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Table of Contents In an emergency, time is often limited and there is a
need for immediate information on the severity and extent of nutritional
problems. The situation
of hastily collected data must be avoided.
Ensuring appropriate methodology, logistics, time available,
and experienced/skilled personnel in order to make prompt and objective
assessment of nutritional needs are the most challenging problems
in the field of emergency management.
The development and adoption of nutritional indicators and
survey standards has a long, yet guided history and evolution.
Attempts to administer effective nutritional surveys
has evolved from citing methodologies of key papers in the 1960's
through the 1980s -- to internationally accepted standards and guidelines
today. Attempts toward
providing these guidelines came in the 1980s then a final push in
1995 and 1999 to provide WHO standard methodologies which are easy
to understand, easy to customize to situations and cultures, and straight-forward
to carry out. Core surveys
of the bare minimum information needed to rapidly assess a nutritional
situation, and agreed upon by international experts, now exist.
There is now a consensus as to what information can be realistically
gathered and effectively analyzed for rapid decision-making regarding
nutritional status. This paper describes the evolution leading to the current consensus
and summarizes some key aspects of rapid nutritional surveys. Introduction
Access to food and maintenance of adequate nutritional
status is a critical determinant of
survival in the initial stages of an emergency. Malnutrition can be the most serious public
health problem and may be a leading cause of death, whether directly
or indirectly. Those
most commonly affected are children between the ages of six months
and five years, though younger infants, older children, adolescents,
pregnant women, breastfeeding women and other adults may also be affected. Malnutrition
has often been a major contributing factor to high death rates among
refugees and internally displaced persons. A 45% prevalence rate of acute malnutrition
was reported in children younger than 5 years of age as Sudanese refugees
arriving in Ethiopia during 1990, 29% among Somali refugees in Kenya
in 1991, and 48% among Mozambican refugees arriving in Zimbabwe in
1992 (1). In
an emergency, time is often limited and there is a need for immediate
information on the severity and extent of nutritional problems.
The situation of hastily collected data, which is later found
to be of little use, must be avoided. Ensuring appropriate methodology, logistics,
time available, and experienced/skilled personnel in order to make
prompt and objective assessment of nutritional needs are the most
challenging problems in the field of emergency management. Currently
there is an optimistic note where nutritional surveys are concerned.
A positive and well-guided evolution in nutritional survey
guidelines has occurred culminating in a group of manuals and documents
to guide responders toward key indicators and technical validity (2-9).
There is now a consensus as to what information can be realistically
gathered and effectively analyzed for rapid decision-making regarding
nutritional status. This
paper describes the historical evolution leading to the current-day
consensus and summarizes some key aspects of rapid nutritional survey
construction, execution, and analysis.
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