April 21, 2023

Brussels, CRED CEDAT, June 9 & 10, 2011

Innovative Methods to assess a nutritional

situation

Damien PEREYRA, EpidemiologistCécile SALPETEUR, HIV & Nutrition Research Advisor

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Content

Pastoralist Survey Method (PSM) – applied research

Listening Posts – applied research ACF Main sources of data Examples of ACF databases

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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

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Innovations of PSM

Qualitative phase + quantitative phase Case definition of SAM Sampling frame Bootstrap estimator Specific worksheet with formulas

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Organogram of Mali field test

Organizing Factor: organization of the nomadic troupes geographically or socially & seasonally

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PSM Sampling

Average P

SU

size

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) PSU: Primary Sampling

Units

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PSM quantitative phase

Identify all eligible children (6-59 months)

Measure MUAC & oedema

Collect other data

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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

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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

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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

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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

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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

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Nutrition Survey Database

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Children Survey Database

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Therapeutic Programme Database

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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 !!

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THANKS