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Output Monitoring System for Integrated Management of Acute Malnutrition (IMAM)

This question was posted the Prevention and treatment of severe acute malnutrition forum area and has 8 replies. You can also reply via email – be sure to leave the subject unchanged.

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Roger Mathisen

Nutritionist

Normal user

20 Mar 2013, 07:39

Dear colleagues,

The IMAM team in Viet Nam will establish an output monitoring system this year for SAM and MAM management and ideally integrate other key interventions in the nutrition package delivered by the National Nutrition Programme such as Breastfeeding, Complementary Feeding and Micronutrient Supplementation. Is there any best practice or open access model we could adapt to local context? We are looking forward receiving your insight and guidance on the way forward.

Mark Myatt

Consultant Epideomiologist

Frequent user

20 Mar 2013, 09:45

Routine monitoring statistics should include:

- Admissions
- Exits
- Proportion of exits discharged as cured (A)
- Proportion of exits transferred to another service
- Proportion of exits defaulted / lost to follow-up
- Proportion of exits known to have died

These are usually aggregated on a weekly or monthly basis.

Additional data that is also useful:

- Admission MUAC
- Length of stay (for patients discharged as cured)
- Numbers screened / referred / admitted

These are usually aggregated on a weekly or monthly basis.

This data can be backed up with seasonal calendars of disease, crops, food prices, food availability, male & female labour demand, and climate.

The most important measure is impact or met need. This is:

	impact = effectiveness * coverage

Effectiveness is the cure rate which is marked as (A) in the first list above.

Coverage can be measured using CSAS, SLEAC, or SQUEAC methods.

You might like to look at this document from UNICEF in Sierra Leone and the SQUEAC / SLEAC Technical Reference.

Roger Mathisen

Nutritionist

Normal user

20 Mar 2013, 11:15

Thanks for your valuable comments, Mark.

We are more specifically looking for information regarding an open access CMAM/IMAM database or software. UNICEF and WFP developed one in Malawi in 2004 for SAM and MAM management, but it had some limitations as it was not web based or using open access software. I believe Pakistan has also developed an output monitoring database recently and the people behind the ENA software another database.

It would be good to know what kind of database systems or software that exists – and to decide which one to roll out to other countries – including Viet Nam.

Charulatha Banerjee

Terre des hommes Foundation

Normal user

20 Mar 2013, 12:04

Greetings from India! In our project addressing both prevention and treatment of Acute Malnutrition we have designed our monitoring system using Epidata as the data entry platform. We currently have monthly data being entered for nearly 8000 children under 5 and also data of 2000 pregnant mothers. Analysis is done by exporting to SPSS. Epidata being free has greatly helped us avoid costs of software development but retains the benefits of customisation. All the output indicators that Mr Myatt mentions are included as are a few others.

Look forward to the other responses

Anonymous 1502

Normal user

20 Mar 2013, 12:12

Dear Roger,

UNICEF HQ is currently rolling out a global SAM reporting tool in an attempt to harmonize terminology and definitions around indicators. The idea is to set up a common framework of key programme output indicators across countries. In terms of country reporting systems, several countries have strong systems: Ethiopia uses Microsoft Access covering core CMAM indicators along the lines of what Mark outlines above. Pakistan, as you say, has developed their own software and interestingly are also looking at incorporating IYCF and micronutrient indicators alongside the CMAM indicators. In developing the Pakistan system, colleagues also created community worker field forms to fill and charted out the data flow. Happy to provide more info to you if you want (jhedges@unicef.org).

Tamsin Walters

en-net moderator

Forum moderator

21 Mar 2013, 09:09

From Vicky Sibson:

Dear Roger

The Minimum Reporting Package (www.mrp-sw.com) is open access and includes reporting for SFP and OTP/SC. SCUK are shortly about to start redeveloping this software to be web-based and will be able to provide some technical support to users. I will shortly publicise this widely so that nutrition actors are aware of the latest achievements on the MRP (an 18 month ECHO grant just ended in December 2013) and next steps on the MRP using newly secured funding. In the meantime please do email me directly for more information – v.sibson@savethechildren.org.uk

Thanks

Vicky

Victoria Sibson

independent nutritionist

Normal user

21 Mar 2013, 12:40

Dear James

It would be really helpful to know the exact CMAM indicators that are being used in the global SAM reporting tool. Perhaps you could share the list or a link so we can all have a look? As you know the MRP includes indicators for SFP which were agreed by consensus some years back and then SAM treatment indicators where added in early 2012, also produced through a consensus building process in which GNC memebrs were invited to participate (see www.mrp-sw.com). As the MRP is being used by a number of NGOs in a number of countries and is open for any future interested partners to use if they see utility in it, it would be great to check the alignment of the indicators in both tools and if there are any clashes, discuss what to do about that so that users are not confused.

Thanks a lot for sharing what you can.

very best

Vicky

Monsurul

Statistican

Normal user

24 Mar 2013, 04:40

Dear Roger,

I think Vietnam uses DHIS 2 (District Health Information System 2) platform as HMIS. In such case, you could use the same platform for OMS. From my experience in South Sudan, we developed a monthly reporting format in DHIS for all Nutrition projects based on Nutrition Cluster's requirement and piloted in one state.

ALFRED K. KARISA

NUTRITION PROJECT OFFICER-WORLD VISION

Normal user

5 Apr 2013, 12:57

In World Vision, we have a CMAM Online database where we input OTP, SFP for <5 years and SFP for PLW into the online database. We do this on a monthly basis and input data such as new admissions, cured, defaulters, re-admissions and other essential data. This can later be analysed and is very user friendly as it has inbuilt formulas that can draw charts, calculate cure, death and defaulter rates respectively. The system generates an excel sheet which comes with all the outputs one can be used to take stock of the project. Anyone with rights can access the online database from any corner/location in the world and with just a click of the mouse, one can analyze and see the progress of a particular program. I believe it is one of the best tools so far and quite user friendly. Actually in 2012, the nutrition project we are implementing here had excellent results attaining cure rate, defaulter rate,and death rate that are within the SPHERE STANDARDS. The website is https://cmam.wvncoe.org

In Kenya, the ministry also has an online information system which is also helpful in inputting data for every health facility in Kenya. It can be accesses from this website.- https://hiskenya.org

If you have more questions, you can get in touch with me through Alfred_Kazungu@wvi.org or through my personal email kkarisah@gmail.com.

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