United Nations System
Standing Committee on Nutrition

 

Nutrition Information in Crisis Situations


Information on the Nutrition Survey Results Database

The database presents the results of the nutrition and mortality surveys which were made available to NICS. All survey reports are checked for methodology and results and only surveys which correspond to the criteria mentioned below, following internationally agreed standards 1,2,3,4 are included in the database:

  • Cluster sampling using a proportional to population size (PPS) sampling, with at least 25 clusters
  • Systematic or simple random sampling
  • Exhaustive surveys

Sample size:
No minimum sample size was defined for including the surveys in the database, as the required sample size depends on the prevalence of malnutrition. All surveys for which the 95% confidence intervals are sufficiently narrow to give interpretable results are included in the database.

Age range, indicators of malnutrition, measles vaccination coverage and mortality

Nutrition indicators in children

Unless specified, the surveys included in the database were carried out among 6 to 59 month old children.

Unless specified, indicators of malnutrition are defined as follow:
Wasting, defined as weigh-for-height index (w-h) < -2 Z-scores of NCHS reference.
Severe wasting, defined as weigh-for-height index < -3 Z-scores of NCHS reference.
Oedematous malnutrition or kwashiorkor, diagnosed as bilateral pitting oedema, usually on the upper surface of the feet. Oedematous malnutrition is always considered as severe malnutrition.
Acute malnutrition, defined as the prevalence of wasting (w-h < -2 Z-scores of NCHS reference) and/or oedema
Severe acute malnutrition, defined as the prevalence of severe wasting (w-h < -3 Z-scores of NCHS reference) and/or oedema.
MUAC, Mid-Upper-Arm Circumference (MUAC) is sometimes used to quickly assess nutrition situations. The results are reported according to the cut-offs used in the survey.

Since the release of the WHO growth standards in 2006, results calculated using the WHO Growth Standards are also reported, when available. 5

Micro-nutrient deficiencies and vitamin A distribution coverage within 6 months prior to the survey

Micro-nutrient deficiencies and vitamin A distribution coverage are reported when data are available.

Nutrition indicators in adults

No international consensus on a definitive method or cut-off to assess adult under-nutrition has been reached 6. Different indicators, such as Body Mass Index (BMI, weight/height 2), MUAC and oedema, as well as different cut-offs are used. When reporting on adult malnutrition, the Reports always mention indicators and cut-offs used by the agency providing the survey.

Measles vaccination coverage

Measles coverage was assessed among 9 to 59 month old children.

Mortality rates

In emergency situations, crude mortality rates and under-five mortality rates are usually expressed as number of deaths/10,000 people/day.

Exclusion of surveys

Convenience sampling or methodology not following the above mentioned criteria

Structure of the database

The database gives:

  • the geographical location of the survey as precisely as possible (columns A to E)
  • the date of the survey (column F)
  • the status of the population surveyed: residents, displaced, refugees…(column G). "Residents/Displaced" indicated that some displaced people are settled among the resident population. The percentage of displaced people is not given because the definition of displaced people varies depending on the survey.
  • the origin of the refugees (column H)
  • the estimated population number in the area surveyed (column I)
  • the percentage of acute malnutrition (see above for definition) using NCHS reference and the 95% Confidence Intervals (columns J and K)
  • the percentage of severe acute malnutrition (see above for definition) using NCHS reference and the 95% Confidence Intervals (columns L and M)
  • the percentage of acute malnutrition (see above for definition) using WHO growth standards and the 95% Confidence Intervals (columns N and O)
  • the percentage of severe acute malnutrition (see above for definition) using NCHS reference and the 95% Confidence Intervals (columns P and Q)
  • the percentage of oedema (column R)
  • the percentage of children with MUAC < a certain cut-off (column S)
  • the percentage of measles vaccination coverage according to cards and according to cards and mothers' statements (columns T and U)
  • the micro-nutrient deficiencies: the page of the report where micro-nutrient deficiencies are reported on (column V)
  • the vitamin A distribution coverage within the six months prior to the survey, unless specify (column W)
  • the nutritional status of women, unless specify (column X)
  • the crude mortality rate and the 95% Confidence Intervals (columns Y and Z)
  • the under-five mortality rate and the 95% Confidence Intervals (columns AA and AB)
  • the agency which conducted the survey (column AC)
  • the link to the contextual information which can be found in the NICS/RNIS reports (column AD)
  • the link to the survey methodology information which can be found in the NICS/ RNIS reports (column AE)

Limitations

Only the survey reports were checked for the methodology and the results, the raw data were not checked and the course of the field survey is unknown. The accuracy of the surveys is therefore not guaranteed. Trend analysis and comparison of survey results are limited by the possible differences in the structure of the populations surveyed. The prevalence of malnutrition needs to be interpreted in regards to contextual information. Users are strongly encouraged to go to the articles of the NICS/RNIS reports and other sources of information to find contextual information.

Notes:
1  SMART (2002) www.smartindicators.org
2  Médecins sans Frontières (1995) Nutritional guidelines. Paris: Médecins sans Frontières
3  WHO (2002) The management of Nutrition in Major Emergencies. Geneva: WHO
4  Duffield A, Taylor A. Emergency Nutrition assessment: Guidelines for Field Workers. London, United Kingdom: Save the Children-UK; 2004.
5  WHO 2006 Child Growth Standards; www.who.int/childgrowth/en
6  SCN (2000) Adults, assessment of nutritional status in emergency affected populations. Geneva: SCN.