UNIVERSITY OF HARGEISA

1. Assessment of the Nutritional
Status of the Community
Edna Dahir

2.  Nutrition is the process by which the body
metabolizes and utilizes nutrients.
 Nutrients are classified as energy nutrients,
organic nutrients and inorganic nutrients.
 Energy nutrients release energy for
maintenance of homeostasis. These are
carbohydrates, proteins and fats.
 Organic nutrients build and maintain body
tissues and regulate body processes.
Introduction

3. Understanding the role of basic nutrients
provides the foundation for selecting foods
that promote good health.
There are six categories of nutrients: water
vitamins, minerals, carbohydrates, proteins
and lipids(fats).

4. Nutritional status is determined by complex interaction
between internal and external factors.
• Internal/constitutional factors like: age, sex,
nutrition behavior, physical activity and disease.
• External environmental factors like: food safety,
culture, social and economic circumstances
• An ideal nutrition status occurs when the supply of
nutrients conforms to the nutritional requirement or
needs
Nutritional status

6. • An optimal nutritional status is a powerful factors for health and
wellbeing. Its major, modifiable and powerful element in
promoting health, preventing and treating diseases and
improving the quality of life.
• Malnutrition may increase risk of susceptibility to infection and
chronic diseases
• Undernutrition: may lead to increased infection and decreases
in physical and mental development and
• Over nutrition: may lead to obesity as well as to metabolic
syndrome or type 2 diabetes
Nutritional status of an individual has consequences

7. Purpose of nutritional assessment
• Identify individuals or population groups at risk of
becoming malnourished
• Identify individuals or population groups who are
malnourished
• To develop health care programs that meet the
community needs which are defined by the assessment
• To measure the effectiveness of the nutritional
programs and interventions once initiated

8. Methods of nutritional assessment
Nutrition is assessed by two methods; direct and indirect
The direct method deal with the individual and measure objective
criteria, while indirect methods use community indices that reflect
the community nutritional status/needs

9. These are summarized as ABCD
• Anthropometric methods
• Clinical methods
• Dietary evaluation methods
• Biochemical, laparotory methods
Indirect methods of nutritional assessment
• economic factors e.g. household, income, food
availability and prices
• Cultural and social habits
Direct methods of nutritional assessment

10. Direct method of nutrition assessment
1.Anthropometric methods
Anthropometric is the measurement of
body height, weight and proportions. Its
essential component of clinical examination
of infants, children and pregnant women.
• These measurement are compared to
reference data of the same age and sex
group in order to evaluate the nutritional
status

13. Interpretation of BMI for adults
For adults 20 years old and older, BMI is interpreted
using standard weight status categories that are the
same for all ages both men and women
BMI WEIGHT STATUS
Below 18.5 Underweight
18.5—24.9 Normal
25.0—29.9 Over weight
30.0 and above Obese

14. Identifying nutritional problems of a population in a clear and
measurable way will help to:
Define needs, opportunities and constraints, and prioritize solutions.
Evaluate programme impact and improve efficiency.
Influence decision making in strategic planning, policy formulation
and resource allocation.
Raise community awareness and participation to maximize long-
term impact.

15. To define the nutritional problem
of the targeted population, it is
necessary to measure its
nutritional status.
Introduction
Nutritional status assessments
enable to determine whether the
individual is well-nourished or
undernourished.
ASSESSMENT
of the nutritional
situation in target
population
ACTION
based on the
analysis &
available
resources
Source: UNICEF, Triple-A Cycle
ANALYSIS
of the causes
of theproblem

19. Examples of illnesses caused by improper nutrient
consumptions
Too little Too much
PEM (protein energy malnutrition ) Stroke
Anemia (iron deficiency) Heart/ arterial disease
Osteoporosis (calcium deficiency) Some cancers
Goiter (iodine deficiency) Obesity
Xeropthalmia (vit A deficiency) Diabetes
Beri-Beri (vitB deficiency) Gall stone
Rickets (vit D deficiency) Gout

20. GROWTH MONITORING
Anthropometry
Growth monitoring is the continuous
monitoring of growth in children.
It can be performed at the individual level,
or at a group level. It can also be:
clinic-based growth monitoring
(conducted by health professionals at Maternal
and Child Health clinics), or
community-based growth monitoring
(conducted by trained members of the
community in villages )

21. SCHOOL CENSUS DATA
Anthropometry
School census data relates to nutritional
assessment occasionally undertaken in
schools.
The objective is to identify high-risk
children with poor health, malnutrition and
low socio-economic status.

22. Clinical examination and biochemical testing
Biochemical testing and clinical
examination can contribute to diagnosing
micronutrient deficiencies.
The most common deficiencies are:
• Iodine,
• vitamin A, and
• Iron
• Vitamin D
• Vitamin C

23. Clinical assessment
• Its an essential feature of all nutritional surveys of ascertaining
the nutritional status of group and individual
• It utilizes a number of physical signs (specific and non specific)
that are known to be associated with malnutrition and deficiency
of vitamins and micronutrients
• Good clinical history should be obtained
• General clinical examination with special attention to organs like
hair, nails, angles of the mouth, gums, skin, eyes, tongue,
muscles, bones and thyroid gland
• Detection of relevant signs helps to establishing the nutritional
diagnosis