ECOLOGICAL ASSESSMENT 2

Malnutrition and its intergenerational

• are the end result of many interacting ecological factors.

Ecological information

will complete the nutrition assessment

ecological assessment

enables planners appreciate the real causes of malnutrition & are able to plan appropriate programs/interventions.

Ecological variables

e.g. crop production

Economic factors

per capita income, population density & social habits

Vital health statistics

e.g. under 5 mortality & fertility index

Assessment of Ecological Factors

• The range of information that can be included as "ecological variables" can be very extensive to be able to support the interpretation of the nutritional status

vital health statistics

The application of statistical methods and technique to the study of vital facts such as those concerning births, deaths and illnesses (NLGNI, 1995)

vital statistics

statistical data which relate the total number of various kinds of biologic or vital events like births, marriages, illnesses, and deaths to the size and characteristics of the affected population

health indicators

A list of information which would determine the health of a particular community like population, crude birth rate, crude death rate, infant and maternal death rates, neonatal rates and tuberculosis death rate

birth

a coming into being; the act process of being born

rates

A relation indicating the number of times a certain event occurs when an certain number of exposures to the risk if occurrence is present in a given period of time.

crude rates

denominator is the total population

specific rates

Events happening to a specified group are related only to the corresponding segment of the population

Rates

can be made specific according to age, sex, education, occupation, marital status, race or exposure

ratio

the result of dividing one quantity by another quantity

death

the cessation of all physical and chemical processes that invariably occurs in all living things.

marriages

the institution whereby men and women are joined in a special kind of social and legal dependence for the purpose of founding and maintaining a family.

migration

the transfer of one individual from one locality to another.

Crude Birth rate (CBR)

is a rough measure of fertility in a population; uses mid year population (which includes the number of men and women incapable of child-being) as its dominator; measures how fast are added to the population through births.

Total Fertility rate

refers to the average number of births that woman would have at the end of her reproductive life; an incubator in assessing the impact of programs on family planning and reproductive behavior.

General fertility rate (GFR)

births are related to the segment to the population deemed to be capable of giving birth.

mortality

Gives a rate with which mortality occurs in a given population; implies effectiveness of health care delivery system and netter health status.

Crude death rate

A rough measure of the force of mortality or the probability of dying in a population because of death rates are largely influenced by age and sex composition of the population.

Infant mortality Rate

The number of deaths among infants under one year of age in a calendar year per 1000 live births in the same period

Infant mortality Rate

An index of the level of health in a community; a high IMR means low levels of health standards which may be secondary to poor maternal and child health care, malnutrition, poor environmental sanitation or deficient health service delivery.

Maternal Mortality rate

Measures the number of deaths due to diseases directly related to pregnancy to deliver and puerperium per 1000 livebirths.

Mortality at the age of 1-4

mainly due to an accumulation of effect of infection, parasitism and malnutrition; child mortality rate (CMR) may therefore be used as an indicator of the nutritional status of a population.

Cause of death rates

Gives the rate of dying secondary to specific causes; a crude rate since it includes to the whole population but can be specific by relating the deaths from the specific cause and group to the mid-year population of the specified group.

Proportionate mortality rate

Proportion of total deaths according to a particular population group from a particular cause

morbidity

Prevalence refers to the proportion of the population or group who are actually ill with a particular disease or infection within the total population.

education

refers to the acquisition of knowledge, which enhance a person’s skill and enable him to contribute fully and more efficiently to expansion of the national output to earn higher income

labor employment

reflects the importance of providing employment to the growing working population, with the objective of raising the level of per capita income in order to promotes people well being

labor employment

indicators include total labor force (employed, unemployed) labor force participation rate; deployed workers

Food and production supply

family and food supply, farming methods, land, finance, distribution

health and nutrition

Includes indicators on a number o bed capacity of government and private hospitals, number of hospitals, number of government medical practitioners- doctors, dentist, nurses, midwife, number of health stations, number of BNS and BHWs; source of drinking water, proportion of children immunized against measles, proportion of infants born with low birth weight, percentage of mother breastfeeding.

Income and prices

1. Refers to information on the economic welfare of the population.

2. Useful indicators in the analysis of purchasing power of household, distribution of goods and services, sources of finance of capital formation, impact of taxes and inflation and other related subjects.

3. Indicators average family income, poverty threshold, average family expenditure, consumer price index for all time, distribution of family income for food, housing fuel, light, water, clothing, transportation, communication, education among others.

Social Services

Vital in promoting social welfare and community development to ensure equitable distribution of social services.
Provides information on the identities, number, location of target person, types of service needed, how much is needed, number of clients served types of amount of social services received, sources of social services and dangers of major natural disasters.

cultural factors

Food attitudes

Disease causation

Child rearing practices

sampling

1. Reference or target population - all the people being investigated

sampling

1. Study or sample population

1. A selected subset a population

2. May be random or non- random

3. May be representative or non-representative

random sample

Each person in the reference population has an equal change or the SAME probability to be taken in the sample.

representative

a sample has to be "————" of the population under security.

E. Types of non-probability sampling

1. Volunteer

2. Quota sampling

3. Social Strata

Simple random sampling

1. Needs lists of eligible populations and random numbers.

2. Possible problems- list not always available, no idea of total numbers of population.

3. Steps

stratified sampling

1. Used when the population consist of distinct subgroups

2. Each group differ with respect to the feature under study

multi stage sampling

two stage sampling or multi stage, carried out in stages using the hierarchical structure of population

cluster sampling

Advised if very little cost is involved, Advantage is that is easiest on the operational level

NUTRITIONAL ASSESSMENT

COMPREHENSIVE PROCESS TO EVALUATE AN INDIVIDUAL NUTRITIONAL STATUS

NUTRITIONAL ASSESSMENT IN A CLINICAL SETTING

TO IDENTIFY NUTRITIONAL DEFICIENCIES, DEVELOP APPROPRIATE INTERVENTIONS AND MONITOR PROGRESS

EARLY DETECTION OF MALNUTRITION

PERSONALIZED NUTRITION INTERVENTIONS

MONITORING NUTRITIONAL STATUS

IMPORTANCES OF NUTRITIONAL ASSESSMENT IN A CLINICAL SETTING

IMPROVED PATIENT OUTCOMES

ENHANCED PATIENTS SATISFACTION

COST SAVINGS

BENEFITS OF IMPLEMENTING A NUTRITIONAL ASSESSMENT SYSTEM

DIETARY ASSESSMENT

EVALUATING FOOD INTAKE AND DIETARY PATTERNS

ANTHROPOMETRIC ASSESSMENT

MEASURING HEIGHT, WEIGH AND BODY COMPOSITION

BIOCHEMICAL ASSESSMENT

ANALYZING BLOOD AND URINE

CLINICAL ASSESSMENT

ASSESSING MEDICAL HISTORY AND PHYSICAL SIGNS OF MALNUTRITION

USE VALIDATED ASSESSMENT TOOLS

INVOLVE A MULTIDISCIPLINARY TEAM

REGULAR MONITOR AND EVALUATE OUTCOMES

PROVIDE PATIENT EDUCATION AND COUNSELING

BEST PRACTICES FOR CONDUCTING A NUTRITIONAL ASSESSMENT

LACK OF STANDARDIZED PROTOCOLS

TIME CONSTRAINTS

INTERDISCIPLINARY COLLABORATION

CHALLENGES IN IMPLEMENTING A NUTRITIONAL ASSESSMENT SYSTEM

ELECTRONIC DIETARY ASSESSMENT TOOLS

BODY COMPOSITION ANALYZER

LABORATORY TEST

MOBILE HEALTH

TOOLS AND TECHNOLOGIES FOR NUTRITIONAL ASSESSMENT IN A CLINICAL SETTING

PATIENT SATISFACTION

FEEDBACK ON PERSONALIZE CARE AND SUPPORT

PREGNANCY AND LACTATION

INCREASED ENERGY AND NUTRIENT REQUIREMENTS FOR FETAL DEVELOPMENT AND BREASTFEEDING

AGING AND ELDERLY

REDUCED APPETITE, CHANGES IN NUTRIENT ABSORPTION, AND INCREASED NUTRITION NEEDS

ATHLETES AND SPORT PERFORMANCE

HIGHER ENERGY EXPENDITURE AND SPECIFIC NUTRIENT REQUIREMENT FOR OPTIMAL PERFORMACE

WEIGHT GAIN MONITORING

IRON AND FOLATE LEVELS

CALCIUM AND VITAMIN D INTAKE

ASSESSMENT OF NUTRITIONAL STATUS IN PREGNANT WOMAN

MINI NUTRITIONAL ASSESSMENT

VITAMIN B12 ANS VITAMIN D LEVELS

ORAL HEALTH AND DENTITION

ASSESSMENT OF NUTRITIONAL STATUS IN ELDERLY PATIENTS

MINI NUTRITIONAL STATUS

ASSESSMENT TOOL TO IDENTIFY MALNUTRITION RISKS AND NUTRITIONAL STATUS IN OLDER STATUS

CHECKING FOR DEFICIENCIES

VITAMIN B12 AND VITAMIN D LEVELS

ENERGY BALANCE

MACRONUTRIENT AND MICRONUTRIENT ANALYSIS

HYDRATION STATUS

ASSESSMENT OF NUTRITIONAL STATUS IN ATHLETES

SELF REPORTING

VARIABILITY IN INDIVIDUALS HAVE UNIQUW NUTRITIONAL REQUIREMENTS BASED ON FACTORS

LIMITED IN INADEQUATE ACCESS

CHALLENGES IN NUTRITIONAL ASSESSMENT

NUTRITIONAL ASSESSMENT

PLAYS A CRUCIAL ROLE IN PROMOTING HEALTH AND PREVENTING DISEASE

ADVANCEMENT OF TECHNOLOGIES

WILL CONTINUE TO ENHANCE THE ACCURACY AND EFFICIENCY

ONGOING RESEARCH

IS NEEDED FOR BETTER UNDERSTANDING