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Introduction
Home
- List of Acronyms
- List of Cooperating Sponsors
- Conversion Tables
Part One
Section I:
Commodities
- Commodity Availability
- Commodity Characteristics
- References
Section II:
Food Commodity
Fact Sheets
- Beans, Black
- Beans, Great Northern
- Beans, Kidney (Light Red, Dark Red, All types)
- Beans, Navy (Pea Beans)
- Beans, Pink
- Beans, Pinto
- Beans, Small Red
- Bulgur (BW)
- Bulgur, Soy Fortified (SFBW)
- Corn (bagged, bulk)
- Cornmeal
- Cornmeal, Soy-Fortified (CMSF)
- Corn Soy Blend (CSB)
- Corn Soy Milk (CSM)
- Corn Soy Milk, Instant (ICSM)
- Lentils
- Non Fat Dry Milk (NFDM)
- Peas
- Rice
- Rice (Parboiled)
- Sorghum
- Sorghum Grits, Soy-Fortified (SFSG)
- Fortified Refined Vegetable Oil
- Wheat
- Wheat Flour
- Wheat Soy Blend (WSB)
- Wheat Soy Milk (WSM)
Section III:
Storage/Shelflife
Specifications
- Storage Specifications
- Storage Inspection Checklist
- Shelf Life of Agricultural Commodities
- References
Section IV:
Controlling
Damage to Food
Commodities
- Cleaning and Inspecting
- Insect Control
- Rodent Control
- Reference Chart for Controlling Damage to Food Commodities
- References
Part Two
An Overview
Part Three
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Part II: Module 5: Emergency Programs
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Updated
January 2006
I.
INTRODUCTION
The
Office of Food for Peace's (FFP) Strategic Objective #1 (SO) for
emergency food aid programs is stated as "Critical food needs of
targeted groups met." This SO, in turn, directly supports the USAID
strategic goal, "Lives saved, suffering associated with natural and
man-made disasters reduced, and conditions necessary for political
and/or economic development re-established." Therefore, PL 480, Title
II-funded emergency food aid programs should be designed and
implemented with this strategic objective in mind.
Title
II emergency food aid is used largely for three types of humanitarian
crises: natural disasters; complex emergencies; and post-emergency
situations. Natural disasters are crises caused by nature, such as
floods, earthquakes, flooding, or drought. Complex emergencies
generally arise from prolonged civil strife, often exacerbated by
climatic and other events, and are characterized by insecurity, failure
or the inability of host governments to respond effectively to assist
refugees, internally displaced persons (IDPs) and other vulnerable
groups. In post-relief situations, food aid is used to help facilitate
resettlement, reintegration of ex-combatants, and in rejuvenating local
food production. In accomplishing the latter objectives, private and
voluntary organizations (PVOs) and other recipient organizations may --
with FFP approval -- monetize a portion of the food aid for local
currency required for an emergency program.
By
meeting the critical food needs of vulnerable groups when a natural,
man-made, or civil disaster strikes, Title II emergency food aid can
minimize human and economic losses and accelerate the return to
normalcy. Emergency food aid can also be an important vehicle in
building the capacity for longer-term food security during the
post-relief period.
During
the design of emergency food aid programs, Cooperating Sponsors (CS)
and USAID endeavor to: (1) target food aid to reach the most vulnerable
populations in a timely and cost-effective manner; (2) undertake
interventions that do not disrupt local production and do not encourage
aid dependency; and (3) incorporate capacity-building activities to
ease the transition from crisis to recovery and eventually to longer
term development. Guidelines to assist in the selection and use of food
aid commodities in emergency programs are outlined below.
II.
GUIDELINES FOR COMMODITY SELECTION FOR EMERGENCY PROGRAMS
This
Module sets forth in five steps how to choose the most appropriate and
cost-effective rations to accomplish emergency program objectives. This
guidance is intended to be flexible enough to encourage the selection
of food aid rations that are most appropriate for each emergency
situation. Box 1 below identifies the five key steps in the commodity
selection process:
STEP 1: PROGRAM DESIGN
The
five key program design steps usually consist of the following: (1)
conducting a needs assessment; (2) determining appropriate use of food
aid; (3) identifying the target population; (4) developing program
activity objectives; and (5) reaching decisions regarding the
distribution mode and frequency. These components are key elements for
the development of Title II Emergency Food Aid proposals. These
guidelines are primarily for use in determining rations selection and
are not meant to be rigidly proscriptive. For detailed guidelines on
proposal development see FFP's
PVO Guidelines for Title II Emergency Food Proposals and Reporting
(Draft). An explanation of each design component follows:
1.
Conducting A Needs Assessment
All
FFP emergency food aid requests must demonstrate the need for food as
an appropriate response to the emergency. A needs assessment should be
carried out in a participatory and timely manner. Frequently, an
in-country needs assessment is carried out on a joint basis involving
several different agencies, including the World Food Program and PVOs.
This assessment is needed to determine the nature, extent, severity of
the emergency (including, whenever possible, an indication of the
degree of malnutrition), food accessibility and availability, and to
identify factors that may impede effective utilization of food. The
assessment should also describe the criteria for selecting the
beneficiaries and geographic areas to be targeted. Key to the
assessment are good estimates as to whether local foods may be used to
supplement the food aid ration package, and how donor and implementing
agencies will work together and what role U.S. food aid will play in
satisfying the populations complete food need.
Primary
Data Collection: Data may be attained through primary sources such as
food consumption surveys, nutritional status surveys, or rapid food
security assessments. Qualitative data may be collected using
techniques such as, in-depth interviews, focus group discussions, rapid
appraisal techniques, and observation verification of self-reported
behavior by participating households. Key informants might include
local health authorities, community leaders, teachers, or other
knowledgeable members of the population. Tips for collecting primary
data are provided in USAID/CDIE's
Performance Monitoring and Evaluation Tips. Other resources can be
found in the Resource List at the end of this module.
Secondary
Data Collection: Secondary data are available from several sources
including: the USAID/Africa Bureau-funded Famine Early Warning System
(FEWS); UN Food and Agriculture Organization (FAO) crop and food supply
reports; UN World Food Program (WFP) food aid assessment reports;
international and local PVO reports and other donor reports. Quarterly
reports on the nutritional status of refugees and internally displaced
persons can be obtained in hard copy or on the Internet from the Refugee Nutrition
Information System (RNIS) of the United Nations Sub-Committee on
Nutrition. The Health Information Network for Advanced Planning
(HINAP) of WHO's Department of Emergency and Humanitarian Action
provides baseline health information, which is updated during an
emergency at The findings from the need assessments will naturally
drive the program design process. Box 2 below contains examples of some
possible general outcomes of an assessment.
Box 2- Examples of Assessment Outcomes
No Food Assistance When:
There is only minor disruption in crop production or marketing systems
or despite a minor or localized crop shortfall, the populations
concerned are able to cope with the situation, or other resource needs
take priority.
Short-Term (Rapid Onset) Assistance
When:
Some food stocks may be lost, normal food supply/marketing systems may
be disrupted, and/or crops may be damaged. Examples include situations
immediately following earthquakes, floods, storms, fires, and
short-duration civil disturbances. The duration may be as little as a
few days or until the next harvest or longer under certain
circumstances.
Medium-Term Assistance When:
It is not possible for the affected populations to return to normalcy
within a period of 12 months or less. This includes massive crop
failures and the inability of refugees or internally displaced persons
(IDPs) to return home for security, political and other reasons.
Longer Term Title II Development
Assistance When:
Refugees and IDPs have returned to their home areas or when populations
affected by drought, floods and other natural disasters can resume
productive agricultural activities. However, in this type of a
transition situation, it is advisable for cooperating sponsors to
consult with FFP prior to designing a Pre-Development or Short Term
Development Program or Development Program (DAP) proposal.
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2. Determining the Appropriate Uses for Food Aid
The objectives of emergency food aid can vary. Some examples of
objectives include: (a) to satisfy the nutritional requirements of
vulnerable target groups; (b) to improve the nutritional status of
malnourished individuals; (c) to enable affected households to maintain
or resume livelihood activities; (d) to reduce sales of household
assets to purchase food; and (e) to prevent mass migration out of areas
affected by drought and other natural disasters. Naturally, each of
these different activities will involve different targeting rations,
and exit criteria.
3.
Identifying the Target Population
Plans
for emergency food aid must include efforts to identify key
characteristics of the recipient populations. The target beneficiaries
may include entire populations of refugees, IDPs or persons who remain
in their home communities. Other programs may be targeted only to
extremely vulnerable groups within these populations, such as young
children, lactating and pregnant women, the elderly, and certain
livelihood groups or particular family units that have lost their
source of income.
In
emergency situations the size and circumstances of target groups can
change quickly due to the movement of conflict zones, worsening drought
conditions, encroaching floods, or other factors. These changing
conditions naturally complicate planning and logistics, which can force
changes to the size of the target group or the size of the ration,
method of transportation or distribution or food storage arrangements.
4.
Developing Program Activity Objectives
Although each CS will approach the achievement of FFP
Strategic Objective No. 1 (Critical Food Needs of Targeted Groups Met)
in different ways, it is urged that cooperating sponsors (CSs) review
USAID's Managing for Results terminology (see Annex 1 ()) prior to
drafting the proposal. Program objectives will be result statements,
that is, a description of the end result to be achieved through the
food aid intervention. One results-oriented objective might be
"Improved nutritional status of target population." Each result statement should have at
least one performance indicator to track progress. Performance
indicators are variables with a particular characteristic or dimension
to measure progress toward achievement of the stated result. For
example, an indicator for the objective, "Improved nutritional status
of target population" could be "average weight-for age- z-score within
the target group". Sample food security and nutrition indicators may be
found in Annex II. USAID/CDIE's Performance
Monitoring and Evaluation Tips also provides guidance on how to
develop result statements and performance indicators. For purposes of
USAID humanitarian goal monitoring in emergency situations, changes in
the wasting (weight for height) of children under five years of age
and, if possible, the crude mortality rate are most important.
5.
Determining the Distribution Mode and Frequency
Emergency
food aid activities can generally be divided into two major categories:
general food distribution and targeted food distribution. General
distribution programs often provide full nutritional support for
emergency affected populations immediately after the onset of a
humanitarian crisis. Food is distributed to all members of the
population on a regular basis. Targeted food aid provides food to only
a segment of the emergency affected population, to meet the particular
needs of the most nutritionally vulnerable households or individuals.
These groups often include children, especially those under five;
orphans or unaccompanied children; pregnant and lactating women; the
elderly, the ill; the handicapped; those who are malnourished; or those
displaced from their homes.
The
distribution of targeted food aid can take any of several different
forms, depending on the characteristics of the targeted group and
contextual circumstances. Common examples of targeted programs are
supplementary feeding for malnourished children or pregnant and
lactating women, therapeutic feeding for the severely malnourished,
school feeding, and/or food-for-work.
A
combination of approaches may be necessary. For example, general
feeding plus supplementary feeding for nutritionally vulnerable groups
may be most effective in some situations. Programming should change
over time to reflect positive or negative changes in circumstances that
affect the population's ability to feed themselves. Similarly, the
rations in a general feeding program may evolve from providing total
daily requirements to providing only partial energy requirements and
selected nutrients before being phased out completely in favor of
targeted feeding for households least able to sustain themselves or
food-for-work activities. In all phases of relief operations, the
participation of affected populations, especially women, in ration
determination, food distribution and monitoring is encouraged. This
maximizes program efficiency and effectiveness and honors the dignity
of the recipients.
There
are two primary emergency food aid distribution methods:
- On-Site
(wet) Feeding: In this type of distribution, recipients are
provided prepared food for consumption on the spot. The most common
examples of on-site feeding are therapeutic feeding of severely
malnourished children and the feeding of children under two and a
caregiver at community feeding centers. The advantage of on-site
feeding is that food rations are eaten under supervision, which helps
to ensure that the food supplement is actually consumed by the target
population. To obtain maximum nutritional improvement, two meals or a
meal and a snack, 365 days per year are suggested. The disadvantages
are that on-site feeding is labor intensive and, therefore, not always
feasible, and the likelihood is high that food may be withheld from
beneficiaries at home because they have already eaten at a feeding
center.
- Take-Home
(dry) Rations: More commonly, uncooked food rations are distributed
to be carried home for preparation and consumption. The advantages of
take-home rations are that they are easier to administer, more
cost-effective, less time consuming, and can reach larger numbers of
people. However, dry rations may be consumed by family members
(leakage) other than the intended beneficiary, if the program is
targeted on special vulnerable groups, or it may be sold/exchanged in
the market, thereby reducing their nutritional impact on the whole
family. Yet, other critical needs of the household may be satisfied
this way. In some cases, a pre-cooked emergency food such as a high
energy, nutrient dense emergency relief biscuit or bar may be
available. The advantage of these types of products includes ease of
handling and a set nutrient profile. While convenient, these foods are
not recommended for long term use. Refer to the specifications for
these bars for their use and appropriateness.
When
designing take-home rations for a targeted group, consideration must be
given to the fact that other family members will almost always share
take-home rations. Some ways of addressing intra-household food sharing
include education, increasing the ration package to accommodate
sharing, or selecting ration commodities that are more likely to be
consumed exclusively by the targeted individuals. For example, blended
cereals may be regarded as "baby food" and thus, less acceptable for
consumption by other family members..
The
mode and frequency of distribution should be based on the accessibility
to the target population, commodity transport and distribution costs,
the nutritional profile of the target group, and the type and quantity
of rations. It is also important to consider the distance and travel
time to and from the center required for caregivers to pick-up and
carry the food or the opportunities lost by beneficiaries and
caretakers while attending on-site feeding.
Back to Five Steps for Selecting Food Rations
STEP
2: SUITABILITY OF FOOD COMMODITIES
Suitability
is defined as those attributes of the individual ration recipient,
target household, or community that will affect their utilization of
the foods provided. Judgment of ration foods' suitability should take
into account traditional diets, food taboos, nutritional content,
physiological appropriateness, resources for preparing the food for
consumption, and the population's ability to access other food. Food
that is not accepted by the population or that cannot be readily
prepared with resources available to the recipients will not be eaten,
and, consequently, cannot effect the intended results.
It is
critical that the design of an emergency program does not compromise
the adoption of appropriate and recommended feeding and dietary
practices including exclusive breast feeding for infants under six
months of age. The eligibility criteria for recipients, quantities,
commodity mix, and recommendations for use of the rations should be
consistent with official government policies and with standard
practices used by USAID and the UN. Detailed recommendations for
appropriate feeding practices are available from USAID's LINKAGES
Project series titled Facts for Feeding at www.linkagesproject.org.
Below
are other key factors that should be examined carefully when choosing
suitable ration commodities:
Cultural
suitability: It is important to consider women's and children's
traditional diets, taste preferences, food taboos, and feeding
practices. Unfamiliar food may be made more acceptable through
nutrition education, food processing, packaging, and/or by combining it
with familiar foods in recipes.
Nutritional
content: This refers to the energy, fat, protein, and micronutrient
content of the rations. There are certain nutritional considerations
for women and children that should be examined when designing food
rations. Young children, especially those up to 24 months of age,
suffer linear growth faltering (stunting) and delayed development that
leaves permanent damage when they are not adequately nourished.
Underweight children are also at much higher risk of death due to
illness than are their well-nourished counterparts. Although energy
(kilocalories) is the main predictor of height and growth, adequate
micronutrients and protein for this age group are also important
particularly vitamin A.
Pregnant
and lactating women need extra energy, protein, and micronutrients to
support the growth of their fetus or infant and maintain their own
health. Pregnant women need the extra nutrients for the growing fetus
and to ensure a healthy and safe birth outcome without depleting her
own reserves and putting herself and her child at greater risk. While
frequent, on-demand breastfeeding helps to maintain the quantity of
breast milk, lactating mothers need extra energy and nutrients to
produce optimal quality breast milk, to protect their own health, and
to assure that their nutritional stores are preserved or restored to
support subsequent pregnancies.
People
with HIV/AIDS suffer from appetite loss (anorexia), eat less food and
have difficulty eating and therefore fail to meet their dietary
requirements. HIV/AIDS also affects how the body uses the foods that
are consumed and this results in nutrient malabsorption. Fevers and the
infections that accompany an HIV infection also lead to greater
nutrient requirements and poor use of the nutrients by the body. There
are several illnesses that are common with people living with HIV/AIDS
and that cause malnutrition. These include poor appetite or anorexia,
losing weight, fever, diarrhea, frequent vomiting, oral thrush and
other infections. Good nutrition for HIV affected people requires the
consumption of an adequate amount of macronutrients such as proteins,
carbohydrates and fats, and micronutrients, which include vitamins and
minerals. A deficiency in macronutrients, also known as protein energy
malnutrition manifests itself in the weight loss and wasting that is
typical of AIDS patients. This weight loss and wasting occurs as a
result of reduced food intake, nutrient malabsorption and changes in
metabolism. Vitamin A for HIV affected people is important for growth,
immune function and maintenance of the lining of the respiratory,
gastrointestinal, and gastro-urinal tracts. Consuming micronutrients
especially vitamin A, B6, B12, iron, and zinc are important for
building a strong immune system and fighting infections. Consuming
fortified foods like the cereal blends and vegetable oil fortified with
vitamin A as well as taking micronutrient supplements at early stages
of HIV infection can slow weight loss and disease progression. In the
case of vitamin A there is the likelihood of reduced transmission
between mother and child and slowing the progression of the disease in
infected people. Refer to the FANTA publication on "Nutritional Care
and Support for Persons Living with HIV/AIDS and other Affected
Household Members" at www.fantaproject.org.
Physiological
appropriateness: Young children and the elderly require food that
can be easily chewed and digested. In particular, infants and young
children are unable to meet their caloric needs through high-bulk
foods, such as cereals and legumes, due to their limited gastric
capacity. See Box 3 below for gastric capacity of children aged 6-24
mos. For example, infants between 9-11 months have a stomach capacity
of 285 grams. If these infants are breast fed an average amount of
breast milk (659 kcal ), they would need 168 grams of CSB to meet their
additional caloric needs (1,290 kcal - 659 kcal = 631 kcal). This
amount of CSB yields about 1,400 grams of gruel (assuming the gruel is
12% CSB). If the infants are fed the gruel four times a day, they would
need to consume 350 grams of gruel at each meal to meet their
supplemental caloric needs with only CSB. This amount is too much for
their stomach capacity. Therefore, to assure that the infant's energy
needs are met, either the infant must be fed less of this gruel more
frequently or an energy-dense, low-bulk source of energy, such as sugar
or vegetable oil, must be added to the gruel. Children who are
undernourished have an even smaller stomach capacity.
Box 3- Stomach Capacity of Children 6 to 23 months
Well nourished:
6-8 months - 249 g
9-11 months - 285 g
12-23 months - 345 g
Growthretarded:
6-8 months - 192 g
9-11 months - 228 g
12-23 months - 273 g
Source: WHO, Complementary Feeding of Young Children in
Developing Countries: a
review of current scientific knowledge, p. 61. |
The
viscosity of prepared foods for children less than 24 months should
also be considered. Cereals vary considerably in viscosity, and once
prepared, can become thick and difficult for these young children to
eat. When mothers dilute the cereals to make them more edible for their
children, they are significantly reducing the density of energy,
protein, and micronutrients, increasing the volume of intake that is
necessary. For this reason, nutrient and energy dense soy-blended
cereals are better choices for dilution than a one-grain cereal.
Digestibility and/or food intolerance problems for this target group
should also be taken into consideration as rations are selected.
Appropriateness
to good feeding practices: The use of specific donated foods
should be consistent with appropriate feeding guidelines including
exclusive breast feeding for infants under 6 months of age and
continued, frequent on-demand breast feeding to 24 months and beyond.
For children 6 to 24 months, it is important to gradually increase food
thickness and add variety as the child ages. However, care must be
taken to ensure that these foods complement rather than replace breast
milk. In addition to breast milk, children over 6 months of age should
be feed other foods with the following recommendations:
- Provide
6 to 8 month old infants approximately 280 kcal per day from
complementary foods.
- Provide
9 to 11 month old infants approximately 450 kcal per day from
complementary foods.
- Provide
12 to 24 month old children approximately 750 kcal per day from
complementary foods.
Feeding
frequency is another important consideration. By combining meals and
snacks, children should be fed complementary foods with the following
frequency:
- Feed
complementary foods for 6 to 8 month old infants 2-3 times per day.
- Feed
complementary foods for 9 to 11 month old infants 3-4 times per
day.
- Feed
complementary foods for 12 to 24 month old children 4-5 times per
day.
Complementary
foods can include the food aid commodity and should be programmed to
ensure the young child has a diversified and nutritious diet. During
illness, the child should continue to receive breast milk and receive
frequent and active feeding. Any feeding activity should be designed
that the young child is feed directly, slowly and patiently. Children
should not be forced to eat.
For
more information on young child and adolescent feeding, refer to the LINKAGES
Project series titled Facts for Feeding.
Availability
of processing and/or storage facilities: Consider factors that will
affect households' ability to prepare the food, such as access
(distance and affordability) to mills, household food storage
capacities, access to fuel for cooking, and preparation time. The
chosen foods should minimize preparation demands, especially fuel wood
demands because of the potentially negative environmental impact.
Characteristics
and availability of locally produced food: Determine the timing of
harvests and seasonal availability and affordability of local foods,
and the affected population's ability to access these foods. Imported
Title II food aid should complement what is already available and
accessible.
Food
and cost effectiveness considerations: Ideally, the most
cost-effective ration package to achieve the desired result should be
selected. However, in rapid onset emergency situations,
cost-effectiveness considerations may be overshadowed temporarily by
the U.S. government's overarching humanitarian response objective,
which is to save lives and reduce human suffering as quickly as
possible.
Back to Five Steps for Selecting Food Rations
STEP 3: RATION SPECIFICATIONS (ENERGY
REQUIREMENTS)
1.
General Food Distribution
Basic
nutritional requirements for individuals vary according to age, sex and
reproductive status. Nevertheless, for practical reasons, rations for
general food distribution are usually distributed equitably for all
persons, male and female of all ages. Therefore, the content of an
individual ration package is based on the average per capita
requirement. This presumes that the food can be redistributed within a
household, which includes individuals some of whom have greater or
lesser than average requirements. The average per capita energy needs
can be calculated using the demography of the affected population and
age/sex-specific energy requirements.
However,
at the onset of an emergency rapid response is essential and,
generally, the demography of the population is not known. Therefore, to
enable planning for quick response, the key international humanitarian
organizations have agreed to respond with rations that supply a default
energy requirement of 2,100 kcal/person/day, if the population is
totally dependent on outside sources of food . This default value was
not selected arbitrarily. It is the average need based on the
demography of a "typical" developing country, and assumes that members
of the population are of average (worldwide) body size, are engaged in
light physical activity, and live in moderate climatic conditions. When
planning for immediate response, the proposed ration package should
meet this energy requirement. In extreme cases, additional energy to
cover high activity or severe cold should be considered. (See Box 4.)
As
soon as possible after the onset of the emergency, the ration should be
adjusted to reflect the true demography of the population being served,
and any good estimates of other reliable sources of food Typically,
when beneficiaries are registered for food rations their age and sex
are recorded, and within a few months after the emergencies' onset
population breakdowns by relatively standard age/sex categories are
available. Using these data, average per capita energy requirements for
the population can easily be calculated using the following guidelines:
To
calculate the average per capita energy requirement in a population of
known demographics (by standard age/sex groups):
- Multiply
the percentage of the population per age/sex group times the
energy requirements for each group. For example, if the percentage of
girls 0-4 is six percent (per demographic data available), multiply
0.06 times 1250 kilocalories. (The energy requirements for each age/sex
group can be found in Table 1 below.) Do this for each age/sex group.
- Sum
the calculations of percentage X per capita energy requirements for
all age groups.
- Multiply
the Total Sum by 1.05 to account for the high fiber content of
typical food aid commodities (Atwater correction).
The
final adjusted sum is theoretically the average per capita energy
requirement across the population. From that point, the energy content
of rations should be based on the results of these calculations, i.e.,
the default of 2,100 kcal/p/d should be replaced by the newly
calculated average. Table 1 below provides a table for calculating the
average energy requirement in a population of unknown demography.
Table 1:
Calculation of Average Energy Requirements in Population of Known
Demography
Age/sex group
|
% of
population
|
X
|
Requirement for
Age/sex group (kcal/d)
|
|
Girls 0-4 yrs
|
|
X
|
12501 =
|
|
Boys 0-4 yrs
|
|
X
|
13201 =
|
|
Girls 5-9 yrs
|
|
X
|
1730 =
|
|
Boys 5-9 yrs
|
|
X
|
1980 =
|
|
Girls10-14 yrs
|
|
X
|
2040 =
|
|
Boys 10-14 yrs
|
|
X
|
2370 =
|
|
Girls 15-18 yrs
|
|
X
|
2120 =
|
|
Boys 15-18 yrs
|
|
X
|
2700 =
|
|
Non-pregnant female 19-59
yrs
|
|
X
|
1990 =
|
|
Pregnant female 20+ years2
|
|
X
|
2275 =
|
|
Male 19-59 yrs
|
|
X
|
2460 =
|
|
Female 60+ yrs
|
|
X
|
1780 =
|
|
Male 60+ yrs
|
|
X
|
2010 =
|
|
SUM
|
100%
|
|
3 =
|
X 1.05 (Atwater
correction) = Average Requirement =
|
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1 For breast fed
children, part of this energy is for the mother and the rest for
complementary feeding of the child
2 A crude estimate for % pregnant females = 4% of all females aged
19-59 years and for % non-pregnant females = 96% of all females aged
19-59 years
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Other
adjustments that reflect differences from assumed conditions (i.e.,
average body size, light activity, and temperate climate) should also
be considered. Members of a population that are engaged in moderate or
high activity (e.g., doing heavy manual labor or walking long distances
to gather fuel), or are living in extremely cold climates, will need
more energy. Simple formulas for adjusting the average per capita
requirement are:
- Add
an extra 100 kcal/p/d for every five degrees below 20° C.
(Note: this may be a seasonal adjustment)
- Add
an extra 140 kcal/p/d for moderate activity levels and 350 kcal/p/d
for heavy activity.
Adjustments
based on extreme body size is also a consideration but will rarely be
needed. The adjustment may be upward (for populations of extremely
large individuals) or downward (for populations of extremely small
individuals).
Finally,
not every assisted population needs food aid to supply all of their
daily needs. Except during the most acute stages of an emergency, many
have access to other food. For example, as a displaced population
adjusts to their new environment or emergency conditions are mitigated,
some find employment and can buy food, and others gain access to land
to farm and produce food. In these cases rations can be reduced, but
reductions should be according to the type and quantity of food
otherwise accessed. There is no simple formula to apply such
adjustments. Each individual situation should be analyzed in terms of
food availability and the households' ability to access that food. This
requires a careful assessment of the household economy and food
security.
In
summary, the per capita energy content of rations for general feeding
should equal the average requirement based on demography (or default of
2100 kcal/p/d) + activity level and/or temperature adjustments +/- body
size adjustment - energy provided by other food (see Box 4 below).
Box 4 - Formula for Determining
Energy Content of and Individual Ration for A General Feeding Program
Average Energy Requirement* + Activity
Level/ Temperature Adjustments +/- Body size adjustment - Energy from
other food = Total kilocalories per daily ration
* From demography or default of 2,100
kcal/p/d, if demography is unknown
|
2.
Targeted Food Distribution
Targeted
food distribution is designed to target only a segment of the emergency
affected population, to meet the particular needs of the most
nutritionally vulnerable households or individuals. These groups often
include young children, orphans or unaccompanied children, pregnant and
lactating women, and those who are malnourished or displaced from their
homes. Young children are most vulnerable to the cycle of malnutrition
and infections and, therefore, should be the first target group to
receive supplemental food. Targeted feeding generally include
supplementary feeding and/or therapeutic feeding programs.
a)
Supplementary Feeding
There
are two types of supplemental feeding programs (SFPs): targeted and
blanketed. Targeted SFPs are aimed at rehabilitating moderately
malnourished target groups, preventing moderately malnourished groups
from becoming severely malnourished, reducing the mortality and
morbidity of children under five, and providing food supplements to
selected pregnant and nursing women and other individuals at risk.
Targeted SFPs should be considered when:
- There
is a prevalence of 10-14 percent acute malnutrition among
children (age 6 to 59 months) whose weight-for-height is below -2 Z
scores or less than 80 percent of the median NCHS/WHO reference values
and/or edema); or
- There
is a prevalence of 5-9 percent acute malnutrition and widespread
food insecurity and high rates of disease
Blanketed
SFPs are intended to prevent widespread malnutrition and excess
mortality among at risk groups. Blanket food distribution is most often
directed to all children under a given age, pregnant and nursing
mothers, the handicapped or elderly. Blanket SFPs are needed when:
- At
the onset of an emergency general food distribution is not
adequately meeting energy deficits;
- The
prevalence of acute malnutrition among children <5 years of age
is equal to or greater than 15 percent;
- The
prevalence of acute malnutrition among children <5 years is 10 -
14 percent, and there are aggravating factors, such as widespread food
insecurity and/or disease;
- There
is an increased rate of malnutrition due to seasonally induced
epidemics; or
- There
are cases of micronutrient deficiencies
Guidelines
for developing rations specifications for supplemental feeding programs
are the same as for Maternal Child Health and Nutrition (MCHN) programs
and can be found in Module 1- MCHN Programs.
b)
Therapeutic Feeding
Although
it is not within the scope of the CRG to discuss details of therapeutic
feeding, a brief mention may be useful here. The objective of
therapeutic feeding programs (TFP) is to provide intensive curative
care for severely malnourished recipients (primarily children with
weight-for-height less than -3 Z score and/or edema). These programs
should be closely supervised by qualified medical professionals. The
establishment of centers for therapeutic feeding should be considered
when the rate of malnutrition among under-fives exceeds 10% and the
capacity of existing facilities is exceeded. For guidance on admission
and practices of therapeutic feeding, see WHO's The Management of
Nutrition in Major Emergencies (see Resource List). For policy
information on therapeutic feeding, refer to http://www.usaid.gov/our_work/humanitarian_assistance/ffp/therapeutic.html
3.
Income Transfer Value.
Food
is seldom used in lieu of cash as an incentive or partial payment for
work for the entire duration of an emergency-feeding program. However,
especially while phasing out of an emergency program, rations may be
designed to serve as an income transfer. For example, some food
commodities with a high monetary value on the local market may be
provided in order to reduce household spending on food and thus free
income to purchase other food or non-food essentials. However, in the
light of cost considerations, low value rations might also serve this
purpose while reaching larger numbers of people. Rations of this type
are most commonly provided through a food-for-work program. Commonly,
the minimum wage paid for work that is available in the area is the
basis for determining the type and quantity of food in the ration,
i.e., the market value of the ration should approximate the minimum
wage. (See Module 2: Food for Work.)
Back to Five Steps for Selecting Food Rations
STEP
4: RATION CALCULATIONS
After
determining the energy requirements of the ration package, the
following may be determined: (1) type of ration package; (2) type and
quantities of food commodities; and (3) the total tonnage of
commodities needed.
Ration
calculators that compute the quantity of foods necessary to
provide a population all micronutrients at the lowest cost can help in
the design of appropriate diets given locally available and affordable
commodities. There are a number of calculators in existence or in
development, including NutriSurvey
(www.nutrisurvey.de/lp/lp.htm).
These tools can be helpful in determining an appropriate
population-level ration, but are not appropriate for therapeutic
feeding, replacement feeding, or individual ration calculation.
1.
Defining the ration package
Energy
is the main macronutrient and is of primary concern for survival.
However, two other macronutrients that deserve consideration are
protein and fat. Protein is important for growth and recuperation from
disease. While a ration package composed of sufficient energy and a
range of protein-rich commodities (cereals, blended foods, legumes)
usually provides a sufficient amount of protein, it is important to
ensure that ration packages provide sufficient protein for
nutritionally vulnerable groups, such as young children and pregnant
and lactating women. Fat is a rich source of energy and essential for
health and the prevention of some diseases. Therefore, ration packages
need to content a minimum amount of fat.
Vitamins
and minerals, referred to collectively as micronutrients, are essential
to the health of people of all ages, but especially for growing
children and women during their reproductive years. Below are some
guidelines for defining the ration package by its nutritional content.
a)
Macronutrients
For
general rations: As with energy, the recommended protein and fat
contents are averages of the needs across a typical population of
diverse ages. WHO's recommendations are the following:
- The
ration should include a mixture of cereal and pulse that provides a
minimum of 46 grams of protein daily per person.
- To
cover the requirements for certain essential fatty acids, 17-20
percent of the ration energy should be provided in the form of fats or
oil, but no more than 10% of energy should come from saturated fatty
acids (found in all animal fats and some vegetable oils).
For
supplementary feeding: Ration content should reflect the protein
and fat needs of the targeted portion of the population. However,
remember that a supplementary ration, by definition, adds to food from
other sources, which also contribute fat and protein to the
beneficiaries' diets, i.e., the supplementary ration does not supply
all of the requirements of fat and protein. With regard to fat and
protein, guidance that should be considered in the design of ration
packages for supplementary feeding targeted exclusively to children or
women are that:
- Fats
and oils in the diet (including the supplementary ration plus
other foods eaten) should provide 20% of total energy intake of women
of reproductive age and 30-40% of total energy for children up to 2
years of age.
- The
needs of pregnant and lactating women are higher than those of
non-pregnant/non-lactating women (7-10 grams per day (g/d) more during
pregnancy and 14-19 g/d during lactation). On the other hand, the
overall protein needs of young children, are lower than the average in
the population overall (only 25-35 g/d).
For
more guidance on developing ration packages for women and children,
refer to Module 1- MCHN Programs. For the elderly, refer to Module 4- Non-Emergency Humanitarian Assistance
Programs.
b)
Micronutrients (vitamins and minerals)
In
emergency situations, target groups are often already micronutrient
deficient and at risk for serious micronutrient deficiencies.
Deficiencies in vitamin A, iron, and iodine, while common, cases of
pellagra (due to niacin deficiency), scurvy (due to vitamin C
deficiency), and beri beri (due to thiamin deficiency) are reported
less frequently. Outbreaks of pellagra, scurvy, and beri beri, however,
are easily avoidable. These deficiencies occur most often in situations
where populations are dependent on a singular or limited sources of
food for an extended period of time, and are more severe when a
nutritionally inadequate ration is provided.
There
are various ways of preventing micronutrient deficiencies through the
use of select Title II commodities. These include: increasing the
variety and quantity of food in the general ration and/or improving the
quality of foods provided in the ration. To increase the nutritional
quality of the ration, a fortified blended food or a non-blended milled
cereal could be included in the ration. Fortified blended foods
are composed of a granulated mixture of partially precooked cereal
flour, soy flour, vegetable oil, and vitamins and minerals. Fortified
blended foods have the benefit of wide range micronutrient
fortification. Non-blended milled cereals are raw commodities
that have been ground so that the commodity is easier to prepare for
cooking. In contrast to the fortified blended commodities, fewer
vitamins and minerals, if any, and usually no other food components are
added to the non-blended milled commodities.
Fortified
blended commodities include Corn Soy Blend, Wheat Soy Blend, Corn Soy
Milk , Wheat Soy Milk, and Instant Corn Soy Milk. These fortified
blended commodities provide a good source of additional energy,
protein, and micronutrients. Each of these blended commodities is
fortified with protein, riboflavin, niacin, thiamin, calcium, iron,
vitamin A, vitamin B12, folic acid, zinc, pantothenic acid, iodine,
magnesium, vitamin C, vitamin D, vitamin E, pyridoxine HCL, and salt.
Details on the level of fortification of blended commodity can be found
in Table 1.3, in Section I of Part One of
the CRG.
Non-blended,
milled commodities include two broad categories: 1) Basic milled
commodities with a limited selection of micronutrients added and 2)
Milled commodities with a limited selection of micronutrients and 15
percent soy added (for increased protein content and quality). The
category of basic milled commodities includes Bulgur Wheat, Cornmeal,
Sorghum Grits, Wheat Flour, and Rice. The category of milled
commodities with soy added includes Soy-Fortified Bulgur Wheat,
Soy-Fortified Cornmeal, and Soy-Fortified Sorghum Grits. While not as
effective to address poor nutrition as fortified blended commodities,
inclusion of a non-blended milled commodity such as Bulgur Wheat or
Soy-Fortified Bulgur Wheat can improve the nutritional content of a
ration. Compared with the fortified blended commodities, non-blended
milled commodities do not offer the same level of protection from most
micronutrient deficiencies. Milled commodities are fortified with
calcium, iron, vitamin A, thiamin, riboflavin, and niacin. Wheat Flour
and Milled Rice are special cases. Wheat Flour is fortified with folic
acid, in addition to calcium, iron, vitamin A, thiamin, riboflavin, and
niacin. Milled Rice is not fortified with additional micronutrients.
The
blended and non-blended fortified commodities, while providing protein,
energy, and micronutrients, do not provide adequate lipids (fat
content) when given alone. Lipids are energy dense, provide essential
fatty acids, and are important in the diet for transport of fat-soluble
vitamins, such as vitamin A, D, E, and K. To increase the lipid content
of the ration, refined vegetable oil can be added. Refined vegetable
oil is not only a good source of lipids and energy, but is fortified
with vitamin A at a level of 60-75 International Units per gram. Two
tablespoons (about 25g) of fortified vegetable oil potentially
satisfies 50 percent of an adult’s requirement for vitamin A. However,
if the vegetable oil is used in food requiring high temperature
cooking, the vitamin A content will be reduced.
Detailed
information on the nutritional content of each of the commodities is
listed in the respective Commodity Fact Sheet, in
Section II of Part One of the CRG. The nutritive data are
estimates. Due to vitamin loss during storage, transport, and cooking,
the amount of vitamins available to the body for utilization will be
less. For example, up to 40 percent of vitamin A can be lost from
fortified commodities exposed to heat, light, and air. Minerals are not
subject to the same degree of deterioration by environmental factors.
The bioavailability of some minerals in cereal can be greatly reduced
by absorption inhibitors present in the cereal commodities and other
foods and liquids commonly consumed. The bioavailability of iron in a
cereal blend, for example, is affected by both phytate in the cereal
and the concurrent consumption of tea and coffee which are rich in
tannins. Due to the inhibiting and enhancing effects of different food
components on micronutrient utilization, any ration composition should
be carried out by someone familiar with dietary approaches to address
micronutrient malnutrition. Given the difficulty of planning diets on
specific micronutrients, it is recommended that ration calculations be
based on energy and protein needs instead of specific micronutrients.
For
more information on the use of fortified blended foods, including
recipes, refer to WFP’s Fortified Blended Foods: Facts and
Practical Uses (2000). For further guidance on ration composition
and the prevention of micronutrient deficiencies, refer to the FANTA
ration guide, Improving the Use of Food Rations in Title II
Maternal/Child Health and Nutrition Programs at http://www.fantaproject.org,
the MOST web-site at http://www.mostproject.org,
the SPHERE Project at http://www.sphereproject.org,
and MSF’s Nutrition Guidelines (2001).
2.
Choosing the type and quantities of food commodities:
a)
General feeding rations: Initial response
Presented
in Table 2 below are three combinations of the basic commodity types
into daily per capita rations that meet the requirements for immediate
response for general feeding in populations of unknown demography
(hence the use of 2,100 kcal/p/d energy requirement). These sample
ration packages have an appropriate balance of macronutrients (17-20%
energy from fat and >46 g protein) and that provides essential
micronutrients (although not 100% of requirements, except vitamin A).
The
first selection is appropriate for populations that traditionally eat
very little pulse, for example for some Asian populations that
traditionally use pulses (legumes) only in desserts. The second
selection is most appropriate where little cereal is eaten, for example
where beans and tubers are the primary staples. The third selection is
included only to accommodate the cases when blended food is simply not
available. During an acute phase of an emergency, milled cereal or
rice, not an unmilled cereal, should be provided because a population
does not have access to milling facilities (either because of location
or cost). This is especially relevant for displaced populations, who
additionally do not have the equipment to hand mill the grain. Note
that in the third selection, it is critical that the cereal provided is
a fortified flour or meal as it does not include blended food.
Table
2: Three Combinations of Ration Packages
Selection 1- Ration Package with
Fewer Pulses
Amount
|
Commodity
|
Protein (g)
|
Fat (g)
|
Energy (kcal)
|
30 g
|
Fortified oil
|
0
|
30
|
270
|
100g
|
Blended food
|
17
|
7
|
376
|
350g
|
Cereal flour or Rice1
|
30-35
|
3.5-6
|
1,260
|
60g
|
Pulse
|
13
|
<1g
|
204
|
Total
|
|
60-65
|
41-442
|
2,100
|
Selection 2- Ration Package with Cereal and Legumes
Amount
|
Commodity
|
Protein (g)
|
Fat (g)
|
Energy (kcal)
|
35 g
|
Fortified oil
|
0
|
35
|
315
|
100g
|
Blended food
|
17
|
7
|
376
|
300g
|
Cereal flour or Rice1
|
25-30
|
3-5
|
1,080
|
100g
|
Pulse
|
22
|
<1g
|
340
|
Total
|
|
64-69
|
46-482
|
2,111
|
Selection 3- Ration Package with No Blended Foods
Amount
|
Commodity
|
Protein (g)
|
Fat (g)
|
Energy (kcal)
|
40 g
|
Fortified oil
|
0
|
40
|
360
|
400g
|
Fortified cereal flour3
|
35-40
|
4-7
|
1,440
|
90g
|
Pulse
|
20
|
<1g
|
306
|
Total
|
|
55-65
|
44-472
|
2,106
|
1. If an unmilled cereal other than rice is used, then 10%
more should be included to account for difference in energy and another
10% for costs/losses during milling.
2. 1g fat = 9 kilocalories
3. Without the blended food to supply micronutrients, only a fortified
milled flour should be used.
|
Things
to keep in mind when designing rations for general feeding are:
Protein:
- Cereal
and pulse provide different types of protein, both of which are
essential to a healthy diet. A diet that includes no animal protein
must include both cereal and pulse to assure intake of all of the
different amino acids needed for body growth and maintenance.
- In
equal quantities of cereal and pulse, pulse caries about twice as
much protein (about 22 g/100g of pulse versus 7-12 g/100g cereal).
- There
are both cereal and pulse in blended foods, therefore, the
protein they provide includes the full range of amino acids needed.
Fat:
- Among
Title II commodities, fortified, vegetable oil is 100% fat and is
the most dense source of energy (1g = 9 kilocalories).
- Blended
foods also contribute fat Energy. (17% of calories from fat).
Micronutrients:
- Among
the Title II commodities, blended foods are the best sources of
micronutrients, except vitamin A.
- Fortified
oil is the best source of vitamin A; 40 g of fortified oil
potentially provides 100% of children's daily needs for vitamin A and
about 70% of adults' needs, assuming shipping and storage times and
cooking does not involve high temperature frying.
In
some cases, micronutrient supplements may be provided by agencies in
emergency situations. It is necessary to determine the amount, type and
frequency of Vitamin A supplements to ensure that women and children
are not provided excessive amounts. Check with the health and other
providers to ensure a joint response to meeting vitamin A needs.
b)
General feeding rations: After more is known
Once
the acute phase of an emergency has passed and the demography of the
population is assessed, adjustments to the ration content should
reflect this knowledge, either increasing or decreasing the energy
content accordingly. A presentation of the demographics and the
calculation of average energy requirements should be included in
proposals for general rations for emergency affected populations,
except for cases of rapid response or when the population is too mobile
or too remote for accurate assessment (e.g., for internally displaced
within a zone of conflict).
As
food production and market activity resumes, food needs may diminish in
terms of energy. The compositional needs, in terms of protein, fat and
micronutrients, should reflect deficits after determining the
contributions of other foods. This will depend on the type and
quantities of foods that are available locally and how well households
in the beneficiary population are able to access that food. In
proposals for rations of other than the recommended content of fat and
protein or the absence of fortified foods, there should be some
demonstration of knowledge about the other food accessed by the
majority of targeted households that justifies the difference.
c)
Supplementary feeding rations
The
choice and quantities of food commodities for supplementary feeding
programs for emergencies are similar to those in other contexts. See
Module 1-MCHN Programs and Module 4-Non-Emergency Humanitarian Relief
for more about the design of rations for this purpose.
3.
Calculating the Total Amount of Food Commodities Needed
Once
the ration package is determined, the total quantity of commodities to
satisfy the needs of a population totally dependent of food aid can be
calculated using the default energy requirement of 2100
kcal/person/day. To calculate the number of metric tons (MT) needed for
each commodity in a general feeding or supplementary emergency ration
package, use the following steps:
- Multiply
the number of grams of the commodity per person per day times
the total number of persons to receive the commodity.
- Multiply
the total number of grams of the commodity times the number of
days food will be provided to the target group.
- Determine
the number of MT of commodity needed by dividing the total
number of grams per program period by 1,000,000 (number of grams in a
MT).
- Complete
the same calculation for each commodity (vegetable oil,
cereal, cereal blend, or legume) that comprises the ration.
Box 5
below provides an illustrative example of how to calculate the total
amount of commodities needed to provide a general feeding emergency
ration package to 100,000 people for six months. These amounts would be
adjusted downward once reliable estimates of other sources of food
available to the general population, and other factors shown in Box 4
can be estimated.
Box 5: Calculating Total Amount of
Commodities Needed for a General Feeding Emergency Ration Package
(Selection 1 from Table 2) to a Beneficiary Population of 100,000 for
Six Months.
OIL
- Multiply grams of
vegetable oil per person times 100,000 times 180 days 30 g oil x
100,000 = 3,000,000 x 180 = 540,000,000 grams
- Divide the total
number of grams of oil by 1,000,000 (the number of grams in a MT)
540,000,000 g. ÷ 1,000,000 = 540 MT of fortified, vegetable oil
WSB
- Multiply grams of
blended wheat soy blend (WSB) cereal per person times 100,000 times 180
days. 100 g of WSB x 100,000 = 10,000,000 x 180 = 1,800,000,000 grams
- Divide the total
number of grams of WSB by 1,000,000 1,800,000,000 ÷ 1,000,000 =
1,800 MT of WSB
RICE
- Multiply grams of
rice per person times 100,000 times 180 days. 350 g x 100,000 =
35,000,000 x 180 = 6,300,000,000
- Divide the total
number of grams of rice by 1,000,000 630,000,000 ÷ 1,000,000 =
6,300 MT of rice
PULSE
- Multiply grams of
pulses per person times 100,000 times 180 days. 60 g x 100,000 =
6,000,000 x 180 = 108,000,000
- Divide the total
number of grams of pulses by 1,000,000 108,000,000 ÷ 1,000,000 =
108 MT of pulses
|
Back to Five Steps for Selecting Food Rations
STEP
5: RANKING AND SELECTION
Still
taking into consideration the nutritional content and suitability of
the commodities (Steps 2 and 3), the next most important consideration
when choosing ration packages is cost-effectiveness and appropriateness
for meeting program objectives. When examining the primary cost
elements, commodity price estimates can be used (sources for obtaining
commodity prices are listed in Annex V).
- Minimizing
Market Disruptions: Even with emergency food aid programs,
an analysis should be done, (the Bellmon determination) to confirm that
local markets will not disrupted. For example, it may be less
disruptive to provide certain foods in the lean season rather than
during the harvest season. In fact, every effort should be made to use
Title II food aid to increase the productivity of the targeted groups
(adequate food intake leads to improved health, which then leads to
increased productivity) and to promote local agricultural production.
Guidance on conducting the Bellmon analysis may be found online at http://www.usaid.gov/our_work/humanitarian_assistance/ffp/bellmon.htm.
Logistics,
Packaging and Storage Considerations: The Bellmon
determination should include an assessment of in-country transportation
and storage capacity. Some commodities may impose undue management or
cost burdens due to unusual local conditions (e.g., transportation,
storage, handling, pilferage, accounting costs, etc.), unsuitable
packaging or a limited shelf life of the commodity.
The
usual sources of data for considering potential market disruptions and
logistical problems include past evaluations of similar programs,
interviews with host government authorities, and local and
international PVOs and discussions with international organizations
(such as the World Bank and United Nations agencies), USAID missions,
USDA Agricultural Attaches and Economic/Commercial Officers at U.S.
Embassies.
The
final step is to rank the alternative ration packages by nutritional
value, cost, and other factors, such as potential market disruptions
and logistical factors. Decisions to change ration packages are easier
when alternative rations and their main attributes have been examined
in advance.
Back to Five Steps
for Selecting Food Rations
III.
RESOURCE LIST
- Collins,
Duffield & Myatt. Assessment of Nutritional Status in
Emergency Affected (Adults) Population. July 2000.
- Food
and Nutrition Technical Assistance (FANTA) Project, Academy for
Educational Development, 1825 Connecticut Avenue, NW, Washington, D.C.,
20009-5721. Tel: 202-884-8000 Fax 202-884-8432. E-mail: fanta@aed.org; Web site www.fantaproject.org.
FANTA has the following publications:
- Agricultural
Productivity Indicators Measurement Guide. Patrick Diskin
- Anthropometry Indicators
Measurement Guide. Bruce Cogill
- Food For Education Indicator
Guide.
Joy Miller del Rosso and Gilles Bergeron
- Food Security Indicators and
Framework for Use in the Monitoring and Evaluation of Food Aid Programs.
Frank Riely,
Nancy Mock, Bruce Cogill, Laura Bailey, and Eric Kenefick
- General
Indicators of Appropriate Feeding of Children 6 through 23 months from
the KPC 2000+. Mary Arimond and Marie T. Ruel
- HIV/AIDS:
A Guide for Nutritional Care and Support 2004. FANTA
- Household
Dietary Diversity Score (HDDS) for Measurement of Household Food
Access: Indicator Guide. Anne Swindale and Paula Bilinsky.
- Improving the Use of Food
Rations
In Title II Maternal/Child Health and Nutrition Programs. Serena
Rajabiun, Beatrice Rogers, Margarita Safdie, Anne Swindale
- Measuring Household Food
Consumption: A Technical Guide. Anne Swindale and Punam
Ohri-Vachaspati
- Months
of Inadequate Household Food Provisioning (MIHFP) for Measurement of
Household Food Access: Indicator Guide. Paula Bilinsky and Anne
Swindale.
- Potential Uses of Food Aid to
Support HIV/AIDS Mitigation Activities in Sub-Saharan Africa. FANTA
- Recommendations for the
Nutrient
Requirements for People living with HIV/AIDS. FANTA.
- Sampling Guide. Robert
Magnani
- Water and Sanitation
Indicators
Measurement Guide. Patricia Billig, Diane Benahmane and Anne
Swindale
- FANTA/Food
Aid Management. Enhancing the Nutritional Quality of
Relief Diets, Workshop Proceedings, April 28-30, 1999. Available at
www.fantaproject.org.
- Linkages
Project. Facts for Feeding (English, Spanish, French).
Academy for Educational Development, 1825 Connecticut Avenue, NW,
Washington, D.C., 20009-5721. Tel: 202-884-8000; Fax: 202-884-8977;
E-mail: linkages@aed.org; Website: www.linkagesproject.org.
- Institute
of Medicine, Estimated Mean per Capita Energy
Requirements for Planning Emergency Food Aid Rations. National
Academy Press. Washington, D.C., 1995. Web site: www.nap.edu.
- SARA Project.
SARA Project.
Nutrition and HIV/AIDS: Evidence, Gaps and Priority Actions.
Ellen Piwoz. SARA Project, Academy for Educational Development. Web site:
(http://www.fantaproject.org/downloads/pdfs/SARA_Nutrition&HIVbrief.pdf).
- SUSTAIN. Final Report of the
Micronutrient Assessment Project. Executive Summary available
on web site:
http://www.sustaintech.org.
- The
Sphere Project. Humanitarian Charter and Minimum Standards in
Disaster Response. 2000. E-mail: sphere@ifrc.org;
Web site: www.sphereproject.org.
- USAID/DCHA.
U.S. International Food Assistance
Report 1999.
January 2000. Web site: http://www.usaid.gov/our_work/humanitarian_assistance/ffp/relatedlinks.html.
- USAID/DCHA.
Commodities Reference Guide (CRG):
Section 1-4.
April 1999. Web site: http://www.usaid.gov/our_work/humanitarian_assistance/ffp/crg.
- USAID/DCHA/FFP.
PVO Guidelines for Title II
Emergency Food
Proposals and Reporting (Draft). 1998. Web site:
http://www.usaid.gov/our_work/humanitarian_assistance/ffp/emerg.htm.
- USAID/CDIE.
Performance Monitoring and
Evaluation Tips. 1996.
Web site: www.usaid.gov/pubs/usaid_eval/#02.
- USAID/Office
of Foreign Disaster Assistance (OFDA). Field
Operations Guide (FOG) for Disaster Assessment and Response.
November 1998.
- UNHCR/WFP.
Guidelines for Estimating Food and
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