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Innovative Methods to assess a nutritional situation

Innovative Methods to assess a nutritional situation. Damien PEREYRA, Epidemiologist Cécile SALPETEUR, HIV & Nutrition Research Advisor. Brussels, CRED CEDAT, June 9 & 10, 2011. Content. Pastoralist Survey Method (PSM) – applied research Listening Posts – applied research

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Innovative Methods to assess a nutritional situation

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  1. Innovative Methods to assess a nutritional situation Damien PEREYRA, Epidemiologist Cécile SALPETEUR, HIV & Nutrition Research Advisor Brussels, CRED CEDAT, June 9 & 10, 2011

  2. Content • Pastoralist Survey Method (PSM) – applied research • Listening Posts – applied research • ACF Main sources of data • Examples of ACF databases

  3. Pastoralist Survey Method (PSM) • Aim: to design, test and validate a new method for assessing the nutrition condition in pastoralist populations • Rationale: • Vulnerability of pastoralists to shocks • Lack of suitable survey method • Progress: • Method designed & peer reviewed in 2007 • First field test in Mali in 2008 • Second test in Ethiopia in March 2010 • Third test in Chad in May 2011 • Funding: ACF and donors in each country • Scientific partners: Anne Marie Mayer, Mark Myatt, Paul Baxter – independent consultants

  4. Innovations of PSM • Qualitative phase + quantitative phase • Case definition of SAM • Sampling frame • Bootstrap estimator • Specific worksheet with formulas

  5. Organogram of Mali field test Organizing Factor: organization of the nomadic troupes geographically or socially & seasonally

  6. PSM Sampling • Sample size depends on • Prevalence estimate (15%) • Precision (3%) • Average PSU size (15) • Sample size = 43 PSUs • Systematic sample of PSUs based on Social Organising Factor (e.g. water points) Average PSU size PSU: Primary Sampling Units

  7. PSM quantitative phase • Identify all eligible children (6-59 months) • Measure MUAC & oedema • Collect other data

  8. PSM dissemination • FEX article, issue #35, on Mali experience, 2008 • Poster at ALNAP fair, London, Nov 2009 • Presentation at MSF Scientific Day, London, May 2010 • Abstract at Porto WPHN conference, Sept 2010 • Article in a peer reviewed journal on the 3 experiences - 2011 • Sharing of survey guideline & toolbox via a website? • Uptake by stakeholders in pastoralist areas

  9. Listening Posts – surveillance system • Aim: to design, test and validate a new method for Surveillance system which will be replicable and sustainable and which collects basic data on food prices, terms of trade and nutritional status • Rationale: • 2008 Food price crisis impact on nut status unknown • Absence or inadequate methods to link food insecurity and economic status to malnutrition • Progress: • Method designed & peer reviewed in 2009 • ACF field test in Burkina Faso in 2010-2011 (ongoing) • SC UK field test in Zimbabwe in 2010-2011 (ongoing) • Soon a third test in Liberia in 2011 by ACF • Funding: ACF, SC UK and donors in each country • Scientific partners: Mark Myatt – independent consultant

  10. Listening Posts project >> HUnger Monitoring System (HUMS) • Livelihoods zones mapping with sentinel sites selected • Small cohort of children 6-24 mo with renewed inclusions • Frequency: quarterly data collection • Data on • Staple food prices, • Terms of trade • Anthropometry • Food diversity and food frequency • Contextual information • And possibly secondary data on: • Feeding centre admissions • Changes in the minimum cost of a healthy diet • Food access • Coping strategies

  11. HUMS dissemination • Presentation of the concept at WFP meeting, June 2009 • Presentation at a meeting hosted by Institute of Medicine ‘Mitigating the Nutritional Impacts of the Global Food Price Crisis’ in Washington in July 2009 • Article in a peer reviewed journal on the 3 experiences - 2012 • Sharing of survey guideline & toolbox via a website? • Uptake by stakeholders in existing national surveillance systems

  12. ACF Main sources of data • SMART SURVEYS: • Nut. Surv. DB: with around 1000 surveys from the 90’s until now • Children Surv. DB: with around 370 000 children from 25 countries (from around 400 cluster surveys 2001-2010) • THERAPEUTIC PROGRAMMES: • Therapeutic Prog. DB: with around 73 000 SAM children treated in 9 countries by ACF from 2005 until now. • Monthly report data: collected monthly with beneficiaries information (data not centralized). • RESEARCH PROJECTS: ad hoc databases

  13. Nutrition Survey Database

  14. Children Survey Database

  15. Therapeutic Programme Database

  16. Improving data collection and use • How to estimate incidence of acute malnutrition to better tailor nutrition programmes size & resources? • Partnership with Health and Nutrition Tracking Service (HNTS) project (C. Prudhon et al.) • How to improve validity of nut surveys conducted by NGOs? • SMART project: partnership with Centre for Disease Control & Prevention (CDC) • How to improve causal analysis of acute malnutrition to better address it? • Nutritional Causal Analysis (NCA) applied research project: partnership with Tufts University How to transmit Knowledge to field teams !!

  17. THANKS

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