Improve the collection of existing data
• Address problems with collecting low birth weight data. There are substantial problems with the collection of low birth weight data, including nonstandard definitions, missing data, and evidence of heaping of reporting around the threshold. Given the increased focus on good nutrition during a child’s first 1,000 days after conception, it is vital to improve how data are collected, reported, and adjusted.
• Collect more data on micronutrient biomarkers. Given the slow overall progress in addressing micronutrient malnutri- tion, we need better data on trends in micronutrient status so we can identify areas of progress and learn from them. Currently, too few nationally representative surveys contain data on multiple micronutrient biomarkers, collected through standardized methods. In part this gap is due to the absence of field-friendly, noninvasive devices that allow for quick, low- cost assessments of biomarkers in small blood samples.
• Collect data on different types of program costs. Rigorous evaluations of programs increasingly collect data on cost and cost-effectiveness. In addition, certain types of cost data are routinely collected as most programs are implemented. But to make these data more useful for, say, prioritizing nutrition interventions, it is important to define unit costs, participa- tion costs, opportunity costs, and recurrent costs; develop methods of collecting data on these costs; and make these data widely available.
Improve data comparability across countries
• Make data for high-income countries more internationally comparable. Nearly half of the WHA data reporting gaps are from countries in Europe and Northern America. This is because these countries use different reporting methods or do not grant access to the raw data to WHO and UNICEF.
• Harmonize data collection on adult obesity. Different sub- populations are covered by different surveys (for example, surveys of women of reproductive age or all adults), using different methods (for example, enumerator reporting versus self-reporting). Given the rising tide of adult obesity, it is urgent to harmonize data collection.
Collect data more frequently
Compared with policy areas such as economic growth, employ- ment, and poverty reduction, nutrition policy is poorly served by national surveys and surveillance systems. In a world that is more uncertain owing to climate change and environmental degrada- tion, it will be important to have more frequent survey data on changes in nutrition status and in nutrition program coverage.
The WHA database currently contains surveys from 125 countries on anthropometry of children under age five. The database excludes surveys from before 2005, but many of the included surveys are quite old. Nearly 40 percent of the surveys are from the period 2005–2009 (Table 9.2). It seems very chal- lenging to make public policy on the basis of five- to nine-year-
old data. Other public policy areas would demand better. Every country should have a national nutrition survey at least every three to four years.
Collect new data
• Collect more data on nutrition intervention coverage. Our knowledge about what works in nutrition has increased greatly in the past five years, but our knowledge of how many people interventions are reaching is weak. As pro- grams are scaled up, the collection of coverage data needs to be scaled up as well.
• Collect data on coverage of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) programs. Given the stubbornness of child wasting rates and the increasing volatilities generated by climate change, getting more data on the coverage of MAM and SAM programs is important. Panel 5.1 suggests some ways to do this.
• Improve data collection on food consumption. The absence of data on food consumption is one of the most glaring gaps among indicators of nutrition outcomes. For children aged 6 to 23 months, data collection is improving through measure- ments of complementary feeding that include data on min- imum acceptable diet (MAD) and minimum dietary diversity (MDD). For severe food insecurity at the national and subna- tional levels, new annual data efforts include the Voices of the Hungry, a partnership of Gallup and the FAO that reports on perceptions of hunger. But given the importance of food consumption for anemia and overweight and obesity, more effort should be made to collect new survey-based data on the quantity and quality of food consumption.
• Collect data on the capacity to design, implement, and evaluate nutrition-relevant actions. Existing data on human resource availability can be mobilized, but new data are needed on performance at the frontline (for example, com- munity health workers), organization (for example, Ministry
TABLE 9.2 YEAR OF THE MOST RECENT SURVEY CONTAINING UNDER-FIVE ANTHROPOMETRY IN THE WHA DATABASE
Year of most recent survey in WHA database 2005 2006 2007 2008 2009 2010 2011 2012 2013 Total
Source: Authors.
Number of countries for which this is the most recent survey 7 8
11 8
14 28 18 25 6
125
Cumulative percentage 5.6
12.0 20.8 27.2 38.4 60.8 75.2 95.2
100.0
ACTIONS & ACCOUNTABILITY TO ACCELERATE THE WORLD’S PROGRESS ON NUTRITION
69
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118