Indicators for SAM in Children

1. Global acute malnutrition
Prevalence rate (%) of global acute
malnutrition in children 6 to 59 months of
age based on presence of bilateral pitting
oedema and / or weight-for-height z-score
less than -2 standard deviations of the
median of the standard population
(WHO 2006)

2. Severe acute malnutrition (SAM)
Prevalence rate (%) of severe acute
malnutrition in children 6 to 59 months of
age based on presence of bilateral pitting
oedema and / or weight-for-height z-score
less than -3 standard deviations of the
median of the standard population
(WHO 2006)

3. Moderate acute malnutrition (MAM)
Prevalence rate (%) of moderate acute
malnutrition in children 6 to 59 months of
age based on presence of weight-for-height
z-score less than -2 and equal or greater
than -3 standard deviations of the median of
the standard population (WHO 2006)

4. Childhood stunting
Prevalence rate (%) of stunting in children 0
to 59 months of age based on height-for-age
z-score less than -2 standard deviations of
the median of the standard population
(WHO 2006)

5. Acute malnutrition based on MUAC
and oedema
Prevalence rate (%) of children 6-59 months
with MUAC less than 125 mm and/or having
bilateral pitting oedema

6. Acute malnutrition in Pregnant and
Lactating Women
Prevalence rate (%) PLW with MUAC less
than 210-230 mm (Note: Countries use a
range of different cut-offs depending on
resources)

7. Undernutrition for
5 to 19 year olds
Prevalence rate (%) of children and
adolescents 5-19 years of age with Z-scores
defined as BMI-for-age index less than -2
standard deviations from the median BMI of
a reference population of
children/adolescents of the same age
and/or having bilateral pitting oedema

8. Acute malnutrition for older people
Prevalence rate (%) of older people with a
MUAC below 210mm or having bilateral
pitting oedema

9. Minimum meal frequency for children
24-59 months
Proportion of children 24-59 months who
are eating 3 meals a day or more

10. Level of risk to common micronutrient
deficiencies (high, medium, low)
Qualitative assessment of nutritional risk of
common micronutrient deficiencies (anaemia,
iodine deficiency, vitamin A deficiency (night
blindness), scurvy, beri beri, vitamin D deficiency)
based on composite indicator analysis on
prevalence rates, diet analysis, water quality and
diarrheal disease, case finding

11. N-020 Vitamin A coverage
in children 6--59 months
Proportion of children 6 - 59 months having
received vitamin A in previous 6 months

12. Iron supplementation coverage rate in
children
Proportion of children 6-59 months of age
receiving micronutrient supplements that
contain adequate iron

13. Iron-folic acid supplementation in
pregnant women
Proportion of pregnant women having
received iron-folic acid contained
supplementation daily in previous 6
months/during pregnancy

14. Iodized salt consumption
Proportion households using
adequately iodized salt in previous 6
months

15. Prevalence rate of vitamin A
deficiency
(1)Proportion of children below five years of
age with sub-clinical vitamin A deficiency (2)
Proportion of women of reproductive age
with clinical vitamin A deficiency

16. Prevalence rate of anaemia
Proportion of children below five years of
age with Hb concentration of <11 g/dL
Proportion of women in reproductive age
with Hb concentration of <12 g/dL

17. Under-five mortality
The rate of death among children
below of 5 years of age in the
population

18. Exclusive breastfeeding
under 6 months
Proportion of infants 0-5 months of age
who are fed exclusively with breast
milk

19. Minimum dietary diversity
Proportion of children 6-23 months of age
who receive foods from 4 or more food
groups

20. Introduction of solid, semi-solid or soft
food
Proportion of children 6-8 months of age
who received solid, semi-solid or soft foods
during the previous day

21. Inappropriate distribution of infant
formula, dried or liquid milk to
children 0-<2 years
Confirmed distribution of infant formula,
dried or liquid milk to children 0-< 2 years

22. Number and percentage of
displacement sites where IDP
population has access to potable
water supply within a safe and risk
free walking distance
This indicator monitors whether IDP
populations in displacement sites have
access to potable water

23. Number and percentage of
displacement sites with food/nutrition
needs where at least one food
distribution has taken place within the
past month
This indicator monitors whether IDP
populations in displacement sites with food
needs have access to food distributions

24. Number and percentage of emergency
affected children/youth (reported as m/f)
from any social-economic background,
disabled, marginalized community, leaving
with HIV/AIDS (3-18 years) accessing
emergency education programmes that
incorporate nutrition interventions
Children and youth with access to schools
with nutrition programmes

25. Coverage of measles vaccination (%)
Measles coverage refers to the percentage of
children who have received at least one dose of
measles-containing vaccine in a given year. This
indicator is used for estimating the vaccine
coverage of the total EPI strategy. To avoid
overestimation, measles vaccination coverage is
often used as a proxy since it is usually lower than
DPT3 coverage.

26. Number of areas where local government across sectors
use knowledge, innovation and education to build a
culture of preparedness, safety and resilience. This is the
be differentiated by age/sex
This could include relevant information on disasters is available and
accessible at all levels, to all stakeholders (through networks,
development of information sharing system. ii. School curricula,
education material and relevant trainings include risk reduction and
recovery concepts and practices. iii. Research methods and tools for
multi risk assessments and cost benefit analysis are developed and
strengthened. iv. Country wide public awareness strategy exists to
stimulate a culture of disaster resilience, with outreach to urban and
rural communities

27. Number and percentage of
households receiving non-food items
This indicator aims to gather
disaggregated data on number
households supported with NFIs.
Overall number of NFIs delivered
should also be collected.

28. Proportion of households where only safe
water is used for drinking and cooking
Safe water is defined as water that: (1) comes from
a protected and/or treated water supply and/or is
treated at household or point of use; (2) is
collected and stored in clean covered or narrow-
necked containers; (3) is transferred safely during
collection at the water point, when transferring
from collection containers to storage, (4)
containers and when transferring to containers
used for drinking or cooking

29. Percentage of households with
capacity to prepare food safely
Proportion of households (female and male
headed households) with capacity to
prepare food safely (fuel, water, cooking
utensils, food)

30. Percentage of households that have
changed intra-household food
distribution
Assessing the impact of the crisis on food
distribution patterns inside the HHs (both female
and male headed households). The change can
occur in several ways and have several degrees of
severity: i.e. adults restrict consumption for
children to eat, women do not eat to give food
only to men (as they work) etc.

31. Number of functional basic health
units/10,000 population
Proxy indicator of geographical accessibility,
and gender balance in staff (adequate
representation of women and men) in
availability of health facilities across
different administrative units

32. Number of community health workers
(F/M) per 10,000 population
Indicator monitoring the availability of
human resources key to delivering
community-based intervention

33. Global acute malnutrition
Prevalence rate (%) of global acute
malnutrition in children 6 to 59 months of
age based on presence of bilateral pitting
oedema and / or weight-for-height z-score
less than -2 standard deviations of the
median of the standard population
(WHO 2006)

34. Proportion of households (both female and
male headed households) where food is
safely stored, prepared and consumed
Safe food practice involves three main precautions: (1)
clean all surfaces in contact with food: wash hands before
food preparation and eating, wash cooking and eating
utensils, (2) use safe ingredients: use safe water and
foodstuffs, wash fresh foods to be eaten raw, (3) store food
safely: protect from flies, separate raw and uncooked
foods, avoid storing leftovers or cooking a long time before
eating.

35. Global acute malnutrition
Prevalence rate (%) of global acute
malnutrition in children 6 to 59 months of
age based on presence of bilateral pitting
oedema and / or weight-for-height z-score
less than -2 standard deviations of the
median of the standard population
(WHO 2006)

36. Proportion of pregnant women, children
under five and other vulnerable people
sleeping under effective insecticide-treated
mosquito nets
Insecticide-treated nets are nets for hanging over sleeping
places, treated with an insecticide that repels, disables and
kills mosquitoes coming into contact with them.
Conventionally treated nets are effective if they have been
retreated correctly within the last six months (or the last
yea the case of some chemicals), not washed more than
three times since the last treatment and without holes or
tears.

37. Proportion of households (Female and
male headed households) with appropriate
water treatment supplies and equipment
Water-treatment supplies and equipment includes
chemicals for flocculation and disinfection, filter systems
and equipment and fuel for boiling. Equipment and
supplies are appropriate where they are already known by
the population concerned or where they are simple
enough for the people concerned to use them safely and
effectively with the instructions provided.