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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

April 21, 2023 2

Content

Pastoralist Survey Method (PSM) – applied research

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

April 21, 2023 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

April 21, 2023 4

Innovations of PSM

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

April 21, 2023 5

Organogram of Mali field test

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

April 21, 2023 6

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

April 21, 2023 7

PSM quantitative phase

Identify all eligible children (6-59 months)

Measure MUAC & oedema

Collect other data

April 21, 2023 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

April 21, 2023 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

April 21, 2023 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

April 21, 2023 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

April 21, 2023 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

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Nutrition Survey Database

April 21, 2023 14

Children Survey Database

April 21, 2023 15

Therapeutic Programme Database

April 21, 2023 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 !!

April 21, 2023 17

THANKS

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