Transcript 4-assessment-and-monitoring

Framework
Emergency
Immediate
Pre-Crisis
Response Phase
Increasing depth
Preparedness
data collection
Beyond the
Immediate Response
Tracking
Mulit-sectoral
Rapid
Assessment
(qualitative &
secondary
quantitative)
Sector-specific rapid
assessments
Early warning systems
Surveillance
Multi-sectoral survey
Follow-up survey:
Health/Nutr/
Food/WASH/etc
(probability sample):
Health/Nutr/
Food/WASH/etc
Periodic surveys
In-depth sector studies
Existing research/studies
(quantitative/qualitative)
Preparedness Monitoring
Sudden 1 wk
onset
Performance Monitoring
6-8 wks
3-6 mo
1 year
The IYCF Assessment Process:
Assessment Objectives
Initial Rapid Assessment (often a multi-sectoral rapid assessment):
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Provides a rapid overview of the situation related to nutrition in general and IYCF
in particular in order to identify the immediate impacts of the crisis and estimate
the needs of the affected population for resources (including human and logistics)
in the first weeks following the crisis. The focus should include mapping of all
available resources, including those under the purview of the government.
Ensure recommendations and dissemination for action and response.
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Timing: as soon as possible(within days) after acute onset emergency
Comprehensive (in-depth) Assessment (sector-specific):
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A more thorough analysis that provides information to more thoroughly assess the
situation, to inform program development, determine resource requirements, and
disseminate additional information to the international community in addition to
the national audience. Often includes:
 Sector-specific rapid assessment
 Survey data (can be single-sector or multi-sectoral: nutritional, anthropometry,
IYCF practices, other data): to document baseline

Timing: 4-8 weeks
IYCF Assessment Process
Key information (Ops Guidance)
Initial Rapid Assessment (often multi-sectoral):
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Demographic profile. Are the following groups under or over-represented: infants
and young children, pg and lactating women, orphans/unaccompanied young
children?
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Feeding practices pre-crisis; any notable changes. Observed and pre-crisis
approaches to feeding orphaned infants (including acceptability of wet-nursing).
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Reported problems (by caregivers, key informants, stakeholders and health staff)
feeding infants and young children (including BF difficulties, poor access to infant
complementary foods)
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Access to safe water, sanitation, hand-washing
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Conspicuous availability of BMS, milk products, bottles and teats in population or
commodity pipeline
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Who is available to provide immediate assistance?
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[Situation related to [mortality], morbidity, nutritional status of infants/young
children]
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[Security risks to women and children]
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[Vulnerability assessment of women & children: HH heads, disability]
IYCF Assessment Process
Additional information (Ops Guidance)
Comprehensive Assessment: obtain information on the following
• Food situation
-- Availability of government and HH food stocks; market survey [food costs]; nutritional
adequacy of food ration; availability of appropriate foods for infant complementary feeding (in
general ration; in targeted feeding programmes)
-- Pregnant and lactating women: is multiple-micronutrient supplementation available;
fortified or unfortified blended foods
• Health environment
-- water quantity and quality, fuel, sanitation, housing, facilities for food preparation and
cooking
-- support offered by health facilities providing antenatal, delivery, postnatal and child care
-- immunization; micronutrient supplementation
• Care environment
-- feeding: Feeding Technique: cup, bottle; frequency; amount – same, less, or same as before
methods of encouraging complementary feeding); factors disrupting breastfeeding (open-ended
question); why; Infant Formula?
-- capacity of potential support givers (BF mothers, trained HWs, trained IYCF counsellors, experienced
women from community) Ask mothers. FG: was there any infant ; health staff interview; key NGOs
-- identify key decision-makers at HH, community and local health facility level
-- identify cultural barriers to relactation, expressing BM or wet-nursing
IYCF Assessment Process
Additional information (Ops Guidance)
Comprehensive Assessment: Surveys
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Population statistics: numbers of accompanied and unaccompanied infants and
young children <24 months (data stratified by age: 0-5 months, 6-11 months,
12-23 months), children aged 24-59 months (2-5 years), pregnant and
lactating women; HH heads, in addition to other standard socio-economic
indicators
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Mortality of infants / Y children and other HH members before (3 months,
sample size of 1000), during and after the emergency event
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Morbidity of infants/Y children: diarrhea and ARI in last 2 weeks (measles)
DEPENDING on the SITUATION:
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Infant and young child feeding practices: Dip-stick (questions on BF and
CF)
OR
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Infant and young child feeding practices: Global standards
-- questions for calculation of standard indicators
-- questions on receipt of donated BMS and bottles, and use in past 24 hours
IYCF Assessment and Monitoring
Assessment Approaches
Initial Rapid Assessment: (called Multi-sectoral Rapid
Assessment, Box 1 on Framework)
Approach: Secondary Data; Qualitative Assessment
Comprehensive Assessment: Sector-Specific Rapid Assessment
(Box 2 on Framework)
Comprehensive Assessment: Multi-sector Surveys
(Box 3 on Framework: see next slide for suggested approaches)
IYCF Assessment and Monitoring
Survey Approaches: Box 3
Quick Dip-Stick Approach
To understand possible gaps in
current practice and make
recommendations for
programming.
Multi-stage cluster sampling;
need to consider infant
feeding practices in design
Suggested questions provided
(see next slide)
WHO methodology/goldstandard approach
To provide information on IYCF
practices using global
indicators for comparison with
other countries or to monitor
change over time within
emergency contexts or
programmes
Use standard questions and
analysis approaches (WHO,
DHS, UNICEF MICS, Child
Survival KPC)
Suggested Suggestions for Dip-Stick Survey: (Box 3 and Box 2)
(results will not be comparable to WHO indicators)
MODIFY QUESTIONS AS PER CONTEXT
BREASTFEEDING
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Have you ever breastfed? ( Y/N)
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Are you still breastfeeding? (Y/N)
If YES: Why did you stop breastfeeding? (Record mother’s response)
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Is this child separated from mother? (Y/N)
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Are you giving any foods or fluids other than breastmilk?
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Are you giving infant formula?
COMPLEMENTARY FEEDING (CF): asked about children >6 months of age
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Are you feeding your child any solids, semi-solids or soft foods?
Are you feeding your child more, less or the same amounts than before the
emergency?
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In the past 24 hours, how many times have you fed your child solids, semi-solids
or soft foods?
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Yesterday did your child get any foods from each of the following food groups:
i) grains, roots & tubers; ii) legumes & nuts; iii) dairy products (milk, cheese &
yogurt); iv) flesh foods (meat, fish, poultry, liver/organ meats); v) eggs; vi) vitA rich fruits and vegetables; vii) other fruits and vegetables; viii) oils and fats
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Has your child received a micronutrient supplement (time period?)