Professional Documents
Culture Documents
SCALING UP NUTRITION
In Practice
April 2014
Information Systems
for Nutrition
IN THIS ISSUE
INTRODUCTION
COUNTRY ARTICLES
5
Rwanda 7
Madagascar 11
Zimbabwe 17
Sri Lanka 21
Namibia 25
Ethiopia 31
INFORMATION SYSTEMS FOR
NUTRITION IN SUN COUNTRIES 36
WHAT HAS BEEN LEARNT?
39
Introduction
Target 1:
Target 2:
Target 3:
Target 4:
40% reduction of the global number of children under 5 who are stunted
Target 5:
Target 6:
Source: WHA65/6 Maternal, infant and young child nutrition. May 2012
3
Information Systems for Nutrition
Country
Articles
5
Information Systems for Nutrition
RWANDA
Monitoring performance
The Government of Rwanda is identifying a small number
of higher level indicators to aid decision-making and record
progress.
Fidele Ngabo, Director of Maternal and Child Health and SUN Focal Point
describes the process
CHILDREN UNDER 5
Stunting:
Wasting:
Overweight:
Low birth weight:
Exclusive breastfeeding:
44.2%
2.8%
6.7%
6.2%
84.9%
National systems
A number of ministries engaged in nutrition health,
agriculture, local government, education, infrastructure
and gender - prepare an annual Joint Action Plan to
Eliminate Malnutrition (JAPEM) through the NCC. Each
ministry submits a quarterly implementation progress
report, which is consolidated for submission to the Prime
Ministers Office. Nutrition outcomes and impact are
monitored though various tools.
In the health sector, key nutrition indicators are monitored
through the health management information system and
through the community based nutrition programme.
Information is collected from district health facilities
and through community monitoring tools by community
health workers. A more comprehensive survey designed
to monitor the health of the population is also conducted
every three to five years through the demographic and
health survey. This collects information on fertility, family
planning, childhood mortality, nutrition, maternal and child
7
Information Systems for Nutrition
Tracking malnutrition
in children through SMS
District systems
Rwanda
Rwanda
DEMOGRAPHICS
10,624
(2010)
(2010)
438
(2010)
82
38
(2005)
300
1200
(2010)
250
1000
34
(2010)
200
29
59
23
(2010)
(2010)
150
(2009)
1,500
(2010)
54
(2010)
5.4
43
(2010)
1,831
(2006)
MDG Target
0
1990
1995
2000
2005
2010
54
Neonatal
Neonatal
death:
death:34%
34%
200
1995
2000
2005
2010
Injuries
Injuries6%
6%
Prevention of mother-to-child
transmission of HIV
80
Birth
60
Measles
Infancy
20 40 60 80 100
1992
DHS
Percent
2000
DHS
2005
DHS
2007-2008
DHS
20 (2010)
EQUITY
CHILD HEALTH
Immunization
21
21
(2005)
(2005)
35
35
(2010)
(2010)
Malaria
Malariaduring
duringpregnancy
pregnancy- -intermittent
intermittent
(%)
preventive
preventivetreatment
treatment(%)
17
17
(2007
(2007-2008)
-2008)
58
44
50
94
94
92
92
96
96
98
98
2005
2008
2009
1992
1992
DHS
DHS
2000
2000
MICS
MICS
2005
2005
DHS
DHS
2007-2008
2007-2008
DHS
DHS
2010
2010
DHS
DHS
Percent
40
40
20
30
4
0
1990
1995
2000
2005
Children
Children<5
<5years
yearswith
withdiarrhoea
diarrhoeatreated
treatedwith
withORS
ORS
1992
DHS
2010
Source: WHO/UNICEF
100
100
80
80
60
60
40
40
20
20
00
50
60
28
28
16
2000
MICS
2005
DHS
13
2007-2008
DHS
Measles
(2010)
(2005)
1992
1992
DHS
DHS
0 10 20 30 40 50 60 70 80 90 100
Percent
Percent
Coverage levels are shown for the poorest 20% (red circles) and the richest
20% (orange circles). The longer the line between the two groups, the
greater the inequality. These estimates may dier from other charts due to
dierences in data sources.
100
80
80
57
52
48
45
44
40
24
20
23
20
18
92
(2010)
Exclusive breastfeeding
100
60
(2007-2008)
11
2000
2000
MICS
MICS
2005
2005
DHS
DHS
21
21
2007-2008
2007-2008
DHS
DHS
21
21
29
29
Percent
Percentofofchildren
childrenreceiving
receivingrst
rstline
linetreatment
treatmentamong
among
those
thosereceiving
receivingany
anyantimalarial
antimalarial
Percent
Percentofofchildren
children<5
<5years
yearssleeping
sleepingunder
underITNs
ITNs
100
100
80
80
60
60
40
40
20
20
00
2010
2010
DHS
DHS
1996
Other NS
2000
DHS
2005
DHS
Improved
Improveddrinking
drinkingwater
watercoverage
coverage
100
100
83
83
88
80
80
85
2010
DHS
15
15
23
23
14
14
40
40
62
62
64
64
Total
Total
Source:
Source:WHO/UNICEF
WHO/UNICEFJMP
JMP2012
2012
2005
DHS
64
64
1990
2010
2010 1990
1990
1990
International
InternationalCode
CodeofofMarketing
Marketingofof
Breastmilk
BreastmilkSubstitutes
Substitutes
No
No
Postnatalhome
homevisits
visitsininrst
rstweek
weekofoflife
life
Postnatal
Yes
Yes
Communitytreatment
treatmentofofpneumonia
pneumoniawith
with
Community
antibiotics
antibiotics
Yes
Yes
16
16
(2007-2008)
-2008)
88
88 (2007
2005
2005
DHS
DHS
2007-2008
2007-2008
DHS
DHS
Improved
Improvedsanitation
sanitationcoverage
coverage
Percent
Percentofofpopulation
populationby
bytype
typeofofsanitation
sanitationfacility,
facility,1990-2010
1990-2010
Improved
Improvedfacilities
facilities
Shared
Sharedfacilities
facilities
Open
Opendefecation
defecation
Unimproved
Unimprovedfacilities
facilities
100
100 77
80
80
62
62
00
33
44
24
24
11
11
77
29
29
33
35
35
55
55
18
18
88
40
40 55
20
20
13
13
33
34
34
52
52
60
60
66
44
69
69
55
55
52
52
36
36
56
56
34
34
00
1990
1990
1990
2010
2010
2010
2010 1990
Rural
Rural
Urban
Urban
2010
2010
Total
Total
1990
1990
1990
2010
2010
2010
2010 1990
Rural
Rural
Urban
Urban
Source:
Source:WHO/UNICEF
WHO/UNICEFJMP
JMP2012
2012
Partial
Partial
Rotavirusvaccine
vaccine
Rotavirus
Yes
Yes
SYSTEMS
SYSTEMSAND
ANDFINANCING
FINANCING
Yes
Yes
Costed
Costednational
nationalimplementation
implementation
plan(s)
plan(s)for
formaternal,
maternal,newborn
newborn
and
andchild
childhealth
healthavailable
available
Density
Densityofofdoctors,
doctors,
nurses
nursesand
andmidwives
midwives
4.7
4.7
(2005)
(2005)
--
--
142
142
(2010)
(2010)
General
Generalgovernment
governmentexpenditure
expenditure
on
onhealth
healthasas%%ofoftotal
totalgovernment
government
expenditure
expenditure(%)
(%)
20
20
(2010)
(2010)
Out-of-pocket
Out-of-pocketexpenditure
expenditureasas%%ofof
total
totalexpenditure
expenditureon
onhealth
health(%)
(%)
22
22
(2010)
(2010)
Ocial
Ocialdevelopment
developmentassistance
assistance
totochild
childhealth
healthper
perchild
child(US$)
(US$)
35
35
(2009)
(2009)
Ocial
Ocialdevelopment
developmentassistance
assistance
totomaternal
maternaland
andneonatal
neonatalhealth
health
per
perlive
livebirth
birth(US$)
(US$)
58
58
(2009)
(2009)
Challenges
(%
(%ofofrecommended
recommendedminimum)
minimum)
13
13
55
Yes
Yes
Lowosmolarity
osmolarityORS
ORSand
andzinc
zincfor
for
Low
managementofofdiarrhoea
diarrhoea
management
(per
(per10,000
10,000population)
population)
56
56
2000
2000
MICS
MICS
21
21
33
33
33
00 22
2000
DHS
24
24
12
12
63
63
20
20
1992
DHS
10
10
62
62
40
20
44
11
20
20
11
11
60
60
60
0
1992
DHS
24 12
16
16 10
12
10 24
Percent
Percentofofpopulation
populationby
bytype
typeofofdrinking
drinkingwater
watersource,
source,1990-2010
1990-2010
Piped
Other
Pipedon
onpremises
premises
Otherimproved
improved
Unimproved
Surface
Unimproved
Surfacewater
water
Careseeking
for pneumonia
Percent
--
WATER
WATERAND
ANDSANITATION
SANITATION
Vitamin A
(past 6 months)
28
28
2010
DHS
NUTRITION
DTP3
--
(<18.5
(<18.5kg/m
kg/m2,2%)
, %)
Percent
Percent
Percent
60
80
20
Early initiation of
breastfeeding
Women
Womenwith
withlow
lowbody
bodymass
massindex
index
Malaria
Malariaprevention
preventionand
andtreatment
treatment
Percent
Percentofofchildren
children<5
<5years
yearswith
withdiarrhoea
diarrhoeareceiving
receivingoral
oral
rehydration
rehydrationtherapy/increased
therapy/increaseduids
uidswith
withcontinued
continuedfeeding
feeding
100
82
80
80
Yes
Yes
National
Nationalavailability
availabilityofofemergency
emergency
obstetric
obstetriccare
careservices
services
Diarrhoeal
Diarrhoealdisease
diseasetreatment
treatment
80
Skilled birth
attendant
DHS 2005
Pneumonia treatment
100
Antenatal care
4+ visits
--
CHILDHEALTH
HEALTH
CHILD
Richest 20%
--
--
(within
(within22days
daysfor
forallallbirths,
births,%)
%)
Percent
Percent
Poorest 20%
Antenatal care
1+ visit
(2010)
(2010)
--
Postnatal
Postnatalvisit
visitfor
formother
mother
2010
No
No
Midwifery
Midwiferypersonnel
personnelauthorized
authorizedtoto
administer
administercore
coreset
setofoflife
lifesaving
saving
interventions
interventions
ambulance dispatched
nearest relevant health
facility notied
district hospital notied
supervisor notied
Key Lessons
Understanding the causes underlying
both food insecurity and chronic
malnutrition in the country guides
planners and decision makers towards
tackling food insecurity and malnutrition
better.
(2005)
(2005)
85
85
Postnatal
Postnatalvisit
visitfor
forbaby
baby
(within
(within22days
daysfor
forallallbirths,
births,%)
%)
00
Source: UNICEF/UNAIDS/WHO
3,3, 8,8,22
Neonatal
Neonataltetanus
tetanusvaccine
vaccine(%)
(%)
40
40
No
No
Specic
Specicnotication
noticationofofmaternal
maternaldeaths
deaths
Pneumococcalvaccine
vaccine
Pneumococcal
C-section
C-sectionrate
rate(total,
(total,urban,
urban,rural;
rural;%)
%)
(Minimum
(Minimumtarget
targetisis5%
5%and
andmaximum
maximumtarget
targetisis15%)
15%)
60
60
20
20
0
2010
DHS
94
94
80
80
67
57
Percent
Percent
Source:
Source:WHO
WHO2010
2010
Antenatal
Antenatalcare
care(4(4orormore
morevisits,
visits,%)
%)
Hypertension
Hypertension
19%
19%
Demand
Demandfor
forfamily
familyplanning
planningsatised
satised(%)
(%)
100
100
100
39
31
26
20
82
69
52
40
Indirect
Indirect17%
17%
Source:
Source:WHO/CHERG
WHO/CHERG2012
2012
Percent
Percentofofwomen
womenaged
aged15-49
15-49years
yearsattended
attendedatatleast
leastonce
onceby
byaa
skilled
skilledhealth
healthprovider
providerduring
duringpregnancy
pregnancy
Percent
Percent
85
0%
0%
12%
12%
Diarrhoea
Diarrhoea
Measles
Measles0%
0%
Antenatal
Antenatalcare
care
Percent
Pregnancy
Neonatal period
Exclusive
breastfeeding
Percent
69
*Postnatal care
100
Pre-pregnancy
Meningitis
Meningitis2%
2%
MATERNALAND
ANDNEWBORN
NEWBORNHEALTH
HEALTH
MATERNAL
35
Other
Otherdirect
direct
11%
11%
*Intrapartum-related
*Intrapartum-relatedevents
events**Sepsis/meningitis/tetanus
**Sepsis/meningitis/tetanus
Haemorrhage
Haemorrhage
34%
34%
Asphyxia*
Asphyxia*
10%
10%
Other
Other2%
2%
Congenital
Congenital2%
2%
HIV/AIDS
HIV/AIDS2%
2%
Malaria
Malaria2%
2%
2015
Maternity
Maternityprotection
protectionininaccordance
accordancewith
with
Convention
Convention183
183
Regional
Regionalestimates
estimates
for
forsub-Saharan
sub-Saharan
Africa
Africa
Embolism
Embolism1%
1%
Sepsis
Sepsis9%
9%
Unsafe
Unsafe
abortion
abortion9%
9%
Sepsis**
Sepsis**6%
6%
230
MDG Target
0
1990
2015
Preterm
Preterm12%
12%
Other
Other25%
25%
340
400
Globally
Globallymore
more
than
thanone
onethird
thirdofof
child
childdeaths
deathsare
are
attributable
attributabletoto
undernutrition
undernutrition
2%
2%
910
600
91
50
Pneumonia
Pneumonia
17%
17%
800
163
100
Causes
Causesof
ofmaternal
maternaldeaths,
deaths,1997-2007
1997-2007
Causes
Causesof
ofunder-ve
under-vedeaths,
deaths,2010
2010
Percent
Percent
POLICIES
POLICIES
DEMOGRAPHICS
DEMOGRAPHICS
Information Flowchart
Per
Percapita
capitatotal
totalexpenditure
expenditureon
on
health
health(Int$)
(Int$)
2010
DHS
9
Information Systems for Nutrition
MADAGASCAR
Promoting ownership of nutrition information
Madagascar is establishing a multi-sectoral
and multi-stakeholder nutrition information system
owned by all stakeholders.
Jean Francois, National Coordinator, National Nutrition Office and
SUN Focal Point with Ralambomahay Lova, Head of Development
Partnership and Nutrition Watch, National Nutrition Office
describe progress so far
CHILDREN UNDER 5
Stunting:
Wasting:
Overweight:
Low birth weight:
Exclusive breastfeeding:
50.1%
15.2%
6.2%
12.7%
50.7%
10
Multiple levels of
information management
Through Government Decree 2013-847 signed in December
2013, a monitoring and evaluation (M&E) system has been
created in Madagascar. The principle aim is to operationalise
a coordinated multi-sectoral system to monitor information
through responsible engagement of all stakeholders.
Regional Nutrition Offices have been established with M&E
groups that are providing a base of reliable, high quality
data accessible to all relevant partners: national institutions,
the private sector, development partners, communities and
decentralised regional bodies. The regional M&E groups
are charged with collating, analysing and reporting on data,
as well as formulating recommendations for interventions
based on the findings.
11
Information Systems for Nutrition
12
Ministry of
Public Health
Ministry of
Education
Ministry of
Agriculture
Ministry of
Water
National
Nutrition Council
United Nations
system
Donor
agencies
Directorate/
Ministry of
Public Health
National
National
Directorate/
Ministry of
Education
National
Directorate/
Ministry of
Agriculture
National
Directorate/
Ministry of
Water
National
Nutrition Office
National
NGO Office
Private
Sector
Regional
Directorate/
Ministry of
Public Health
Regional
Directorate/
Ministry of
Education
Regional
Directorate/
Ministry of
Agriculture
Regional
Directorate/
Ministry of
Water
Regional
Nutrition Office
Regional
Office
District Service/
Ministry of
Public Health
CISCO /
Ministry of
Education
CIR Agri /
CSA Ministry of
Agriculture
M&E Group
Local NGOs
Private
Sector
Basic Health
Centres/
Ministry of
Public Health
ZAP/
Ministry of
Education
Animaters
Implementing
Agencies
Private
Sector
Community
Health Workers
Primary
Schools
Community
Nutrition Agents
Community
Agents
National
Region
District
Commune
Responding to emergencies
Madagascar is an island which is struck every year by natural
disasters such as cyclones and flooding. In addition, there
are periods of drought and pest infestations that affect
areas of the island. Nutritionrelated information is sent to
the government to launch an appropriate response when
disasters strike. The information includes:
Child underweight collected through community
growth monitoring and promotion sites
Child wasting based on mid-upper arm
circumference collected at community growth
monitoring and promotion sites and health centres
Children affected by diarrhoea recorded at health
centres
Children affected by acute respiratory infections
recorded at health centres
Information from the early warning system on:
Mass displacement of the population and their
livestock
Sale of kitchen utensils and jewellery on the streets.
Fluctuating prices of food and basic items on
the market
13
Conclusions
Different
Sector
Ministries
National
Directorates of
Sector Ministries
Regional
Directorates of
Sector Ministries
Services
Dconcentrs
des Ministres
Sectoriels
PRESIDENT
Government
National
Nutrition Council
United Nations
Agencies
Donor
Agencies
National
NGO Office
Private
Sector
Regional
Office
Private
Sector
Implementing
Agencies
Private
Sector
M&E Officers
Local NGOs
Basic
Health Post
Animaters
Implementing
Agencies
Community
Health Workers
Community
Nutrition Workers
Community
Workers
14
Key Lessons
15
Information Systems for Nutrition
ZIMBABWE
Analysing and using information from
multiple sources
There are many different sources of data relevant for nutrition
in Zimbabwe.
George Kembo, Director, National Food and Nutrition Council and
SUN Focal Point
describes how the information is analysed and used
CHILDREN UNDER 5
Exclusive breastfeeding:
Stunting:
Wasting:
Overweight:
Low birth weight:
32.0%
3.0%
5.5%
9.5%
31.4%
In response to persistent hunger and under-nutrition, particularly among the poor, the Government
of Zimbabwe launched a Food and Nutrition Security Policy in May 2013. The policy marks the start
of a concerted effort to promote economic development by addressing food security and nutrition
challenges in a robust, coordinated, and multi-sectoral manner. The Food and Nutrition Council (FNC)
is the national agency mandated to lead the coordinated, multi-sectoral response. The FNC engages
multiple ministries and other stakeholders including United Nations agencies, non-governmental
organizations (NGOs) and the business community.
Government commitment
The government sets out seven commitments in the Food
and Nutrition Security Policy including a commitment to a
national integrated food and nutrition security information
system. Key aspects of the information system are:
reporting on inequity
16
FAO Zimbabwe
17
18
Dissemination of information
The FNC is currently establishing a website to create a forum
where the public can have access to food and nutrition security
data and can also provide feedback. Information is presented
in the form of maps, graphs, tables and dashboards.
nutrition information systems. In Zimbabwe these multisectoral coordination and governance structures are being
strengthened at national, provincial and district level and
are being established at ward level.
Key Lessons
The quality of advocacy improves as
nutrition information systems are
strengthened and local evidence is
documented.
Communities can play a vital role in
contributing to nutrition information
systems through building the
capacity of community based
volunteers participating in disaster
preparedness and response activities
and also providing specific follow
up to vulnerable households and/or
individuals in wards.
Feedback to communities is a vital
part of nutrition information systems
enabling them to prioritise their own
problems and areas for response.
Participatory monitoring and evaluation
results in participatory response and
increased sustainability of nutrition
information systems.
19
Information Systems for Nutrition
SRI LANKA
Identifying vulnerable households
Sri Lanka is developing a system to identify and target
vulnerable households through the collection of village-level
information.
Lalith Chandradasa, National Nutrition Secretariat Coordinator
reviews the success so far
20
CHILDREN UNDER 5
Stunting:
Wasting:
Overweight:
Low birth weight:
Exclusive breastfeeding:
19.2%
11.7%
0.9%
18.1%
75.8%
Monitoring impact
The MsAPN has adopted five of the six key results areas that
were agreed at the World Health Assembly (WHA) in 2012.
The exception is the breastfeeding target which has already
been met with exclusive breastfeeding levels standing at
over 75%. The government is using the targets to monitor
the impact of the MsAPN up until 2016. A total of 24
indicators have been identified under the five key results
areas. Data collected in 2012 through the national
21
Monitoring implementation
There are 16 ministries included under the MsAPN. For
each ministry, a set of interventions have been identified
with associated indicators. Progress reviews are conducted
by the NNC every month to review programme coverage
and access. A health information system is being set up
by the Ministry of Health which will provide information
every quarter on nutrition specific interventions including
coverage and access.
Identifying nutritionally
vulnerable households
The MsAPN was based on the lessons learnt from pilot
projects in two districts of Sri Lanka (Monaragala and
Nuwara Eliya) where rates of under-nutrition are high.
With the support of the United Nations Childrens Fund
(UNICEF), a multi-sectoral approach was operationalized
based on multi-sectoral District Nutrition Action Plans.
The approach:
targets nutritionally vulnerable
households
adopts a multi-sectoral
approach to identify and
address identified risk factors
implements through existing
structures and systems
22
4. Pregnant teenager
e.g.
e.g.
Time for
food preparation
Selection of
nutritious food
for meals
Child care
practices
Information /
advertisement
Home
garden
Food
availability
Water
Communicable
/respiratory
diseases
Housing conditions
(smoke filled kitchen)
Household &
Child
Nutritional
Status
Food
affordability
Livestock &
fisheries
Household
income
management
Child abuse
and neglect
Early childhood
development
and pre-schools
Families with
school drop out
children
Teenage
pregnancies
Micro
credit
Alcohol &
substance abuse
Household
income
Education
levels
Employable
skills
Women headed/
single parent
household
The multidimensional nature of nutrition requires not only health but all sectors to assist
Beginning
Monitor Pregnant
mothers
Economic reasons
Poor child care and practices
Poor feeding/dietary behaviour
Household food insecurity
Communicable disease
Poor housing conditions
Alcoholism and drug addiction
Sanitation
Monitor children
Child feeding
practices
PHMs maintain a book for affected children and pregnant mothers (with addresses)
After 2 months
After 4 months
After 6 months
Publicising
nutrition
information
Low BMI
Adequate weight gain
In adequate weight gain
Key Lessons
Targeting at household level and
providing responses is achievable when
a coherent multi-sectoral approach
is taken.
When different sectors work together
around a common results framework
and view nutrition as one of their duties,
it shifts responsibility from nutrition
being seen as solely a health issue to a
multi-sectoral issue
Sustaining a multi-sectoral monitoring
and response system is challenging but
achievable if it is well established in
existing systems.
Visualizing progress through colour
coding systems and understanding
the link between cause and impact
is helpful.
Regular multi-sectoral review meetings
allow collective decisions and raises
the profile of nutrition.
23
Information Systems for Nutrition
NAMIBIA
Developing a dashboard of indicators
Namibia is tracking progress using a dashboard of indicators.
Marjorie van Wyk, Chief Health Programme Administrator, Subdivision:
Food and Nutrition, Ministry of Health and Social Services and
SUN Focal Point with others10
describes efforts to
CHILDREN UNDER 2
Stunting:
Wasting:
Overweight:
Low birth weight:
Exclusive breastfeeding:
29.0%
7.5%
4.3%
14.0%
23.9%
24
UNICEF Namibia
25
Information Systems for Nutrition
[MULTI-SECTORAL
NUTRITION
IMPLEMENTATION
PLAN,
RESULTS
Part of the results
framework
for Namibia
showing
objectives
indicators
FRAMEWORK & DASHBOARD
OFand
INDICATORS
]
WASH strategy launched
# of TWG meetings held
# ECD centre workers trained
# ECD centres implementing and meeting the IYCF standards
Objective
1.2
1.2.2 Train Health workers in routine vitamin A, Zinc, IFA supplementation for women and
young children 6-59m
1.2.3 Implement Maternal and Child Health Days (MCHD) as key delivery platform in high
burden regions for critical low cost high impact maternal and child health interventions
Information on programme
implementation
1.2.6 Develop national mandatory food fortification programme including National Food
Standards and regulations
UNICEF Namibia
26
17
27
Information Systems for Nutrition
UNICEF Namibia
UNICEF Namibia
28
Key Lessons
Survey data can be developed into
advocacy materials (regional profiles)
to highlight nutrition and build political
commitment for scaling up nutrition
at the highest level. Profiles can be
updated as new data becomes available.
By building a results framework and
indicator dashboard into national
multi-sectoral nutrition implementation
plans, progress across sectors can be
monitored by comparing baseline and
target data.
A results framework and indicator
dashboard can clearly show the link
between intervention activities
and inputs, outputs, outcomes and
eventually impact.
Measuring the success of interventions
in different sectors (e.g. WASH) using
nutrition indicators (wasting in children)
is being applied in some areas.
29
Information Systems for Nutrition
ETHIOPIA
Transforming the nutrition information system
Ethiopia has transformed its information system for nutrition.
Ferew Lemma, Senior Advisor, Office of the Minister of Health and
SUN Focal Point
provides an update of how routine information is bolstering
the system
CHILDREN UNDER 5
Stunting:
Wasting:
Overweight:
Low birth weight:
Exclusive breastfeeding:
44.4%
9.7%
1.7%
10.8%
52.0%
30
Main achievements of
the Nutrition Information System
31
Information Systems for Nutrition
Key Lessons
Ethiopian woman
32
33
Information Systems for Nutrition
34
Source: Can the Nutrition Information System be trusted to build on available data sources?
(Field Exchange, Issue 40, February 2011, page 11, Patrizia Fracassi)
35
Information Systems for Nutrition
Kyrgyz Republic
Maharashtra
Tajikistan
Ethiopia
Pakistan
Myanmar
Yemen
Chad (cluster)
Burkina Faso
Nepal
Bangladesh
Niger
Lao PDR
Nigeria
Mauritania
Mali
Vietnam
Benin
Haiti
Sri Lanka
Senegal
El Salvador
Guatemala
The Gambia
Kenya
Guinea Bissau
Costa Rica
Rwanda
Liberia
Burundi
Peru
Cameroon
Tanzania
Comoros
South Sudan
Guinea
Togo
Ghana
Sierra Leone
Congo Brazzaville
Ivory Cost
Mozambique
Malawi
Madagascar
Namibia
Congo DR
Zambia
Swaziland
36
Indonesia
Uganda
Zimbabwe
Countries access information from surveys and routine data sources to perform situation analyses and
monitor implementation of selected programmes. There is no developed common results framework (CRF)
to consistently collate, analyze and present information across key sectors.
Countries with CRF established or under development to collate, analyze and present information across key sectors.
They are strengthening systems to monitor implementation at decentralized level.
Countries use CRF to collate information from main sources across relevant sectors.
They are able to collect data at decentralized level but require support to revitalize,
refine and strengthen systems for optimal analysis, presentation and use of available information.
No information currently available.
37
38
Save the Children / Sebastian Rich
What has
been learnt?
39
Strengthening information
systems for nutrition:
Observations by
Andris Piebalgs,
European Commissioner
for Development and
SUN Lead Group
40
41
ENDNOTES
1
Administratively, Madagascar is divided into 22 regions, 119 districts, 1,570 towns and 17,500 Fokotany (neighborhoods).
The health districts encompass 55 health centres, 768 health posts, 551 rural maternity posts and 1,384 basic (community) health
centres. The 55 health centres are, in theory, district hospitals but because of the lack of technical equipment they lack the capacity to
fulfil this role.
The Global Nutrition Cluster was established in 2006 with a vision to safeguard and improve the nutritional status of emergency affected
populations by ensuring a coordinated, appropriate response that is predictable, timely, effective and at scale. The Global Nutrition
Cluster is made up of 40 partner organizations and two organisations-observers. Country-level Nutrition Clusters are activated during
nutritional emergencies.
There are 8 administrative provinces, divided into 60 districts and 1,960 wards in Zimbabwe.
SMART (Standardized Monitoring and Assessment of Relief and Transitions) methodology is an improved survey method for the
assessment of severity of a humanitarian crisis based on the two indicators: (i) Nutritional status of children under-five; (ii) Mortality rate
of the population.
In 2006, WHO published new child growth standards to replace the previously recommended 1977 child growth reference.
Public health midwives (PHMs) have been an important part of the primary healthcare system in Sri Lanka since early in the twentieth
century. Traditionally these health workers focused only on midwifery, but now PHMs have evolved into a professional cadre, playing a
role in preventive health covering many aspects other than midwifery. Their services are immensely valued in rural settings where health
resources are scarce.
Sri Lanka is divided into nine provinces, 25 districts, 331 divisions and 14,022 Grama Niladari areas (cluster of villages or wasama).
This article was co-authored by Len Le Roux, Director, Partnerships Southern Africa, Synergos Institute, Myo-Zin Nyunt, Chief of Health,
UNICEF Namibia, and Karan Courtney-Haag, Nutrition Specialist Consultant, UNICEF Namibia.
42
10
11
There are 14 regions in Namibia further subdivided into 121 electoral constituencies. The number and size of each constituency varies
with the size and population of each region.
12
Community Led Total Sanitation (CLTS) is an innovative method for mobilising communities to completely eliminate open defecation.
Communities are facilitated to conduct their own appraisal and analysis of open defecation and take their own action to become open
defecation free.
13
Ethiopia is divided into nine regional states and two cities. Regions are divided into zones and then into districts or woredas.
There are about 670 rural woreda and about 100 urban woreda.
14
Established in 2005, the productive safety net progamme provides multi-annual predictable transfers such as food, cash or a
combination of both, to help chronically food insecure people survive food deficit periods and avoid depleting their productive assets
while attempting to meet their basic food requirements.
43