UNICEF NYHQ
National Nutrition
Information Systems
October 2013
1
Background
Why are experiences of national nutrition information
systems important for community-based SAM treatment?
•
Programming trends
•
•
•
•
•
to expand SAM management in-country
to integrate SAM management into national/govt systems
to link SAM management to preventative action (& stunting agenda)
Programme trends mirrored in information
So we need to:
1.
2.
Understand how SAM data from a wide range of sources comes together
at national level
See SAM information within broader efforts around nutrition information
collection /analysis/usage
Elements of national nutrition information system
Situation & Early Warning
GAM/SAM
Surveillance
IYCF status
Micronutrient
Nutrition
Information
Needs
Source
Routine information e.g.:
- SAM Admissions
- IYCF counselling
- MN distribution
(National & Sub-National Level)
(National / Sub-National Level)
Geographical Coverage
Food security
Health situation
Sanitation and hygiene
(National & Sub-National Level)
(National & Sub-National Level)
(Sub-National Level)
Country profile (pop. data;
risks; DRR etc.)
Method
Delivery
Supply Availability
Annual Budgets for
Nutrition interventions
(National Level)
Performance
SAM performance
indicators
IYCF + MN KAP
trends
(National & Sub-National
Level)
Intervention
Coverage
(National & Sub-National
Level)
Surveys (MICS, SMART, etc.)
Routine data etc.
Routine data; coverage
surveys; KAP studies
FEWS-NET; VAM
UNICEF Country Reports
Coverage Monitoring Network
MoH Surveys (National)
NGO Reports
UNICEF Country Reports
NGO Surveys (Sub-National)
Generic example: nutrition information / reporting system
Situational /
Impact
- Survey
- Survey
- Survey
Programme
performance
Programme delivery
Vertical
programme
Vertical
programme
Vertical
programme
CMAM
programme
- Coverage
surveys
- KAP studies/
surveys
- Surveillance
District /
Province /
National
HMIS
Govt/UN
/NGOs
District /
Province /
National
District /
Province /
National
HMIS
MoH
District /
Province /
National
Govt/UN
/NGOs
Country SAM reporting systems
As of 2012, 51 COs (of 62 reporting) have CMAM/SAM
reporting system*
Report source
20
17
Manager of system
34
15
15
11
8
10
5
0
District
health office
Health
Facilities
Implementing Regional
partners
health office
35
30
25
20
15
10
5
0
16
1
Govt run
UNICEF run
(Pakistan)
UNICEF/Govt run
• Information comes together at national level differently across countries
• Govt + UNICEF play a significant role in bringing together SAM info at national
level
* UNICEF Global SAM Management Update 2012
Country examples
1.
Pakistan: how CMAM output data(+) comes
together at national level
2.
Viet Nam: challenges of bringing together
nutrition information reporting streams
Pakistan: Nutrition programming context
• UNICEF continues to be a major supporter of nutrition
programming, particularly for CMAM.
• Main programme interventions:
• CMAM (MUAC screening; OTPs; SFPs),
• Micronutrient supplementation
• IYCF messaging
• Changing programming landscape in Pakistan:
• Increased government ownership of nutrition programming (inc. CMAM)
• Increased non-UNICEF supported NGO activity (e.g. NGO consortia in Sindh)
• Increased programming focus shift from emergency to development (from
CMAM to IYCF/MN.
Pakistan national nutrition information system
Component
What
Who
Situational /
EWS
• National and localized
nutrition surveys (MICS; FANS
(2010/2011); NNS (2011)
• DEWS
• Nutrition / health
situation indicators
• Disease/health info
• Govt
• WHO
Delivery
• DHIS
• National Programme
Reporting
• NIS database
• MRP
• WFP supply system
• MNCH / NP indicators
• SAM/MAM
admissions by site
• IYCF counseling;
• MN distribution;
• Supply
•
•
•
•
Govt
UNICEF
ECHO
WFP
Performance • National Programme
Reporting
• NIS database
• MRP
• WFP supply system
• IYCF/MN/MNCH
• SAM/MAM PIs; LoS +
AWG
• Stocks
•
•
•
•
Govt
UNICEF;
ECHO
WFP
NIS information flow (KP/FATA)
UNICEF
Reporting flow (KP/FATA)
NIS system
NIS key findings: challenges
Macro level
• Standardization issues (2 provinces use; MRP)
• Utilization and reporting flow issues (analysis; usage)
• Sustainability issues (resource heavy)
Technical
• Content gaps
• Quality issues
• IT technical issues
Viet Nam: Nutrition programming context
• Government-led nutrition programming
• Development focus on stunting:
• National Targeted Programmes – (Nutrition [PEMC]
and Maternal & Child Health (IYCF; MN)
• NGO programmes (IYCF ‘franchise’)
• Introduction of IMAM pilot
• (Government-led / UNICEF-supported)
Current Nutrition Data Flow
Village
VHW collects individual data and
compiles monthly summary
PEMC (IYCF & Vit
A); MCH;
monthly
Commune
Monthly meeting at commune: Commune
Nutrition Focal Point (or commune head) compiles
data monthly in hard copy (inc IMAM)
25th each
month
PEMC (IYCF & Vit A); MCH
monthly
IMAM; & general report
monthly
District HC
/Hospital
Monthly meeting: District Nutrition FP
collects specific programme reports
Monthly meeting: District planning FP
collects general and specific programme
reports
30th each
month
Current Nutrition Data Flow (cont.)
District Nutrition FP compiles
programme reports monthly; sends
either monthly / quarterly summary to
province via letter & email
District HC
/Hospital
5th of
month
PEMC (Vit A)
quarterly
District planning FP compiles general
report (& IMAM) monthly; sends either
monthly / quarterly summary to province
via letter & email
PEMC (IYCF); Quarterly
IMAM lines
Complexity
of reporting
MCH: Monthly
General reports
Monthly/quarterly
IMAM (inpatient)
IMAM
(inpatient)
Provincial
Hospital
Curative & IMAM
Curative data
data
IMAM
(inpatient)
Province
Preventive Health Centre
receives; data and compiles
Reproductive Health Centre
(Nutrition FP) receives data and
compiles
Health Service
Department/Planning
receives data and compiles
Current Nutrition Data Flow (cont.)
Province
Annual
Nutrition survey
data
PHC compiles and
sends via email &
letter
PEMC (Vit A)
quarterly
HSD/Planning
compiles and sends via
email & letter
RHC Nut FP compiles and sends
via email & letter
PEMC (IYCF );
MCH:
Quarterly
Monthly
Complexity of reporting lines continues
National
NIN (NSS)
NIN (PEMC)
Regional
institution
MCH
MoH
Obstetrics
hospital south
General reports
Monthly/quarterly
MoH (Cabinet
Office)
Other experiences of national systems
• Data generation
•
•
•
•
Advances in coherence, quality, standardization & technology
But: Quality / credibility; politics; timeliness (surveys & routine systems)
Coherence (different reporting lines / staff / frequencies / indicators etc.)
Resources & capacity (technology; info collection)
• Data analysis
• Sudan Darfur Update; Pakistan Cluster Update;
• FSNAU; WCARO DevInfo & monthly report
• But: Need for clarity of roles for analysis; capacity; breadth of analysis
• Data utilization
• For advocacy and fundraising (Ethiopia & Sudan); programme adaptation
(Kenya MYRs
adjusted targets, strategy, funding needs etc.)
• But: Translation to programme adaptation; politics; level of info needed for
programme staff
Implications / Next steps
A. For bringing CMAM reporting together at country level:
1.
2.
3.
Advocate for government ownership at national level & build capacity
Standardization of indicators/ & forms; develop tools & technology; clarify
reporting lines
Strengthen analysis & utilization of data
B. For linking CMAM with other nutrition/multi-sector reporting:
1.
2.
3.
4.
Advocate for Government buy-in & ownership
Map, assess and harmonize / streamline
Strengthen integrated data analysis
Data utilization
Thank you
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