Nutrition Surveys and Surveillance Activities in Russia and the Newly Independent States A Review of USAID-Sponsored Activities (1994) / Chapter Skim
Currently Skimming:
FINDINGS AND CONCLUSIONS
FINDINGS AND CONCLUSIONS
Pages 31-58
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 31... ...
The committee's primary goals were to understand the food and nutrition situation in Russia at the time and to examine the methods of data collection for the projects reviewed. The CIN was not asked to critique the specific studies in detail, nor could this be achieved with the information, process, or time available to the committee.
|
From page 32... ...
evidence of new constraints in the population's ability to purchase food or of new shortages in the food supply; and 3. indications of changes in market food security.
|
From page 33... ...
With these caveats in mind, the general conclusions of the committee concerning Round One of the RLMS were that, for children aged 1-17 years, there was little evidence of acute, short-term malnutrition (weight or height Z scores < -2) or chronic malnutrition (height-for-age Z scores < _2~.6 Anthropometric values of the Russian children were similar to those in most developed countries.
|
From page 34... ...
Nevertheless, the northern latitude, possible recent lack of cod liver oil supplements to infants and children (reported in Kyrgyzstan) , lack of food fortification with vitamin D, and historical concern about rickets suggest that this condition should be monitored closely.
|
From page 35... ...
This finding suggested to the committee that a significant proportion of households may be at risk of household food insecurity. One very valuable aspect of the RLMS, provided it is carried out on a regular basis, will be the ability to track households over time to assess the effects of structural adjustment on household food security.
|
From page 36... ...
This is also information that is well-understood by most decision makers and may be more likely to trigger action than perceptions of household food insecurity or measurements of changes in food consumption. Extensive data on various aspects of market food security were collected during the RLMS, but they were not presented in the Round One report provided to the committee.
|
From page 37... ...
Again, a failure in the system that provides these important micronutrients through supplements could have serious health and nutrition consequences that would not necessarily be detected through traditional food consumption surveys. An additional problem is that the social safety net that contributed directly to maintaining adequate health and nutrition in certain dependent population groups (e.g., orphans and the elderly or disabled who live alone or in public 7 Iodine Deficiency Disorders in Eastern Europe.
|
From page 38... ...
The CARE Pensioner Surveys highlight the importance of monitoring the level of assistance through the Department of Social Assistance by making it clear what a central role this program has played in protecting the health and nutritional status of dependent pensioners. Although, the surveys did not present direct evidence of deterioration in these services, it seems logical to assume that declining public resources may cause some social workers to lose their jobs, while the erosion of the value of salaries will cause others to seek secondary forms of income generation.
|
From page 39... ...
There were no analyses of longitudinal data from Russia that enabled the committee to evaluate changes in food security or nutritional status during the time periods examined. The CIN made the following conclusions regarding Question 1: · Due to lack of appropriate qualitative data, it is not certain that the population groups surveyed were those at most risk of food shortage or nutritional problems.
|
From page 40... ...
were not considered by the researchers. · Anecdotal evidence suggested that consumption of alcohol in the Russian populations surveyed was rising, but the relevance of this finding to food security or nutritional status was not clear.
|
From page 41... ...
Insights are essential for designing a quantitative survey that can be conducted efficiently and interpreted with confidence. This qualitative information can be used to address changes that threaten nutrition, to understand coping strategies, and to discuss intervention options and who will determine them.
|
From page 42... ...
This question refers not only to reasons for overall food shortages, but also to shortages of specific kinds of foods, such as fortified products intended to prevent previously prevalent micronutrient deficiencies. Information should be obtained on perceptions of dietary changes that may occur or that have occurred as a result of economic stress.
|
From page 43... ...
The problem of expenditures threatening food purchasing power may occur when costs of other basic needs besides food, such as medicines or housing, are excessive. This information can be obtained by interviewing officials responsible for these human needs (e.g., officials in health or welfare departments)
|
From page 44... ...
. Another reason is that it may be more efficient to introduce nutritional and food security considerations into other kinds of surveys (e.g., health, welfare)
|
From page 45... ...
It is important to differentiate between data that are vital for revealing outcomes of concern (e.g., malnutrition discerned by anthropometry, household food security, or perceptions of change for the worse) from data that illuminate the causes of these outcomes (e.g., economic status or lack of iron supplements)
|
From page 46... ...
When Necessary, Conduct Nutrition Monitoring Through Repeated Surveys The qualitative information collected will give an idea about the speed with which the emerging situation is likely to evolve. On that basis, monthly information is probably needed in Armenia due to the rapidly changing situation (and is apparently being collected by the government)
|
From page 47... ...
The committee felt that this information is important not only to understand the situation as it evolves in the near future, but also in the longer term. This tactic requires information gathering that need not be so well predefined or so timely.
|
From page 48... ...
For example, if it is clear that distribution problems are causing local market food insecurity, these problems can be dealt with without quantitative information from household food surveys. The specific information to be collected should depend on current circumstances and the possible actions that might be taken.
|
From page 49... ...
Thus, the distribution of BMIs must be presented. Food Availability at the Household Level One of the earliest signs of major changes in food availability or in purchasing power is that households and individuals perceive feeling insecure about their food supply.
|
From page 50... ...
Infant Feeding Practices and Food Availability These measures include the duration of breast-feeding and the availability of nutritionally adequate, complementary, and weaning foods. General Indicators of Nutritional Status and Health Other kinds of information are also useful as general indicators of the health and nutritional status of the population.
|
From page 51... ...
In general, such information should provide a sense of the problems that might exist and their likely causes, whether the problem is likely to be acute or chronic, probable vulnerable groups, options for action, who has need of the information, and how quickly the information is needed. · At a minimum, specific qualitative measures should be elicited in advance of any survey and should ideally provide information on such items as recent changes in market food supply, usual sources of income and food and the population groups for whom access to these have changed, rising costs of competing necessities, the functionality of existing food and other safety nets, knowledge about how household food strategies might change under stress, and what kinds of interventions might be possible in a given population in a given region (which requires talking directly with the potential decision makers)
|
From page 52... ...
As noted earlier, evidence available from the surveys examined does not permit definitive conclusions regarding the impact of the current political dislocations in the NIS on the food supply or nutritional status of vulnerable groups. In part, this gap exists because the surveys did not allow the committee to determine which are the most vulnerable population groups or to understand the causes of any food-related problems.
|
From page 53... ...
Therefore, household food insecurity can arise from market insecurity and/or from inadequate household food purchasing power. Direct food aid from the United States to assure market food security should only be considered when the national food supply is inadequate (although this is a complex issue for which political, economic, programmatic, contractual, and diplomatic variables need to be considered)
|
From page 54... ...
Similarly, there was strong anecdotal evidence for lack of medical supplies such as vaccines, of nutrient supplements such as iron and vitamin D, of fortified foods such as iodized salt, and of appropriate infant foods. If true, this lack may explain a significant part of any increased prevalence of mortality, morbidity, anemia, and micronutrient deficiency diseases, such as goiter and rickets, and infant growth faltering.
|
From page 55... ...
Nonetheless, the committee wishes to express its view that institutional support and institutional development are important goals that should be kept in mind, even within the relatively short time frame and limited mandate that the USAID has established for itself in the region. Given the relatively high level of professional training in the population, the relatively well-developed food processing industry, and the well-developed social support infrastructure in Russia and many of the other NIS prior to 1990, institutional support and development in the area of food and nutrition would not require the same investment in basic training and basic infrastructure that would be required in most other regions where USAID is actively involved in providing assistance.
|
From page 56... ...
Given that the World Bank usually has well-established lines of communication with ministries of finance and planning, as well as health and agriculture, it may be in a particularly good position to encourage adjustments in economic policy to prevent nutritional deterioration during this period of rapid economic adjustment. Conclusions The evidence presented to the committee was too out-dated to permit definitive conclusions regarding the current food supply and nutritional status of vulnerable groups or the causes of food-related problems (e.g., a market food shortage versus inadequate purchasing power)
|
From page 57... ...
. The currently high level of interest of bilateral and multilateral agencies concerning the NIS means that there are opportunities for USAID to leverage its food and nutrition monitoring assistance and to increase communication about NIS problems with other organizations.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.