We told you in a recent blog post that we will be adding nutrition indicators to the existing data that we collect using our mobile modalities. We are thrilled to announce that this is finally happening!
Monitoring nutrition: why it’s important
Undernutrition is a huge global problem. Worldwide, 800 million people are calorie deficient and about two billion suffer from micronutrient malnutrition – not having the essential vitamins and minerals. Women and young children are at the greatest risk – nearly half of all deaths in children under five, or 3.1 million child deaths annually, are linked to undernutrition. Malnutrition in the first 1,000 days (from conception to child’s 2nd birthday) can cause irreversible damage to children’s brains and growth.
We have recently seen a lot of high-level political commitments to address undernutrition. However, one of the biggest challenges to turn the commitments into action has been the lack of timely data for effective programming. This is where our mVAM modalities could help: voice calls, SMS or IVR could be used to collect data for nutrition surveillance (especially in hard-to-reach areas). Potentially, mVAM tools could help provide real-time information to help manage nutrition programs. Over the coming months, we’ll try testing this approach.
Mobile data has worked for food security indicators. Will it work for children’s nutrition?
In the past, we have tested various mobile methodologies to demonstrate that it can be used to gather credible data on food security. In the last few years whilst expanding to 26 countries we’ve learnt that remote data collection is fast, cost-effective and the most efficient way to collect information, especially in hard-to-reach areas. The results of our experiments show that live voice calls and SMS are complementary and can be useful in different contexts. We are testing both how both mobile methodologies could collect data on nutrition indicators. In Southern Africa, we are going to be trying a nutrition survey using SMS and in Eastern Africa, we will be comparing the results on nutrition indicators from face-to-face and live phone call interviews.
The challenge of monitoring nutrition by mobile
To date, mVAM has collected information about household food consumption and coping strategies. This usually involves calling randomly selected people. We also call trusted key informants that tell us about food security in their community. Nutrition is different because we’re looking for information about women of reproductive age and children under five. Mothers of children of that age are also a relatively small group, and the challenge will be reaching such a small demographic and ensuring their participation.
How do you actually monitor nutrition?
You might be wondering how we go about monitoring nutritional status. Undernutrition results from a combination of immediate, underlying and basic determinants – diseases and inadequate dietary intake are the two immediate determinants of undernutrition, and food security is one the three underlying determinants of undernutrition. While there are many underlying causes of undernutrition, dietary quality is a very important determinant of nutritional adequacy; therefore our efforts will be focused on monitoring dietary quality of women and young children.
In the first phase, in line with the 1000 days initiative, we will be testing two internationally validated indicators. The first indicator we have decided to collect data on is Minimum Acceptable Diet (MAD) (MAD). This is one of the globally validated indicators to assess Infant and Young Child Feeding (IYCF). It collects information on both the minimum feeding frequency and the appropriate minimum dietary diversity for various age groups. The other indicator we are going to collect is the Minimum Dietary Diversity-Women (MDD-W) that collects information about whether or not women 15-49 years of age have consumed at least five out of ten defined food groups the previous day or night. This will allow us to assess the diversity of women’s diets, an important dimension of their diet quality. This information is crucial, not just because inadequate dietary intake is an immediate cause of undernutrition, but also because dietary diversity is correlated with many other aspects of food insecurity. Eventually, we will also explore using other indicators of maternal and child undernutrition, as well as other mobile methodologies.
We’re aware that others have tested mobile to collect nutrition data (see an interesting paper in the mHealth series about testing SMS for IYCF indicators in China, published in 2013). We look forward to building on these lessons. We are very excited to collaborate with our internal and external partners to test the indicators. Stay tuned to know more about how we are bringing an innovation in nutrition and food security monitoring!