Surveillance
Food Security Pre Departure Training
22 mars 2016
Surveillance : Objectives and Principles
 Surveillance systems can have various differences in
their objectives and designs, but they share a common
function of :
“monitoring and analyzing the food security situation
(and nutritional status) of the population/targeted
areas, and sharing findings/recommendations in order
to enable decision makers to define adequate food
security strategies and have timely responses”(ACFIN,
2005).
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Surveillance : Objectives and Principles
 Use the nutritional causal analysis as its analytical framework.
 Be actively transversal, taking into account the different
nutrition, water and sanitation, food security and health
components.
 Be based on a comprehensive reference (or preliminary) analysis
of the food security situation.
 Be based on a set of indicators, defined from the reference
analysis, for information collection and analysis.
 Use several levels and sources of information and analysis
(households, communities, regional, primary and secondary
information).
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Surveillance : Objectives and Principles
 Be as objective as possible and always triangulate information
(through other sources and local contacts such as INGO, LNGO,
authorities, key contacts on the field etc).
 Be designed as a tool for internal and external communication with
minimal time delays between collection and distribution of
information.
 Fall within the mandate of ACFIN.
 Be seen in all its stages to answer the what, why, when, where, who
and how of a given and changing situation.
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Considerations Prior to Setting up a
Surveillance System:
 Is there a lack of information regarding the food security
situation and changes in this at a country/regional/local level,
within ACFIN or with other actors?
 Is the context evolving? Is the environment insecure?
 Is there a risk of degradation of the food security situation of the
population in a given area? What is the expected time scale of
this degradation?
 Is food security directly related to climatic conditions (expected
rains fail and thus may impact heavily on food insecurity)?
 Are there normal seasonal changes in the food security situation?
 Is there a lack of precise information concerning the evolution of
the food security situation? Is enough information available to
make timely decisions according to the evolution of the
situation?
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Considerations Prior to Setting up a
Surveillance System:
 Is there a need to understand and follow changes especially
increases in admissions in nutrition feeding centers?
 Is there a demand for information that cannot be addressed
either internally or externally?
 Who will use the information?
 How will the information be used?
 Have interventions continued when no longer pertinent because
there was not enough information available to make informed
decisions regarding changes?
 Responses to the above questions need to be analyzed and
where there is a risk of degradation of a food security situation
and very little regular or formalized information exists, it could
be appropriate to set up a surveillance system.
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Surveillance : Methodologies
 There are two main methodologies employed in surveillance systems
operating within the ACFIN network :
• One uses as its basis sentinel sites with information collected from
these sites on a regular basis. This tends to be used in reasonably
stable situations (Malawi, Philippines) or where there are cyclical
crises with accompanying high risks of malnutrition (Mali/Niger).
Using this methodology, we will have a series of data monitoring
the development of food security over time.
• The other is based on a more ad hoc methodology and is
implemented when the situation changes rapidly in time and space,
which often corresponds to emergency and unstable situations
(Somalia, Sudan). It can include rapid assessments, thematic
assessments (refugee/displaced camps, food aid) as well as regular
information collection such as market surveys. It does not focus on
tracking the changes in one area, but rather responds to alerts and
is thus more specific to one population group at one given time.
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Surveillance : Sentinel sites Methodologies
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Sentinel sites (which can be villages, communities, urban blocks, etc.) are
fixed at the outset in the area of surveillance according to the initial zoning
of the area and representative families are selected according to the
household typology established in the preliminary information collection.
The sentinel site must be representative of the relatively homogeneous
zone in which it is situated.
These sentinel sites are tracked over time to monitor the evolution of the
situation. The same (closed, direct and fixed) questionnaire is delivered
on a regular basis (often monthly or seasonally) to the same households or
to another household in the same typology grouping in the sentinel site;
From the initiation of the sentinel sites, the questionnaire and methodology
must be validated by pilot tests. As the objective is to track changes in the
situation, only minimal modifications should be made in the design and
information collection and therefore must be as accurate as possible from
the outset.
This methodology is usually implemented in coordination with other
organizations or government systems, thus there is a greater centralization
and sharing of information.
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Surveillance : Ad-Hoc Methodologies
 This is usually based on thematic issues relevant to the particular
context and time in which the system is operating. The themes can
be adapted to contextual or situational changes and can be
increased or reduced within the capacities of the surveillance team.
It can be highly reactive to new situations and can launch an
assessment very rapidly after an alert. The assessment may last only
a few hours but gives invaluable information for planners.
 Such systems rely heavily on qualitative information collected
through semi-structured questionnaires or guidelines delivered to
key informants and focus groups as well as individual households.
They are particularly relevant when the situation changes in time
and space and where populations are likely to move (such as in
emergencies). Ad hoc surveillance systems can be transversal in
nature and easily adapted to each situation. Generally the ad hoc
systems are implemented by only one organization; however
sometimes joint collaboration assessments can be managed with
other agencies for one-off assessments or for information sharing
and advocacy.
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Attributes of the different surveillance
methodologies
Sentinel sites : Positive attributes
 The interviewer and the household develop a
relationship of confidence.
 The interviewer can detect false information.
 The area covered can be increased.
 It’s easier for the team to establish a routine.
 Once the system is set up it does not change.
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Attributes of the different surveillance
methodologies
Sentinel sites : Negative attributes
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Sample sizes are not sufficiently representative.
The same household every time results in:
(i) errors in the preliminary information will be followed through in the
questionnaire, without being picked up;
(ii) fatigue of the interviewees
resulting in aberrant data which limits the validity of the information
(iii) personal security of the interviewers (aggression from
interviewees/communities who are fed up of teams visiting them and giving
nothing in return)
(iv) household cannot be expected to be available every time
(v) people are used to the questionnaire – could lead to lack of interest but also
inaccurate information
The proportion of households per province is different.
No adaptation of the questionnaire for provincial/area contextual differences.
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Attributes of the different surveillance
methodologies
Ad-Hoc : Positive attributes
 Wide range of information, because of no limit to questionnaire
(questionnaires are designed for the specific situation).
The flexibility of the system:
 (i) one can delete or include information as necessary;
 (ii) areas of operation can be changed;
 (iii) villages and households will not have repeated visits;
 (iv) there is no bottom or top limit on the number of households
to get valid information;
 (v) absent staff or unfilled positions does not affect the system –
the system can adapt to the constraints
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Attributes of the different surveillance
methodologies
Ad-Hoc : Negative attributes
 Limited time – to complete all the interviews.
 Analysis of the findings is long and complex with a large aspect
of subjectivity due to the qualitative nature of the information.
 Planning is difficult as the system needs to be reactive (cars,
staff, time, questionnaire, objectives...).
 Staff training is long:
 (i) needs to be continuous
 (ii) the questionnaire needs adapting to contextual changes
 Interviewee fatigue.
 Difficult to compare one situation/time period with another.
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Indicators:
 As highlighted in the principles, all surveillance systems are
based on a set of indicators for information collection and
analysis. The indicators are set up after the reference
information has been collected and analyzed and are based on
the key issues which can lead to food insecurity in the particular
context under study.
 The indicators can be static or dynamic and give contextual
information or information linked more directly to programs.
They should include transversal information relevant to the
other technical departments and actors. The same indicator
when used in different contexts could be static or dynamic.
Population figures is such an indicator where in a stable zone of
intervention this remains fairly static or in an unstable zone
where it is dynamic and can be considered as a key indicator of
negative change in the humanitarian situation of a given
population.
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Indicators
Contextual Information
Programme-related information
Static
Information collected
Indicator once and updated when
necessary (number and
location of markets,
water points, etc.)
Information collected once and
updated when necessary (profile
of beneficiaries, typology of the
population, food habits, etc.)
Dynamic Information allowing the
Indicator detection of changes in
the context (population
movements, security
issues, etc.)
Information that is specific to
each program and liable to
change (harvest quantities, food
aid received, number of
nutritional feeding center
beneficiaries, etc.)
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Main Indicators identified by ACF-IN
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Heading
Indicator
General Issues
Security
Movements (population, animals)
Water, Sanitation and Hygiene
Nutrition and Health
Trade and Markets
General points
Financial Issues
Sources of Income
Expenditure
Credit/loan
Food Issues
Source of Food
Diet (quantity and quality)
Household Food Stocks
Agricultural Issues
Agricultural Production
Access to and use of land
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Indicators
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As the indicators are based on reference (preliminary) information, they are
not fixed in stone. They are selected according to the context and should
not be too ambitious. Each context may require more or less indicators in
order to be relevant and may not include all of the above. There will always
be some indispensable indicators which may also change over time as a
result of contextual changes, or which may change in terms of regularity of
the information collection.
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Whatever the indicator, it must be simple, reproducible, measurable,
specific and comparable. It can be based on qualitative or quantitative
information and must allow for analysis to determine whether a situation is
changing (for the better or for worse) and what impact this change is likely
to have on the population in the zones under study.
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The definition of the indicators rests on the reference information
collected; subsequent follow-up of these indicators is thus completely
related to the analysis of this reference information. The importance of
good quality reference information cannot be emphasized enough in order
to have as accurate an analysis as possible of changes in the food security
situation of the population.
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Detailed Macro Indicators
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Static
- administrative information: number, name, and situation of the administrative
‘sub-entities’ (district, village)
- demographic and socio-cultural information (numbers)
- compilation of sanitary information (health centers, hospitals…)
- compilation of economic information (cities, economic poles, non-agricultural
natural resources, transport networks, markets, flow of merchandise…)
- agro-ecological information: relief, climate, soils & types of vegetation,
principle crops (%), agricultural returns…
- security information
- humanitarian information (cover by programs of ACFIN and other agencies)
Dynamic
- demographic information (population movements)
- agro-ecological information (rain fall…)
- security events
- evolution of market prices
- household food basket
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Detailed Meso and Micro Indicators
At the village (or camp) level:
 administrative characteristics (province, commune, section, etc.)
 number (proportion) of residents/displaced/refugee etc.(demographic
characteristics)
 zone (in reference to the initial division)
 existence of a health center (type = clinic, hospital, health center, patient
population radius, number people, maximum commute, etc.)
 existence of a market (type, size, client population radius, commute, etc.)
 access to water: structures such as wells, pumps, networks, etc. (according
to the water quality, number of water points / habitants, etc.)
 level of destruction of village (estimated in total percentage, or in number
of houses…)
 majority religion / ethnicities …
 Static or dynamic depending on the context:
 total number of inhabitants
 number of households
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Detailed Meso and Micro Indicators
At the household level
 Dynamic composition
 implementation of coping mechanisms (ex: sale of certain goods) /
or by contrast, re-capitalization
 follow-up of food consumption
 food resources
 expenses/revenues
 agricultural activities: harvests, availability of seeds…
 exterior assistance
 health-related information
 main sources of food (for different household types)
 main sources of income (for different household types)
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Surveillance Team Training
 Training is vital to ensure the best quality of output from the
team but it also helps enormously in maintaining motivation
levels. De-motivation has often been seen in surveillance teams
for many different reasons: lack of involvement in setting
objectives, designing the questionnaire, analyzing the
information, reporting and knowing what happens as a result of
the data collection.
 It remains paradoxical that in most cases surveillance personnel
are extremely dedicated to their work but pass through periods
when motivation is reduced. It is important that the surveillance
teams sees the tangible results of their work and understands
the impact that this work has on the population.
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Data Analysis
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The analytical system in place must allow us to follow the food
security situation with ease. The analysis must stay within the
framework of the nutritional causal analysis upon which the whole
system is based and must indicate:
if a situation has generally improved, deteriorated or remained
stable
for whom the situation has changed
where and when this change has taken place
what new/continuing needs should be addressed
for how long the new situation is predicted to continue
Data analysis is undertaken in 2 main ways:
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use of software packages (Sphynx preferably or Excel)
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team de-briefings or analytical workshops
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Dissemination of Surveillance Results
Supports
Methods of Diffusion
Written bulletin
Mail, e-mail, web page, media, hard copy
Reports
Hard copy, e-mail, web page
Posters
Meetings, workshops
Summarized article
Media, web, e-mail
Oral presentation
Meetings, workshops Media
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Regularity for the Diffusion of Surveillance
Results
Context
Regularity
Acute humanitarian crisis,
conflicts, unpredictable and
cyclical natural disasters.
At least monthly, Ad hoc report if
necessary
(A quarterly summary update may
be produced but it will have been
punctuated with more regular
reports)
Post-emergency and
rehabilitation programs, stable
situations, cyclical natural
disasters...
Monthly, quarterly, seasonal
reports
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Potential Users of Information
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ACFIN
International NGO’s
National/Local NGO’s
UN agencies
Government/Line Ministries
Community (translation may be needed)
Donors
International Bodies
Universities and research institutions
Media, public
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Follow-up of information disseminated
 It is often not enough just to give someone a report and hope
that the person reads and then acts on it. A follow-up meeting or
phone call can be a very effective way to ensure that your
information has been read and taken into account. Other
advantages are:
 Measure the reach and the impact of our system
 Receive feed back (constructive criticism)
 Validation of dissemination tools
 Measure the level of understanding by the users
 Follow-up can therefore be done through:
 Questionnaires
 Formal and informal meetings
 Phone conversations
 Follow-up of stakeholders interventions
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Summary of Surveillance
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Surveillance systems monitor and analyze the food security situation (and nutritional status)
of the population/targeted areas, and share the findings/recommendations in order to
enable decision makers to define adequate food security strategies and have timely
responses.
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The needs, methodology, uses of the information and capacities of the teams must all be
carefully considered when developing a surveillance system.
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The two types of surveillance systems can be classified as sentinel site and ad hoc systems;
each with specific characteristics adapted to the given contexts.
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Surveillance systems should be transversal in nature and should constantly refer to the
nutrition causal analysis.
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The definition and identification of indicators is the base for monitoring the evolution of the
situation. The indicators can be static or dynamic in nature, depending upon the specific
context and should consider the macro, meso and micro characteristics.
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Data analysis is the often the limiting factor in many programs; however the timeliness and
degree of analysis are the key factors for ensuring results from the surveillance systems.
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Many surveillance programs are faced with a variety of problems that can affect the quality
and impact of the program. These problems should be considered from the initial stages in
order to reduce the potential risks.
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