Post on 23-Feb-2016
description
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UNICEF NYHQNational Nutrition Information SystemsOctober 2013
BackgroundWhy are experiences of national nutrition information systems important for community-based SAM treatment?• Programming trends
• to expand SAM management in-country • to integrate SAM management into national/govt systems• to link SAM management to preventative action (& stunting agenda)
• Programme trends mirrored in information• So we need to:
1. Understand how SAM data from a wide range of sources comes together at national level
2. See SAM information within broader efforts around nutrition information collection /analysis/usage
GAM/SAMSurveillanceIYCF status
Micronutrient(National / Sub-National Level)
Situation & Early Warning
Surveys (MICS, SMART, etc.)
FEWS-NET; VAM
Routine information e.g.:- SAM Admissions- IYCF counselling- MN distribution
(National & Sub-National Level)
Delivery
Geographical Coverage(National & Sub-National Level)
Performance
Annual Budgets for Nutrition interventions
(National Level)
Nutrition Information Needs
Method
Source
SAM performance indicators
IYCF + MN KAP trends
(National & Sub-National Level)
Routine data; coverage surveys; KAP studies
UNICEF Country Reports
Intervention Coverage
(National & Sub-National Level)
MoH Surveys (National)
NGO Surveys (Sub-National)
Coverage Monitoring Network
UNICEF Country Reports
Supply Availability(Sub-National Level)
NGO Reports
Food securityHealth situation
Sanitation and hygiene(National & Sub-National
Level)
Routine data etc.
Elements of national nutrition information system
Country profile (pop. data; risks; DRR etc.)
MoH
Generic example: nutrition information / reporting system
Situational / Impact
Vertical programme
Programme delivery
HMIS
CMAM programme
- Survey- Survey- Survey
Vertical programme
Vertical programme
- Surveillance
- Coverage surveys
- KAP studies/ surveys
Programme performance
District / Province / National
District / Province / National
District / Province / National
District / Province / National
HMISGovt/UN/
NGOs
Govt/UN/
NGOs
Country SAM reporting systems
As of 2012, 51 COs (of 62 reporting) have CMAM/SAM reporting system*
• Information comes together at national level differently across countries• Govt + UNICEF play a significant role in bringing together SAM info at national level
* UNICEF Global SAM Management Update 2012
Govt run UNICEF run (Pakistan) UNICEF/Govt run0
5
10
15
20
25
30
3534
1
16
Manager of system
District health office
Health Facilities Implementing partners
Regional health office
02468
1012141618
1715
8
11
Report source
1. Pakistan: how CMAM output data(+) comes together at national level
2. Viet Nam: challenges of bringing together nutrition information reporting streams
Country examples
Pakistan: Nutrition programming context
• UNICEF continues to be a major supporter of nutrition programming, particularly for CMAM.
• Main programme interventions:• CMAM (MUAC screening; OTPs; SFPs), • Micronutrient supplementation• IYCF messaging
• Changing programming landscape in Pakistan:• Increased government ownership of nutrition programming (inc. CMAM)• Increased non-UNICEF supported NGO activity (e.g. NGO consortia in Sindh) • Increased programming focus shift from emergency to development (from
CMAM to IYCF/MN.
Pakistan national nutrition information system
Component What WhoSituational / EWS
• National and localized nutrition surveys (MICS; FANS (2010/2011); NNS (2011)
• DEWS
• Nutrition / health situation indicators
• Disease/health info
• Govt• WHO
Delivery • DHIS• National Programme
Reporting• NIS database• MRP• WFP supply system
• MNCH / NP indicators• SAM/MAM
admissions by site • IYCF counseling; • MN distribution; • Supply
• Govt• UNICEF• ECHO• WFP
Performance • National Programme Reporting
• NIS database• MRP• WFP supply system
• IYCF/MN/MNCH• SAM/MAM PIs; LoS +
AWG• Stocks
• Govt• UNICEF;• ECHO• WFP
NIS information flow (KP/FATA)
UNICEF
Reporting flow (KP/FATA)
NIS system
NIS key findings: challenges
Macro level• Standardization issues (2 provinces use; MRP)• Utilization and reporting flow issues (analysis; usage) • Sustainability issues (resource heavy)
Technical• Content gaps• Quality issues• IT technical issues
Viet Nam: Nutrition programming context
• Government-led nutrition programming• Development focus on stunting:
• National Targeted Programmes – (Nutrition [PEMC] and Maternal & Child Health (IYCF; MN)
• NGO programmes (IYCF ‘franchise’)• Introduction of IMAM pilot
• (Government-led / UNICEF-supported)
Current Nutrition Data Flow
Village
District HC/Hospital
VHW collects individual data and compiles monthly summary
Commune Monthly meeting at commune: Commune Nutrition Focal Point (or commune head) compiles
data monthly in hard copy (inc IMAM)
Monthly meeting: District planning FP collects general and specific programme
reports
25th each month
Monthly meeting: District Nutrition FP collects specific programme reports
30th each month
PEMC (IYCF & Vit A); MCHmonthly
IMAM; & general reportmonthly
PEMC (IYCF & Vit A); MCH;monthly
Current Nutrition Data Flow (cont.)
District HC/Hospital
Province
District planning FP compiles general report (& IMAM) monthly; sends either
monthly / quarterly summary to province via letter & email
Reproductive Health Centre (Nutrition FP) receives data and
compiles
5th of month
District Nutrition FP compiles programme reports monthly; sends
either monthly / quarterly summary to province via letter & email
Health Service Department/Planning
receives data and compiles
Preventive Health Centre receives; data and compiles
General reportsMonthly/quarterly
PEMC (Vit A)quarterly
PEMC (IYCF); Quarterly MCH: Monthly IMAM
Provincial Hospital
Curative data
IMAM (inpatient)
IMAM (inpatient)
Curative & IMAM data
IMAM (inpatient)
Complexity of reporting lines
Current Nutrition Data Flow (cont.)
Province RHC Nut FP compiles and sends
via email & letter
National
HSD/Planning compiles and sends via
email & letter
NIN (PEMC) MCHRegional
institutionObstetrics
hospital south
PHC compiles and sends via email &
letter
MoH (Cabinet Office)
PEMC (IYCF ); QuarterlyMCH: Monthly
PEMC (Vit A)quarterly
General reportsMonthly/quarterly
NIN (NSS)
Annual Nutrition survey
data
MoH
Complexity of reporting lines continues
Other experiences of national systems
• Data generation• Advances in coherence, quality, standardization & technology• But: Quality / credibility; politics; timeliness (surveys & routine systems)• Coherence (different reporting lines / staff / frequencies / indicators etc.)• Resources & capacity (technology; info collection)
• Data analysis• Sudan Darfur Update; Pakistan Cluster Update; • FSNAU; WCARO DevInfo & monthly report• But: Need for clarity of roles for analysis; capacity; breadth of analysis
• Data utilization• For advocacy and fundraising (Ethiopia & Sudan); programme adaptation
(Kenya MYRs adjusted targets, strategy, funding needs etc.)• But: Translation to programme adaptation; politics; level of info needed for
programme staff
Implications / Next steps
A. For bringing CMAM reporting together at country level: 1. Advocate for government ownership at national level & build capacity 2. Standardization of indicators/ & forms; develop tools & technology; clarify
reporting lines3. Strengthen analysis & utilization of data
B. For linking CMAM with other nutrition/multi-sector reporting:4. Advocate for Government buy-in & ownership5. Map, assess and harmonize / streamline6. Strengthen integrated data analysis7. Data utilization
Thank you
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