Surveillance

If long-term food supply problems seem likely, as in areas with subsistence agriculture and poor communications, the nutritional status of the community should be monitored. This can be accomplished by making regular physical measurements of a suitable sample of the population. Since young children are the most sensitive to nutritional changes, the surveillance system should be based on them, remembering that the most serious malnutrition results from an acute exacerbation of chronic under-nutrition. In emergency situations, weight-for-height will provide the best indicator of acute changes in nutritional status. If height and weight cannot be measured, arm circumference, which is simple and easy to measure, may be used to gauge changes in communities.

As the results of the first needs assessments become available, more accurate information will make it possible to adjust preliminary estimates of the proportion of the population most in need of long-term food distribution. Surveys of need should make sure to cover not only food availability, but also identify areas where problems of labor, tools, marketing/and other variables affecting distribution have arisen. As soon as an area is able to return to normal consumption patterns, distribution should be phased out.