GCA NGCA
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Psychological Distress
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Psychological Distress GCA (N=711) NGCA (N=396)n (%) 95%CI n (%) 95%CI
Felt most or all of the time in past
30 days
Nervous 286 (40.2) 35.3-45.4 162 (40.9) 34.1-48.1
Hopeless 170 (23.9) 20.4-27.9 137 (34.6) 28.5-41.2
Restless/Fidgety 252 (35.4) 29.2-42.2 178 (44.9) 37.6-52.6
Depressed 233 (32.8) 27.0-39.2 139 (35.1) 29.8-40.8
Everything is an effort 245 (34.5) 28.7-40.7 158 (39.9) 33.3-46.8
Worthless 151 (21.2) 17.1-26.0 89 (22.5) 18.0-27.6
Suffers from serious psychological
distress
239 (33.6) 28.0-39.7 168 (42.5) 36.1-49.2
Mean (SD) Median (IQR) Mean (SD) Median (IQR)
Kessler K6 Score 9.7 (6.7) 8 (4-15) 11.4 (6.8) 12 (6-16)
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Psychological Distress GCA (N=711) NGCA (N=396)n (%) 95%CI n (%) 95%CI
Felt most or all of the time in past
30 days
Nervous 286 (40.2) 35.3-45.4 162 (40.9) 34.1-48.1
Hopeless 170 (23.9) 20.4-27.9 137 (34.6) 28.5-41.2
Restless/Fidgety 252 (35.4) 29.2-42.2 178 (44.9) 37.6-52.6
Depressed 233 (32.8) 27.0-39.2 139 (35.1) 29.8-40.8
Everything is an effort 245 (34.5) 28.7-40.7 158 (39.9) 33.3-46.8
Worthless 151 (21.2) 17.1-26.0 89 (22.5) 18.0-27.6
Suffers from serious psychological
distress
239 (33.6) 28.0-39.7 168 (42.5) 36.1-49.2
Mean (SD) Median (IQR) Mean (SD) Median (IQR)
Kessler K6 Score 9.7 (6.7) 8 (4-15) 11.4 (6.8) 12 (6-16)
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Psychological DistressGCA NGCA
n/N % n/N %
Income per capita ($/day)
<$2/day 130/344 37.8 92/216 42.6
$2-$3/day 56/185 30.3 29/67 43.3
$3-$4/day 24/72 33.3 8/16 50.0
>$4/day 6/30 20.0 10/25 40.0
Living Situation
Lives alone 84/234 35.9 63/123 51.2
Lives with people >60 only 85/289 29.4 60/163 36.8
Lives with people <60 70/188 37.2 45/109 41.3
Dependency
Independent 191/642 29.8 125/341 36.7
Moderately Dependent 27/41 65.9 15/22 68.2
Severely Dependent 21/28 75.0 28/32 87.5
BMI, mean (SD) (N=158) 29.0 (6.2) 30.5 (6.8)
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Psychological DistressGCA NGCA
n/N % n/N %
Income per capita ($/day)
<$2/day 130/344 37.8 92/216 42.6
$2-$3/day 56/185 30.3 29/67 43.3
$3-$4/day 24/72 33.3 8/16 50.0
>$4/day 6/30 20.0 10/25 40.0
Living Situation
Lives alone 84/234 35.9 63/123 51.2
Lives with people >60 only 85/289 29.4 60/163 36.8
Lives with people <60 70/188 37.2 45/109 41.3
Dependency
Independent 191/642 29.8 125/341 36.7
Moderately Dependent 27/41 65.9 15/22 68.2
Severely Dependent 21/28 75.0 28/32 87.5
BMI, mean (SD) (N=158) 29.0 (6.2) 30.5 (6.8)
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Anthropometry
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BMI (kg/m2) Total
GCA (N=488) NGCA (N=305)
n (%) 95%CI n (%) 95%CI
Underweight (<18.5) 7 (1.4) 0.6-3.2 2 (0.7) 0.0-5.1
Normal (18.5-24.99) 123 (25.2) 20.9-30.0 55 (18.0) 14.6-22.1
Overweight (25-
29.99)
162 (33.2) 29.5-37.2 107 (35.1) 30.0-52.4
Obese (>30) 196 (40.2) 35.8-44.7 141 (46.2) 40.1-52.4
Mean (SD)
(95%CI)
29.1 (5.8)
(28.5-29.6)
29.8 (6.0)
(29.2-30.5)
Median (IQR) 28.8
(24.8-33.0)
29.4(26.0-33.1)
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BMI (kg/m2) Total
GCA (N=488) NGCA (N=305)
n (%) 95%CI n (%) 95%CI
Underweight (<18.5) 7 (1.4) 0.6-3.2 2 (0.7) 0.0-5.1
Normal (18.5-24.99) 123 (25.2) 20.9-30.0 55 (18.0) 14.6-22.1
Overweight (25-
29.99)
162 (33.2) 29.5-37.2 107 (35.1) 30.0-52.4
Obese (>30) 196 (40.2) 35.8-44.7 141 (46.2) 40.1-52.4
Mean (SD)
(95%CI)
29.1 (5.8)
(28.5-29.6)
29.8 (6.0)
(29.2-30.5)
Median (IQR) 28.8
(24.8-33.0)
29.4(26.0-33.1)
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BMI (kg/m2) Total
GCA (N=488) NGCA (N=305)
n (%) 95%CI n (%) 95%CI
Underweight (<18.5) 7 (1.4) 0.6-3.2 2 (0.7) 0.0-5.1
Normal (18.5-24.99) 123 (25.2) 20.9-30.0 55 (18.0) 14.6-22.1
Overweight (25-
29.99)
162 (33.2) 29.5-37.2 107 (35.1) 30.0-52.4
Obese (>30) 196 (40.2) 35.8-44.7 141 (46.2) 40.1-52.4
Mean (SD)
(95%CI)
29.1 (5.8)
(28.5-29.6)
29.8 (6.0)
(29.2-30.5)
Median (IQR) 28.8
(24.8-33.0)
29.4(26.0-33.1)
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BMI (kg/m2) Total
GCA (N=488) NGCA (N=305)
n (%) 95%CI n (%) 95%CI
Underweight (<18.5) 7 (1.4) 0.6-3.2 2 (0.7) 0.0-5.1
Normal (18.5-24.99) 123 (25.2) 20.9-30.0 55 (18.0) 14.6-22.1
Overweight (25-
29.99)
162 (33.2) 29.5-37.2 107 (35.1) 30.0-52.4
Obese (>30) 196 (40.2) 35.8-44.7 141 (46.2) 40.1-52.4
Mean (SD)
(95%CI)
29.1 (5.8)
(28.5-29.6)
29.8 (6.0)
(29.2-30.5)
Median (IQR) 28.8
(24.8-33.0)
29.4(26.0-33.1)
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BMI (kg/m2) Male
GCA (N=169) NGCA (N=88)
n (%) 95%CI n (%) 95%CI
Underweight (<18.5) 1 (0.6) 0.0-4.5 1 (1.1) 0.2-8.2
Normal (18.5-24.99) 58 (34.3) 27.8-41.5 22 (25.0) 19.0-32.2
Overweight (25-
29.99)
67 (39.7) 33.1-46.6 33 (37.5) 28.4-47.6
Obese (>30) 43 (25.4) 19.4-32.6 32 (36.4) 27.4-46.4
Mean (SD)
(95%CI)
27.2 (4.7)
(26.5-27.9)
38.0 (5.2)
(27.0-29.1)
Median (IQR) 26.7
(24.0-30.1)
27.8(24.9-31.1)
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BMI (kg/m2) Male
GCA (N=169) NGCA (N=88)
n (%) 95%CI n (%) 95%CI
Underweight (<18.5) 1 (0.6) 0.0-4.5 1 (1.1) 0.2-8.2
Normal (18.5-24.99) 58 (34.3) 27.8-41.5 22 (25.0) 19.0-32.2
Overweight (25-
29.99)
67 (39.7) 33.1-46.6 33 (37.5) 28.4-47.6
Obese (>30) 43 (25.4) 19.4-32.6 32 (36.4) 27.4-46.4
Mean (SD)
(95%CI)
27.2 (4.7)
(26.5-27.9)
38.0 (5.2)
(27.0-29.1)
Median (IQR) 26.7
(24.0-30.1)
27.8(24.9-31.1)
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BMI (kg/m2) Female
GCA (N=319) NGCA (N=217)
n (%) 95%CI n (%) 95%CI
Underweight (<18.5) 6 (1.9) 0.8-4.6 1 (0.5) 0.0-3.7
Normal (18.5-24.99) 65 (20.4) 15.2-26.7 33 (15.2) 10.9-20.8
Overweight (25-
29.99)
95 (29.8) 25.1-35.0 74 (34.1) 27.2-41.8
Obese (>30) 153 (47.9) 42.2-53.7 109 (50.2) 42.2-58.2
Mean (SD)
(95%CI)
30.0 (6.0)
(29.3- 30.8)
30.6 (6.2)
(29.6-31.5)
Median (IQR) 29.8
(25.6-33.7)
30.1(26.8-33.9)
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BMI (kg/m2) Female
GCA (N=319) NGCA (N=217)
n (%) 95%CI n (%) 95%CI
Underweight (<18.5) 6 (1.9) 0.8-4.6 1 (0.5) 0.0-3.7
Normal (18.5-24.99) 65 (20.4) 15.2-26.7 33 (15.2) 10.9-20.8
Overweight (25-
29.99)
95 (29.8) 25.1-35.0 74 (34.1) 27.2-41.8
Obese (>30) 153 (47.9) 42.2-53.7 109 (50.2) 42.2-58.2
Mean (SD)
(95%CI)
30.0 (6.0)
(29.3- 30.8)
30.6 (6.2)
(29.6-31.5)
Median (IQR) 29.8
(25.6-33.7)
30.1(26.8-33.9)
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Conclusions and Recommendations
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Discussion-Demographics/Income
• In both GCA and NGCA about 2/3 of the sample were female and 1/3 of the sample were males• Life expectancy 66 years for males vs. 76 years for females
• About half of the sample was 60-70 years and half was >70 years• Slightly larger proportion of people >70 years in NGCA areas (57% vs. 51%)
• Many people living in poverty• 55% of people in GCA and 67% of people in NGCA living on <$2/day• 85% of people in GCA and 88% of people in NGCA living on <$3/day• Only 22% of people in NGCA who are registered to receive Ukrainian pension
received it in the month preceding the survey, however almost all received DNR pension
• About 1/3 of the population (31% GCA and 29% NGCA) live alone
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Discussion-Assistance
• Few households (about 10%) in GCA are registered to receive humanitarian assistance• 5.6% of individuals in Donetsk, 25.9% in Luhansk
• Only 6.5% of households have received assistance in 3 months preceding survey
• Majority of households (about 86%) in NGCA are registered to receive humanitarian assistance• 83% of households have received assistance in 3 months preceding survey
• All households (83%) that have received assistance received food assistance• 98% received food assistance from Akhmetov Foundation
• Only 1 household received cash or voucher assistance, 4 households received non-food assistance and 1 household received transportation assistance
• Low proportion of IDPs in both samples (<2% of the sample in GCA and NGCA)
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Discussion-Nutrition• Most common foods eaten are cereals/grains and white/yellow
potatoes, and vegetables• Mean number of food groups eaten in day preceding survey was 4.5 in GCA
and NGCA
• 79% of people in GCA and 71% of people in NGCA consumed iron-rich foods in the day preceding the survey
• People living on <$2/day ate less fruits, milk, and meat
• About 2% of people in GCA and 0.5% of people in NGCA experienced moderate or severe hunger in the 30 days preceding the survey• 93% of these people in GCA live on <$2/day
• 100% of people in both areas live on <$3/day
• Only 2 people in NGCA. One person had received food assistance.
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• Around 70% of respondents have some type of chronic disease in both areas• Women have higher prevalence of hypertension and cardiovascular disease
• About 79% of respondents in GCA and 67% in NGCA with a chronic condition take medications regularly for at least one condition• Out of those who don’t take medications for at least one chronic condition,
about 40% in GCA and 60% in NGCA reported this was due to cost
• Most people do not have problems accessing healthcare• 21% in GCA and 13% in NGCA reported an acute illness
• 26% in GCA and 20% in NGCA of those of those with an acute illness sought care
• Only 15% listed cost of care or access to the clinic as reasons for not seeking care in both areas
Discussion-Health
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• About 12% of the sample in GCA and 17% of sample in NGCA had moderate or severe dependency• People of older ages have a higher prevalence of dependency than those of
younger ages
• In GCA about 46% of people and in NGCA about 37% of people who may need help with daily activities do not receive any help or do not receive help every day
Discussion-Dependency
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• 33% of people in GCA and 43% of people in NGCA reported suffering from severe psychological distress
• 70% of people in GCA and 80% of people in NGCA with moderate or severe dependency reported suffering from severe psychological distress
Discussion-Psychological Distress
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• Undernutrition is not a major problem in this population• Only 7 individuals in GCA (1.7%) and 2 individuals in NGCA (0.7%) had a BMI
<18.5 kg/m2
• Only 25% of individuals in GCA and 18% of individuals in NGCA were in the normal BMI range• 34% of men in GCA and 35% of men in NGCA had a normal BMI; compared to
20% of women in GCA and 15% of women in NGCA• 75% of people in GCA and 81% of people in NGCA are overweight or obese
• Obesity is a major problem in this older population• About 40% of people in GCA and 46% of people in NGCA are considered
obese• About 50% of women in both areas are considered obese
Discussion-Nutritional Status
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Recommendations1. Provide psychosocial support services to all older individuals living in
both areas if needed
2. Identify the people who are suffering from extreme hunger for targeted assistance• 93% of those with moderate or severe hunger in GCA live on <$2/day• 100% of those with moderate or severe hunger in both areas live on <$3/day
3. Modify food and voucher assistance in both areas to encourage healthier diets • Distribution of food vouchers for people to buy fresh fruits and vegetables, meat,
milk products, etc.
4. Engage in promotional activities on health and healthy diets in both areas• Specifically targeting older women
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Recommendations
5. Identify people who are not taking medications for chronic diseases regularly for targeted assistance
6. Identify and provide assistance to those who are moderately and severely dependent without everyday help
7. Do not limit humanitarian assistance in GCA areas to only internally displaced persons
8. Consider including cash/voucher assistance for purchasing medications for chronic diseases as part of humanitarian aid
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Questions
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MUAC (mm) GCA Total
N=408
NGCA Total
N=303
n (%) 95%CI n (%) 95%CI
< 185 0 0 0 0
185-210 1 (0.3) 0.0-1.8 1 (0.3) 0.0-2.6
> 210 407 (99.8) 98.2-99.9 302 (99.7) 97.5-99.9
Mean (95%CI) 313.6
(309.2-318.0)
307.0
(302.7-311.4)
Median (IQR) 310
(286-344)
304(282-329)
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MUAC (mm) GCA Male
N=143
GCA Male
N=88
n (%) 95%CI n (%) 95%CI
< 185 0 0 0 0
185-210 0 0 0 0
> 210 143 100 88 100
Mean (95%CI) 305.4
(298.5-312.4)
300.3
(293.5-307.1)
Median (IQR) 304
(286-328)
299(281-321)
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MUAC (mm) GCA Female
N=265
NGCA Female
N=215
n (%) 95%CI n (%) 95%CI
< 185 0 0 0 0
185-210 1 (0.4) 0.0-2.8 1 (0.5) (0.0-3.5)
> 210 264 (99.6) 97.2-99.9 214 (99.5) (96.5-99.9)
Mean (95%CI) 317.9
(312.6-323.3)
309.7
(303.7-315.8)
Median (IQR) 314
(288-350)
308(282-332)
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Response Rate Donetsk Luhansk GCA Total NGCA
Total Households N=1,914 N=611 N=2,525 N=1,324
Absent 809 (42.3%) 355 (58.1%) 1164 (46.1%) 701 (52.9%)
Refused 47 (2.5%) 62 (10.2%) 109 (4.3%) 14 (1.1%)
No one over 60 523 (27.3%) 58 (9.5%) 581 (23.0%) 299 (22.6%)
Consented 535 (28.0%) 136 (22.3%) 671 (26.6%) 310 (23.4%)
Total Respondents over 60 in
Consenting Households N=690 N=196 N=886 N=423
Absent 47 (6.8%) 5 (2.6%) 52 (5.9%) 4 (0.9%)
Refused 57 (8.3%) 23 (11.7%) 80 (9.0%) 1 (0.2%)
Interviewed 592 (85.8%) 166 (84.7%) 758 (85.6%) 418 (98.8%)
Measured MUAC 352 (51.0%) 56 (28.6%) 408 (46.0%) 303 (71.6%)
Measured Weight and Demi-
span388 (56.2%) 100 (51.0%) 488 (55.1%) 305 (72.1%)