|Nutrition Guidelines (MSF, 1995, 191 p.)|
|Part I: Nutrition Strategies in Emergency Situations|
|1. Food crises|
|2. Assessment of the nutritional situation|
|3. Interventions: ensuring adequate general food availability and accessibility|
|4. Interventions: selective feeding programmes|
|Part II: Rapid Nutrition Surveys|
|1. Introduction to anthropometric surveys|
|2. Anthropometric measurements and indices|
|3. Sampling methods|
|4. Analysis, interpretation and recommendations|
|Part III Selective feeding programmes|
|1. Justification for selective programmes|
|2. Criteria for admission and discharge to selective feeding programmes|
|3. Screening and selection|
|4.Treatment in a therapeutic feeding centre|
|5. Treatment in supplementary feeding programmes|
|6. Implementation and management of a feeding centre|
|7. Registration and monitoring|
|8. Evaluation of feeding programmes|
|9. Food management|
|Annex 1: Rapid assessment of the state of health of displaced populations or refugees (A.Moren - Medical News, No. 1)|
|Annex 2: Mid - Upper Arm Circumference (MUAC)|
|Annex 3: Nutritional status assessment in adults and adolescents|
|Annex 4: Agencies involved in food relief|
|Annex 5: Food composition table|
|Annex 6: GENERAL RATION: How to calculate the energetic value|
|Annex 7: Micronutrient deficiencies|
|Annex 8: Food basket monitoring methodology|
|Annex 9: Analyzing nutritional survey data|
|Annex 10: Drawing of a random number|
|Annex 11: Standardization of anthropometric measuring techniques|
|Annex 12: Data collection forms|
|Annex 13: W/H Reference tables|
|Annex 14: Selection of food items for selective feeding programmes|
|Annex 15: Oral rehydration for severely malnourished children|
|Annex 16a: Preparation of High Energy Milk|
|Annex 16b: Recipes for porridge for use in therapeutic and wet supplementary feeding programmes|
|Annex 16c: Recipes for premix for dry ration supplementary feeding programmes|
|Annex 17a:Example of a Therapeutic feeding centre|
|Annex 17b: example of layouth of a <<wet>> supplementary feeding centre|
|Annex 17c: Example of a DRY SFP|
|Annex 18a: Example of an Attendance register (tfp or SFP)|
|Annex 18b: Example of a Nutritional Status Monitoring (SFP)|
|Annex 19a: TFP individual monitoring card|
|Annex 19b: SFP individual monitoring card|
|Annex 19c: Individual card for Supplementary feeding centre|
|Annex 19d: Example of an individual card for dry blanket SFC|
|Annex 20: Feeding programme indicator graphs|
|Annex 22: MSF nutrition kits|
The collection of information for monitoring and evaluation should be an integral part of all nutrition programmes. Evaluation is a learning process involving continuous collection of information to monitor the progress in achieving set goals and to suggest adaptations to the progamme, or closure with time.
Monitoring and evaluation will involve the planned and regular collection and analysis of:
· PROCESS INDICATORS to evaluate the progress in implementation and the trends in programme needs over time (i.e. attendance rates, coverage, recovery rates).
· IMPACT INDICATORS to evaluate the effect the programme is having/had on the population, and to summarize the total efficacy of the programme (malnutrition prevalence, mortality figures, numbers served).
Assessment of impact is extremely difficult as analysis of trends in health indicators does not prove that the programme has caused the change. However, a well collected data set can be used to argue for an association of the programme with the change in overall health status.
It makes little sense to only look at indicators of IMPACT for evaluating a nutritional programme. First it is necessary to know that the programme serves a useful purpose and is running well. PROCESS information will allow you to see how well the programme is functioning and adapt programme emphasis and design over time. PROCESS Indicators should be thoroughly analyzed and Interpreted (see Chapter 8, Part III).
The collection of information for evaluation needs to be planned during initial programme design. If information is not collected in a regular and systematic fashion, quality and relevance of the programme cannot be assessed while giving services.
It is the responsibility of coordinators and the team to implement the collection of process evaluation data systems and compile and analyze the data. Coordinators and their teams should be prepared to act to change programme design and management procedures based on feedback received through regular evaluation (see Chapter 8, Part III).
In camps, IMPACT indicators may be collected along with malnutrition prevalence rates, mortality rates, etc., and interpreted as a function of nutritional programme efficacy in conjunction with other relief activities.