A question of surveys

By Sara Wuehler, Senior Research Advisor

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The Food and Agriculture Organization of the United Nations just published a report for “moving forward” with methods of assessing the quality of women’s diets.

Women’s diets have an impact on their quality of life, and the quality of life of their offspring. Knowledge of just what is being consumed can help policy makers decide who needs nutrition programs and how those programs can be most effective at reducing and preventing malnutrition. However, dietary data can be difficult to collect and analyze.

The Micronutrient Initiative (MI) recently assisted Ethiopia, Kenya and Zimbabwe in completing national nutrition surveys to assess the diets of women and children. These surveys are rarely implemented at the national level in developing countries, so local governments invited MI to provide this assistance. These surveys were conducted in collaboration with local researchers to ensure transfer of technical expertise – one of MI’s goals to help build capacities wherever we work.

We must invest in generating data and in building local capacity to empower countries.

The following three examples demonstrate how dietary data is providing countries with the evidence they need to develop cost-effective programs that benefit both the entire population and also those who are most vulnerable to health and nutrition risks.

A question of fortification

Food fortification is used in many countries across the world to reduce the risk of anemia, improve one’s ability fight infection and prevent birth defects. However, these beneficial effects could be reversed or overshadowed by negative effects if micronutrients are added in levels that are too high.

With MI’s support, the Ethiopian Ministry of Health is using data from the 2011 Ethiopian National Food Consumption Survey (NFCS) to develop their national fortification strategy with confidence. Data from this survey are being used to identify potential foods to fortify, how many individuals consume those foods, and the appropriate level of fortification that will be necessary to maximize impact while avoiding potential risks.

A question of young children

Small children’s nutritional needs are different than those of adults, which is why the data from the Ethiopia’s NFCS are also being analyzed to assist the Ministry of Health to develop programs that reduce nutrient deficiencies in young children. These deficiencies can lead to poor development, inability to fight infection, stunted growth, and sometimes death.

Data from the NFCS are being used to identify foods that are available in households and where there are gaps in the nutrients that young children obtain from those foods. With these data, Ethiopian researchers are assisting their country to develop nutrition programs based on locally available foods for family whose resources are insufficient to fulfill needs.

A question of women

The World Health Organization recommends the provision of calcium supplements to pregnant women in areas with low calcium intakes.

Researchers have found that these supplements can reduce the risk of hypertension and pre-eclampsia, severe risks to the lives of women and newborns.

Data from the NFCS indicate that most women in Ethiopia consume very little calcium. However, some foods that are available during certain seasons are very high in calcium. Thus, researchers are using individual-level diets from women across Ethiopia to determine how to develop a program that provides calcium supplements to women during pregnancy while keeping total intakes in safe ranges during all seasons. With this evidence, the government will be able to adapt global recommendations for calcium supplementation to local contexts and thus safely reduce the risk of mortality and morbidity among pregnant women.

These projects are helping Ethiopia maximize the beneficial effects of their nutrition programs and through this, Ethiopia is setting the example for other countries in similar situations.

Surveys require a significant investment in time and resources, and sometimes require technical skills that are not yet available in countries. However, information from surveys can be extremely useful for decision makers and program implementers.

Progress in nutrition – specifically the new Sustainable Development Goals and the World Health Assembly targetswill be achieved as more countries become willing to invest, as is Ethiopia.

Wuehler Sara headshot

Sara Wuehler

Senior Technical Advisor, Nutrition Information Systems

Dr. Sara Wuehler, Senior Technical Advisor, Nutrition Information Systems, works with country-based collaborators in conceptualizing and designing surveillance activities to improve the effectiveness and relevance of Nutrition International-supported programs. Sara also focuses on building the capacity of individuals in each country to develop surveillance activities that identify program gaps and then use those data to promote improvements for effective programs. Sara has a PhD in Nutrition, with an emphasis in International Nutrition, and an MS in Food Science and Nutrition. She is a Registered Dietitian and a Lactation Consultant. Sara joined Nutrition International in 2011.