Ctown 2.ppt Experience in nutrition information systems in the region

Fitting systems together and deciding priorities

Kenya Purpose – primary, (secondary)CHANISDHS CBS/ NatlMICS Area- Level surveysALRMPFEWSNETVAM/WFPFIVIMS Long Term Planning & Policy Making XXX(X) Program Monitoring & Evaluation X (X) Timely Warning (X) XXXXX Repeated national surveys (CBS, DHS, MICS), giving provincial trends Clinic based reporting system (CHANIS) Sentinel sites monthly assessment (MUAC) by ALRMP Area-level surveys, drought-prone areas, ad hoc

Uganda Data source/system Main purpose Long term planning Program monitoring Timely warning of food/nutrition crises DHSY(Y)No HMIS current(Y)Y HMIS with selected site focus(P) P C-based programs thru HMIS(P)PP EWS – prodn, climate etc(Y)NoY EWS – pricesNo Y Y – yes, (Y) – sometimes, P – potential, (P) – maybe.

Ethiopia Repeated national surveys, give trends to region or zone level (WMS, DHS) EOS screening data (AC, then w/h) Area level surveys, often following EOS data signals Several others, e.g. SCF sentinel repeated surveys (discontinued) Sentinel use of screening data (first stage) might be feasible

AdvantagesDisadvantages Quantity of data more manageableGaps in the system (missed areas of deterioration) Quality of data improvesPossible ‘Hawthorne’ effect Trend analysis more manageableTrigger for action set to prevalence levels not trends (system provides trends not prevalence levels) Data collection cycle can be shortenedDoes not address the needs of non- sedentary populations Capacity building improves with focused resources Capacity for analysis at sites may not by sustainable Sentinel approach means selecting limited number of sites for focusing data collection/analysis, usually chosen as most likely to show change – these can be clinics or programme sites capturing data already collected, or clusters for sampling for new surveys

SurveyAgencyDateSeasonSample Design Sampling Frame Accurate To* AreaSelf- Weighted Age- Band Rural Nutrition Su Survey CSA02/ /1984 Peak2 Stage cluster PPS 1984 CensusZoneRuralNation, Region, Zone 0-59 Rural Nutrition Survey CSA02/ /1984 Peak2 Stage cluster PPS 1984 Census with fresh HH list ZoneRuralNation, Region, Zone 0-59 WMSCSA01/ /1996 Peak2 Stage cluster PPS (rural); 3 Stage cluster PPS (urban) 1984 Census with fresh HH list RegionRural/UrbanNation, Region 3-59 WMSCSA01/ /1998 Peak2 Stage cluster PPS (rural); 3 Stage cluster PPS (urban) 1984 Census with fresh HH list ZoneRural/UrbanNation, Region, Zone 3-59 WMSCSA01/ /2000 Peak2 Stage cluster PPS (rural); 3 Stage cluster PPS (urban) 1984 Census with fresh HH list ZoneRural/UrbanNation, Region, Zone 3-59 DHSCSA, ORC Macro 02/ /2000, Beginning Slack 2 Stage cluster PP square root of size 1984 Census with fresh HH list RegionRural/UrbanNation, Region, Zone 0-59 WMSCSA06/ /2005 Slack2 Stage cluster PPS (rural); 3 Stage cluster PPS (urban) 2003 Agricultural Enumeration (Rural); 2004 Urban Census ZoneRural/UrbanNation, Region, Zone 3-59 Sources: WHO, Global Database on Child Growth and Malnutrition; CSA, 1996; CSA, 1998; CSA, 2000; DHS, 2000; CSA, 2004 * Levels of accuracy in the Table 1 refer to levels published in survey’s reports. These surveys exclude non-sedentary populations (did not sample some zones in Afar and Somali regions), and are therefore accurate only to the sedentary populations of geographic areas. The 2004 WMS (data from 2005) excludes Gambella region entirely. Gambella region has had high levels of malnutrition in the past (i.e. the 2000 WMS reports 13% wasting, 32% underweight, and 40.5% stunting).

Somalia – FSAU Agro-met, satellite, animal and crop conditions, prices, etc Area level surveys, including wasting in children: sentinel site and ad hoc surveys

Botswana National surveys, BFHS (Family Health Surveys), MICS 2000 Clinic-based reporting (BNNSS)

Education JanuaryApril # weighed% uwt# weighed% uwt None Primary P/prim

Zimbabwe Repeated national surveys Sentinel survey system, 6-monthly