Guidelines for Nutrition Surveys - Bangladesh June 2015 Anthropometry, Mortality, IYCF, Food Security and WASH. 1 Funded By: ECHO Prepared by: IPHN, INFS, and UNICEF 2 ACKNOWLEDGEMENTS This National Guidelines for Nutrition Surveys in Bangladesh are designed to provide clear instructions and guidance on area based nutrition surveys. I wish to convey my gratitude to the Director DGHS and the director IPHN/NNS for the strong leadership in preparing this guidelines. I do also acknowledge the contributions of the Program Manager and deputy program manager - Nutrition In Emergencies – under IPHN/NNS for their valuable administrative and technical support in the preparation of the guidelines. I gratefully acknowledge the contribution of the members of the technical committee formed under IPHN to review the draft guidelines. Contributions by staff from the following organisations is who were members of the technical committee is highly appreciated. - MOHFW - NNS/IPHN - UNICEF - Action Contre La Faim (ACF) - ICDDR,B - Institute of Nutrition and Food Science (INFS) of Dhaka University. I would also like to appreciate the time, review and useful recommendations provided by the curriculum committee towards finalisation of the guidelines. Thanks too to all the participants from government and development partners who attended and contributed at consultative workshops at national level. Regards. Name 3 ACRONYMS CI Confidence Interval CDR Crude death rate DEFF Design effect DR Death Rate ENA Emergency nutrition assessment EPI Expanded programme on immunisation FCS Food Consumption Score FGD Focus group discussion GAM Global acute malnutrition HAZ Height-for-age z-score HFA Height-for-age IYCF Infant and young child feeding MAM Moderate acute malnutrition MUAC Mid upper arm circumference NCHS National centre for health statistics PPS Probability proportional to population size RNA Rapid nutrition assessment SAM Severe acute malnutrition SMART Standardized Monitoring and Assessment for Relief and Transitions WASH Water Sanitation and Hygiene WAZ Weight-for-age z-score WFA Weight-for-age WFH Weight-for-height WHM Weight-for-height median WHO World Health Organisation WHZ Weight for Height Z score 4 TABLE OF CONTENTS ACKNOWLEDGEMENTS ........................................................................................................................... 2 ACRONYMS .............................................................................................................................................. 3 TABLE OF CONTENTS ............................................................................................................................... 4 1. INTRODUCTION ................................................................................................................................... 9 2. BACKGROUND ................................................................................................................................... 10 3. STEPS IN CONDUCTING NUTRITION SURVEYS ................................................................................... 11 3.1 Decide whether to conduct a survey ................................................................................................ 12 3.2 Define survey objectives ................................................................................................................. 12 3.3 Define geographic area and population groups ............................................................................... 13 3.4 Meet local leadership and authorities .............................................................................................. 13 3.5 Determine the timing of the survey ................................................................................................. 14 3.6 Gather population data and other data ............................................................................................. 14 3.7 Select the sampling method, determine sample size ....................................................................... 14 3.8 Decide which data to collect ............................................................................................................ 14 3.9 Prepare supplies and equipment ...................................................................................................... 15 3.10 Select and train survey teams ....................................................................................................... 15 3.11 Collect data and manage survey teams .......................................................................................... 16 3.12 Enter and clean data....................................................................................................................... 16 3.13 Analyze data and interpret results ................................................................................................ 17 3.14 Write and disseminate the report ................................................................................................... 17 4. SAMPLING ....................................................................................................................................... 18 4.1 Defining sampling ............................................................................................................................ 18 4.2 Selecting the sampling method ....................................................................................................... 18 4.3 Setting parameters for sample size calculation................................................................................ 20 4.4 Simple/systematic random sampling .............................................................................................. 24 4.5 Cluster sampling .............................................................................................................................. 26 4.6 Adjustment for small sample size .................................................................................................... 29 5. SURVEY FIELD PROCEDURES ............................................................................................................. 30 5.1 Bias .................................................................................................................................................. 30 5.2 Supervising data collection .............................................................................................................. 31 5 5.3 Special circumstances ...................................................................................................................... 31 6. SELECTION AND TRAINING OF TEAMS .............................................................................................. 33 6.1 Selection of survey teams ................................................................................................................ 33 6.2 Training of survey teams ................................................................................................................. 33 6.3 Roles and responsibilities of team members .................................................................................. 34 6.4 Standardisation test .......................................................................................................................... 36 7. DATA COLLECTION .................................................................................................................... 39 7.1 Anthropometry ................................................................................................................................ 39 7.2 Mortality .......................................................................................................................................... 45 7.3 Additional indicators ....................................................................................................................... 47 8. DATA ENTRY AND CLEANING ................................................................................................... 51 8.1 Data entry ........................................................................................................................................ 54 8.2 Plausibility check ............................................................................................................................. 54 9. DATA ANALYSIS AND INTERPRETATION .............................................................................. 57 9.1 Data analysis .................................................................................................................................... 57 9.2 Interpretation of results .................................................................................................................. 58 10. REPORT WRITING AND DISSEMINATION .............................................................................. 64 10.1 Preliminary Report ........................................................................................................................ 64 10.2 Final report .................................................................................................................................... 65 11. RAPID NUTRITION ASSESSMENTS .......................................................................................... 67 11.1 Decide whether to conduct a RNA ................................................................................................ 67 11.2 Define RNA objectives.................................................................................................................