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Information on the NICS Database


The Nutrition Survey Results database presents the outcomes of the nutrition and mortality surveys which have been made available to NICS. All survey reports are checked for methodology and results. Only those surveys which correspond to the criteria mentioned below, following internationally agreed standards 1,2,3,4, are included in the database:

  • Cluster sampling using a proportional to population size (PPS) sampling, with at least 25 clusters
  • Systematic or simple random sampling
  • Exhaustive surveys

Sample size

The required sample size for any given survey depends on the prevalence of malnutrition; therefore, no minimum sample size is defined for inclusion in the database. All surveys are included for which the 95% confidence intervals are sufficiently narrow to give interpretable results.
 

Age range, indicators of malnutrition, measles vaccination coverage and mortality

 

Age range of children

Unless specified, the surveys included in the database were carried out among 6 to 59 month old children. Unless specified, indicators of malnutrition are defined as follows:

Child nutrition indicators:

Wasting

Defined as weigh-for-height index (w-h) < -2 Z-scores of NCHS reference standards.

Severe wasting

Defined as weigh-for-height index < -3 Z-scores of NCHS reference standards.

Oedematous malnutrition (or kwashiorkor)

Diagnosed as bilateral pitting oedema, usually on the upper surface of the feet. Oedematous malnutrition is always considered as severe malnutrition.

Acute malnutrition

Defined as the prevalence of wasting (w-h < -2 Z-scores of NCHS reference standards) and/or oedema.

Since the release of the WHO growth standards in 2006, results calculated using the WHO Growth Standards are also reported, when available. 5

Severe acute malnutrition

Defined as the prevalence of severe wasting (w-h < -3 Z-scores of NCHS reference standards) and/or oedema.

Since the release of the WHO growth standards in 2006, results calculated using the WHO Growth Standards are also reported, when available. 5

MUAC

Mid-Upper-Arm Circumference (MUAC) is sometimes used to quickly assess nutrition situations. The results are reported according to the cut-offs used in the survey.

Micro-nutrient deficiencies and vitamin A distribution coverage  

Micro-nutrient deficiencies and vitamin A distribution coverage within 6 months prior to the survey are reported where data are available. 

Nutrition indicators in adults

No international consensus has been reached on a definitive method or cut-off to assess adult under-nutrition 6.
Various indicators such as Body Mass Index (BMI: weight (kg)/height (m) 2), MUAC and oedema, as well as different cut-offs, are used. When reporting on adult malnutrition, indicators and cut-offs used by the agency providing the survey are mentioned.  

Measles vaccination coverage

Measles coverage was assessed among 9 to 59 month old children.

Mortality rates

In emergency situations, crude mortality rates and under-five mortality rates are usually expressed as number of deaths/10,000 people/day.

Exclusion of surveys

Surveys are excluded which use convenience sampling or methodology that is not in accordance with the above-mentioned criteria.


Structure of the database


The database provides:

  • the geographical location of the survey (columns A to E)
  • the date of the survey (column F)
  • the status of the population surveyed: residents, displaced, refugees...(column G). * "Residents/Displaced" indicates that some displaced people are settled among the resident population. The percentage of displaced people is not given because the definition of displaced people varies depending on the survey.
  • the origin of the refugees (column H)
  • the estimated population number in the area surveyed (column I)
  • the household sample size (column J)
  • the children sample size (column K)
  • the adult sample size (column L)
  • the percentage of acute malnutrition (see above for definition) using NCHS reference standards and 95% Confidence Intervals (columns M and N)
  • the percentage of severe acute malnutrition (see above for definition) using NCHS reference standards and 95% Confidence Intervals (columns O and P)
  • the percentage of acute malnutrition (see above for definition) using WHO growth standards and 95% Confidence Intervals (columns Q and R)
  • the percentage of severe acute malnutrition (see above for definition) using WHO growth standards and 95% Confidence Intervals (columns S and T)
  • the percentage of oedema (column U)
  • the percentage of children with MUAC below a certain cut-off (column V)
  • the percentage of measles vaccination coverage according to cards and according to cards and mothers' statements (columns W and X)
  • micro-nutrient deficiencies (column Y)
  • vitamin A distribution coverage within the six months prior to the survey, unless stated otherwise (column Z)
  • the nutritional status of women, unless stated otherwise (column AA)
  • the crude mortality rate and 95% Confidence Intervals (columns AB and AC)
  • the under-five mortality rate and 95% Confidence Intervals (columns AD and AE)
  • the agency or agencies which conducted the survey (column AF)
  • the relevant NICS/RNIS report providing contextual information (column AG)
  • the relevant NICS/RNIS report providing information on survey methodology (column AH). 

Limitations

Only the survey reports were checked for methodology and results; the raw data was not checked and the course of the field survey is unknown. The accuracy of the surveys is therefore not guaranteed. Trend analysis and comparison of survey results are limited by possible differences in the structure of the populations surveyed. The prevalence of malnutrition needs to be interpreted with regards to contextual information. Users are strongly encouraged to refer to the NICS/RNIS reports, and other relevant sources, to find such information.  

Notes

1  SMART (2006) http://www.smartindicators.org/
2  Médecins sans Frontières (2002) Nutritional guidelines. Paris: Médecins sans Frontières
3  WHO (2002) The management of Nutrition in Major Emergencies. Geneva: WHO
4  Duffield A, Taylor A. Emergency Nutrition assessment: Guidelines for Field Workers. London, United Kingdom: Save the Children-UK; 2004.
5  WHO 2006 Child Growth Standards; www.who.int/childgrowth/en
6  UNSCN (2000) Adults, assessment of nutritional status in emergency affected populations. Geneva: SCN.


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