Note: Refer to chapter III, Food and Nutrition section, for the methods used in assessing nutritional status mentioned in the section below.

a. Nutritional Status

Determine rate of moderate acute malnutrition. Determine rate of severe acute malnutrition. Determine how surveys were conducted.

Methodology used, such as 30 by 30 cluster surveys, mid-upper arm circumference, weight for height/age, and height for age. Sample size. How sample was selected.

Determine if data are available from mother and child health clinics. Determine if data are available from existing supplementary feeding programs (SFPs), center-based therapeutic feeding programs (TFCs), or community-based therapeutic care (CTC) programs: If a food distribution program exists, identify:

Targeted or general. Commodities. Ration and kilocalories per person per day. Method of distribution (daily/weekly/monthly). How long has the population been receiving this ration?

Ascertain the prior nutritional status of the affected population.

b. Public Health-Related Risk of Malnutrition

Identify disease outbreaks that may affect nutrition status (e.g., measles, acute diarrhea). Is there a risk that outbreaks will occur in the future? Estimate the measles vaccination coverage of the population. Are there apparent micronutrient deficiencies? Estimate the vitamin A supplement coverage. Is vitamin A provided in measles vaccinations? Ascertain the crude mortality rate/under-5 mortality rate. What method was used to determine the rate? Identify factors that affect the energy requirements of the affected population or make them more vulnerable to malnutrition:

Presence of persons with HIV/AIDS or tuberculosis (TB). Current or predicted decline in ambient air temperature (which can also increase the prevalence of acute respiratory infections). Have people been in water or wet clothes for long periods of time?

c. Care-Related Risk of Malnutrition

Ascertain whether changes in work patterns (e.g., due to migration, displacement, or armed conflict) have altered household composition, roles, and responsibilities. Are there large numbers of separated children? Determine whether the normal care environment has been disrupted (e.g., through displacement) or has altered access to water, food for children, secondary careers. Describe normal infant feeding practices:

Length of time mothers exclusively breastfeed their children. Whether mothers are bottle-feeding or using manu-factured complementary foods. Is there an infrastructure that can support safe bottle feeding?

Determine whether evidence exists of donations of baby foods and milks, bottles and teats, or requests for donations. In pastoral communities, have the herds been away from young children for long? Has access to milk changed from normal? Ascertain whether HIV/AIDS has affected caring practices at the household level.

d. Food Access-Related Risk of Malnutrition

See the Food section of this chapter.

e. Nutrition Interventions

Describe nutrition intervention or community-based support that existed before the disaster, and identify the groups involved (e.g., NGOs, religious groups, government or UN agencies). Describe nutrition policies (past, ongoing, and lapsed), planned long-term nutrition responses, and programs being implemented or planned in response to the current situation. Identify formal and informal local structures through which potential interventions could be channeled. Describe the capacity of the Ministry of Health, religious organizations, HIV/AIDS community support groups, infant feeding support groups, or NGOs with a long- or short-term presence in the area. Determine the availability of food and describe the food pipeline. Is the population likely to move (for pasture/assistance/work) in the near future?

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TOC: J. Assessment Checklists

J. Assessment Checklists

4. Nutrition

a. Nutritional Status

b. Public Health-Related Risk of Malnutrition

c. Care-Related Risk of Malnutrition

d. Food Access-Related Risk of Malnutrition

e. Nutrition Interventions