Information Management Systems
Setting up and managing a Comprehensive Information Management System
Planning, Monitoring and Evaluation
Means of Data Collection
- Secondary data are available from national Demographic Health Survey and can be used as baseline indicators for setting up the M&E database. Segregated data by Regions and Districts and by separate categories might be accessible from the Bureau of Statistics.
Secondary data will give the prevalence of malnutrition at a specific time. Information on trends in malnutrition prevalence may come from ad-hoc surveys or from routine nutritional surveillance provided that key variables such as seasonality and age-group are the same or similar to allow comparisons. Before planning a new survey, it is always beneficial to first consider what data can be obtained from earlier surveys.
- Annual or bi-annual Nutrition and Health Surveys are conducted in countries that present with elements of humanitarian crisis with long-term underdevelopment. The *SMART methodology
(Standardized Monitoring and Assessment of Relief and Transition) has been introduced in several countries to improve the effectiveness and efficiency of nutrition surveys. The new, easy to use software that comes with the package incorporates all stages of implementation including quality checks on data. It integrates nutritional status, mortality and food security data to inform on the magnitude and severity of a crisis.
The package includes instruction on the standardization test for weight and height to assess the competency of the survey team on anthropometric measurement techniques. The Household Economic Approach may be used to analyze the most likely connection between a "shock" (failure of crop or increase in food process) and poor people's future ability to get sufficient food where methods, assumptions and uncertainties are clearly stated.
The information is obtained from "key informants" rather than by primary data collection to set the findings in context, allowing a prediction of likely future changes in nutrition, food needs and relief action.
- Where the coverage of monthly growth monitoring is high (e.g. India), indicators to assess malnutrition trends could be incorporated by developing an integrated surveillance system. This would mean randomly selecting a sample of children at the beginning of each year and measuring their weight, height and mid-upper arm circumference at monthly intervals thereafter, along with occurrence of diarrhoea and acute respiratory infections.
The malnutrition data will indicate trends (recent changes in the previous three months or a change from the preceding year) and should be triangulated with other indicators like mortality, health (e.g. epidemics of measles) and food security for further interpretation. Aggravating factors that might be specific to the context should be taken into account.
Food security data could be recorded from a sub-group of the sampled children and might include: availability of main staples, variety of diet (number of food-groups), frequency of meals and access to coping mechanisms (e.g. casual labour or savings).
- Where the routine coverage of MUAC screening and checking of Oedema is high (e.g. Ethiopia), trends in malnutrition can be observed from the monthly reporting system. Data on occurrence of diarrhoea and acute respiratory infections should also be collected. Malnutrition data should be triangulated with other indicators like health (e.g. epidemics of measles), mortality and food security for further interpretation. Food security data might be collected from key informants using the Household Economic Approach.
- Treatment-based routine monitoring systems should be established in all therapeutic (in-patient and out-patient) and supplementary feeding programs. Trends on admission may indicate seasonal or sudden changes and can be compared with the preceding year. Sudden increases in admission should be triangulated with other indicators like mortality, health and food security for further interpretation.
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* SMART (Standardized Monitoring and Assessment of Relief and Transition)
smartindicators.org | SMART Training and Survey Packages | Melody Tondeur
SMART methodology is an improved survey method based on the two most vital, basic public health indicators to assess the severity of a humanitarian crisis: nutritional status of children under-five and mortality rate of the population.
26 January, 2014