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EMERGENCY NUTRITION UPDATE ENU JANUARY-MARCH 2010 ISSUE 5 ........................................................ In the Spotlight Nutrition Surveillance Welcome to the fifth edition of WV’s Emergency Nutrition Update and the launch of our ENU spotlight themes. As well as our usual selection of updated tools and guidelines, news from the field, research pieces and staff updates, our ENU’s will now also e including a section specifically focusing on a ey theme area. his edition’s potlight theme will e Nutrition ureillance and help readers to understand further what does the literature and field e perience say aout these systems and what systems are currently recommended for use in WV programming. , UENE EENAN Food Security Briefs for 30 Countries Now Available from FAO ood security has a significant impact on nutritional status. ulished y the A and EU, food security riefs, updated eery three months, proide a snapshot of the food security situation in oer countries. hese riefs are part of the EUA program ‘ining nformation and ecision aing to mproe ood ecurity’ designed to assist oernments, onors, implementing agencies with decisionmaing related to food security issues. Each country rief coers topics such as cereal and liestoc prices and factors affecting the current food security situation. hey are aailale at httpwww.foodsec.orgpuscountry.htm Inter-Agency Standing Committee (IASC) Gender E-Learning Course – Different Needs Equal Opportunities As gender is a ey crosscutting issue in nutrition programming the following free hour selfpaced online course is eing highlighted here. ased on the nteragency tanding ommittee’s A ender andoo “Women, girls, oys and men, different needs eual opportunities”, the A ender online course launched in arch ¢ enales course participants to • earn how to effectiely integrate gender euality into humanitarian programmes • ae the opportunity to practice their sills through an interactie, online, simulated humanitarian crisis • Earn a certificate in gender mainstreaming in humanitarian settings o find out more go to httpwww.iascelearning.orghome hild in ali hoto y ustin ouglass 1 ........................................................ ENU Nutrition Surveillance Objectives of Data Sources for Nutrition What is nutrition Nutrition Surveillance Surveillance Systems • o etter inform and influence nformation for nutrition sureillance systems surveillance, hat programming decisions comes from a ariety of sources these include, • o monitor the condition of the population nutrition sureys, health facility information methods are used, including clinicased growth monitoring, • o identify potentially at ris areas as an rapid assessments, communityased growth hat or is early warning system monitoring and sentinel site sureillance. • o identify trends in nutrition status oer nformation on the wide range of factors World Vision time. affecting nutrition is also collected including, health, food security, water. doing in nutrition • o monitor interention outcomes. • o uild capacity for monitoring nutrition World Vision’s Contribution surveillance status of the population. to Nutrition Surveillance • o facilitate information sharing. World Vision most commonly contriutes to Nutrition Surveillance is the “continuous n a national leel, Nutrition ureillance oernment nutrition sureillance systems collection and analysis of nutritional status data systems are most often estalished y the y sharing reports from nutrition sureys in order to gie warning of impending crisis oernments, with information proided y and rapid assessments with goernment or to mae policy and programmatic decisions arious partners including Ns. n crisis authorities. World Vision also wors with that will lead to improement in the nutrition situations or areas of high ulneraility where local health officials to strength community situation of the population. his ongoing oernment systems are not functioning or ased growth monitoring and promotion scrutiny generally uses methods distinguished where additional support is reuired, nutrition systems. World Vision has plans to undertae y their practicality, uniformity and freuently sureillance systems hae een set up y non a nutrition sureillance pro¦ect, using sentinel their rapidity, rather than complete accuracy. goernmental partners e.g. UN agencies or site monitoring in East Africa in partnership ts main purpose is to detect changes in trends Ns. he ood ecurity Analysis Unit for with – read elow for further details. or distriution in order to initiate inestigatie omalia AU, httpwww.fsausomali.org or control measures.”¢ managed y A is one such e ample. lanned Nutrition entinel ites ureillance ystem in Africa Submitted by Cyprian Ouma – WV Africa Region CMAM Advisor Background populations and egistered hildren • location of the people at ris ost As do nutrition and health sureys • roision of trends oer time • appro imate numer of people who are in periods ranging from eery four to fie • ore indepth information on other affected years. hese are long gap periods wherey indicators lie maret trends and disease • what is happening to them and how is it the nutrition and food security status could outreas happening deteriorate without eing reported on a timely • seerity of the situation asis to allow for immediate interention. • educed data turnaround time wherey n order to address this, WV is planning to data is readily aailale at the site itself • eolution of the crisis oer time pilot a entinel ites ureillance ystem in • ata to trigger more detailed nutritional • what is already done y the households Africa. his system focuses on undertaing and communities plus the goernment, and sureillance in a limited numer of sites sureys as and when reuired or population for the specific purpose of • mplementation with relatiely little capacity other partners food – non food detecting trends in the oerall welleing of and integration into longer term monitoring • reuired assistance food – nonfood the community. he sites may e specific system Pilot population groups or illages which coer populations at ris. t is anticipated that the setting up of such WV is currently planning to undertae a ¢ a nutrition sureillance system to collect, month pilot sureillance system in partnership ompared to one off sureys, such a system analyse, interpret and report on information with in wanda, «enya and two other has arious potential adantages including aout the nutritional status of populations African countries to e decided, with funding • educed cost – arge sureys costs will assist to inform appropriate response from WV East Africa egional ffice. as much as ª, compared to less strategies and improe an understanding of a e pensie sureillance systems range of things including he pilot sentinel sites will e estalished in • who are the people at ris ulnerale As ased on report and • lose monitoring of chronically ulnerale other documents. ata will e collected on ¢. , aitch , aataai and Valerde V ¢¨© Nutrition ureillance enea W 2 ........................................................ a monthly asis from each of the selected ¢ ommunityA he ey unit of the At the National ffice leel, the health and illages in the A with a minimum numer system is the community itself, usually nutrition team will direct and coordinate of ¢¬ children assessed per A ¬ children a illage. At this leel the sureillance the oerall dissemination of the data. he from samples. system will e operated from the A administratie functions of this national where data related to health, food office team will e to plan, superise, and nutrition will e collected support, and ealuate the routine operation n areas faced ith a either monthly or uarterly of the system at the ¯onal and A leel. crisis, the need for accurate eg underweight, stunting, ts technical functions will e to receie, data on a regular and timely wasting, diahorrea, measles etc. process, and analy®e summari®ed data Verification, taulation, and and information from ¯onal sureillance basis is ey since it provides a summari®ation of data will e groups. he interpretation of indicators basis on hich to mae rational done at the community leel. At will e undertaen y a multidisciplinary specified interals the accumulated group of e perts consisting of the decisions for humanitarian data will e assemled and health and nutrition section staff. n interventions transmitted to the corresponding the asis of their interpretation, specific ¯onal leel group. After this, the recommendations for sectoral action A will receie from the ¯onal will e formulated for action y ’s leel a summary of the data donors and other staeholders eg o. collected in the region including hese recommendations will, in turn, e ata analysis will then e undertaen its own contriution together with specific transmitted to the support offices and immediately and information disseminated recommendations for action in its area of adocacy teams where the appropriate on a timely asis to the A management. influence. decisions will also e taen. he asic analysis that will e done and the summary of indicators or main factors analy®ed At the ¯onal leel, a intersectoral group Next Steps will e as follows of sponsorship, and EA people A staeholders worshop with oerment, • he proportion of children malnourished in will e estalished to assess ¯onal and World Vision will e held in the each sites ased on underweight, stunting conditions, superise and support local coming months to deelop concrete plans and wasting A sureillance actiities and recommend for the implementation of this pilot pro¦ect. • isease incidences in the sentinel sites action. ata from this leel will e transmitted to the national leel only in Watch this space for updates on the pilot. n As per the diagram aoe, the system will summari®ed form and at specified uarterly the meantime, for any additional ueries please operate at arious leels including community interals. contact yprian uma. ¢. , aitch , aataai and Valerde V ¢¨© Nutrition ureillance enea WA, ®onal and national. 3 ........................................................ NEW E E Statement on the Use of Alternative Sampling Designs for Nutrition Surveys in Emergency Settings mergency utrition Woring roup, utrition Centre of pertise – ebruary Background n light of the release of this guide in ortality estimates can proide aluale oernment and humanitarian agencies eptemer , and the ongoing capacity information in emergency setting howeer, need populationased data to understand uilding efforts within WV on monitoring and the alternatie sampling designs as descried the aggraating and underlying causal factors ealuation methodologies e.g. A and in this guide are not appropriate for measuring of undernutrition and to select the most ²A, there is a need for guidance as to if mortality. he sample si®es of the and appropriate actions to improe the health, and when alternatie sampling designs should ° designs are too small to proide a useful nutrition and surial of the population. e used in the conte t of WV programs. epidemiologic measure of a rare eent such as n many cases, information on the seerity mortality. Wor to deelop and alidate new of the situation and the causal factors of Use of Alternative methods to assess mortality—some of which undernutrition is needed efore there can Sampling Designs in World may e appropriate for use in complement e any allocation of resources or planning with the and ° designs—is ongoing. of interentions. n an emergency situation, Vision Programs he decision to use alternatie sampling certain areas may need to e assessed n emergency settings, populationased designs in WV field programs must e made recurrently oer a relatiely short time sureys are conducted to fulfil two main on a caseycase asis in consultation period in order to determine what type of o¦ecties ¢ to assess the seerity and with a nutrition technical adisor. f it is assistance may e reuired and for how long. magnitude of the situation and to otain determined that an alternatie sampling design urey methods for use in emergency settings data for prolem analysis and response is appropriate, the methods outlined in the therefore need to e oth time and resource planning. ¦ectie ¢ is usually accomplished ANA uide should e followed. efficient. y measuring leels of acute malnutrition. he he Alternative Sampling esigns uide second o¦ectie can e fulfilled y collecting Resources for mergency Settings A uide for survey information on indicators related to moridity, coerage of accination serices, household ANA ro¦ect. Alternative Sampling esigns planning, data analysis and planning, pulished food security, and water and sanitation. for mergency Settings A uide for Survey y ANA, outlines different sampling he use of alternatie sampling designs for lanning, ata Collection and Analysis ood designs, all of which are appropriate for field sureys is appropriate when time spent and Nutrition echnical Assistance ro¦ect emergency settings, where the time spent collecting data must e limited e.g. a surey ANA, Academy for Educational collecting data should e limited ut must e using A methodology is not possile, eelopment, Washington , . http sufficient to otain the necessary information ut information on acute malnutrition and www.fantapro¦ect.orgpulicationsasg. aout the population. he three designs related indicators is reuired. shtml were deeloped to proide reliale methods for rapid assessment of the prealence of .................................... acute malnutrition and useful measures of secondary indicators releant to needs assessment and response planning, including child and householdleel indicators such as Nutrition he hift of Ws trategic ocus moridity prealence, accination coerage, household food security, and access to water and sanitation. hese designs can e used to Submitted by Marianna Stephens – utrition measure changes in these indicators oertime, ‘W has revised its Advisor, WV ood rogramming Management so are appropriate for ealuating program roup M impact. he three sampling designs , food baset to provide °±, seuential design descried in the guide and are each hyrid designs coming commodities that can unger affects an estimated one illion aspects of cluster sampling and ot ²uality people around the world, mostly in Africa, Assurance ampling ²A. better prevent and ndia, and outheast Asia. unger taes ield applications hae shown that these treat undernutrition its toll on the indiidual and society from designs proide meaningful and alid results, increasing the prealence of chronic diseases and reuire sustantially less time and cost including micronutrient and higher mortality to impaired mental and for data collection than is reuired for physical deelopment to higher healthcare carrying out a cluster design. As of deficiencies’ costs to lower economic output. f we want ¨, the designs are sufficiently alidated to achiee the illennium eelopment for wideNNUE scale adoption, so oals, we must urgently and effectiely that real data collection needs can e met in address undernutrition. a time and costefficient manner. he guide World Vision and W hae wored alongside one another for ¢ years to tacle proides detailed instructions for the planning, hunger related malnutrition, deeloping an understanding of the prolem, and oth haing implementation, and analysis of data collected een ery actie in uilding awareness of the prolem and aailale solutions. his past y the designs. anuary, W released their Nutrition mproement Approach NA which has shifted its he deelopment, testing and alidation of strategic focus from food security proiding enough calories to including nutrition security the three alternatie sampling designs was proiding nutrientrich food. he new strategy places more focus on specific target groups. completed y ANA with atholic elief hese include children younger than two years, pregnant and lactating women, moderately erices , hio tate Uniersity U, malnourished populations, people suffering from micronutrient deficiencies and people with ae the hildren U U, and a team of chronic illnesses VA, . (Focus - Continues on Page 5) statistical e perts at arard chool of ulic ealth . . he World ood rogramme Nutrition mproement Approach, anuary ¢. 4
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