Nutrition Information System in Sudan

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Nutrition Information System in Sudan

• Dr. Kazuko Yoshizawa
• Nutrition Advisor for S/FMOH, WHO Sudan
• Ms. Durria Mohamed Osman
• Information, Documentation and Research
• PHC, FMOH

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Objective

•  
• To give situation analysis
• To explore possible networking with different
  sections of WHO, MOH and other UN agencies for
  revitalization and strengthening of the
  government nutrition and food security and the
  response mechanism.

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Background

• Nutrition and food security information system
  (surveys and surveillance) and the response
  mechanism used to exist, which were lead by the
  government but not functioning now.
• UNICEF, WFP, FAO and NGOs are conducting surveys
  and surveillance covering different regions of
  the country and collecting information for the
  programme, mostly for acute malnutrition.

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Contd.

• Prevalence of chronic malnutrition in children
  under 5 is 43 and acute malnutrition is16 for
  North Sudan while they were 45 and 21
  respectively among the same age group for
  Southern Sudan (MICS 2000, personal contact with
  FMOH).
• Prevalence of micronutrient deficiency diseases
  are high (iodine, VA, iron/folic acid)

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UNICEF 2003secondary source
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Malnutrition is multi-factorial.

• Malnutrition is recognized as an underlying cause
  to explain almost 60 of death in
• The three major causes of death in diarrhoea and malaria.
• Malnutrition is an outcome of socio-economic
  development

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HNP-related MDG indicators, Sudan(Sudan Health
Report, 2003, World Bank)
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Malnutrition Indicators

• Global Malnutrition
• Moderate Malnutrition 70 79.9 WFH
• Severe Malnutrition
• 
  

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The 4th MDG is to reduce two-thirds between 1990 and 2015(Sudan Health
Status 2003)
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Measuring Socio-Economic Disparities in Health
(Sudan Health Status
2003)
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Early Warning System for Darfur by WHO/FMOH

• Weekly
• Communicable diseases
• Cases of malnutrition
• Weight for Height
• Information is disseminated to the partners in
  and out of Sudan.
• Response mechanism

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Contd.

• Most of SM cases reported from several camps
• South Darfur Kalma (14.1), Ottash (3.9),
  Geredha (5.4), Mersheng (4.7) and
• Wehida (6.5)
• North Darfur Abu Shoak (10.9) and
• Zamzam (2.5)
• West Darfur Morni (3.2) and Zalling (2.2)

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Malnutrition under 5
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Malnutrition over 5
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Five Year Trend
World Vision presented in WDC 2002
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Surveys in Sudan

• 1986-87 Sudan Emergency, Recovery Information
  Surveillance System (SERISS) A national survey
  by NND and Health Statistics Department, MOF.
• Pop. regions, funded by USAID
• Data collection over a period of a whole year
• Has served as the baseline data for future
  surveys to be compared with.
• 1990 - Quarterly nutrition monitoring survey at
  the national level in order to bridge the food
  gap which was then going on in Kordofan, Darfur,
  Eastern and parts of Central zones.

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Contd.

• 1992 A community based nut surveillance for early
  earning purpose was introduced. Objective the
  timely and appropriate intervention To meet this
  objective, data analysis at the provincial level.
  Monitoring of nutritional status of children and
  mothers. The programme was expanding is expanded
  at the health area. Functioning in Kassala,
  Sennar and N. Kordofan
• Micronutrient prevalence survey (IDD, VAD, IDA)
  are conducted in some parts of the country.
  Questions were added to the quarterly monitoring
  surveys to cover micronutrient deficiencies as
  well.

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Contd.

• 1989-90 Demographic Survey
• 1999 Safety Motherhood Survey
• 2000 Multiple Indicator Cluster Survey

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Response

• In response to the drought of 1983, 1984 and
  1985, the government established a Relief and
  Rehabilitation Commission (RRC) for policies,
  plans and programme to rehabilitate the affected
  areas by coordinating national and international
  efforts.

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Cont.

• EWU was set up within the RRC.
• Food Security Unit was set up in MOAP.
• Khartoum MOH set up an emergency preparedness
  unit for natural and man-made disasters to info
  collection and to response within the health
  sector.
• Experiences 2005 in WHO/MOH night blindness in
  WN, goiter for treatment in SD, no buffer stock
  of supplement of lipidol

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Health/nutrition indicators to facilitate
coordination

• The status of the population and the
  effectiveness of relief (e.g. death rates x
  10,000, trends)
• Reasons for alert (e.g. signs of epidemics)
• Difference between crisis and normal seasonal
  variations ( e.g. epidemiological curve)
• Security (e.g. No. of intentional injuries)
• Quality of water
• Water, sanitation, availability of soap and
  buckets (e.g. No. of cases of diarrhea)
• Food security (e.g. No. of cases of acute
  malnutrition)
• Nutritional value of food aid
• Health care (e.g. closest functioning health
  facility, availability of drugs)
• Logistic and communications (e.g. state of cold
  chain)

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Cont.

• You must monitor support activities, too
• How is the health information system working ?
• How often are coordination meetings held ?
• Is training being organized ? Is it attended ?
• Are new projects being prepared ? Funded ?
• You need denominators get figures or estimates
  on the No. of population and breakdown
• Review the Case Definitions with the partners,
  not only for diseases e.g. who is the affected
  population ?
• http//www.who.int/disasters

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Chronic/Noncommunicable Disease (CD)

• The rapid rise of chronic, noncommunicable
  diseases represents one of the major health
  challenges to global development.
• Chronic diseases currently account for some 60
  of global deaths and almost one third of the
  global burden of disease.
• The principle CD stroke, cancer, diabetes and
  chronic respiratory diseases.

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WHO "Stop the global epidemic of chronic disease"

• A new report forecasts that deaths from chronic
  diseases in the Western Pacific Region will
  increase by 20 over the next 10 years
• Manila Determined global action to prevent
  chronic disease could save the lives of 36
  million people who would otherwise die by 2015.
• Chronic diseases are by far the leading cause of
  death in the world and their impact is steadily
  growing.

http//www.wpro.who.int/media_centre/press_release
s/pr_20051005.htm
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Bagchi 2005 in Cairo
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Bagchi 2005 in Cairo
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Summary

• PEM and micronutrient deficiency disorders are
  significant public health problems acute and
  chronic
• Some of the diet related non-communicable
  diseases might be emerging soon among some
  population (urban).
• There was no nutrition information system and the
  response mechanism lead by the government.

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Recommendation

• Revitalization and strengthening of the currently
  and previously existing system by the government.

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Areas to cover for nutrition information system
in Sudan

• Malnutrition and food security
• Communicable disease
• Non-communicable disease
• Food safety and environment
• Socio-economic factors

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Potential Opportunities

• For Nutrition Information
• Liaise with Sections of Epidemiology, EWRS,
  Statistics, Planning, GIS, IEC of WHO/MOH
• Liaise with/set up HIS
• Scaling up of the currently existing system in
  other states
• Liaise with UN agencies and NGOs (Nut
  Coordination Meeting Darfur and non-Darfur)

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Contd.

• For Response mechanism
• Revitalization of previously existed a Relief and
  Rehabilitation Commission
• Rationale resources, know-how and baseline
  database are available
• Needs vision, appropriate technology and
  capacity building