DCHA Planning Framework

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USAID Office of Food for Peace ME WorkshopAug
20-23/Aug 27-30, 2007
Anthropometric indicators and indices

Monica Woldt, FANTA
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Session objectives

• By the end of the session, participants will be
  able to
• Name five common anthropometric indices and their
  importance/use.
• Explain the public health implications of high
  prevalence of malnutrition.
• Identify four common errors in the use of
  anthropometric indices and indicators.
• Develop anthropometric indicators for your APT
  program in Drylandique.

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Plan for the session

• Brief overview of anthropometry and role in FFP
  and Title II programs
• Exercise 1 Getting to know common
  anthropometric indices
• Public health implications of high prevalence of
  malnutrition
• Common errors in use of anthropometric
  indices/indicators
• Exercise 2 Developing anthropometric indicators
  for the APT program in Drylandique

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Overview of anthropometry

• Definition
• Anthropometry is the study and technique of
  taking a persons body measurements (height or
  length, weight, arm circumference, etc),
  especially for use on a comparison or
  classification basis to establish his/her
  nutritional status

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Overview, contd

• Anthropometric index
• Usually made up of two or more variables that
  are used together to measure an underlying
  characteristic

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Overview, contd

• Well be looking at five Anthropometric indices
• Height for age
• Weight for age
• Weight for height
• Mid-Upper Arm Circumference
• Body Mass Index

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Anthropometric indicators as a part of USAID and
FFP indicators and reporting systems

• Cooperating Sponsor Program Indicators
• IPTT Impact and annual monitoring (program
  management and performance reporting)
• Food for Peace Washington PMP indicators
• USAID Mission Indicators
• F indicators

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Anthropometric indicators in FFP PMP

• SO Food Insecurity among Vulnerable Populations
  Reduced
• of underweight children 0-5 yrs in Title II-
  assisted areas in FFP priority countries
• of applicable programs reporting maintenance or
  improvement in nutritional status

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Exercise 1 Getting to know anthropometric
indices

• Please work in groups at your tables
• Each table has a piece of poster board with 5
  anthropometric indices written across the top
  columns, and descriptions of various
  characteristics of the indices along the rows
  (egWhat this measures Age range, etc)
• Each table also has index cards with descriptions
  of the various characteristics.
• As a group, work together to place the index
  cards in their correct locations (column and
  row).
• You will have 15 minutes for the exercise.

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International Reference Standard Distribution And
Classification of Undernutrition
MODERATE
SEVERE
MILD
0.13
2.14
13.59
13.59
2.14
0.13
34.1
34.1
-4 -3 -2 -1
0 1 2
3 4
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What our program anthropometric results tell us
about Drylandique
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What our program anthropometric results tell us
about Drylandique
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Setting suitable targets for anthropometric
impact indicators

• Use the experience of similar programs as a guide
• Average annual percentage reduction in stunting
  2.4
• Average annual percentage reduction in
  underweight 1.9
• Average annual reduction increases dramatically
  in programs greater than 3 yrs in length

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• Implications of the WHO 2006 Child Growth
  Standards
• for
• Monitoring, Evaluation, Reporting

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Implications of the WHO 2006 Child Growth
Standards Tips for Monitoring, Evaluation, and
Reporting

• When using anthropometric data for ME or
  reporting trends across time, the same references
  must be used to process the anthropometric data
  for all points in time
• Analysts should check with host government and
  donor(s) about which references should be used to
  meet reporting requirements

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Implications of the WHO 2006 Child Growth
Standards Tips for Monitoring, Evaluation, and
Reporting

• For clarity in program reporting Will be
  important to label which reference was used for
  processing the anthropometric data (i.e. NCHS
  1978 or WHO 2006)
• Programs may wish to process and report
  anthropometric data using both set of references
  until adoption of the WHO 2006 child growth
  standards is more widespread

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Common errors in using anthropometric indices
indicators in MYAPs

• Inappropriate age range for anthropometric
  indicator
• Targets for anthropometric indicator are
  inappropriate (e.g. too ambitious, not ambitious
  enough)
• Anthropometric indicators do not match program
  design/interventions
• Confusion over use of the new WHO 2006 Child
  Growth Standards

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Exercise 2 Developing anthropometric indicators
for the APT program in Drylandique

• Read the brief description of the nutritional
  situation in the Ambo Watershed Development
  Initiative project area, and the corresponding
  program design.
• Given the situation in the Ambo Watershed area
  and Puno Province, feel free to further develop
  the program design, stating any assumptions about
  the program.
• Develop anthropometric indicators and targets
  that are tightly linked to specific programmatic
  approaches you have used or selected.
• Groups will have 15 minutes to read and discuss
  the handout and prepare the indicators.

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References

• Cogill, Bruce. Anthropometric Indicators
  Measurement Guide. Food and Nutrition Technical
  Assistance Project, Academy for Educational
  Development, Washington, D.C., 2003.
• Collins, S., A. Duffield and M. Myatt. Assessment
  of nutritional status in emergency-affected
  populations Adults. UN ACC/SCN, Geneva, July,
  2000.
• Nutrition Working Group, Child Survival
  Collaborations and Resources Group (CORE).
  Positive Deviance/Hearth A Resource Guide for
  Sustainably Rehabilitating Malnourished Children,
  Washington, D.C. December 2002.
• Remancus, Sandra, Penelope Nestle and Leslie
  Elder, forthcoming. Women's Nutrition Indicator
  Guide. Food and Nutrition Technical Assistance
  Project, Washington DC.
• Valid International. Community-based Therapeutic
  Care (CTC) A Field Manual. Oxford, UK Valid
  International, 2006.
• World Health Organization (WHO). Physical Status
  The use and interpretation of anthropometry.
  Report of a WHO Expert Committee. WHO, Geneva,
  1995.