This document discusses nutritional surveillance. It begins with an introduction defining nutritional surveillance as the regular collection and analysis of nutrition data. It then outlines the purpose of nutritional surveillance, which includes monitoring nutrition situations, informing policies, and tracking program progress. The document also provides a brief history of nutritional surveillance and describes the process involving data collection, analysis, dissemination and decision making. It further discusses challenges and provides guidance on establishing nutritional surveillance systems.
This was done as a student presentation using photographs & content from various web sites & textbooks on the assumption of fair usage for studying & is for NON-COMMERCIAL purposes.
Nutritional assessment using anthropometric, biochemical, clinical, and dietary methods with a larger understanding of anthropometric methods used in Ethiopia
This was done as a student presentation using photographs & content from various web sites & textbooks on the assumption of fair usage for studying & is for NON-COMMERCIAL purposes.
Nutritional assessment using anthropometric, biochemical, clinical, and dietary methods with a larger understanding of anthropometric methods used in Ethiopia
This is the presentation about "Nutritional Epidemiology". By lacking of different minerals in our food we may suffer different types of disease... The types of disease are mentioned in this presentation.
This is the presentation about "Nutritional Epidemiology". By lacking of different minerals in our food we may suffer different types of disease... The types of disease are mentioned in this presentation.
IFPRI-FAO Panel Discussion "Accelerating Progress to Overcome Malnutrition" on Janury 30, 2015. Presentation by Jomo Kwame Sundaram, FAO Assistant Director-General for Economic and Social Development.
UN System Standing Committee on Nutrition country study for the Second International Conference on Nutrition Country Policy Analysis
Nutrition Impact of Agriculture and Food Systems
Thailand
Workshop 3: The Agriculture Nutrition Nexus and the Way Forward at The Caribbean-Pacific Agri-Food Forum 2015 (CPAF2015) taking place 2-6 November in Barbados with support from the Intra-ACP Agricultural Policy programme, organized in partnership with the Barbados Agricultural Society (BAS) and the Inter-American Institute for Cooperation on Agriculture (IICA). http://www.cta.int/en/news/caribbean-pacific-agri-food-forum.html
Former Dietary Guidelines Advisory Committee members discussed the role nutrition science and research plays in shaping U.S. food policy issues, such as the Dietary Guidelines for Americans, and the impact on consumers and industry.
Key Takeaways:
The role federal agencies play in making food and nutrition policy recommendations
Insights into the science and process related challenges faced when creating the DGAC Report
Thoughts from past DGAC members on the newly released 2015 DGAC Report
Food Security Measurement in the Context of the Sustainable Development Goals...FAO
FIRST Webinar #3 - Food Security Measurement in the Context of the Sustainable Development Goals Monitoring Framework
This presentation was prepared for a webinar is organized jointly with the European Commission Directorate-General for International Cooperation and Development, in the framework of the FAO-EU Partnership Programme: Food and Nutrition Security Impact, Resilience, Sustainability and Transformation (FIRST).
SPEAKER:
Mr Carlo Cafiero, Senior Statistician and Economist, FAO Statistics Division
MODERATOR:
Ms Terri Ballard, Food and Nutrition Security Measurement Specialist, FAO Statistics Division
Find out more about FIRST, FAO-EU Partnership Programme: http://www.fao.org/europeanunion/eu-projects/first/en/
Contextualization nutrition food system and food safety issues in VietnamILRI
Presented by Truong Tuyet Mai, Fred Unger and Stef de Haan at the CRP-A4NH, Vietnam Partner Day Sharing Progress and Planning ahead for Collaborative Research Workshop, Hanoi, Vietnam, 23 March 2018
Linking Agriculture, Food Systems and Nutrition for Food and Nutrition Security in Myanmar by Khin Mar Cho, International Agricultural Extension and Nutrition Specialist, Cornell University.
Presented at the ReSAKSS-Asia - MIID conference "Evolving Agrifood Systems in Asia: Achieving food and nutrition security by 2030" on Oct 30-31, 2019 in Yangon, Myanmar.
RMNCH+A approach has been launched in 2013 and it essentially looks to address the major causes of mortality among women and children as well as the delays in accessing and utilizing health care and services. The RMNCH+A strategic approach has been developed to provide an understanding of ‘continuum of care’ to ensure equal focus on various life stages.
The RMNCH+A appropriately directs the States to focus their efforts on the most vulnerable population and disadvantaged groups in the country. It also emphasizes on the need to reinforce efforts in those poor performing districts that have already been identified as the high focus districts.
A food policy is designed to influence the operation of the food system network of farms, distributors, restaurants, retailers, and consumers . It impacts on how food is produced, processed, distributed, marketed, consumed, and disposed. Implementing good food policies is crucial to achieving more equitable and sustainable food systems. This paper provides a brief introduction on food policy. Matthew N. O. Sadiku | Tolulope J. Ashaolu | Sarhan M. Musa ""Food Policy: An Introduction"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-2 , February 2020,
URL: https://www.ijtsrd.com/papers/ijtsrd30133.pdf
Paper Url : https://www.ijtsrd.com/engineering/food-engineering/30133/food-policy-an-introduction/matthew-n-o-sadiku
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
2. OUTLINE
• List of Abbreviations
• Introduction
• Purpose of Nutritional Surveillance
• History of Nutritional Surveillance
• Process of Nutritional Surveillance
• Challenges of Nutritional Surveillance Systems
• Establishing a Nutritional Surveillance System
• Examples of Nutritional Surveillance in Nigeria
• Conclusion
• References
2
3. LIST OF ABBREVIATIONS…1
• BMGF – Bill and Melinda Gates Foundation
• DHS – Demographic and Health Survey
• FAO – Food and Agriculture Organization
• FMOH – Federal Ministry of Health
• MICS – Multiple Indicator Cluster Survey
• MUAC – Mid Upper Arm Circumference
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 3
4. LIST OF ABBREVIATIONS…2
• NACA – National Agency for the Control of AIDS
• NDHS – Nigeria Demographic and Health Survey
• NPHCDA – National Primary Health Care
Development Agency
• SOML – Saving One Million Lives
• UNFPA – United Nations Population Fund
• UNICEF – United Nations Children’s Fund
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 4
5. LIST OF ABBREVIATIONS…3
• USAID – United States Agency for
International Development
• WHO – World Health Organization
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 5
6. INTRODUCTION…1
• Nutritional surveillance means to watch
over nutrition in order to make decisions
that lead to improvements in nutrition in
populations (Mason and Mitchell 1983)
• It involves the regular and systematic
collection of data on nutritional outcomes
and exposures.
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 6
7. • The regular and timely collection, analysis
and reporting of data on nutrition risk
factors, nutritional status and nutrition-
related diseases in the population
INTRODUCTION…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 7
8. PURPOSE OF NUTRITIONAL
SURVEILLANCE…1
• To monitor the nutrition situation
• To identify factors associated with
malnutrition
• To inform nutrition policies and programmes
• To track progress towards achieving nutrition
goals
• To serve as an early warning of increased
nutritional risk
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 8
9. • To assess the delivery and coverage of
services
• To evaluate programmes and
interventions
• To detect the impact of change in policies
PURPOSE OF NUTRITIONAL
SURVEILLANCE…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 9
10. HISTORY OF NUTRITIONAL
SURVEILLANCE…1
• First World Food Conference in 1974,
FAO, WHO and UNICEF were invited to
establish a global nutrition surveillance
system
• This led to national surveillance systems
being set up – about 20 countries by the
1980s
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 10
11. • Early nutrition surveillance systems were
primarily based on growth monitoring
data from clinics plus infrequent surveys.
• A few school census systems existed
mainly in Central America
HISTORY OF NUTRITIONAL
SURVEILLANCE…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 11
12. • Today, there is substantial political
momentum to reduce the numbers of
children affected by undernutrition as
demonstrated by political and financial
commitments by national governments
and international organizations
HISTORY OF NUTRITIONAL
SURVEILLANCE…3
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 12
13. THE PROCESS OF NUTRITION
SURVEILLANCE
1. Collection
•Creates data
2. Collation
•Creates
organized data
3. Analysis and
interpretation
•Creates
information
4. Dissemination
& communication
•Leads to
knowledge
Decision making
and action
•Leads to
improvement in
nutrition
situation
13
14. Surveillance is a continuous process
ANALYSIS
of the causes of the
problem
ASSESSMENT
of the nutritional
situation in the target
population
The Analysis stage
aims to analyze the
causes of malnutrition
as represented in
various conceptual
frameworks such as
UNICEF
The Assessment stage
aims to define the
nutritional problem in
terms of magnitude and
distribution
ACTION
based on the
analysis and
available resources
14
15. DATA COLLECTION
• In nutritional surveillance, information
should be collected both on the
nutritional status of the population and
on the underlying causes of
malnutrition
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 15
17. 1. Nutritional status depends on the dietary
intake of food and nutrients as well as
disease.
2. The dietary intake or food consumption
of a family or a person depends on the
food available to the family and on the
nutrition awareness in the family.
MAJOR DETERMINANTS OF
NUTRITIONAL STATUS…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 17
18. 3. Food availability depends:
(a)on the relation between food prices and
earnings in a market economy;
(b)on the food harvests in subsistence
households; and
(c)on both the price– wage relationship and on
production in mixed market and subsistence
households (the exact relationships between
these factors and food availability in a mixed
household economy are not usually known and
are difficult to determine).
MAJOR DETERMINANTS OF
NUTRITIONAL STATUS…3
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 18
19. 4. The relation between food prices and
earnings is largely influenced by imports
or food aid.
5. Local food production is influenced by
many interrelated factors, both inside
and outside the country (e.g. the
weather).
MAJOR DETERMINANTS OF
NUTRITIONAL STATUS…4
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 19
20. 6. Food utilization depends on the
physiological status of the human body
which, in turn, is influenced by the
environment, accessibility to safe water,
and the morbidity status which itself
results from inadequacies in the
environment and water and sanitation
situations.
MAJOR DETERMINANTS OF
NUTRITIONAL STATUS…5
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 20
21. INDICATORS TO BE MONITORED…1
• Anthropometric and biochemical
indicators are used to assess nutritional
status of the population
• These indicators aim to answer the
following questions:
–Who suffers from malnutrition? (children,
elderly, mothers)
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 21
22. –What is the type of malnutrition? (wasting,
stunting, iodine deficiency)
–When? (recent or chronic problem)
–Where? Which areas are most affected?
INDICATORS TO BE MONITORED…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 22
23. • There are 3 primary anthropometric
indices for children under five years of age
–Wasting (using weight-for-age and MUAC)
–Underweight (using weight-for-age)
–Stunting (using height-for-age)
INDICATORS TO BE MONITORED…3
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 23
24. • Food security, health and care practice
indicators are used to analyze the causes
of the nutritional problem
–Why are people malnourished or at risk of
malnutrition?
INDICATORS TO BE MONITORED…4
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 24
25. METHODS OF DATA COLLECTION…1
• Large-scale national surveys
• Repeated small-scale surveys
• Clinic-based monitoring
• Sentinel site surveillance
• School census data
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 25
26. • Rapid nutrition assessments
• Rapid screening based on MUAC
measurement
• Selective feeding programmes or services
statistics monitoring
METHODS OF DATA COLLECTION…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 26
27. LARGE-SCALE NATIONAL SURVEYS…1
• Examples include Demographic and Health
Surveys (DHS), Multiple Indicator Cluster
Surveys (MICS)
Advantages
• They provide valuable data to assess trends in
nutrition nationally and globally.
• Long-term trends can be observed.
• Standardized methodology
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 27
28. Disadvantages
• Need to train and supervise large numbers of
surveyors for quality control
• High cost
• Long period between data collection and
release of findings
• Acute malnutrition could be missed because
of long period between surveys
LARGE-SCALE NATIONAL SURVEYS…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 28
29. REPEATED SMALL-SCALE SURVEYS…1
• They are the most common method used in
emergencies.
• To be comparable, they should be conducted
in the same geographical area and at the
same time/season of the year.
• Repeating the surveys make them useful in
surveillance as against a single ad-hoc small-
scale survey
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 29
30. Limitations
• Require technical expertise
• High cost
REPEATED SMALL-SCALE SURVEYS…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 30
31. CLINIC-BASED MONITORING
• A component of health information system
• Can be applied both in emergency and non-
emergency situations
Limitations
• Population attending clinics may not be
representative
• Captures only younger children
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 31
32. SENTINEL SITE SURVEILLANCE…1
• Monitoring of a set of indicators in selected
communities or service-delivery sites
• Ranges from technically sophisticated large-
scale to simple community-based monitoring
of several key indicators
• Aims to produce trends in the nutrition
situation in identified vulnerable areas in
order to provide early warning of
deterioration
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 32
33. Limitations
• Problems with analysis of data and
representativeness
SENTINEL SITE SURVEILLANCE…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 33
34. SCHOOL CENSUS DATA…1
• To identify high-risk populations with
poor health, malnutrition and low
socioeconomic status
• Focuses on stunting and can provide large
coverage
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 34
35. SCHOOL CENSUS DATA…2
Limitations
• Not useful in emergency situations
• Representativeness is determined by
school attendance
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 35
36. RAPID NUTRITION
ASSESSMENTS/RAPID SCREENINGS…1
• They are conducted to obtain a quick
snapshot of the nutrition situation.
• Important source of information
especially at the onset of an emergency to
determine magnitude and severity of a
crisis
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 36
37. Limitation
• Information may not always be
representative
RAPID NUTRITION
ASSESSMENTS/RAPID SCREENINGS…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 37
38. PROGRAMME/SERVICE STATISTICS
• Indicators such as admissions, cure,
defaulting and case-fatality rates provide a
measure of:
– programme quality
– trends in acute malnutrition
– the most vulnerable groups
– seasonal trends
– Underlying causes of malnutrition such as
morbidity patterns
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 38
39. ANALYSIS OF DATA
• Variety of tools
• Quality control, major challenges
– Accurate estimation of age
– Height/length measurement
– Weight measurement
• How to address them
– Training and ongoing supervision
– Quality checks with specialized softwares
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 39
40. PRESENTATION OF DATA
• Compare current data with previous and
establish trends: numbers in isolation mean very
little.
• Seasonal interpretation is also critical
• Consider underlying causes and assess
predictable changes in the nutrition situation:
– risk factors likely to result in further deterioration
– mitigating factors leading to improvement
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 40
41. INTERPRETATION OF DATA…1
• To properly understand and interpret nutritional data,
the following should be considered:
– The actual prevalence rates of acute malnutrition in relation
to thresholds and decision making frameworks
– Trends over time and seasonality (reviewing expected
seasonal changes in nutritional status),
– The underlying causes of acute malnutrition
– The relationship between malnutrition and mortality
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 41
42. DISSEMINATION OF DATA
• There must be timely dissemination of
information to aid appropriate responses
especially in a crisis situation.
• Can be done through national nutrition
coordination units or clusters
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 42
43. CHALLENGES OF A NUTRITIONAL
SURVEILLANCE SYSTEM…1
• Sustainability and continued effectiveness
of the system
–Waning donor interest
–Change in funding priorities
–No crisis situation for a long period
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 43
44. • Institutionalization – Reliance on
information sources that cut across several
government ministries can pose problems
– Where the system should be located
– How it links with existing systems
– Who ultimately makes the decisions about the
analysis of the information
– Who determines the appropriate response
CHALLENGES OF A NUTRITIONAL
SURVEILLANCE SYSTEM…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 44
45. • Linking information to action
–Lack of confidence in the data
–Political reasons for failing to act on
surveillance information
CHALLENGES OF A NUTRITIONAL
SURVEILLANCE SYSTEM…3
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 45
46. • Be clear on the objectives and what the
information will be used for (Consider the
availability of resources, staff capacity,
sustainability, environmental factors and
response capacity).
• Review and map existing nutrition
information sources to prevent duplication
and where possible, ensure linkage or
integration with existing information
systems.
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 46
ESTABLISHING A NUTRITION
SURVEILLANCE SYSTEM…1
47. • Define a minimum set of core indicators
that refer both to nutritional status and
provide an understanding of the
underlying causes of malnutrition.
• Design the system based on the most
appropriate methods. Several methods
may be appropriate in some contexts.
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 47
ESTABLISHING A NUTRITION
SURVEILLANCE SYSTEM…2
48. • Ensure adequate training and supervision
of data collection (include simple quality
checks to assure reliability of data).
• Consider contextual issues when
interpreting data: seasonality, population
movement, morbidity patterns and
historical trends.
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 48
ESTABLISHING A NUTRITION
SURVEILLANCE SYSTEM…3
49. • Ensure information is presented in a
timely and accessible manner to decision
makers and to the community.
• Establish triggers to determine when
more detailed nutrition assessments are
necessary.
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 49
ESTABLISHING A NUTRITION
SURVEILLANCE SYSTEM…4
50. • Consider how the information from the
surveillance system will link to action or
response.
• For longer term systems in emergency
prone areas, consider sustainability issues
from the outset.
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 50
ESTABLISHING A NUTRITION
SURVEILLANCE SYSTEM…5
51. EXAMPLES OF NUTRITIONAL
SURVEILLANCE IN NIGERIA
• MICS: 1995, 1999, 2007, 2011, 2016-17, 2020
(survey design)
• NDHS: 1986 (Ondo State), 1990, 1999, 2003,
2008, 2013, 2018
• Nutrition and food security surveillance:
North East Nigeria 2016
• National Nutrition and Health Survey: 2014,
2015, 2018
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 51
52. MICS5 2016-17…1
• Carried out in 2016/2017 by the National
Bureau of Statistics in collaboration with
NPHCDA and NACA
• Technical support provided by UNICEF
• Financial support provided by WHO, World
Bank, SOML, BMGF, UNFPA, USAID and
UNICEF
(NBS and UNICEF, 2017)
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 52
53. MICS5 2016-17…2
• Underweight prevalence in under 5
– Moderate and severe 31.5%
– Severe 11.5%
• Stunting prevalence in under 5
– Moderate and severe 43.6%
– Severe 22.8%
• Wasting prevalence in under 5
– Moderate and severe 10.8%
– Severe 2.9%
(NBS and UNICEF, 2017)
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 53
54. NDHS 2018…1
• Implemented by the National Population
Commission in collaboration with the National
Malaria Elimination Programme of FMOH
• Technical support provided by ICF Maryland
through The DHS Program, a USAID-funded
project
• Financial support provided by USAID, Global
Fund, BMGF, UNFPA and WHO
(NPC and ICF, 2019)
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 54
55. • Stunting prevalence in children 6 – 59
months 37%
• Wasting prevalence in children 6 – 59
months 7%
• Underweight prevalence in children 6 –
59 months 22%
(NPC and ICF, 2019)
NDHS 2018…2
18/3/2020
Nutritional Surveillance - Dr. Otaigbe 55
56. CONCLUSION
• Nutritional surveillance is essential to
monitor the nutrition situation in an area
and consequently decide on the best
course of action.
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 56
57. REFERENCES
• Mason JB and Mitchell JT, 1983. Nutritional
Surveillance. Bulletin of the World Health
Organization. 61(5):745-755.
• National Bureau of Statistics (NBS) and United
Nations Children’s Fund (UNICEF), 2017. Multiple
Indicator Cluster Survey 2016-17, Survey Findings
Report. Abuja, Nigeria: National Bureau of Statistics
and United Nations Children’s Fund.
• National Population Commission (NPC) and ICF,
2019. Nigeria Demographic and Health Survey 2018.
Abuja, Nigeria, and Rockville, Maryland, USA: NPC
and ICF.
Nutritional Surveillance - Dr. Otaigbe 18/3/2020 57