Cover Image
close this bookNutrition Guidelines (MSF, 1995, 191 p.)
View the document(introduction...)
View the documentPreface
close this folderPart I: Nutrition Strategies in Emergency Situations
View the document1. Food crises
View the document2. Assessment of the nutritional situation
View the document3. Interventions: ensuring adequate general food availability and accessibility
View the document4. Interventions: selective feeding programmes
View the document5. Evaluation
close this folderPart II: Rapid Nutrition Surveys
View the document1. Introduction to anthropometric surveys
View the document2. Anthropometric measurements and indices
View the document3. Sampling methods
View the document4. Analysis, interpretation and recommendations
View the document5. Conclusions
close this folderPart III Selective feeding programmes
View the document1. Justification for selective programmes
View the document2. Criteria for admission and discharge to selective feeding programmes
View the document3. Screening and selection
View the document4.Treatment in a therapeutic feeding centre
View the document5. Treatment in supplementary feeding programmes
View the document6. Implementation and management of a feeding centre
View the document7. Registration and monitoring
View the document8. Evaluation of feeding programmes
View the document9. Food management
close this folderAnnexes
View the documentAnnex 1: Rapid assessment of the state of health of displaced populations or refugees (A.Moren - Medical News, No. 1)
View the documentAnnex 2: Mid - Upper Arm Circumference (MUAC)
View the documentAnnex 3: Nutritional status assessment in adults and adolescents
View the documentAnnex 4: Agencies involved in food relief
View the documentAnnex 5: Food composition table
View the documentAnnex 6: GENERAL RATION: How to calculate the energetic value
View the documentAnnex 7: Micronutrient deficiencies
View the documentAnnex 8: Food basket monitoring methodology
View the documentAnnex 9: Analyzing nutritional survey data
View the documentAnnex 10: Drawing of a random number
View the documentAnnex 11: Standardization of anthropometric measuring techniques
View the documentAnnex 12: Data collection forms
View the documentAnnex 13: W/H Reference tables
View the documentAnnex 14: Selection of food items for selective feeding programmes
View the documentAnnex 15: Oral rehydration for severely malnourished children
View the documentAnnex 16a: Preparation of High Energy Milk
View the documentAnnex 16b: Recipes for porridge for use in therapeutic and wet supplementary feeding programmes
View the documentAnnex 16c: Recipes for premix for dry ration supplementary feeding programmes
View the documentAnnex 17a:Example of a Therapeutic feeding centre
View the documentAnnex 17b: example of layouth of a <<wet>> supplementary feeding centre
View the documentAnnex 17c: Example of a DRY SFP
View the documentAnnex 18a: Example of an Attendance register (tfp or SFP)
View the documentAnnex 18b: Example of a Nutritional Status Monitoring (SFP)
View the documentAnnex 19a: TFP individual monitoring card
View the documentAnnex 19b: SFP individual monitoring card
View the documentAnnex 19c: Individual card for Supplementary feeding centre
View the documentAnnex 19d: Example of an individual card for dry blanket SFC
View the documentAnnex 20: Feeding programme indicator graphs
View the documentAnnex 22: MSF nutrition kits
View the documentBibliography

9. Food management

Food needs

The composition of rations and exact make-up of recipes depends on availability (from donors and local markets) and local acceptability (local food habits) of foods. See Annex 14 and 16 for suitable ration sizes, food commodities used and recipes.

Try to obtain the foods from donors with in - country food stocks:

- International organizations
- Bilateral donations
- NGO's (see Annex 4)

If donors are unable to supply adequate quantities of food or supply essential items rapidly enough, essential commodities (cereals, pulses, oil, sugar) may be bought locally/regionally.

In order to prevent serious disruptions in the programme, due to irregular food supply, each feeding centre/programme should always have its own buffer stock, sufficient to cover needs for one to three months, depending on local storage and supply conditions.

Transport capacity is critical in the planning and location of feeding centres - a normal 4x4 pick-up can carry 1,000 kg, if roads are not too bad.

Calculations of monthly food needs for wet feeding centres should be based on the needs of a child with an average weight of 9 kg:

200 kcal/kg/day x 9 = 1.81/child/day - TFP Depends on food used in wet SFP.

Example:

If the initial survey estimated the number of severely malnourished children at 245, the food to be ordered for one month will be:

DSM: 80g x 1.81 x 245 children x 30 = 1058 kg = 1.058 Mt Oil: 60g x 1.81 x 245 x 30 = 794 kg = 0.794 Mt Sugar: 50g x 1.81 x 245 x 30 = 662 kg = 0.662 Mt

Estimates are increased by 10% to allow for losses during transport and preparation, so the total amount to be ordered in this example will be: DSM: 1.164 Mt, Oil: 0.875 Mt. Sugar: 0. 728 Mt, Total: 2. 767 Mt. This amount of food will require at least 3 trips by pick-up.

In addition, local foods need to be purchased for meals for carers.

For calculating food needs for one month for dry ration distribution programmes: average attendance: 150 children per week, dry ration for one child per day:

- 270 gram dry premix containing:
- WSB 140g
- DSM 50g
- 1250Kcal + 46g protein sugar 30g oil 50g food needs for one month for 150 children, including an addition of 10% for losses:

WSB

(140 x 30 x 150) + 10% = 693 kg

DSM

(50 x 30 x 150) + 10% = 248 kg

sugar

(30 x 30 x 150) + 10% = 149 kg

oil

(50 x 30 x 150) + 10% = 248 kg

Total

= 1,338 kg

this amount of food can be transported in 2 pick-up loads.

Actual consumption

The actual consumption of the commodities has to be checked in order to:

- adapt the theoretical calculation of the food needs to the actual needs,
- compare the consumption with the number of beneficiaries to control preparation of meals and unexplained losses of food.

Example of check on the actual consumption:

No. of children registered at the end of the month: 150

Calculated needs for this month (including 10% losses)

WSB

140 x 30 x 150 +10%

= 693 kg

DSM

50 x 30 x 150 +10%

= 248 kg

Sugar

30 x 30 x 150 +10%

= 149 kg

Oil

50x 30x 150+10%

= 248 kg

Actual consumption:

WSB

700 kg

Corresponds

DSM

300 kg

20% Overconsumption

Sugar

200 kg

> 30% Overconsumption

Oil

200 kg

20% Underconsumption

Stock management

Good management of the food stock is essential for the successful performance of a selective feeding programme. The store must be properly locked, foods carefully stacked and good ventilation ensured. Food stock management should be systematized so that there is stock rotation (old foods used before the new) and there are always sufficient quantities of ALL commodities in the buffer stock.

Only one person should be responsible for the store, and only with his approval can commodities be released from the storehouse; all commodities going in and out of the store must be systematically registered.

The supply and use of the different commodities must be summarized in a monthly stock balance.


FIGURE

At the end of each month, a physical count (stockcount) of the stocks should be made to cross - check the stock balance. The stockcount should equal the closing stock of the stock balance. If this is not the case, and differences are unacceptable, try to find out reasons and change the food management system accordingly.

The end - of - the - month stockcount should be taken as the opening stock for the next month.

Food Orders

The required food stock at the beginning of the month will depend on the extent of the predicted consumption as well as the size of the required buffer stock. The frequency and stability of the food supply determines the amount of food needed as a buffer stock. If a stable monthly supply can be guaranteed, a buffer of one month is sufficient (although 2 - 3 may be preferred). Large stocks should be avoided, because the management is more difficult, food has a limited shelf lifen, and for security reasons.

The quantity of food to be ordered each month, allowing for a one month buffer stock, can be calculated as follows:

Monthly Order = (2 x Monthly Consumption) - Stock Count

Example:

A feeding centre consumes 0.625 MT of sugar every month. There are 0.25 MT in stock at the end of the month. The next order will be: (2 x 0.625) - 0.25 = 1 MT.

(All food orders should be made in Metric Tonnes = 1000 kg)