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Research. Do NOT change current methods unless new methods have been tested. MR method - prior birth history CMR v <5MR other data: 30-35yr children, Mother:child ratio, demographic profile etc. Anthro - calculation from mean/ GIS other data: MUAC vs anthro (mort risk). CMR - why?.

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Research
Research

  • Do NOT change current methods unless new methods have been tested.

  • MR method - prior birth history

  • CMR v <5MR

  • other data: 30-35yr children, Mother:child ratio, demographic profile etc.

  • Anthro - calculation from mean/ GIS

  • other data: MUAC vs anthro (mort risk)


Cmr why
CMR - why?

  • Most basic public health indicator - should have some idea of CMR in all populations

  • Need to assess overall severity of population stress

  • to inform resource allocation

  • documentation/ advocacy

  • calibration of surveillance data/ triangulation

  • urgency of intervention


Cmr when
CMR - When?

  • Best obtained with surveillance methods

  • use survey if no reliable data from other sources

  • Co-ordination of timing with other agencies

  • At same time as anthro survey

  • seasonality/ peak


Cmr how
CMR - How?

  • By surveillance methods where possible (with calibration)

  • No evidence based basis for choice of a particular method at the moment

  • Current household method most often used - other methods should be chosen where they are thought to have advantages

  • need to assess prior birth history method as it appears to be the most promising method

  • 3 month recall where possible.


Cmr who
CMR - Who?

  • Scale - each agency has different purpose for survey. National to micro scale.

  • To large a scale averages out pockets: to small a scale misses pockets and is not generalisable- difficult to use data to inform where there is a problem.

  • Commend areas based upon characteristic likely to be important determinant - Agroeconomic zones, tribal/ethnic areas, etc. and not necessarily administrative districts

  • CANNOT in general be used to decide where to set up a program - this comes from other information


Anthro why
Anthro - why?

  • Need to assess overall severity of nutritional stress in population.

  • to inform resource allocation

  • documentation/ advocacy

  • urgency of intervention


Anthro when
Anthro - When?

  • Need to design feeding programs

  • when surveillance /program data shows that there is a problem

  • when program “coverage” likely to have changed.

  • Seasonality/ peak and trough

  • Co-ordination of timing with other agencies


Anthro how
Anthro - How?

  • Systematic random sample where feasible otherwise cluster sampling

  • 30x30 clusters unless data to inform assumptions and expertise available

  • use systematic random or random for cluster choice if feasible and convenient. Otherwise start - chose person from crowd and go to his/her house to start; then EPI-n with bottle spin after each house.

  • Take ALL children in house

  • use houses with no children for CMR/demographic other data collection.


Anthro who
Anthro - Who?

  • As with Mortality rates - each agency has different purpose for survey. National to micro scale.

  • To large a scale averages out pockets: to small a scale misses pockets and is not generalisable- difficult to use data to inform where there is a problem.

  • Commend areas based upon characteristic likely to be important determinant - Agroeconomic zones, tribal/ethnic areas, etc. and not necessarily administrative districts

  • CANNOT in general be used to decide where to set up a program - this comes from other information


Anthro who 2
Anthro - Who? 2

  • From program data - e.g. map admissions to TFC - new arrivals - anecdotal information.

  • Assess with anthro survey (area often security delimited)

  • secure areas likely to be best


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