Roy 10b comparative analysis and applications of nutritional assessment
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Transcript of Roy 10b comparative analysis and applications of nutritional assessment
Multi Sectoral Issues in Nutritional Assessment with Examples from
Health Sectors
Dr. SK RoyMBBS, M.Sc. Nutr (London),
Dip-in-Biotech(UNU), PhD(London), FRCP (Edin)
Nutritional Status Assessment
Nutritional status indicators whether the individual is well-nourished or undernourished
To define the nutritional problem of the targeted population, nutritional statusis measured
Nutritiona
l Nee
d Assessment of
the Communi
ty
•Define needs, opportunities and constraints, and prioritize solutions
Evaluate of
nutrition
programm
es
•Evaluate programme impact and improve efficiency.
Policy change and
sustainability
•Influence decision making in strategic planning, policy formulation and resource allocation.
•Raise community awareness and participation to maximize long-term impact.
Nutritional Assessment
Nutritional status assessment
Triple A Cycle (Source –UNICEF)
Analysis
Action
Assessment
Nutritional status assessments measure
Anthropometric Biochemical or physiological characteristics.
These assessmentscombined with the analysis of underlying
causes will result in appropriate action.
Incorporating nutritional objectives- into development policies and programmes.
Household food security Protecting consumers through improved food
quality and safety. Preventing and managing infectious
diseases Promoting breastfeeding Promoting appropriate diets and healthy
lifestyles Assessing, analyzing and monitoring nutrition
situations
Issues in Nutritional Assessment
Food &AgricultureFood security
Agricultural productionFood Safety
HealthAnd family planning
Supplementation Prgrammes for Vulnerable groups
EPI, IMCI. Nutritional Surveys (BDHS,NNP baseline )Nutritional services
Law enforcing agency
Food Safety At consumer level
Penalization
Commerce and Finance
Market StabilizationControl of Food price
Import Export Balance
Multi sectoral contribution in Nutritional Assessment
Methods of Nutritional Assessment
Different anthropometrical indicesWeightHeightMid upper arm circumferencesSkin fold thicknessDemi-span or armspanKnee height Sitting height Skin fold thickness Head circumference
It is precise and accurate
It uses standardized technique
It is suitable for large sample sizes, such as representative population samples
Inexpensive equipment and skills can be learnt quickly.
Advantages of Anthropometry in Nutritional Assessment
Uses of Anthropometrical Methods
Large population based surveys
Bangladesh Demographic and Health survey 2007
National Nutrition Survey –Baseline Survey 2004
Clinic Based
Done by Health Care professionals
Example: Maternal and child health care Clinic
National surveys
which are periodically conducted at national level (BDHS-2007, NNP 2004)
Small-scale surveys which are carried out at local level to gather
nutrition information within the shortest time possible.
MDGF Baseline Survey Conducted In Bhola And Borguna (WFP/UNICEF/ FAO)
Use of Anthropometrical Assessment
Biochemical testing contribute to diagnosing micronutrient deficiencies.
The most common deficiencies are: • Iron • vitamin A, and• Iodine During emergencies:
scurvy Beri-Beri (vitamin B 1 deficiency) pellagra (vitamin B 3 deficiency).
Biochemical testing for Nutritional Assessment
Example : National Nutritional survey 2004
Haemoglobin level among adolescent girls
Table salt iodine level
Urinary iodine excretion
Prevalence of stool parasite
Biochemical testing for Nutritional Assessment
Information on food intake may help to better understand the causes of malnutrition
and can also be used as a proxy for nutritional
outcome.
Indirect correlates of Nutritional Status
Food intake or consumption surveys assess the types and amounts of food eaten. This can be represented
in terms of daily energy and nutrient intake per person.
May involve weighing amounts of food eaten or using dietary recall.
Difficulties: labour-intensive time consuming and costly. Dietary recall are more dependent on memory. The analysis of food intake surveys requires high level of skills the use of specific software availability of a food composition table.
Food Intake Surveys
Advantages: provide invaluable information on
quantities, diet quality and on whether energy and nutrient intake
are being met. This type of assessment is undertaken
in stable contexts where more information is needed about dietary causes of malnutrition.
Food Intake Surveys
Dietary diversity (DD) scores is a proxy of nutritional quality of the diet.
The DD scores consists of a simple count of the number of food groups consumed by an individual or a household over a given period of time.
The assumption is that the higher the score, the better the quality of the diet.
Assessing DD is useful to evaluate the impact of a wide range of programmes on dietary quality.
Examples are livelihoods and crop diversification, nutrition education, school and homestead gardens.
DIETARY DIVERSITY SCORES
These assessments may be carried out in stable situations where there is a known problem of lack of dietary diversity and where efforts to improve agricultural diversification in order to improve diet have been ongoing for many years.
The DD assessment can also be used in emergency contexts, where shock can adversely impact the quality of the diet.
DIETARY DIVERSITY SCORES
Carried out at food distribution sites
camp situations, e.g. among refugees
in order to ensure that food distribution systems are operating optimally
to help identify any risk of nutrition problems, especially micronutrient deficiency diseases.
FOOD BASKET MONITORING (FBM)
Where camp populations are dependent on long-term food aid, FBM is critical, especially where the ration diversity is limited and where there is an absence of micronutrient rich foods in the ration, e.g. fortified Corn Soy Blend.
Computer programmes to calculate micronutrient
content of food rations are available.
FOOD BASKET MONITORING (FBM)
THANK YOU VERY MUCH