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Bilukha O.,Centers for Disease Control and Prevention | Prudhon C.,World Health Organization | Moloney G.,Food Security and Nutrition Analysis Unit Somalia | Hailey P.,UNICEF in Nairobi | Doledec D.,UNICEF in Nairobi
Food and Nutrition Bulletin | Year: 2012

The technical discourse on nutrition surveillance started decades ago, and the first technical guidelines were proposed in mid-1970s. In spite of this long history, little evidence and consensus exists on the best methods for conducting nutrition surveillance, and on the validity of data produced by these approaches. Multiple nutrition surveillance systems exist in humanitarian settings; however, the validity and usefulness of data produced by these systems are often questionable. In this paper, we outline and define five major methodological approaches to collecting child anthropometric data through surveillance: repeated surveys, community-based sentinel sites, mass screenings, admission data from feeding centers, and data from health clinics. We discuss outstanding methodological and practical challenges with direct implications for quality, validity, and interpretability of collected data and highlight comparative advantages and disadvantages of different methods. We also propose ways forward to building a better evidence base by documenting the strengths and limitations of different approaches, with the eventual goal of achieving consensus on the best ways to collect anthropometric data through surveillance. © 2012, The United Nations University.

Hillbruner C.,FEWS NET | Moloney G.,Food Security and Nutrition Analysis Unit Somalia
Global Food Security | Year: 2012

Starting in July 2011, the United Nations made a series of public famine declarations for southern Somalia, based on joint technical analysis by the USAID-funded Famine Early Warning Systems Network (FEWS NET) and the FAO-managed Food Security and Nutrition Analysis Unit for Somalia (FSNAU). During the 11 months prior to the Famine declaration, early warning was provided by FEWS NET and FSNAU, including a specific Famine warning in March 2011. While early warning has been provided in advance of many past food crises, these early warnings were notable in terms of the timeliness, quantity and quality of the warning provided, and the use of a formalized Famine definition. However, in the absence of incentives for early action, preventable food security emergencies are likely to persist, regardless of the quality of the early warnings that is provided. © 2012 Elsevier B.V.

Noor A.M.,Kenya Medical Research Institute | Noor A.M.,University of Oxford | Alegana V.A.,Kenya Medical Research Institute | Patil A.P.,Sense Inc. | And 6 more authors.
BMJ Open | Year: 2012

Objectives: To measure the receptive risks of malaria in Somalia and compare decisions on intervention scale-up based on this map and the more widely used contemporary risk maps. Design: Cross-sectional community Plasmodium falciparum parasite rate (PfPR) data for the period 2007e2010 corrected to a standard age range of 2 to <10 years (PfPR 2-10) and used within a Bayesian spaceetime geostatistical framework to predict the contemporary (2010) mean PfPR 2-10 and the maximum annual mean PfPR 2-10 (receptive) from the highest predicted PfPR 2-10 value over the study period as an estimate of receptivity. Setting: Randomly sampled communities in Somalia. Participants: Randomly sampled individuals of all ages. Main outcome measure: Cartographic descriptions of malaria receptivity and contemporary risks in Somalia at the district level. Results: The contemporary annual PfPR 2-10 map estimated that all districts (n=74) and population (n=8.4 million) in Somalia were under hypoendemic transmission (≤10% PfPR 2-10). Of these, 23% of the districts, home to 13% of the population, were under transmission of <1% PfPR 2-10. About 58% of the districts and 55% of the population were in the risk class of 1% to <5% PfPR 2-10. In contrast, the receptivity map estimated 65% of the districts and 69% of the population were under mesoendemic transmission (>10%e50% PfPR 2-10) and the rest as hypoendemic. Conclusion: Compared with maps of receptive risks, contemporary maps of transmission mask disparities of malaria risk necessary to prioritise and sustain future control. As malaria risk declines across Africa, efforts must be invested in measuring receptivity for efficient control planning.

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