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Summary Table 1: Nutrition Situation in Emergency Sites

Theoretical Background on the Use of Nutritional Status of Children Under Five

Physical growth in childhood is a proxy indicator of the nutritional well being of a population. Typically, weight and height are measured and compared with the average values for the international reference population of well-nourished North American children (the National Center for Health Statistics (NCHS) population). Deviations from the reference population are usually expressed either as standard deviations (also called Z scores) from the reference median, or as a percentage of the reference median. Classification according to Z-scores is recommended by WHO as the more statistically valid method. It should be noted that the Z score and percent of median methods are not statistically equivalent, and therefore results obtained using the different methods are not comparable. Acute malnutrition is defined as weight/height <-2Z scores and/or the presence of oedema. Severe acute malnutrition is defined as weight/height <-3Z scores and/or oedema.

Selection of the nutrition data

Nutrition data were taken from surveys, which used a probabilistic sampling methodology, complying with internationally agreed standards. ^1,2,3 The following studies were not taken into account:

• those for which the methodology was impossible to check
• those that relied on data collected using convenience sample methodologies
• those for which the methodology was not in agreement with WHO/international standard.

Nutrition data were taken from surveys, which assessed children aged between six to 59 months (65 to 110 cm).

Severity of the nutrition situation compared to standard

The WHO definition was used (WHO, 2000, the management of severe malnutrition in major emergencies, WHO: Geneva)

However, thresholds have to be used with caution and in relation to contextual analysis. Trend analysis is recommended to follow a situation: if nutrition indicators are deteriorating over time, even if not above the threshold, this indicates a worsening situation.

Comparison with the previous year

Where available, data of the emergency sites were compared to data recorded in the same area in the previous year, taking into account seasonal variation.

Comparison with a Comparative Reference Point (CRP)

Were defined as comparative reference points:

Resident populations

Data of representative surveys at emergency site, regional or national level, carried out at a time when political and climate situation was estimated "normal."

Refugee/displaced population

Data of representative surveys of surrounding resident populations in the same environmental conditions.
CRP could be determined mostly for refugees and displaced populations and for "new crises."

1. WHO (2002) The management of Nutrition in Major Emergencies. Geneva: WHO (back to text)
2. SMART (2002) www.smartindicators.org (back to text)
3. Médecins sans Frontières (1995) Nutritional guidelines. Paris: Médecins sans Frontières (back to text)

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