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nutritional indicators

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Caroline André

Diététicienne Santé Publique

Normal user

12 Oct 2018, 14:51

Hello to all,

I am starting a job in an NGO (in Haiti) that fights against acute malnutrition and as the only nutritionist, I would like to ask for your help!

Briefly, three programs have been put in place (for many years):
- latrine project: setting up 50 latrines in villages that do not have any (the only selection criterion). No link is made between this WASH project and malnutrition.
- nutrition project: mobile "clinics" (18 in all) dedicated to the management of acute malnutrition (moderate + severe without complications). This represents approximately 60 children / month.
AND screening (MUAC, weight, height) at home (± 3000 children detected per month by 40 "monitors"). During home-based screening, the "monitors" talk with the mothers and inform them about the importance of home hygiene, dietary diversity, breastfeeding, etc. (education mainly of the type "face-to-face information")
- family planning project: distribution of condoms + contraceptives and setting up, if requested, of an IUD or implants. And educational sessions (targeted group type). No link is made with child malnutrition.

There are still huge organizational gaps as well as in data collection (nothing is computerized), no valid evaluation could be done and prevention / education is not sufficiently present (or not very participatory methods).

Do you have any advice to give me about "starting" a data collection (in excel)? types of indicators to be taken up? before a database can be established within the NGO.
Currently, only the overall prevalence of malnutrition (acute, moderate and acute with complications) by sex in children 6-59 months and the number of vitamins A and albendazole distributed / month is carried out. All other data collected remain on "paper" and are not used.

- Would you have basic formats to share? What do you encode on a daily basis?
- Which database do you use?
- What type of study / research will you advise me to do first in order to have a global view of the nutritional situation?
- No emphasis is placed on chronic malnutrition currently. Do you think it's wise to include Z-score height for age? (knowing that the prevalence of stunting in Haiti is> 20%)
- Do you have experience in empowering mothers in screening for acute malnutrition (with MUAC)?

I thank you in advance for sharing your experiences on the ground!

Suzanne Fuhrman

Nutrition in Emergencies, WFP

Normal user

24 Oct 2018, 18:02

Hello, you have quite a few parts to your question here, so I'll try to give my views on some of them.

The first thing that comes to mind is that first you should find out what already exists at country level, what other NGOs are doing, and what information in collected in government health data systems.

CMAM Report (http://www.cmamreport.com/) can be used to keep data from your treatment activities. It uses standardized indicators for CMAM.

For IYCF indicators, see here: https://www.fantaproject.org/monitoring-and-evaluation/iycf-indicators

You might also think about using digital tools to collect routine monitoring or survey/research data. ODK is an open source tool that can be used (https://opendatakit.org/).

Is there any existing government database, or data system that you should work to feed your information into? Often, excel based databases are used.

There are several survey methodologies and also formative research techniques that can be used to find out more about the nutrition situation, and the drivers of malnutrition. I would first try to find out what existing information there is, either in your project area, at national level, or even in a neighboring/similar geographic area.

When you say that the prevalence of malnutrition is carried out, what is used to determine these estimates? The limitations of screening data often mean that it is not representative of the area as a whole, unless exhaustive screening or a robust sampling method is done.

For mothers screening with MUAC, there are a lot of positive experiences. Check out ALIMA's MUAC publications "Mothers Understand and Can Do it."

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