Training Course on Assessment of Nutritional Status (18 Dec - 22 Dec 2011)
The course, held in FPMU from 18 to 22 December 2011, provides an overview of the common nutrition assessment tools and their relevance to decision making. Field and laboratory methods for nutritional deficiency assessment, nutritional screening and surveillance, dietary assessment as well as dietary diversity and food group indices are discussed. Clinical methods including body composition, biochemical and clinical factors related to macro and micronutrient deficiencies are presented. Issues related to the validity and reliability of these methods are addressed in the context of the strengths and limitations of each method. By the end of the course, the participants should have some familiarity with the common nutritional assessment methods as well as their practical applications at the individual and population wide levels. The course was coordinated by Dr. Lalita Bhattacharjee, Nutritionist, NFPCSP-FAO and Dr. Md. Abdul Mannan, National Nutrition Advisor, NFPCSP-FAO.
Click on each Topic title to download the PowerPoint presentation or click here to download the .zip file containing all the presentations.
Module 1: Nutritional status, definition and understanding of the food and nutrition situation and Scaling up nutrition interventions
Lecture 1: The food and nutrition situation in Bangladesh
- Who suffers most, when and where?
- Definition of malnutrition - under nutrition and overnutrition
- Burden of malnutrition : human and economic costs
- Costs of micronutrient malnutrition – Iron, VAD and IDD
- Intergenerational cycle of malnutrition : Nutritional deficiencies in the life cycle and accumulated risks
- Causal framework of malnutrition
- Need to assess the extent of the problem
Resource person:
Dr Tahmeed Ahmed, ICDDR’B
Lecture 2a: Areas of interventions in National Nutrition Services (NNS)
- Scaling up proven direct and Indirect nutrition interventions
Resource person:
Dr Mustafiz Rahman, PPC, MoHFW
Lecture 2b: Areas of interventions in National Food Policy Plan of Action (NFP PoA) and Nutrition Programmes in Country Investment Plan (CIP)
- Potential benefits and expected outcomes
Resource person:
Dr M Abdul Mannan, NFPCSP-FAO
Module 2: Anthropometric assessment
Lecture 3: Introduction to key indicators, including their interpretation and use for decision making:
- Assessment of growth and childhood anthropometry,
- Growth monitoring charts, how to use and interpret growth monitoring charts;
- WHO Classification for assessing severity of malnutrition 0 -59 months,
- Z scores, underweight, stunting and wasting,
- Anthropometric indicators in school age and adolescence;
- Community based management of acute malnutrition
- Reference cut off values
- Interpretations and implications on action;
- Advantages and limitations of nutritional anthropometry
Resource person:
Dr Golam Mothabbir, Save the Children
Lecture 4: Introduction to key indicators, including their interpretation and use for decision making:
- Adult anthropometry and body composition,
- Body mass index measurements and nutritional status;
- Chronic energy deficiency, Overweight and obesity;
- Skin fold thickness, Hip/waist ratio
- Weight gain, monitoring and assessment during pregnancy
- Reference cut off values
- Anthropometric assessment of adults and elderly
- Interpretation and implications on action
Resource person:
Dr Dewan S Alam, ICDDR’B
Practical Exercise 1: Exercises on nutritional indicators for needs assessment
- Collating nutritional data/information from different population based sources
- Review of evidence from different sources and identify discrepancies if any
- Comparison of indicators across different age/sex groups
- Discussion on use in project implementation and monitoring
Resource person:
Dr Firdousi Naher, IFPRI
Dr M Abdul Mannan, NFPCSP-FAO
Module 3: Biochemical and Clinical Assessment
Lecture 5: Introduction to key indicators, including their relevance to different contexts interpretation and use for decision making:
- Iron deficiency anemia (IDA) : Hemoglobin and hematocrit levels in blood, serum transferring saturation and ferritin levels; vulnerable groups, cut off values; indicators of risk: prevalence of parasitic infections (hook worms, schistosomiasis and malaria)
Resource person:
Dr Tahmeed Ahmed, ICDDR’B
Lecture 6: Introduction to key indicators, including their relevance to different contexts interpretation and use for decision making:
- Biochemical and Clinical indices to assess nutritional status and response to nutritional interventions
- Vitamin A deficiency (VAD) : Clinical signs of VAD, serum retinol estimation, retinol levels in breast milk and under five mortality rate,
- Indicators of risk, absence of breast feeding among young infants , (% children no longer breast fed), prevalence of parasitic infections and diarrhea in preschool children during the last 15 days
- Iodine deficiency disorders (IDD): Total goiter rate, cut off values, urinary iodine levels (UIL), target populations (school age children), cut off values, median urinary iodine, Water, soil and salt iodine content
Resource person:
Dr Zeba Mahmud, MI
Practical Exercise 2: Visit to Paediatric and Antenatal Care wards in ICDDR,B
Resource person:
Dr Tahmeed Ahmed, ICDDR’B
Module 4: Dietary Assessment
Lecture 7a: Introduction to key indicators, including their relevance to different contexts interpretation and use for decision making:
- Determinants of food intake and nutritional status
- Methods of dietary assessment :National and household data
- Assessment of individual food and nutrient intakes and nutrient adequacy
- Food frequency questionnaires (FFQ)
- Rapid methods of dietary assessment, key informant interviews, focus group discussions
- Simplified assessment of specific nutrients (micronutrients)
- Recommended nutrient intakes and evaluating nutrient intakes
Resource person:
Dr Lalita Bhattacharjee, NFPCSP –FAO
Lecture 7b: Conversion of food intakes to nutrients
- Calculating nutrient values of recipes from ingredient data
- Testing iodine content of salt : Kit and Home based methods
Resource person:
Dr Nazma Shaheen, INFS, DU
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Ms Cadi Parveen Banu, INFS, DU
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Lecture 8: Introduction to key indicators, including their relevance to different contexts interpretation and use for decision making:
- Dietary diversity, its measurement and interpretation
- Analyzing dietary diversity data
- Dietary diversity and food consumption score (household, women and young children)
Resource person:
Ms Nusha Chowdhury, WFP
Practical exercise 3: Food security and nutrition surveillance
- Use of dietary diversity data at food security and nutritional surveillance.
Resource person:
Ms Jilian Waid, HKI
Post Test
Resource person:
Dr Lalita Bhattacharjee, NFPCSP-FAO
Dr M Abdul Mannan, NFPCSP-FAO
Module 5: Nutritional assessment in policy and programmatic application
Lecture 9: Linking dietary intakes with nutritional assessment
- Selecting most appropriate methods for nutritional assessment
- Illustration of association between dietary adequacy and anthropometry
- Interpreting nutritional status information and response to food security and nutrition interventions
Resource person:
Dr Tina Sanghvi, A&T
Lecture 10: Comparative analysis and applications of nutritional assessment
- Multi sectoral issues in nutritional assessment with examples from the Multiple Indicators Cluster Survey
- Multi sectoral issues in nutritional assessment with examples from Health Sector
Resource person:
Dr Dipankar Roy, MICS,BBS,Ministry of Planning.
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