Information Management Systems

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This section is intended mainly for practitioners and program managers. It provides insights on key indicators and means of verifications for preventive and curative nutrition. It also explores different ways of collecting and presenting data for different purposes.

Setting up and managing a Comprehensive Information Management System

Planning, Monitoring and Evaluation

Use and Presentation of Data

• Key indicators on preventive nutrition are usually collected through Demographic Health Surveys and respond to priority public health interventions like micro-nutrient supplementation and promotion of breastfeeding. Specific indicators related to positive behavioural changes in the family feeding practices are more difficult to obtain. Qualitative studies should provide insights on identified poor practices to increase understanding on underlying causes (cultural, social and economic barriers). Comprehensive data on complementary feeding practices and maternal nutrition are not always available. More often, they are insufficiently linked to specific interventions aimed at these population groups.
   
• The WHO decision-chart to assess the magnitude and severity of a nutrition crisis and decide on the required action is based on the prevalence of wasting and a limited number of aggravating factors including: general food ration below 2100kcal/person/day, Crude Death Rate greater than 1/10,000/day and epidemics of measles or whooping cough.

Indicators	Acceptable	Risky		Serious
GAM (WHZ)	5-9.9% usual range and stable	5-9.9% (with aggravating factors)	10-14.9%	10-14.% (with aggravating factors)	15% or more
CMR/10,000/day	<1/10,000/d.	>1 / 10,000/d.	<1 / 10,000/d.	>1 / 10,000/d.	<1 / 10,000/d.
Food availability at household level	More than 2100 kcal/pers./d.	< 2100 Kcal/pers./d.	> 2100 kcal/person/d.	< 2100 Kcal/pers./d.	> 2100 kcal/pers./d.
Epidemic of measles or whooping cough	NO	YES	NO	YES	NO
Action required	Attention to malnourished children through regular services with emphasis on SAM	Supplementary feeding for MAM and therapeutic feeding for SAM		General ration Supplementary feeding for MAM and therapeutic feeding for SAM

• New tools are currently under development to support in the triangulation of different indicators. An example of a more comprehensive table of indicators is provided below:

• Nutrition indicators can be triangulated with food security and livelihood information to assess the severity of a crisis and implications for humanitarian responses. Check the IPC tool for an Integrated Food Security and Humanitarian Phase Classification.
   
• The decision whether and when it is necessary to intervene with feeding programs should be based on four main considerations: 1) Prevalence of and trends in malnutrition; 2) The context (including careful assessment of aggravating factors that determine the severity of a crisis); 3) Available resources - human, material and financial and 4) Public health priorities.
   
• Treatment of severe malnutrition in stable development situations might be overlooked by health systems as too specialized and expensive. Many children die as a result. It is not difficult to integrate standardized protocols into existing treatment protocols to achieve a substantial impact on child mortality. In-patient and out-patient treatment and active case-findings of children with acute malnutrition should be regarded as essential components of integrated management of child illnesses.
   
• When acute malnutrition is affecting disproportionately low-income classes a strategy that addresses inequalities in access to food and health services should be identified to provide a safety-net during seasonal or sudden hunger-gaps. Development principles of sustainability, ownership and capacity building should be included as part of the strategy and would build on locally available coping mechanisms.

11 April, 2013