1 people empowerment advocacy & communal harmony (peach)

1People Empowerment Advocacy & Communal Harmony (PEACH)

ACF Action Contre le Faim

AFASS Acceptable, feasible, affordable, sustainable and safe

ALNAP Active Learning Network for Accountability & Performance

ARV Antiretroviral (treatment of AIDS)

BCG Bacille Calmette Guerin (vaccination against tuberculosis)

BFHI Baby friendly hospital initiative

BMI Body mass index

BMS Breast milk substitute

CAP Consolidated appeals process

CBO Community based organization

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Acronyms

People Empowerment Advocacy & Communal Harmony (PEACH)

CBTD Community based targeting and distribution (of food aid)

CDC Centre for Disease Control (US)

CERF Central emergency response fund

CHAP Consolidated humanitarian action plan

CHASE Conflict, humanitarian and security department (of DFID)

CHW Community health workers

CI Confidence interval

CIDA Canadian International Development Agency

CIMIC Civil-military cooperation

CMAM Community based management of acute malnutrition

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Acronyms …


CMR Crude mortality rate

CRED Centre for Research on the Epidemiology of Disasters

CRS Catholic Relief Services

CSB Corn soya blend

CTC Community therapeutic care

DAC Development assistance committee

DEC Disasters Emergency Committee (of UK agencies)

DFID Department for Int. Development (of UK government)

DHA Department for Humanitarian Affairs

DHS Demographic and health surveys

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Acronyms …


DRC Danish Refugees Council

DSM Dried skimmed milk

ECB Emergency Capacity Building project

ECHO European Community Humanitarian Organization

EMOP Emergency operation (by WFP)

ESFP Emergency supplementary feeding programme

ENA Emergency nutrition assessment

ENN Emergency Nutrition Network

ERC Emergency relief coordinator

ESFP Emergency supplementary feeding programmes

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Acronyms …








BMI Body mass index




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Acronyms …








BMI Body mass index




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Acronyms …


EWS Early warning system

FANTA Food and Nutrition Technical Assistance

FAO Food and Agriculture Organization

FFW Food for work

FSAU Food Security Analysis Unit

GAM Global acute malnutrition

GFD General food distribution

GHD Good humanitarian donorship

HAP Humanitarian Accountability Partnership

HBC Home based care

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Acronyms …


HDR Humanitarian daily ration

HFA Height for age

HIS Health information system

HIV Human immunodeficiency virus

IASC Inter-Agency Standing Committee

IBFAN International Baby Food Action Network

ICRC International Committee of the Red Cross

IDD Iodine deficiency disorder

IDP Internally displaced person

IEC Information, education and communication

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Acronyms …


IFE Infant and young child feeding in emergencies

IFRC International Federation of the Red Cross

IGA Income generation activity

IHL International humanitarian law

IMCI Integrated management of childhood illnesses

IRA Initial rapid assessment

IYCF Infant and young child feeding

KABP Knowledge, attitude, beliefs and practice

LBW Low birth weight

LQAS Lot quality assurance sampling

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Acronyms …


MCH Mother and child health

MDD Micronutrient deficiency disorder

MDG Millennium development goal

MICS Multi-indicator cluster surveys

MOH Ministry of Health

MOU Memorandum of understanding

MSF Medecins San Frontieres

MTCT Mother to child transmission (of HIV)

MUAC Mid upper arm circumference

NCHS National Center for Health Statistics

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Acronyms …


NGT Naso-gastric tube

NICS Nutrition information in crisis situations (bulletin of the SCN)

NIE Nutrition in emergencies

NIV Nutrient intake values

OSDM On-site distribution monitoring (of food aid)

OCHA Office for the Coordination of Humanitarian Affairs

ODA Official development assistance

ODAN Emergency needs assessment branch (of WFP)

ODI Overseas Development Institute

OECD Organization for Economic Cooperation and Development

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Acronyms …


OFDA Office for disaster assistance (of USAID)

ORS Oral rehydration solution

OTP Outpatient

PDM Post-distribution monitoring (of food aid)

PLWHA People living with HIV and AIDs

PMTCT Prevention of mother to child transmission (of HIV)

RC Relief Committee

RTF Ready to feed formula

RUTF Ready to use therapeutic food

SD Standard deviation

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Acronyms …


SAM Severe acute malnutrition

SCHR Steering committee for humanitarian response (of NGOs)

SCN Standing Committee on Nutrition (of the UN)

SC-UK Save the Children Fund UK

SLI Safe levels of intake

SMART Standardized Monitoring & Assessment of Relief & Transitions

SFP Supplementary feeding programme

STI Sexually transmitted infection

UN United Nations

UNDP United Nations Development Fund

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Acronyms …


UNHCR United Nations High Commissioner for Refugees

UNICEF United Nations Children’s Fund

USAID United States Agency for International Development

U5MR Under five mortality rate

VAM Vulnerability assessment and monitoring unit (of WFP)

VCT Voluntary counseling and testing (for HIV)

WASH Water, sanitation and hygiene

WFA Weight for age

WFH Weight for height

WFP World Food Programme

WHO World Health Organization16

Acronyms …


Accountability Means by which individuals and organisations report to a

recognised authority and are held responsible for their actions

Acute malnutrition Also known as wasting, is a sign of ‘thinness’ and

develops as a result of recent rapid weight loss or a failure to gain weight.

In children, it is measured through the weight for height nutritional index

In adults it is measured by body mass index or mid upper arm circumference


Continu…

Acute respiratory infectionOne of the major killers of young children in developing

countries It is defined as the presence of a runny nose or cough for atleast

two consecutive days plus one or more of the following signs independent of duration: Erythematous mucosa (an increased redness of the mucosa,

due to an increase in its hemoglobin content because of increased blood flow)

Hoarse-cry (rough in sound) Respiratory distress or fever


Continu…

Adequate basic rationAdequate ration meets the population's minimum energy,

protein, fat and micronutrient requirements for light physical activity

It is nutritionally balanced, diversified and culturally acceptableFit for human consumption and easily digestible for children

AnaemiaCaused by lack of iron, folate or vitamin B12

Difficult to diagnose accurately from clinical signs which include pallor, tiredness, headaches and breathlessness

Angular stomatitisA Sign of riboflavin deficiency characterized by inflammation

in the corners of the mouth


Continu…

Anthropometric statusGrowth status of an individual in relation to population reference

values

AnthropometryBody measurements Used as a measure of an individual's nutritional (anthropometric)

status

Artificial feedingFeeding of young infants with breast milk substitute

Antiretroviral therapyTreatment that suppresses or stops a retrovirus


Continu…Retrovirus is the human immunodeficiency virus (HIV) that

causes AIDS

AriboflavinosisCondition resulting from a deficiency in riboflavin (vitamin B2)Characterised by the presence of angular stomatitis

Beri-beriCaused by thiamine deficiencyClinically recognizable syndromes include:

Wet beri-beri (involvement of CNS) Dry beri-beri (involvement of CV system) Infantile beri-beri (Beri-beri of infants)

Blanket feedingFeeding of all an affected population without targeting specific

population groups22


Continu…Bitot’s spotsClinical sign of vitamin A deficiency Characterized by dryness accompanied by foamy accumulations

on the conjunctiva that often appear near the outer edge of the iris

Blended foodA precooked fortified mixture of cereals and other ingredients

such as pulses, dried skimmed milk and vegetable oilBlended foods include wheat soy blend, corn soy blend, and

'faffa’ – Chinese sea food dish

Body mass indexAcute malnutrition in adults is measured using body mass index

or weight/height2


Continu…

Breast milk substitutes Any food being marketed or otherwise represented as a partial or

total replacement for breast milk, whether or not suitable for that purpose

Cash transferA form of humanitarian assistance Providing cash in some form to emergency-affected populations

Chronic malnutritionAlso known as stunting, is a sign of ‘shortness’ and develops

over a long period of time In children and adults, it is measured through the height for age

nutritional index


Continu…

ClusterA group of individuals selected in a sample on the basis of a

common criterion (e.g. living within a particular neighbourhood)

Cluster samplingA representative sample where the sampling unit, children or

adults, are selected in groups (clusters) rather than individually

The Code International code of marketing of breast-milk substitutes, was

adopted by the World Health Assembly in 1981

Cold chainA temperature-controlled supply chain for vaccines

Corn soya blendType of blended food


Continu…ColostrumFirst thick yellow milk secreted by the breasts in the last few

weeks of pregnancy and the first two to three days after childbirthContains high levels of protein and antibodies

ConjunctivaMembrane around the eye which is examined for signs of

anaemia and jaundice

Community based therapeutic careConcept of treating as many cases as possible of severe acute

malnutrition as outpatients using RUTFs; Also called home-based treatment or ambulatory treatment

Complementary feedingAge-appropriate, adequate and safe solid or semi-solid food in

addition to breast milk or a breast milk substitute26


Continu…Confidence intervalStatistical term which reflects the error introduced by the

sampling method and the sample sizeConfidence intervals are usually associated with a probability of

95 per centFor example, if the survey is done 100 times the value will be

within the range of the confidence interval 95 times out of 100

Coping strategiesStrategies employed by individuals or households during crises to

preserve productive assets which are needed to sustain a living in the future

Crude mortality rateThe proportion of a defined population who die each day

expressed over 10,000


Continu…Cretinism Sever mental and physical disability which occurs in the

offspring of women with sever iodine deficiency in the first trimester of pregnancy


Continu…

DiarrhoeaOne of the major killer of young children in developing countries It is defined as presence of three or more liquid or semi-liquid

stools per day accompanied or not by blood, mucous or fever

Dry feedingFood provided in the form of a dry (take home) ration

Early warning system Information system designed to monitor indicators that may

predict or forewarn of impending food shortages or famine

Emergency school feedingFood provided either as a cooked meal or supplement in school To improve school attendance and performance, and to alleviate

hunger


Continu…

Endemic diseaseAn infectious disease that occurs throughout the year in a

populationFor example malaria, worms, chest infections

EnergyEnergy is not a nutrient, but a measure of total food intakeCalories or kilocalories are the unitary measure of energyEnergy is needed for the essential body functions, growth and

physical activities

EnrichmentMicronutrients lost or removed during food processing are added

back or restored in the final product (e.g. wheat flour is enriched with vitamin B1, niacin and iron)


Continu…

EpidemicAn outbreak of an unusually high number of cases of a disease

within a certain time or area

Exclusive breastfeedingAn infant receives only breast milk and no other liquids or solids,

not even water, with the exception of drops or syrups consisting of vitamins, mineral supplements or medicines

FoetusDeveloping unborn child inside the mother’s uterus

Follow-on/follow-up formulaSpecially formulated milks for infants of six months and over


Continu…

Food economy approachA particular methodology used to assess food security

Food for workFood given as payment for work performed in the context of a

supervised public works programme, to address acute food insecurity and create community capital

Food securityAccess by all people at all times to sufficient, safe and nutritious

food needed for a healthy and active life

Food taboosFood that should not be eaten on cultural or religious grounds

Fortified foodsThe foods to which fortificants are added


Continu…

Fortification of foodAddition of micronutrients during or after processing to a food,

bringing the micronutrients to levels over and above the amounts in the original food product

FortificantsThe vitamins and minerals added to fortified foods

General food distributionFree distribution of a combination of food commodities to an

emergency affected population

Global acute malnutritionModerate and severe acute malnutrition measured by weight for

height <-2 Z scores or <80 per cent of the median plus oedema


Continu…

GoitreSwelling of the thyroid gland in the neck caused by iodine

deficiency

Growth monitoring and promotionAn individual child’s growth (weight for age) is measured at

intervals and the results plotted on a ‘Road to Health’ chart

Healthcare systemAny governmental, non-governmental or private institution

providing healthcare

Home-modified animal milkBreast milk substitute for infants up to six monthsPrepared at home from fresh or processed animal milk, suitably

diluted with water and with the addition of sugar and micronutrients


Continu…HIV-positive Infected with HIV

Home based careProgrammes to care for the chronically ill by providing support to

sick people at home

Humanitarian daily rationsA type of emergency ration which is a nutritionally balanced,

ready-to-eat complete food. They generally come in two forms: as compressed, vacuum packed bars or tablets

Humanitarian imperativeThe premise (basis) that humanitarian action should be based on

need and need alone

HumanityTo prevent and alleviate human sufferingTo protect life and health and ensure respect for the human being


Continu…

ImmunityBody’s capacity to fight disease via the immune system

ImpartialityAid is given regardless of the race, creed (religious) or nationality

of the recipients and without adverse distinction of any kindAid priorities are calculated on the basis of need alone

IncidenceNumber of new cases

IndependenceHumanitarian aid is not a partisan (party) or political act Aid will not be used to further a particular political or religious

standpoint36


Continu…

Infant and young child feedingTo describe the feeding of infants (aged less than 12 months and

young children (aged from 12 to 23 months)

Infant formulaBreast milk substitute formulated industrially in accordance with

applicable Codex Alimentarius standards

Infant feeding equipment Bottles, teats, syringes and baby cups with or without lids and/or

spouts (to emit or discharge forcibly)

International codeThe International Code of Marketing of Breast-Milk Substitutes

was adopted by the World Health Assembly in 198137


Continu…

Information, education and communicationAims to provide people with an informed base for making choicesNutrition information refers to knowledge, such as information

about new foods that are being introduced in an emergency situation

Nutrition education refers to training or orientation for a particular purpose such as support for breastfeeding

Nutrition communication refers to the method by which information is imparted

Inpatient carePatients with complicated severe malnutrition (metabolic

disturbances) are treated in inpatient care before continuing treatment in outpatient care


Continu…

Alternative terms are phase I, therapeutic feeding unit, therapeutic feeding centre or stabilisation centre

Iodine deficiency disorders A range of abnormalities including goiter and cretinism

KwashiorkorClinical form of malnutrition associated with growth failure (in

children)Characterized by oedema (swelling) and loss of appetite

LivelihoodsComprises the capabilities, assets and activities required for a

means of livingHouseholds are assumed to have different types of assets and adopt

livelihood strategies to achieve livelihood outcomes


Continu…

Low birth weightA birth weight of less than 2.5 kgs

MacronutrientsFat, protein and carbohydrate that are needed for a wide range of

body functions and processes

Malaria Infectious disease caused by protozoan parasites from the

Plasmodium family Transmitted by the sting of the Anopheles mosquito or by a

contaminated needle or transfusionFalciparum malaria is the most deadly type

Mastitis Infection of the breast


Continu…MarasmusClinical form of malnutrition associated with growth failure (in

children) Characterized by a severe loss of body weight or wasting

MalnutritionBroad range of clinical conditions in children and adults that result

from deficiencies in one or a number of nutrients

MeaslesPerson with fever and maculopapular rash (i.e. non-vesicular)Cough, coryza (i.e. runny nose)Conjunctivitis (i.e. red eyes)


Continu…

MicronutrientsAll vitamins and the minerals that are required in tiny amounts and

needed for a wide range of body functions and processes

Micronutrient deficiency diseasesClassic nutritional diseases such as scurvy, beriberi and pellagra

are good examples of these sorts of disease

Micronutrient malnutritionExistence of sub-optimal nutritional status due to a lack of intake,

absorption, or utilisation of one or more vitamins or mineralsExcessive intake of some micronutrients may also result in adverse

effects

Morbidity Illness


Continu…

MortalityDeath

Mid upper arm circumferenceMeasured on a straight left arm (in right handed people) mid way

between the tip of the shoulder (acromium) and the tip of the elbow (olecranon)

A measure of acute malnutrition or wasting

NeonatalApplies to babies born alive during the first 28 days of life

NeutralityHumanitarian assistance should be provided without engaging in

hostilities or taking sides in controversies of a political, religious or ideological nature


Continu…

Night blindness Inability to see well in the dark or in a darkened roomAn early sign of vitamin A deficiency

Nutritional indexDerived by relating an individual’s body measurement with the

expected value of an individual of the same height (or age) from a reference population

Weight-for-height is the nutritional index commonly used to reflect acute malnutrition (wasting) in emergency nutritional assessments

Nutritional requirementsAmount of energy, protein, fat and micronutrients needed for an

individual to sustain a healthy life44


Continu…

Nutritional screeningCarried out to identify and select malnourished children in the

population

Nutritional statusGrowth or micronutrient status of an individual

Nutrition surveillanceRegular collection of nutrition information Used for making decisions about actions or policies that will affect

nutrition

Nutrition surveySurvey to assess the severity and extent of malnutrition


Continu…

ObesityA person is obese when their body mass index (weight/height2)

exceeds 30

OedemaExcessive accumulation of extracellular fluid in the bodyBilateral oedema (fluid retention on both sides of the body) is a

clinical sign of severe acute malnutrition

Outpatient carePatients with non-complicated severe malnutrition are treated in

outpatient careAlternative terms are home based rehabilitation, outpatient

therapeutic programmes or ambulatory care (not stationery care)


Continu…

PellagraCaused by niacin deficiency Affects the skin, gastro intestinal tract and nervous systemsSometimes called the 3Ds: dermatitis, diarrhoea and dementia

Percentage of the medianAnthropometric status of an individual expressed as a percentage

of the expected value (or median) for the reference population

PerinatalPeriod during birth and the first 7 days of life

PlumpynutCommercial brand of ready to eat therapeutic food


Continu…Pneumonia Inflammation of one or both lungs with consolidation (whole)Frequently but not always due to infection Infection may be bacterial, viral, fungal or parasiticSymptoms may include fever, chills, cough with sputum

production (a mass of salivary material), chest pain, and shortness of breath

PrevalencePercentage of the population with a specific characteristic at a

given point in time

Public nutrition approachTo addressing nutritional problems that recognizes that nutritional

status is affected by a complex mix of factors48


Continu…

ProphylaxisPrevention of disease usually using an antibiotic

Purposive samplingDeliberate selection of sites, i.e. not randomly selectedSites are selected as they are representative of a certain area which

has specific characteristics such as specific vulnerabilities, which may not be similar for the larger area

Used to determine feeding centre coverage areaResults should not be extrapolated to the general population

outside of the defined area

Random samplingA method whereby subjects are selected as part of a sample purely

by chance


Continu…

Rapid nutrition assessmentAn assessment carried out quickly to establish whether there is a

major nutrition problem and to identify immediate needsScreening individuals for inclusion in selective feeding

programmes is also a form of rapid nutrition assessment

RationThe ration or food basket usually consists of a variety of basic food

items (cereals, oil and pulses) Additional foods known as complementary foods (meat or fish,

vegetables and fruit, fortified cereal blends, sugar, condiments) which enhance nutritional adequacy and palatability


Continu…

Ready to eat mealsA type of emergency ration which is a nutritionally balanced,

ready-to-eat complete foodThey generally come in two forms:

Compressed Vacuum packed bars or tablets

Recommended daily allowanceAverage daily dietary intake level that is sufficient to meet the

nutrient requirements of nearly all (approximately 98 per cent) healthy individuals


Continu…

Ready to use therapeutic foodsSpecialized products for use in the management of severe

malnutritionSolid version of F100 with the same macro and micronutrient

composition plus ironAvailable as pastes, spreads or biscuitsThey are ready to eat and do not get contaminated by bacteria

Reference population Also known as growth standards Based on surveys of healthy children, whose measurements

represent an international reference for deriving an individual's anthropometric status


Continu…

Rehabilitation phaseThird phase of treatment for complicated SAM or initial treatment

for uncomplicated SAMAim is to promote rapid weight gain and to regain strength through

regular feeds of high nutrient and energy dense foods (F100) Ideally implemented as outpatient treatment

Re-lactation Induced lactation (breastfeeding) in someone who has previously

lactated

Replacement feeding Feeding infants who are receiving no breast milk through

alternative methods


Continu…

RicketsCaused by Vitamin D deficiencyAffects bone development resulting in bowing of the legs when

severe

SampleSub-set of the population selected to be surveyed

Sampling intervalThe interval which separates two statistical items selected in a

systematic sample, or two clusters in a cluster sample

ScurvyCaused by Vitamin C deficiencySigns include swollen and bleeding gums, and slow healing or

reopening of old wounds54


Continu…

School feedingProvision of meals or snacks to schoolchildren to improve

nutrition and promote education

School censusNutrition monitoring undertaken in schools usually through

measuring height for age (stunting) every couple of years

SeasonalitySeasonal variation of various factors that affect nutritional status

such as: Disease Different sources of food The agricultural cycle


Continu…

Selective feeding programmesSupplementary feeding or therapeutic care programmes

Sentinel sitePurposively selected community or service delivery site, used to

detect changes in context, programme or outcome variableCommunities or areas are purposively selected for a number of

reasons, such as vulnerability to food insecurity in times of stressSentinel sites can range from health centres, to villages, to districts

Severe acute malnutritionSevere acute malnutrition measured by weight for height <-3 Z

scores or <70 per cent of the median plus oedema


Continu…

Stabilisation phase Initial phase of inpatient treatment for complicated SAMAim is to stabilise and readjust patient's metabolism through use of

special foods (F75) and medical treatment It allows close monitoring of the patient and urgent therapy if

complications developedAlso known as phase I or initiation phase

Standard deviationA measure of the variation around the mean value of a distributionA standard deviation is equal to the square root of the sum of the

squares of deviations from the mean


Continu…

StandardsDesired levels of programme delivery and impact in terms of

quality

StuntingSee chronic malnutrition

Supplementary feeding Provision of food to the nutritionally or socially vulnerable in

addition to the general food distributionTo save lives and/or to prevent malnutrition

SupplementationProvision of nutrients either via a food or as a tablet, capsule,

syrup, or powder58


Continu…

Supplementary sucklingTechnique to induce lactation by providing therapeutic milk to the

infant while he/she is sucklingWhen suckling, the child gets therapeutic milk from a tube

attached to the mothers nippleSuckling stimulates breast milk production which eventually

replaces therapeutic milk

Systematic samplingA sampling method whereby subjects are selected using a fixed

interval between subjects


Continu…

TargetingRestricting the coverage of the intervention to those identified as

the most vulnerable

Therapeutic careFeeding and medical treatment to rehabilitate severely

malnourished children

Therapeutic milkMilk based products developed to meet :

Energy macro-and micronutrient needs of the severely malnourished promote metabolic balance (F75) and weight gain (F100)


Continu…

Transition phaseSecond phase of inpatient treatment for complicated SAMAim is to adapt progressively to the large amounts of food and

nutrients that will be offered in the rehabilitation phase (outpatient or inpatient) and to monitor the patient

Under 5 mortality rateProportion of children aged under five in a defined population who

die each day expressed over 10,000

Under nutrition Insufficient intake of energy, protein or micronutrients, which in

turn leads to nutritional deficiency


Continu…

UnderweightWasting or stunting or a combination of both, measured through

the weight for age nutritional index

VulnerabilityCharacteristics of a person or group in terms of their capacity to

anticipate, cope with, resist and recover from the impact of a natural (or man-made) hazard

Weight for ageA measure of underweight

Weight for heightA measure of acute malnutrition or wasting


Continu…

Wet feedingFood aid provided in the form of a cooked ration to be consumed

on site

Wet nursingBreastfeeding by a woman of a baby that isn’t her own

XerophthalmiaCaused by vitamin A deficiency Includes a range of eye signs including night blindness, Bitot’s

spots and corneal ulceration

Z scoreThe difference between a value and the mean of a distribution.

Equivalent to a standard deviation63


1 people empowerment advocacy & communal harmony (peach)

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