Standardized Monitoring and Assessment of Relief and Transitions (SMART) Survey Report in Akoka County, Upper Nile State, South Sudan (June 2026)

Country: South Sudan Source: REACH Initiative Please refer to the attached file. Executive Summary Between June 11 and 16 of 2026, a SMART survey was conducted across all five Payams (Benthiang, Riang, Rom, Baichan and Akoka) in Akoka County, Upper Nile State, South Sudan. The survey employed a two-stage probability sampling that ensures representativeness of the target population: first, villages were identified using the probability proportional to population size (PPS) method of cluster sampling, then, households were selected using simple random sampling. Anthropometric data was collected from 388 children aged 6-59 months from 320 households in 32 clustered villages in Akoka County and their nutritional status analyzed. Since the final sample size exceeded the minimum 309 children required as per the applied sampling methodology in the validated protocol, there was no need to activate any reserve clusters. The Global Acute Malnutrition (GAM) prevalence based on weight for height z score (WHZ) and/or Oedema was estimated at 28.8% (95% CI: 23.7 – 34.4), placing the county in a critical but very close to catastrophe phase according to WHO thresholds and IPC AMN classification. Severe Acute Malnutrition (SAM) was recorded at 9.8% (95% CI: 6.5 – 14.3). The nutrition situation remains precarious, with the GAM level having deteriorated within the same phase reported in the recent FSNMS Round 31 survey conducted in July 2025 (27.8% 95% CI: 19.3 – 38.2 GAM), signaling a worsening trend in acute malnutrition in the county. The Crude Mortality Rate (CMR) was 1.18 per 10,000 persons per day (95% CI: 0.69 – 2.01) well above the emergency threshold signaling a concerning public health crisis in the county whereas and the Under-5 Mortality Rate (U5MR) was 1.16 (95% CI: 0.41 – 3.21), which below emergency thresholds but indicative of a worse situation combined with the nutritional status.
2026-08-17 03:02:22