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close this bookMethods for the Evaluation of the Impact of Food and Nutrition Programmes (UNU, 1984, 287 pages)
View the documentPreface
close this folder1. Basic concepts for the design of evaluation during programme implementation
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View the documentIntroduction
View the documentCosts of evaluation
View the documentPurposes of evaluation
View the documentSetting programme objectives as a basis for evaluation
View the documentInvestigating causality
View the documentConfounding variables and evaluation design
View the documentLevels of analysis
View the documentDefinitions of population groups involved
View the documentEffect/cost
View the documentAppropriate indicators for different objectives
View the documentNote on sample size
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close this folder2. Stages in the evaluation of ongoing programmes
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View the documentIntroduction
View the documentStage 1: preliminary tasks
View the documentStage 2: evaluating the plan of the programme
View the documentStage 3: evaluating implementation
View the documentStage 4: evaluating gross outcome
View the documentStage 5: evaluating net outcome
View the documentStage 6: move to a built-in evaluation
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close this folder3. Measuring the impact of nutrition interventions on physical growth
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View the documentIntroduction
View the documentGeneral considerations
View the documentMinimum anthropometric battery
View the documentMethodology
View the documentPhysical growth norms
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close this folder4. Measuring impact using laboratory methodologies
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View the documentIntroduction
View the documentDevelopment of a primary nutritional deficiency
View the documentChoice of tissue for laboratory assessment
View the documentSelection of laboratory methodologies for nutritional impact evaluation
View the documentLaboratory methods for assessment of nutritional impact
View the documentAnnex A. Laboratory evaluation of protein nutriture
View the documentAnnex B. Laboratory evaluation of vitamin A nutriture
View the documentAnnex C. Suggested methods for hematology
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close this folder5. Measuring impact using clinical, morbidity, and mortality data
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View the documentFramework for analysis
View the documentMethods of measurement
View the documentAnnex A. Field nutrition assessment form
View the documentAnnex B. Xerophthalmia field survey forms
View the documentAnnex C. Diarrhoea/growth study illness surveillance form
View the documentAnnex D. Brief examination of child
View the documentAnnex E. Birth report form
View the documentAnnex F. Death report form
View the documentAnnex G. Maternity history questionnaire
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close this folder6. Measuring impact by assessing dietary intake and food consumption
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View the documentReasons for assessing household food practices
View the documentDeciding on a method
View the documentModels for household dietary assessment
View the documentAdditional data
View the documentSteps and procedures in surveying
View the documentAssessing dietary change
View the documentSummary
View the documentAnnex A. Development of a score card for the rapid assessment of calorie and nutrient intakes
View the documentAnnex B. Household quantitative intake record
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close this folder7. Measuring impact using immunologic techniques
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View the documentIntroduction
View the documentMethodologies
View the documentConcluding remarks
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close this folder8. Measuring impact on physical activity and physical fitness
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View the documentIntroduction
View the documentPhysical activity and energy expenditure
View the documentGeneral comments on methodology
View the documentTechniques available for measuring energy expenditure
View the documentGeneral considerations in use of techniques
View the documentPhysical fitness measurement
View the documentConclusion
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close this folder9. Methods for the behavioural assessment of the consequences of malnutrition
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View the documentDescription of methods in published studies
View the documentAn information-processing approach
View the documentAnnex: Behavioural test battery
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close this folder10. Anthropological methodologies for assessing household organization and structure
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View the documentIntroduction
View the documentThe basic household interview
View the documentComponents of the basic household interview
View the documentSome general methodological issues concerning the household interview
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close this folder11. Micro-economic analysis in the evaluation of supplementary feeding programmes
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View the documentThe use of micro-economic analysis
View the documentMeasurement issues
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close this folder12. Data recording and processing
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View the documentIntroduction
View the documentData recording
View the documentData processing
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close this folder13. Policy evaluations
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View the documentA policy evaluation methodology
View the documentImplication of evaluation methodology
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close this folder14. Built-in evaluation systems for supplementary feeding programmes why and how
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View the documentIntroduction
View the documentThe concept of a built-in evaluation system
View the documentReasons for built-in evaluation
View the documentCharacteristics of a built-in evaluation system
View the documentImplementing a built-in evaluation system
View the documentUse of the data for overall programme management
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View the documentParticipants
View the documentOther UNU titles of interest

Concluding remarks

Recent studies have documented the usefulness of employing immunocompetence as a functional measure of nutrition (17). In growing infants, it may be a sensitive index of imminent failure to thrive and of infectionrelated morbidity.

Obviously, there are many unanswered questions. Many of the immunologic processes act in unison and often interact in a synergistic fashion. Impairment of one facet of immunity may be of little functional consequence for the host if other components are intact. The specificity of tests of immunocompetence is debatable. Other disorders, often clinically apparent, as well as infection, can depress immune responses. The threshold of clinically relevant immuno-deficiency is ill-defined. How much reduction in the number of circulating T cells is biologically significant? Does a 50 per cent decrease in serum complement C3 concentration predispose to more frequent or severe infection? Infection often complicates malnutrition and can suppress immunity.

The answers to these and other crucial questions must await further investigation. Nevertheless, existing knowledge indicates that the assessment of immunocompetence by the methods currently available provides useful prognostic information in relation to nutritional deficiency and in the evaluation of nutrition intervention programmes.