A.

Nutrition Information Systems

Importance of having a well organized nutrition information systems in an emergency [4]

Nutrition information system enhances processes of decision-making. They are

specifically useful in collection and analysis of population data regarding indicators like

mortality and malnourishment for example. This makes them particularly useful in cases of

emergency and intervention as they facilitate agency intergration with established national and

international policies regarding food and nutrition

Nutrition information systems also support management of overall health system for the

realization of an ultimate goal of enhancing and maintaining the general health of a specific

populace or community. This is achieved through provision of relevant and reliable information

to health practitioners for planning, implementing, evaluation and monitoring of health and

nutrition program. In the process, the personnel involved are able to learn improved of

information processing mechanisms that directly relate to healthcare provision.

These system also facilitate the promotion of minimum required standardization

measures ensuring a desired level of safety and quality in information handling and. They also

aid in timely detection and control of statistical errors that would otherwise escalate health

problems. Additionally, such systems facilitate innovation via research and development by

offering logical responses of the relationships between inputs and outcomes in an emergency.

They also monitor program outputs and smooth the progress of performance-based resource

allocations.
Finally yet importantly, nutrition information system allow foe easy monitoring of trends, thus

act as a platform for occurrence predictions, owing to efficient data presentation and

interpretation.

Challenges affecting Nutrition Information Systems in an emergency [4]

Nutrition information systems in an emergency involve complex definitions of

monitoring indicators and program strategies among other vital domains. They hence require the

limited expertise of information managers, resulting in high costs. The domains involved are also

difficult to measure and or determine. These involve system inputs, outputs and outcomes.

The process of data collection, which forms the foundation for information systems, is highly

vulnerable to inadequacies and inefficiencies owing to the sensitive nature of information sought.

As such, poor analysis is often a prevailing risk involved.

The resultant information presented by nutritional information systems requires constant

revisions at all levels to ensure reliable reporting. Additionally, reliance on external sources (out

of the region) for capacity risks compromising the sustainability of the information gathered.

Technical aspects of data security involving computer viruses, malfunctions and hacking pose as

major threats to a nutrition information system.

 B. There has been a severe drought in one ASAL district for several

months. In addition, there has been high death rate among the

population living there. Some of the death rates are being associated

with acute under nutrition. As a nutritionist discuss the following;

Program to be initiated to immediately address the problem of moderately malnourished under

five children

1. Blanket supplementary feeding program

This program would offer a food basket containing food items like cereals, legumes and

oil to the household units within the community. The essence is to cushion the population

from starvation and to provide food for the adversely affected- Children under five (U5)

and also pregnant and lactating women (PLW) most of whom are likely to be taking care

of a child or children under five and who are at risk of malnutrition or are already

moderately malnourished. This program runs for a period until the malnutrition rates go

down and the community has found ways of dealing with the shock.

2. Targeted supplementary feeding program (TSFP)

This is a program that that targets (is directed at) a specific group with nutrition

vulnerability. The essence is to supplement for nutrients that are deficient for those that

are vulnerable. The targeted population consumes the food from the family pot put takes

what the program gives as additional nutrients.

 The under five children as well as PLWs are given ‘plump sap’ after screening and

admission into the program. The visit TSFP sites biweekly for monitoring, and collection

of more supplements.

This program has to be accompanied by an IYCF (infant and young child feeding

program) that will offer breast feeding support and education on optimal complementary

feeding for the children 6- 59 months or under age five.

The program has also to complement health and hygiene program to deal with the

underlying factors of malnutrition.

Mobile programs also increase coverage to the program.

The admission criteria on the program

The establishment of stationary and mobile site centers within the district(s) by mapped villages,

schools and health centers. The admission criteria for moderately malnourished children under

five is as follows

• Children with a weight-for-height <-2 to >-3SD and/or MUAC between 11.5cm and 12.4cm.

• Pregnant and lactating mothers with a MUAC that is

<21 cm

• PLWHA with a MUAC that is < 23.3cm

• Other adults with a MUAC of < 18.5cm

• Other adults BMI < 18.5

At risk groups include chronically ill children (with TB, HIV and AIDS, Malaria, persistent

diarrhea, vomiting, Kala Azar measles), as well as those with the growth chart showing a decline

in growth. (National guidelines for management of malnutrition Kenya, 2009)

The discharge criteria for the program

Locals would be classified in groups as mentioned above. Mothers would bring their children to

health centers in the villages while mobile sites would involve door-to-door initiatives. The

discharge criterion is indicated below:

• Children maintain a weight-for-height >-2SD

- And/or MUAC ≥12.5cm for a period of two consecutive weighs/measurements

• Pregnant and lactating mothers attain a MUAC that is above 23cm

• PLWHA attain above 23.3cm

• Other adults attain a MUAC of above 18.5cm

• Other adults BMI above 18.5

At risk group, include children who have recovered from illness and those whose growth curves

are steadily increasing. (National guidelines for management of malnutrition Kenya, 2009)

Food commodities to be used in the program

- Supplementary feeding program commodities are to include cereals, legumes and oil.

The limitations to food aid as intervention strategy in an emergency [4]

- Not sustainable because of cost of the program, especially if all households are covered.

- Risk of spoilage

- Risk of theft

- Risk of corruption and misuse by aid workers.

- Risk of resale
- Beneficiaries may lack fuel
References

Ministry of Medical Services, Ministry of Public Health and Sanitation, Kenya. National

guidelines for management of malnutrition Kenya, 2009.

Lippeveld T, 2001. Health information system

Darcy J, Hoffmann CA. According to need. Need assessment and decision- making in the

humanitarian sector. London: Overseas Development Institute; 2003. Humanitarian

Policy Group Report 15. Available from: http://www.odi.

org.uk/hpg/papers/hpgreport15.pdf

Lippeveld T, Sauerborn R, Bodart C. Design and implementation of health Information Systems.

Geneva: World Health Organization; 2000.

Kaiser R, Spiegel P, Hendersen A, Gerber M. The application of geographic information systems

and global positioning systems in humanitarian emergencies: lessons learned, program

implications and future research. Disasters 2003; 27:127-40.