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					    The Zimbabwe Food and Nutrition
    Sentinel Site Surveillance System



                                          Nairobi
                                    Feb 1 – 3, 2007

For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY
               The Zimbabwe Food and Nutrition Sentinel Site Surveillance System



                                  Uses of Information

        1. Inform and influence programming
              • Evidence-based decisions
              • Better targeting of interventions
              • Monitor interventions (VAS)

        2. Early warning


        3. Monitor trends

For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY
               The Zimbabwe Food and Nutrition Sentinel Site Surveillance System



                                   Some Background
    • Pilot implemented in November of 2004 with the first round
    of data collection
    • Three more subsequent rounds of data collection carried
    out in March 05, November 05, October 06
    • Coordinated by the Food and Nutrition Council in
    collaboration with the National Nutrition Unit of the MoHCW




For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY
               The Zimbabwe Food and Nutrition Sentinel Site Surveillance System


                                          Methodology
          • Pilot was 1 district from each province as a sentinel site as well
          as the 2 major cities (Harare and Bulawayo), 10 villages each
          district with 30 children in each village
                -District chosen by Provincial Medical Director as vulnerable
                district, criteria provided including VAC results
          • 3rd and 4th rounds expanded to 23 sites, with 2-3 districts per
          province
          • Same villages sampled each round, households random
          • Future to consider rolling sample of villages, with each village
          being sampled at least twice for trends
          •Indicators collected on anthropometry (6-59 mos), health,
          wat/san, hunger, VAS, HH salt IDD, bfing, OVC status, chronic ill
          in HH
For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY
               The Zimbabwe Food and Nutrition Sentinel Site Surveillance System

                                          Methodology
          • Overall concept to be a bi-annual collection of data
          utilizing sentinel site methodology
          • Due to costs and duplication of effort with VAC,
          being considered to have bi-annual data collection:
                • VAC in April/May for post harvest data
                • Sentinel site in Oct/Nov for early warning,
                update on VAC
          • VAC to be scaled back closer to monitoring exercise



For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY
                  Stunting and Underw eight Levels High in Com m ercial Farm ing
                                             Areas


          50%
          45%
          40%
          35%
                                                                                  Wasting
          30%
          25%                                                                     Underw eight
          20%
                                                                                  Stunting
          15%
          10%
           5%
           0%




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        Commercial Farm n=33


For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY
                         The Zimbabwe Food and Nutrition Sentinel Site Surveillance System




                                         Vitamin A Coverage, March 2005


                          100
            % Coverage




                           80
                           60
                           40
                           20
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                                        not received   received with chc     received no chc



For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY
               The Zimbabwe Food and Nutrition Sentinel Site Surveillance System


                                          Some Issues

            • Government desire to scaling up (necessary?,
            feasible?)
            • Sustainability without external assistance (limited/short-
            term), even with low costs
            • Limited utilization of secondary data and developing a
            more holistic approach to analysis
                  •Multiple sources of information available (DHS,
                  NNS, HMIS, therapeutic feeding stats, PASS, MN
                  survey)
            • Timely release of information

For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY
               The Zimbabwe Food and Nutrition Sentinel Site Surveillance System



                                          Successes

    • Four data collections (sentinel site), three for trend data
    • The system has been accepted and approved by the
    government (SSAC and Cabinet) and is now recognized as a
    means of regular data collection and reporting
    • Evidence for better programming: UNICEF and VAS,
    MoHCW supplementary budget
    • System is flexible and has adjusted rapidly based on
    lessons learned

For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY
               The Zimbabwe Food and Nutrition Sentinel Site Surveillance System



                                          Way Forward
   • Monitoring, integrating and reporting of other information,
   such as disease surveillance, early warning systems, crop
   assessments, drought data, etc
   • Essentially more integrated system utilizing multiple
   sources of information to establish context
   • Establishment of posts within government, capacity building




For every child
Health, Education, Equality, Protection
ADVANCE HUMANITY