A. INTER-AGENCY FOOD AND NUTRITION SURVEILLANCE PROGRAMME
B. GLOSSARY
C. MAIN DATA SOURCES
(Source: Guidelines on project proposal preparation for the Inter-Agency Food and Nutrition Surveillance Programme)The Interagency Food and Nutrition Surveillance Programme (IFNS) is a joint initiative by the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO), and the United Nations Children's Fund (UNICEF) to assist a large number of countries and regional institutions to establish and strengthen food and nutrition surveillance programmes over the next five years. It is being developed in response to an evident need for a renewed and concerted effort to strengthen food and nutrition surveillance systems in the light of the economic recession of the last few years and its associated negative effects, particularly on poor and vulnerable population groups. A recommendation for a $10 million noted project to support the establishment and strengthening of food and nutrition surveillance systems through the IFNS programme was approved by UNICEF's Executive Board at its May, 1987 session1. In January, 1988 the WHO Executive Board recommended the adoption of a resolution to support countries in establishing and making use of effective nutritional status surveillance systems in collaboration with FAO, UNICEF and other UN agencies2. The IFNS initiative was an outcome of the twelfth session of the ACC Subcommittee on Nutrition (ACC/SCN) in 1986 and has also been formally endorsed at its 1987 and 1988 meetings3.
1 UNICEF: Strengthening food and nutrition surveillance systems. (E/ICEF/1987/P./L.37), UNICEF Executive Board, New York, 1987.Origins of the Programme2 World Health Organization: Resolution of the WHO Executive Board: Infant and young child nutrition. EB. 81/R16 WHO, Geneva, 1988.
3 ACC/SCN: Proposal for expanding nutritional surveillance. Report of the ACC/SCN Working Group on Nutritional Surveillance, (Document for ACC/SCN 13th. Session), 1987.
Food and nutrition surveillance is the regular provision of information and its use for decision-making on policies and programmes which, directly or indirectly, affect nutrition. The original concept of surveillance came from the public health field where surveillance of infectious diseases plays an important role in prevention and treatment of disease. At the 1974 World Food Conference a resolution was passed recommending the establishment of a global surveillance system by FAO/WHO/UNICEF “to monitor the food and nutrition conditions of the disadvantaged groups of the population at risk, and to provide a method of rapid and permanent assessment of all factors which influence food consumption patterns and nutritional status”. This approach was established in international terms after the 1974 World Food Conference and a Joint FAO/WHO/UNICEF Committee in 1975 agreed on the general methodological basis for promoting such surveillance activities. By the early 1980's some 20 countries, many supported independently by the respective UN Agencies, were operating some type of food or nutrition surveillance system for the purposes of policy, programme planning and advocacy, and timely warning.
The practical aim of the IFNS programme is to extend these approaches to many more countries in a collaborative manner in order to make data on nutritional status and related food and nutrition information more available on a regular and frequent basis; and to encourage their use to guide economic and social policy making and planning in tackling food and nutrition problems and reacting to warning trends that may be revealed. The participating agencies have been supporting countries in the development of sectoral information and analysis from their respective vantage points and will continue to support these programmes to interpret and predict changes so that appropriate interventions can be undertaken.
There has also been an increasing recognition in the last few years of the devastating effects of economic recession on poor and vulnerable groups, especially children, and of the importance of ensuring that the current structural adjustment policies that governments are obliged to carry out are so designed that the potentially damaging effects are reduced to a minimum. Monitoring nutrition, particularly of vulnerable groups, is one of the best methods of assessing how people are being affected and how compensatory measures are working. This growing concern with the human dimensions of economic adjustment policies has underlined the urgent need to monitor changes in nutritional status in as many countries as possible. The nutritional status of young children is probably the most sensitive indicator of sudden changes in food security and health status, acting as an early signal of distress, ill health, famine and, eventually, death.
Goals and Objectives
The overall goal of the IFNS programme is to improve the survival and development of children, women, and other disadvantaged groups through the strengthening of government policies and programmes and community actions affecting nutritional status and development, aimed at protecting the vulnerable in times of stress and, in the long run, improving their overall welfare. This will be accomplished through strengthening food and nutrition surveillance and by encouraging policy-makers to use surveillance data on changes in the human condition as frequently as they use indicators of economic change in making policy decisions. An essential feature of the programme is that the data it produces shall lead to specific nutritional and other interventions and also be linked with current programmes in health, nutrition, agriculture, etc. in the country.
Within this broad framework the special focus of the IFNS programme is to encourage the regular and frequent reporting of a few common indicators in a standardized, simple and timely fashion in order to alert decision-makers to the presence of a problem, and to stimulate them to make use of further information in order to initiate appropriate action. The programme will also support surveillance systems in the broader context, appropriate to the country situation.
The specific objectives of the IFNS programme are:
a) To produce and analyze existing information on trends in a limited number of specified indicators of food and nutrition at national and sub national levels;b) To promote the prompt use of this information for national programming and national and international advocacy;
c) To strengthen the institutional capacity of countries to produce, analyze and use food and nutrition data; and
d) To promote widespread recognition and use of this information at country and regional levels in the development of policies, plans and programmes.
(NB: Notes are ordered as presented in the graphics)
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Under 5 mortality rate (U5MR): number of deaths of
children under 5 years of age per 1,000 live births for a given year |
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Infant mortality rate (IMR): number of deaths of
infants under one year of age per 1,000 live births for a given year. |
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GNP per capita: gross national product. Annual GNP per
capita is expressed in current $US. |
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Estimated prevalence of underweight children: a brief
description of the method used to estimate this figure (given at top of graphic)
follows, a full account is given in the 'Supplement on Methods and Statistics
for the First Report of the World Nutrition Situation', ACC/SCN, 1987 (in
press). Estimates of the prevalence (proportion) and number of underweight
children were calculated using, as a first step, data from surveys considered to
be nationally representative, as given by WHO (Global Nutritional Status,
Anthropometric Indicators. Doc. Ref. NUT/ANTREF/3/87, 1987), and from a previous
compilation reported by Haaga, Kenrick, Test, Mason (An Estimate of the
Prevalence of Malnutrition in Developing Countries. World Health Statistics
Quarterly, 38, 331-347, 1985). Underweight is defined as less than 2 standard
deviations (SD's) of weight-for-age, using NCHS standards, as adopted by WHO.
Estimates refer to the 0-60 month old population. An equation for interpolation
by country and year was calculated by regressing these estimates on other
selected independent factors. The model thus developed was then applied to the
complete set of countries covered in the 'First Report' to estimate their
prevalence of less than 2 SD's weight-for-age. This was done for three time
points: 1975, 1980 and 1984. The regression method was necessary because
representative prevalence estimates of malnutrition were not available for most
countries covered by the 'First Report', nor for more than one or two different
years in any one country. Each country's predicted prevalence was weighted by
the 0 through 4 year old child populations, for the three years of interest.
This gave the number of 0-4 years who were underweight; dividing this by the
total child population for that country gave estimates prevalences underweight.
The country estimate has been given as a range at the head of the
graphic. |
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Debt Ratio: this is the ratio of total debt service on
public and publicly guaranteed long-term debt to the export of goods and
services. Expressed as a fraction. |
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Debt: debt outstanding and disbursed. Public and
publicly guaranteed long-term debt outstanding and disbursed. Expressed as US$
millions. |
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GNP: gross national product. Gross domestic product at
purchaser values (market prices) plus net factor income from abroad. Expressed
in millions of local currency units at constant 1980 market prices. |
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Exchange rate: expressed as US$ per (usually) 1,000
units of local currency. |
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Food Production Index: per caput. This index shows the
relative level of food production in a year compared to the average for the base
period 1979/81. Thus the 1979/81 value is always 100 on the graph, marked with a
line. The index is “... based on the sum of price-weighted quantities of
different agricultural commodities produced after deductions of quantities used
as seed and feed weighted in a similar manner” (1986 FAO Production
Yearbook, Vol. 40, FAO 1987). Food production includes all commodities
considered edible and containing nutrients (e.g. this excludes coffee and
tea). |
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Cereal availability: calculated as sum of the annual
production corrected for loss due to milling, plus commercial cereal imports,
plus cereals imported as food aid. Expressed in units of 1,000 metric
tons. |
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Unfavourable crop conditions: refers to unfavourable
prospects for current crops, whether due to area planted or adverse weather
conditions, plant pests, diseases and other calamities which indicate a need for
close monitoring of the crops for the remainder of the growing season. This
information is gathered by FAO as part of its global early warning system on
food and agriculture. |
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Food shortages: refers to exceptional shortfall in
aggregated supplies or a local deficit as a result of crop failures, natural
disasters, interruptions of imports, disruption of distribution, excessive
post-harvest losses, other bottlenecks and/or increased demand for food arising
from population movements within the country or an influx of refugees. This
information is gathered by FAQ as part of its global early warning system on
food and agriculture. |
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CPI: consumer price index. Base year is 1980 |
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FPI: food price index. Base year is 1980 |
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IMF credit: use of IMF credit in US$
millions. |
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Trends in Prevalence: Monthly or annual trends in the
percentage prevalence of anthropometric indicators. The choice of cut-point
varies from country-to-country and due caution must be exercised if
inter-country comparisons are been made. Where possible, a guide line has been
added to show the expected prevalence level corresponding to the given
cut-point. For example, if the cut-point is set at <-2 Standard Deviations
below the median of the reference curve, then the expected percentage would be
2.5% for a normal or Gaussian curve. |
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Prevalence Deseasonalized: Where monthly prevalence
time series are available, the original data have been decomposed into seasonal,
trend and level components. To provide a clearer picture of the changing level
of prevalence over time, the de-seasonalized series has been graphed. The method
used to generate the smoothed series is explained in the Appendix to the First
Report on the World Nutrition Situation. |
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Under 5 mortality rate (U5MR), Infant mortality rate (IMR):
United Nations Population Division and the United Nations Statistical
Office; provided courtesy of UNICEF. |
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CPI, FPI: Bulletin of Labour Statistics, 1984 and 1986,
1988, ILO, Geneva. Also IFS Supplement on Price Statistics, 1986, International
Monetary Fund. |
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GNP: World Bank Tapes, 1987. Courtesy of ILO,
Geneva. |
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GNP per capita: World Development Report 1988, The
World Bank, OUP, 1988. |
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Debt Outstanding and Disbursed, Debt Ratio & Use of IMF
Credit: World Debt Tables 1986-87 Edition, The World Bank, 1987. |
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Exchange rate: International Financial Statistics, The
International Monetary Fund, 1987. |
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Food Production Index, Cereal availability, Unfavourable
crop conditions, Food shortages: FAO AGROSTAT Tapes, Reports on Foodcrops
and Shortages, FAO, Rome. |
Sources of anthropometric and other country data1
1 Most of these were commissioned by ACC/SCN or otherwise written specifically as background for this report.Africa:
Benin: Catholic Relief Services/Ministry of Labour and Social Affairs.
Botswana: Family Health Division, Ministry of Health.
Burkina Faso: Catholic Relief Services/Ministry of Health.
Burkina Faso: Ministere de la Sante et de L'Action Sociale, “Rapport sur la Situation Nutritionnelle et Alimentaire au Burkina Faso”, October 1987.
Chad: Guha-Sapir, Lechat, M., “Risk Factors and Vulnerability of Children to Drought Related Famines: The Case of Chad”. Unpublished report.
Ethiopia: Appleton, J., “Nutritional Status Monitoring in Wollo, Ethiopia, 1982-1984 - An Early Warning System?”, Save the Children Fund (UK). Other NGO sources.
Gambia: Nutrition Unit, Medical and Health Department, “Report on the Feb./March 1988 National Nutrition Surveillance Programme for 0-5 Year Olds”, August 1988, and “Report on the Aug./Sept. 1987 National Nutrition Surveillance Programme for 0-5 Year Olds”, February 1988.
Gambia: Cole, T., “Maternal Weight Changes over 10 Years in West Kiang, The Gambia”.
Ghana: Catholic Relief Services/Ministry of Health.
Lesotho: Catholic Relief Services/Food and Nutrition Coordinating Office.
Madagascar: Catholic Relief Services/Ministry of Health.
Mali: Mondot-Bernard, J., Monjour, L, Karam, M., “Satisfaction of Food Requirements and Agricultural Development in Mali, Vol. II”, Development Centre of the Organization for Economic Co-Operation and Development, Paris 1980.
Mauritania: Warrack-Goldman, H., Brown, B., Binkin, N.J., “Nutritional Status of Mauritanian Children During a Drought Emergency”, Ecology of Food and Nutrition, Vol. 18, 1986.
Mauritania: WHO Anthropometry Data Bank, Nutrition Unit, WHO, Geneva.
Niger: Catholic Relief Services, courtesy of Famine Early Warning System, Tulane University.
Rwanda: Catholic Relief Services/Ministry of Health.
Sudan: Directorate of Primary Health Care, Ministry of Health, “Sudan Emergency and Recovery Information and Surveillance System: Report Nos. 1 & 2”, Khartoum 1986, 1987.
Tanzania: Joint Nutrition Support Programme, “Nutritional Status of Under 5's: JNSP Area”, Nutrition Division, WHO, Geneva.
Togo: Catholic Relief Services/Ministry of Health.
Asia:
Bangladesh: Bureau of Statistics, “Report of the Child Nutrition Status Module: Bangladesh Household Expenditure Survey - 1985-86”, January 1987.
China: Institute of Nutrition and Food Hygiene, Chinese Academy of Preventive Medicine.
Indonesia: Central Bureau of Statistics, “National Socioeconomic Survey”, data provided courtesy of Dr. Soekirman, National Development Planning Agency.
Philippines: Bocobo, D.L., Bondad, M., “Report on the Nutrition Situation in the Philippines”, National Nutrition Council, April 1987.
Sri Lanka: Ameresekere, R., “Country Report on Sri Lanka - Nutritional Indicators, Public Policies and Adjustment Measures”, July 1988.
Thailand: Chawalit Suntikitrungruang, “Food and Nutrition Situation: 1988 Thailand Country Report”, Nutrition Division, Department of Healt, June 1988.
Latin America and the Caribbean:
Bolivia: Quevedo, F.R., “Bolivia: Indicadores Nutricionales”, La Paz, April 1988.
Colombia: Montoya, C.H., “Situacion Nutricional Y Alimentaria Colombia”, Bogota, May 1988.
Costa Rica: Division de Nutrition Y Salud, Instituto de Nutrition de Centre America Y Panama (INCAP), “Situation Nutritional de Costa Rica”, June 1988.
Chile: Avila, B., Garcia, F., Vera, G., “Situation Alimentaria Nutricional de Chile: Periodo 1984-1987”, Santiago, 1988.
Chile: Ministerio de Salud, “Boletin Epidemiologico de Chile”, Vol. 14, No. 4, April 1987.
Chile: Ministerio de Salud, “Estado Nutricional de la Poblacion Materno Infantil Controlada en el Sistema Nacional de Servicios de Salud Diciembre de 1986 Y elolucion 1984-1986”, May 1987.
Cuba: Ministerio de Salud Publica, “Situacion Nutricional del Pais”, Cuba, 1988.
Guatemala; Division de Nutricion Y Salud, Instituto de Nutricion de Centro America Y Panama (INCAP), “Situacion Nutricional de Guatemala: 1980-1987”, June 1988.
Jamaica: Fox, K., Ashley, D., “Report of Survey of Health Status of Children less than Ten Years in Jamaica”, December 1985.
Nicaragua: Division de Nutricion Y Salud, Instituto de Nutricion de Centro America Y Panama (INCAP), “Situacion Nutricional de Nicaragua: 1980-1987”, June 1988.
Peru: Rivera, M.G.N., “Informe Peru”, Lima, June 1988.
Uruguay: Bove, L.M.I. (INDA), “Uruguay: Situacion Alimentario-Nutricional: Algunos Factores Condicionantes 1970-1987”, Instituto Nacional De Alimentacion, Montevideo, May 1988.
Venezuela: de Paternina, A.P., de Valera, Y.H., Rivas, S., “Actualizacion de la Situacion Nutricional en Venezuela Periodo 1984-1987”, Caracas, May 1988.
In addition to the sources listed above, the “Europa Year Book 1988”, (Europa Publications Ltd., 1987, London) was consulted for background material on political, agricultural and economic development.
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