Menu ENN Search

Improving nutrition surveys: New developments and changes at UNHCR

By Timo Luege, Caroline Wilkinson and Maeve de France

Timo Luege is an independent, humanitarian communications and advocacy consultant based in Berlin, Germany. Timo has experience working for non-governmental organisations (NGOs), United Nations (UN) and the Red Cross Red Crescent Movement both at headquarters and in the field. Timo works regularly for CartONG1.

Caroline Wilkinson is the Senior Nutrition Officer for the United Nations High Commission for Refugees (UNHCR) and was fully involved in the development of the SENS and the introduction of mobile data collection in UNHCR SENS surveys. She previously worked for 14 years with Action Contre la Faim (ACF) in several countries and headquarters in Paris.

Maeve de France has been an Information Management Project Manager for CartONG for three years. Prior to this she worked for five years in the private sector as a geographical information management project manager.

Over the last two years, the number of people facing crisis-level food insecurity has grown from 80 million to 135 million (FSIN, 2017). At the same time, many humanitarian organisations providing food and nutrition services (in kind or cash-based) are struggling with ever-increasing funding gaps, which have repeatedly forced them to cut back assistance.

Given that aid organisations need to reach more people on decreased budgets, it is ever more important that the money is spent as efficiently as possible. Surveys and assessments are an essential part of ensuring that sparse funds go to the most urgent crises and that in each crisis the most vulnerable are prioritised.

Box 1: Summary of SENS report contents

A SENS report includes information on the following data:

  • Levels of malnutrition and key health indicators in children
  • Levels of anaemia in children and women
  • Feeding practices of infants and young children
  • Access to food at the household level
  • Access to safe drinking water, toilets and hygiene practices at the household level
  • Access to and use of mosquito nets at the household level

UNHCR’s Standardised Expanded Nutrition Survey (SENS), described in Box 1,  is based on the Standardised Monitoring and Assessment of Relief and Transitions (SMART) methodology and provides valuable data to identify urgent needs, and changes in needs, in refugee contexts. Over the last five years the number of SENS surveys has risen from 63 in 2012 to 109 in 2016.

But every survey is only as good as the data it captures. Since 2011 UNHCR and its implementing partner for mobile data collection (MDC), CartONG, have been using MDC to increase data quality. As part of that collaboration, the percentage of SENS surveys that use MDC has grown from 32 per cent in 2013 to 95 per cent in 2016.

Most recently, UNHCR and CartONG have focused on three areas to further increase the quality of SENS for all humanitarian organisations that are using it.

1. Making SENS trainings less burdensome

Gathering anthropometric data is labour-intensive. A typical survey team consists of four to six people who must carry scales and height boards, take measurements and record data. There are many opportunities for mistakes to creep in, particularly when getting information from children or infants. To reduce the likelihood of data-capture errors, UNHCR and partners train all enumerators rigorously. This involves a five-day training that includes, among other things, what is known as the standardisation test. Conducting a standardisation test for anthropometric measures is a fundamental part of the training, since it allows objective assessment of the precision and accuracy of the measurements made by the enumerators, their strengths and weaknesses.

During the standardisation test, up to 20 enumerators measure ten children, usually aged between 18 and 59 months. Each measurement is repeated twice by each enumerator for each child, with a time interval between both rounds of measurements. Collecting all measurements takes between half a day and a full day, which is exhausting and tiring for both the survey team and the children. At the end of the day the measurements are compared with reference data collected by the trainer and that information is used to determine which enumerators are capable of which role, or whether some enumerators need additional training prior to the start of the survey. Until now, the facilitator has manually entered the captured data into a spreadsheet at the end of the day, a process that took a considerable amount of time and was a potential source of data input errors.

While UNHCR has used smartphones to capture SENS data for many years, prior to 2016 they had not been used for the standardisation tests that are part of the enumerators’ training. The main advantages of using smartphones for the standardisation tests are that data entry is much faster; there are fewer data entry errors; and it is harder for trainees to “cheat” during the training; for example, by manually copying data that has been captured earlier (see Figure 1). While this process still has some technical challenges that need to be resolved, the technical implementation has already improved significantly from Jordan in 2016 to Burundi in 2017. UNHCR and CartONG are confident that the remaining technical issues can be ironed out in 2018 and that full support for MBC for the SENS survey standardisation tests can be made available soon.

Figure 1: Screenshot of a standardisation test using a smartphone

2. Monitoring and verifying the sampling strategy through geolocation

A typical SENS survey takes between 30 and 45 minutes per household, so most teams can only talk to between 12 and 17 families per day. Particularly in large refugee camps, this means relying on random sampling to ensure that the data are representative. In some cases, with multiple teams working  in different parts of a camp or town, it can be difficult for the survey manager and supervisors to monitor progress of the teams and to ensure that the sampling methodology is being followed by all team members. By setting the smartphones to collect global positioning system (GPS) data, together with the survey data, supervisors can see precisely which houses were visited and whether this was in line with the agreed sampling strategy. In addition, supervisors can see whether teams have taken unusually long or were uncharacteristically fast when collecting data in specific locations, either of which might indicate  data quality issues.

3. Putting SENS on the map

While most nutrition experts feel very comfortable reading long tables with rows of data, this information is not always easy to convey to donors or to use in reports for non-experts. Maps can help make technical data more easily consumable for a wider audience. The new SENS mapper is a free, browser-based data viewer that can quickly show the distribution of SENS data on a map, including indicators for nutrition, safe drinking water and mosquito net coverage and where there are gaps.

While it is generally accepted that malnutrition is not geographically clustered, these maps can nevertheless be useful advocacy tools. Possible examples include showing that malnutrition levels are very different for new arrivals compared to refugees who have had access to food and services in a camp over a longer period. Similarly, a map could highlight areas of a camp where refugees have insecticide-treated nets but are not using them.

The free SENS mapper has just been published and can be accessed through the UNHCR map portal (http://maps.unhcr.org/apps/mdc_mapper/sens/index.html). The SENS mapper can easily create visualisations like those displayed in Figure 1 if SENS data is captured with smartphones.

Figure 2: Screenshot of the free SENS mapper

Red dots represent households with at least one anaemic child; green dots represent households with no anaemic children.

For more information, contact: hqphn@unhcr.org.


Endnotes

1CartONG, a long-time partner of UNHCR, is a French non-profit organisation committed to furthering the use of mapping, mobile data collection and information management in emergency relief and development programmes.


References

FSIN 2017. Food Security Information Network (FSIN) Global report on Food Crises 2017.  www.fao.org/fileadmin/user_upload/newsroom/docs/20170328_Full Report_Global Report on Food Crises_v1.pdf Retrieved: 4 Dec 2017.

More like this

FEX: Experiences with mobile data collection in UNHCR standardised expanded nutrition surveys

By Ellen Cecilie Andresen, Mélody Tondeur, and Caroline Wilkinson Since 2011, Ellen Cecilie Andresen has been a nutritionist with the Public Health Section at UNHCR...

en-net: Nutrition Survey Co-ordinator Jordan


Nutrition Survey Co-ordinator Jordan - UNHCR

Dates of consultancy: from 03/04/2016 to 24 /06/2016

Duty Station: Amman and for the report...

FEX: Open Data Kit Software to conduct nutrition surveys: Field experiences from Northern Kenya

By Daniel Muhinja, Sisay Sinamo, Lydia Ndungu and Cynthia Nyakwama Daniel Muhinja is National Nutrition Specialist with World Vision (WV) Kenya, providing technical leadership...

en-net: Standardization excercise / Test

Hello all, I would like to ask in this forum about the success rate, practicality and impact of standardization exercise on the overall quality of data collection documented...

en-net: SMART survey consultancy S Sudan (Juba) with Concern Worldwide

Concern Worldwide, South Sudan TOR for a Consultant to conduct a SMART Nutrition Survey in Juba POC Kator Payam, Central Equatoria State, South Sudan June...

en-net: SMART survey consultancy S Sudan (Unity State) with Concern Worldwide

Concern Worldwide, South Sudan TOR for a Consultant to conduct a SMART Nutrition Survey in Bentiu POC (Rubkona County) Unity State, South Sudan July 2015 Background Concern...

FEX: UNHCR standardised nutrition survey guidelines and training

By Melody Tondeur and Andrew Seal Melody Tondeur is an ENN Consultant and one of the team members implementing the Anaemia Control, Prevention and Reduction Project, a...

FEX: Monitoring and evaluation of programmes in unstable populations: Experiences with the UNHCR Global SENS Database

By Melody Tondeur, Caroline Wilkinson, Valerie Gatchell, Tanya Khara and Mark Myatt View this article as a pdf Lisez cet article en français ici Mélody Tondeur...

en-net: Nutrition Survey Co-ordinator Tanzania

TERMS OF REFERENCE
CONSULTANT, NUTRITION SURVEY COORDINATOR
EXPERIENCED IN NUTRITION SURVEYS AND SMART METHODOLOGY
TANZANIA –...

en-net: Nutrition Survey Co-ordinator Sudan

TERMS OF REFERENCE
CONSULTANT, NUTRITION SURVEY COORDINATOR
EXPERIENCED IN NUTRITION SURVEYS AND SMART METHODOLOGY
SUDAN – WHITE...

en-net: Baseline survey consultancy for Concern Worldwide nutrition project, Karamoja, Uganda in Q3 2016

Concern Worldwide in Uganda has an interesting opportunity for a baseline survey consultancy in a new nutrition project in two districts in Karamoja, Uganda. Please see...

FEX: Comparison of LQAS and 30-by-30 two-stage cluster sampled survey method for the assessment of coverage indicators

By Asrat Dibaba, Charles Chimombo, Ari Uotila, Whitney King and Mark Myatt Asrat Dibaba is the Maternal, Newborn and Child Health Advisor for World Vision East Africa Region...

FEX: Improving the quality of nutritional survey data worldwide: Putting Child Kwashiorkor on the Map Initiative

By Lauren Browne Lauren Browne is the Data Manager for the Kwashiorkor Mapping project and joined the team after interning with ACF-UK and Save the Children UK. She completed...

FEX: Nutrition surveillance in emergency contexts: South Sudan case study

By Alina Michalska, Eva Leidman, Suzanne Fuhrman, Louise Mwirigi, Oleg Bilukha, and Cecile Basquin Alina Michalska is the SMART Programme Manager at Action Contre la Faim...

en-net: Anthropometric survey target group: 0-59 months vs. 6-59 months and implications

Greetings EN-NET,
When I learned to do anthro surveys years ago, I was taught to sample children 6-59 months old. The rationale includes this group being most...

en-net: Surveys in Urban areas

Dear all,

Are there any examples of surveys done in peri-urban/urban areas with mixed populations of resident and migrant populations? I am looking particularly to...

FEX: Impact evaluation of a cash-transfer programme for Syrian refugees in Lebanon

By Christian Lehmann and Daniel T. R. Masterson Daniel Masterson is a PhD student in Political Science at Yale University. Daniel worked for UNHCR in Syria in 2007 and 2008....

en-net: Cost of a SMART survey

We've had a question to ENN regarding what is the typical cost of a SMART survey. I imagine there is a spectrum and depends on context, but any information that you can...

FEX: WFP experiences of vulnerability assessment of Syrian refugees in Lebanon

By Susana Moreno Romero Susana Moreno Romero is the Food Security Specialist and responsible of the VAM (Vulnerability Analysis and Mapping) team in WFP Lebanon since 2013,...

FEX: RAM-OP: A rapid assessment method for assessing the nutritional status, vulnerabilities, and needs of older people in emergency and development settings

By Pascale Fritsch (HelpAge International), Katja Siling (VALID International), and Mark Myatt (Brixton Health) Dr Pascale Fritsch is an experienced public health specialist....

Close

Reference this page

Timo Luege, Caroline Wilkinson and Maeve de France (2018). Improving nutrition surveys: New developments and changes at UNHCR. Field Exchange 57, March 2018. p40. www.ennonline.net/fex/57/nutritionsurveysunhcr