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Food and Nutrition Surveillance

Main Nutritional Assessment


Methods

Anthropometry: weight, height, MUAC (Mid-


Upper-Arm Circumference) -- mainly for
<5years since they are sensitive to factors
influencing nutritional status-illness/ food
Biochemical Methods
Clinical Assessment
Dietary Methods
Nutritional Surveillance

Is the process of monitoring changes in the


nutritional status of a population over a
period of time.

Nutrition surveillance involves data collection,


processing, analyses, interpretation and
communication.
Purpose of Nutritional
Surveillance

Nutrition data is a vital indicator for the overall health


and welfare of populations especially where regular
demographic and health surveys are lacking.
Surveillance data is critical for making decisions that
will assist in improved nutrition outcomes of a
population e.g. when to start or phase out a nutrition
intervention such as supplementary feeding
program.
Nutrition data can be used in crisis mitigation
especially as an early warning indicator to respond to
threats such as droughts or disease outbreaks.
Data collected assists in providing baseline
information on nutrition, socio-economic
factors, demographic characteristics, food
security and cultural aspects of a population.
Information is important for decision making
on program planning, management,
monitoring and evaluation.
Type of Data

Quantitative: numeric
Qualitative: Narrative (to supplement the
quantitative data) FGD (Focus Group
Discussions), formal (in-depth) and informal
interviews of key informants, case studies,
observation.
Principle Users

Communities involved in the design, planning


and management of nutrition related
programs.
Government authorities and Non
Governmental Organizations supporting food
security, health and nutrition related
programs.
Food Aid agencies e.g. WFP (World Food
Programme), CARE
Donors
Industries addressing nutrition and health
related issues
Nutrition Surveillance in Somalia by FSAU
(Food Security Analysis Unit) utilizes diverse
range of information sources to develop an
efficient and effective nutrition surveillance
system. These are, nutrition surveys, health
facilities, rapid assessment, and sentinel
sites.
A nutritional survey is a method by which
information is obtained concerning the
nutritional status of a population or a
subgroup. Such information is collected by
asking nutrition related questions in an
interview to a representative sample of the
population.
Steps in conducting survey

Planning the survey


Administering the survey: partner contacts,
training and tool pre-testing, data collection,
data management, report and presentation
(quality control maintained in all steps).
Planning Survey

A review of the existing information


related to the anticipated survey area
Identify survey goals and objectives
Identify survey indicators
Selecting survey methodology
Select survey sample
Survey plan (cont)

Liaising with partners: roles &


responsibilities
Data collection tools and instrument
Pre-testing the tools
Data collection

NB: quality control ensured at all levels


Typical survey designs include

Longitudinal survey: data is collected for the same


population over a long period of time. Longitudinal
studies are useful in establishing trends over a long
period of time
Cross-sectional surveys: This is one of the
commonly used survey designs that looks into
population issues at a given point in time.
In emergency: Cross sectional survey mainly used.
Sampling methods are

Two Stage Cluster sampling


Random sampling
Systematic sampling
Stratified sampling
When to conduct Survey

At the beginning of a nutrition project cycle to


provide baseline information for program
formulation
During initial phase of emergency situation to
measure nutritional status and plan a short
term response
During the course of the nutrition program to
assess and monitor the impact
Monitor progress (regular monitoring of the
situation).
At the end of the project circle to evaluate its
extent and impact.
Any other time deemed necessary to
establish a baseline.
Type of info. in surveys

Demographic HH details, residential status


Socio-economic issues: income, food source,
coping strategies, water source, hygiene
Anthropometric measurements
Intervention coverage
Morbidity
Food consumption
Mortality
Quality control measures

Thorough training of staff plus pre-testing of tools (interpretation


of the questionnaires, if necessary)
Standardization tests- Intra-personal/ interpersonal errors
Close monitoring of the field work by qualified persons
Cross-checking of the field questionnaires for anomaly daily
Daily review of enumerator experiences and problems
Progress review per plan and by checklist
Data cleaning: collection, entry,
Integrity of equipments: maintain accuracy using known
weights
Health Facility

Summary of anthropometric measurements of <5yrs,


morbidity and EPI (Expanded Programme on
Immunization) from MCH (Mean Corpuscular
Hemoglobin) collected
The MCH are located in vast vulnerable area
Data collected from it serve as early indicator in case of
crises.
HF (Hazardous Fragmentation) data indicates trends in
malnutrition rates over a period of time
N.B. Data from HF is not representative of the entire
population and its biased since only the sick or those
who can access the health facility are assessed
Key issues in site based surveillance

Importance of carrying out surveillance


Anthropometric data- quality of data/integrity
of equipment and staff quality
Recording and interpreting measurements
Clinical diagnosis: obvious micronutrient
deficiency- VAD, anaemia, IDD
Causes of malnutrition
Rapid Assessment

Mainly carried out on ad hoc bases.


Useful when:
When nutrition information are fast needed
When resources of carrying out Nutrition survey are
limited.
MUAC is usually used. Additional methods include:
FGD, Key informant interview, observation (transect
walks), seasonal calendars and Case study.
Steps in planning a rapid assessment

Define objectives (who to assess-children,


women, why),
Determine target site/area/population
Develop appropriate method of data
collection: representative
Staff identification and training (involve the
existing authority)
Materials and equipment
Type of information

MUAC measurements: adults (women), <5yr


Food availability and accessibility
Water sources
Common diseases- how are recent trends
Access to health services/ other interventions
Livestock and population movement- destinations/
origin of emigrants
Type of food consumed/freq. of feeding
Security situation