TRAITEMENT OF NUTRITIONAL AND MORTALITY

SURVEYS
DATA ANALYSIS WITH NUTRISURVEY

ACKNOWLEDGEMENTS

We would like to thank Yvonne Grellety and Michal Golden for revising the present work.

TABLE OF CONTENTS

A. Description & Preparation.4

1. Opening..4

1.1

Nutrisurvey.4

1.2

An existing file..4

2. Useful Icons..4
3. Planning.5
3.1. Naming the Survey.......5
3.2. Sampling.6
3.3. Sample size calculation.6
3.4. Sample size for Mortality Rate Survey7
3.5. Sample size for both anthropometry
and mortality analysis..8
3.6. Calculating Clusters...8
3.7. Selecting Clusters .....9
4. Training.11
5. Options..13
5.1. Data Entry..13
5.2.

Plausibility Check...14

5.3.

Report....14

6. Data Entry Anthropometry16

6.1.

Variable View16

7. Data Entry Mortality18

B.

Introducing Data
1. Anthropometry
1.1. Data Entry .......19
1.2. Pasting data from Excel.20

2. Mortality.....21
C.

Data Quality Check.......23

D. Results & Data Analysis

1. Anthropometry..........24
2. Mortality.24
3. Analysis25
3.1. Excel..25
3.2. EPI Info.25
E. Annexes........26

NUTRISURVEY

This program can be downloaded free from www.smartindicators.org or

www.nutrisurvey.de/ena/ena.html . (If it is already installed in a computer, it is important
to check that is the latest update).

A. DESCRIPTION AND PREPARATION

1.

1.1.

OPENING

Nutrisurvey ena

Once installed, the first things that will appear on the screen are the names of the
persons who designed this software, as well as the e-mail and website from where ena
has been downloaded. Press click on <OK>.
1.2.

An existing file

When closing down the software, after saving your file, the
way to open it (or any other existing Nutrisurvey file) is by
opening first Nutrisurvey ena, secondly by clicking on and
thirdly by searching the file.as that you want to open.
Or using the icon shown in chapter 2 (below), after opening
Nutrisurvey ena.

2.

New

menu

USEFUL ICONS

Opens a new file in .as format

Open

Opens an existing .as file

Save

Saves the actual file.as

Save as

Saves file.as with a chosen name

Import

Imports files .rec EPI-Info 5/6 or DBase .dbf

Exit

Exits from actual module and returns to principal

The first page to appear will be Data Entry, but you have to go to:

3.

PLANNING

STEPS TO FOLLOW
3.1.

Naming the survey

You need to give a unique name to your survey. However, it is important to be consistent
in the naming of files and directories and to give all files names that can be recognized
later by any team member.
The name of the file should start with a three letter code for the country (e.g., SUD for
Sudan, ZAM for Zambia, ANG for Angola, etc.), then the file-name should have the date of
the survey in YYMM format (year, year, month, month). In certain circumstances the
region, type of subject (refugee, IDP, resident) or the agency involved can be usefully
included in the name of all the files. Then there is a code for the type of file: REP for
report, DAT for the data file, etc.
Thus, a file named <LIB_0409_rep.doc> would be the report of a survey taken in August
2004 in Liberia. There may be several simultaneous surveys conducted in Liberia around
that time, <LIB_0409_IDP_Buchanan_AAH_dat.xls> would be the data file for a survey
with IDPs in Buchanan, Liberia in September 2004 conducted by Action Against Hunger.
3.2. Sampling

The next step is to choose the type of sample you will use: 1) random survey or 2) cluster
survey.
3.3.

Sample size calculation

Calculate the sample size for the anthropometric survey. Introduce the target population
size. The population will be children under 5-years-old. If that number is unknown, an
estimate of 20% or less (in case of having a high mortality rate in the area) of total
population will be used as our population size.
3.3.1.

Estimated prevalence

Enter estimated prevalence of GAM. With a fixed sample size, the higher the malnutrition
prevalence, the lower the precision obtained. When making this assessment always
decide upon a plausible range of values, rather than a single one. In many situations, a
reasonable statement would be: Given the situation, the malnutrition prevalence is
unlikely to be above 20% or below 10%.
In other words, if there is no certainty of this value, the higher (maximum)
prevalence expected from a range of similar values must be introduced.
Nevertheless, if you are interested in a particular prevalence (e.g. the level that would
trigger an emergency response), and you suspect the actual prevalence is below this
threshold, enter the threshold number.
3.3.2.

Desired precision

The first consideration is the minimum precision needed to meet the objectives of the
survey. (For further explanation descriptions and tables-, please go to the SMART
METHODOLOGY manual.)
The desirable precision and expected malnutrition prevalence rate are interconnected. If
there is a very high prevalence of acute malnutrition (e.g. 40%) the precision does not
need to be high to enable agencies to make appropriate decisions. At a prevalence of
over 35% or so, services will be overwhelmed and urgent and substantial intervention will
be needed. A confidence interval of plus or minus 10% (25-45%) is perfectly acceptable
under these circumstances. Normally, it can be set a 5% precision or more for high
prevalence, falling to about 2.5% precision for lower prevalence.
In general, the lower the prevalence the greater the precision needed.
Ex. For 5% PREVALENCE, you will need 2.5 to 3% precision
3.3.3.

Design effect

If its a random sampling survey, then the design effect will always be 1.
In cluster sampling, design effects can vary from 1 (if the population is homogeneous so
that all the clusters are similar to one another) to 4 or higher where some clusters are not
affected and others are severely affected.
In most nutritional emergencies, the design effect is about 1.5 increasing to 2 or more in
more heterogeneous or large-scale surveys.
If the design effect is thought to be much greater than 2 then the population is
sufficiently heterogeneous and therefore it is better to conduct two separate surveys,
each focused upon more homogeneous sections of the population: e.g. Two cluster

surveys, each with a design effect of 1.5, can be conducted with the same effort as one
survey with a design effect of 3.
The advice to anticipate a range of likely values for the prevalence and for the design
effect, within which you anticipate the results will fall is important. In Nutrisurvey ena
you should enter:

The widest confidence interval that is acceptable = the minimum acceptable

precision
The highest prevalence that is anticipated
The largest design effect that is likely to be encountered

(For further explanation descriptions and tables-, please go to the SMART

METHODOLOGY manual.)
Upon entering all these values in their respective boxes, the sample size will be
automatically calculated and will appear in the turquoise box.
3.3.4. Increase sample size
By 5% or 10% to allow unforeseen contingencies.
EXAMPLE 1:
Lets look at the following example:

Our sample size is 754. And if we increase this number 5%, according to the last step,
then our sample size will be 792.
3.3.5. Divide the sample size by the average number of U5 children to have a
household sample size.
e.g. if the average U5 children is 1.5, divide 792 by 1.5 = 528

3.4.

Sample size for mortality rate survey

For the death rate component of the survey (you may need information from
governmental and/or non-governmental organizations (NGOs) working in health):
1.Enter an estimate of the total population that is targeted by the survey.
2.Enter the expected mortality rate (x.xx/10,000 persons/day)
3.Enter the required precision (x.xx/10,000 persons/day). For example, if your
expected mortality rate is 2.0/10,000 persons/per day and you want a confidence
interval of 1.4 - 2.6, enter a required precision of 0.6 (that is 2.0 -/+ 0.6 which gives
1.4 - 2.6). The precision chosen has a substantial effect upon the sample size
needed.

4.Enter the design effect. The default design effect for sample size calculations for
mortality is 2.0. If violence-related-mortality is limited, a design effect of 1.5 for
crude death rate may also be sufficient. You can also use the last survey raw data
and check the design effect in ena: it calculates the design effect.
5.Enter the chosen recall period in days. In most situations, 90 days (or from 30 to 120
days) will be used. However, the decision should be made individually for each
emergency context according to the date of the last event that occurs in this area.
EXAMPLE 2

3.4.1.

Divide the sample size by the average number of persons per

household to have a household sample size.

e.g. 1646 divided by the average persons per HH e.g. 4 = 416

3.5.

Sample size for both anthropometry and mortality analysis

3.5.1.

For anthropometry analysis, e.g. 528

3.5.2.

For mortality analysis, e.g. 416

The final sample size per household that will be retained will be 528

3.6.
3.6.1.

Calculating Clusters

For Anthropometric Survey

In cluster surveys, sample size should be divided by the number of
households that can be visited each day. This will provide the number of
clusters.

To continue with EXAMPLE 1, lets say that each of our teams can visit 14 households
(HH) per day. (For further details on how to calculate this number, please go to SMART
Methodology Manual). Dividing 528/14 = 37.7 Whenever the result has a decimal, it is
advised to round up to the next whole number. Then we will have 38 clusters for our
survey.
In pastoral/nomadic zones we can have difficulties finding children. If this is
the case, it is advised to decrease the number of children/cluster and
increase the number of clusters.

Statistically, the minimum amount of clusters that each of the surveys

(anthropometric & mortality) can have for them to be valid is 26. However,
in ACF we STRONGLY RECOMMEND having 30 clusters, minimum.

3.7.

Selecting clusters

When designing a combined survey (with both components: nutrition & mortality), the
sample size to estimate malnutrition prevalence, as well as the number of households
needed to estimate mortality rate are calculated, and then:
The greater of these numbers is chosen for the survey.
If you are attempting to undertake a survey in an area of nomads where the
population frequently moves large distances, it is likely that you may travel to an
area to find that there is no-one there and no-one nearby.
If you suspect that this might happen, you should select some extra
clusters before you start the survey. This way, if one cluster is deserted you
can replace it with another one.

3.7.1.

Table for Cluster Sampling

1. Enter number of clusters

To randomize the clusters obtain the best available census data for each
village, district, or section on the map using the smallest existing unit:
It is important to define your geographical area very realistically in the
planning stage, taking into account: travel, security, and any other factor that
could influence your ability to get to the cluster site before listing the sites in
the planning table.

2.

Define what constituents a village: it should be the smallest unit with population
figure. Then, under Geographical unit column enter the names of all the towns,
cities, districts or other areas that will potentially be chosen to include in a cluster.
All potential areas have to be entered. It does not matter what order the areas are
entered. But if any village is omitted at this step, it then will not be part of the
surveyed population.
The smallest available geographical unit is always chosen, as long as
population data are available and the geographical unit has a name. If the
number of children is less than 30, add another area with that one. Each area
should have a local name, so that the inhabitants are familiar with the
boundaries of the area when the local name for the area is used.

3.

Under Population size column enter the estimated population size for each
village.

4. With the Number of Clusters and their names entered, click on <Assign Cluster>
The computer will then select the areas where there will be clusters. This should
be done only ONCE. It will potentially introduce a bias if they are reselected.

3.7.2. Random Number Table

If you want to do a random survey, then you need to generate a random table based in
the box <Random Number Table>. For that you need the following data: for Range
from and to the total range of children of the total population, i.e. 1-1,350 and enter for
Numbers the sample size to use. Then, click on <Generate Table>.

The children to be interviewed will be shown in a Word sheet.

10

4. TRAINING

This page is used to standardize our teams in measuring weight and height (or length).
The aim of the standardization test consists on improving the quality of the
measurements. All the members of the teams should measure twice 10 or more children
with a time interval between individual measures. (Check SMART METHODOLOGY to
observe the appropriate procedure for standardization.)
The outcome of this exercise will be analyzed by Nutrisurvey Ena: you only need to enter
the measures and then click on <Report>. Precision and accuracy are assessed by 1)
calculating the variation between their repeated measurements (repeatability of
measurements); 2) calculating the variation between each team members
measurements and the ones of the supervisor. Each team member is then given a score
of competence in performing measures (OK or POOR). If the results are OK it means the
enumerator is standardized, if the results are POOR the enumerator should repeat the
exercise completely, perhaps with different people paired in teams.

11

Report for Evaluation of Enumerators

Weight:
Precision:
Sum of Square
[W2-W1]
Supervisor
Enumerator 1

7,29
6,76 OK

Accuracy:
Sum of Square
[Superv.(W1+W2)Enum.(W1+W2]
1,69 OK

Height:
Precision:
Sum of Square
[W2-W1]
Supervisor
Enumerator 1

4,84
10,89 POOR

Accuracy:
Sum of Square
[Superv.(W1+W2)Enum.(W1+W2]
0,25 OK

For evaluating the enumerators the precision and the accuracy of their measurements is calculated.
For precision, the sum of the square of the differences for the double measurements is calculated. This value
should be less than two times the value of the supervisor.
For the accuracy, the sum of the square of the differences between the enumerator values (weight1+weight2) and
the supervisor values (weight1+weight2) is calculated. This value should be less than three times the accuracy
value of the supervisor.

12

5.

OPTIONS

This is the last of the screens of Nutrisurvey, but is useful to fill out before entering the
data. The software has an automatic way for entering data in Data Entry. We could
agree and save these options or simply modify them based on our needs. If we save
them, we should always remember that we are establishing these options for future
surveys. However, they can be modified any time a new survey is planned.

5.1.
5.1.1.

Data Entry:

Automatic filling out:

The program selects all these options; it is advised,
nevertheless, that the number of household be introduced
manually, because the number of children in one household
could be greater than one.
We recommend not filling out Household No. automatically.

5.1.2.

Entering of age mainly:

Either method can be selected depending on the document you
find at household level: e.g. in some countries like Tanzania,

13

5.1.3.

every child has a birthday datein other countries, which is

mostly the case, you have no birthdate and you have then to
estimate the age in months; in this case, you should use with
months.
Entering of data:
You can select introducing data directly or with Pull Down
Editors for some of the variables (sex, birthdate, edema). See
the example below.
We recommend using directly as 1.1.99, 10199 or 010199 option.

5.1.4.
In this page we can also select if
we want the program to calculate
anthropometric
indices
after
pasting data from another file.
5.1.5.

Weight of clothes

5.1.6.

Correction for Edema:

Here we can
introduce
average
weight in grams of clothing of survey subjects to be
automatically
subtracted
from
the
weight
introduced in Data Entry page.
We can select automatic correction of weight for
edema found:
n/y = average weight of body weight edema
0,1,2,3 = mild, moderate or severe edema
We dont recommend using it, unless strictly necessary.

5.2. Plausibility Check:

Enter the z-scores and the age range (in months) for the
plausibility report in the box.
The plausibility check report, after entering all your data, will
give you the questionable ID no.(s) out of range that you
have selected, e.g. >3Z-score and <-3Z-score from the mean
of the WH of the sample size.
In the Data Entry sheet, the software will highlight gross errors similar to flag in Epi Info
in pink. but they are not the same as the ones in the plausibility check in this version.
5.3.

14

Report:

If we want our report to be grouped by ages (in months).

We can change the age groups by only changing the first number in each range, ena is
automatically changing the other one from the range above.

Once finished introducing desired parameters,

the bottom right hand side of the page.

click on which is located at

15

6.

DATA ENTRY ANTHROPOMETRY

Fill out this page with the data gathered in the field questionnaire.
Take in account that the field questionnaire follows the
programs same order to facilitate data entry.
Nutrisurvey ena has a form that we can use and can be obtained clicking on:
Form for anthropometric survey

Other uses of this module are:

Form for mortality
Paste Data
Copy Data
Plausibility Check
Check of double entry
Report in Word
6.1.

Form to gather mortality information

Pastes data from clipboard
Copies data from current survey to Excel format
Verifies presence of errors
Corroborates presence of errors when two
persons are entering the same data
Reproduces report in Word format

Variable View:

This is one of the two sections of page Data Entry. In Variable View we should save the
file using the same instructions we used in Planning. (We can find these in the 1st.
step.) In <Variable View> section and before introducing data we should establish ranks
to be used in the survey.

16

Some variables in ena are automatically ranked; however, you can change some of them,
like for example height ranks if the targeted population has growth retardation. These
changes should be included in the report.
Ena will then check all those data which are out of range and highlight them in pink in
<Data View> section.
In this latter section, data cleaning also can be made by using Plausibility check clicking
on Check Table every time you enter some data; this facilitates to underline errors.

The entered data have to be checked using the original written data collection sheets.
Any error in data entry should be corrected immediately.
If a child is excluded from the survey, his information will
disappear from the page and we should click again on Check
Table.
Column/Variable:

Add: place mouse in <Data View> section and over line No. 1 of
the column where we want a variable to appear and click on Add. A
little box will appear, where the name of the extra column should be
entered (ex. Measles), then click on Enter or OK.
Delete: place mouse in <Data View> section on any spot below
the column title we want to eliminate and click on Delete; a box will
appear asking if we want to erase this column. Click on Yes or
Enter.
Sort: place mouse in <Data View> section on any spot below the
column title that we want to use to classify our database. Click on
it. A box will appear telling that our database will be classified by:
column name. Click on Yes or Enter.

17

Filter: click on Filter. A box will appear asking us to define which variable we
need for selecting cases from database.
Select the variable,
introduce the desired ranges, and then click OK.

Row/Data:
For adding a child to the survey we click on New. A new line will
appear at the end of the listing.
For adding data and to insert a blank line in a specific place of your
list, place the mouse and click over the line where you want the new
one to appear and then click on Insert.
To erase data of a child, place mouse on the line you want to
eliminate and click on Delete.
We can choose the references for evaluating our data, NCHS or WHO.
Results will automatically be shown in <Data View> and in Results
Anthropometry page.

At clicking on Disclaimer youll see the following:

It will disappear with a second click.

Go To:
If
If
If

you click on this icon, you automatically go to subject ID 1.

you click on this icon, you automatically go to the last subject.
you click on this icon, a box will ask you the ID number you are looking for; enter
the number and click on OK, then the software will automatically go to this ID

number.

7.

Data Entry Mortality

To enter the data in this sheet, you can use the Word sheet of the software as a
questionnaire. This form is located under the command Extras at the left top of the
screen; click on Form for mortality rate survey. There is one called the SMART Standard
form and the other one called Simple form (one sheet/cluster).
Dont use the simple form at the moment but the standard form as a questionnaire.

18

Icons on this page:

Save Survey
Add line
Erase line
Paste data from clipboard
Transfer data to Excel format

B.

INTRODUCING DATA

19

1.
1.1.

Anthropometry

Data Entry in Data View Section

On the first line introduce survey date, cluster number (if used), and team number.

The population that has been chosen for a cluster has already
been introduced with a number in our database during Planning
stage, so we should use that same number of cluster in this
panel.
The identification number of each child WILL BE ENTERED automatically one by
one for each new introduced case.
The household number should NOT BE ENTERED automatically, because you can
have more than one child in the same household. The ID Household number should be
the same as the one in mortality entry data.
Enter age in months in corresponding square.
Anthropometrical variables are calculated automatically. Any major error or flag will
appear in pink but they are not the same as the ones selected in the plausibility check.
1.2.

Pasting data from Excel to Nutrisurvey ena

If you have survey data in excel format, Nutrisurvey can analyze it by pasting it in
Data Entry sheet. To do so, follow the steps:
a. On your excel sheet select only those data of the variables that you included in
your <Data View> section, then click on Copy icon.

b. Go to Nutrisurvey ena <Data View> section and place your mouse and click over
line 1, under SURVDATE column, and then click on Paste icon.

20

2.

Mortality

21

This screen has the instructions written down at the top of it. It is important to take in
account the following:
In box of HH members total enter the total number of members in the HH and
<5 the total number of children <5 years of age in this HH.
In join HH exclude births during Recall Period.
In leave HH exclude deaths during this same period.

C.

DATA QUALITY CHECK

This step is useful for finding and interpreting errors.

In Data Entry page we find the box:

In Plausibility Print Report, ena lists values out of range from the ones that you put in
Options (e.g. WH<-3 & WH>3Z-score). It points errors in your data, first for your total
sample and then by teams. (See Annex 1 with an example of the way Nutrisurvey
reports errors found with their interpretation).
Remember that in order to find errors as soon as possible, we mentioned before to enter
the ranges of the variables needed in your survey in both <Variable View> of Data Entry
and in Options pages.
We can also check mistakes by making two persons entering the same data. Using the
Extras icon, and if you click on:

22

Check of double entry, the software will

check data quality corroborating data introduced by
two persons.

D.

1.

RESULTS & DATA ANALYSIS

Anthropometry

When all the data are entered, we can move on to Results Anthropometry sheet. Here
you will find your results based on the references you chose earlier in Data Entry
Anthropometry sheet: (NCHS or WHO) and also you are able to obtain the graphs
according to the chosen indicators, and then by sex, age or cluster; you can also obtain a
partial report in Word and Excel formats.

23

2.

Mortality

Once introduced all mortality data in this screen, the software will automatically calculate
and show results in Results Mortality sheet. Here, it is the Crude Death Rate which is
calculated as well as its components [a], [b], [c], [d], [e], and [f].

3.

Analysis

Nutrisurvey does not analyze MUAC or any additional variables, so we can choose
between Excel or EPI Info Analysis.
3.1.

Excel Analysis

You can enter your data directly on excel or transfer your data from Ena to Excel format
by clicking
on Data Entry sheets for both Anthropometry and Mortality.

24

Or using the box displayed by clicking on Extras, and then clicking again on Copy Data to
Excel.
Excel will show in the last columns all the data in percentage of the medians.

At the same time that you enter the data, you should transfer
them to Excel to save your data.
To sort your data by variables in Excel, place the mouse over line 1 (the one with the
variables names) and select the whole line with a left click. Then click on Datos, place
Mouse over Filtros, click and then re-click on Autofiltro.

At this moment we
can use filters, also,
to select for e.g.
MUAC
or
which
children are eligible
to get admitted to a
center.

3.2.

EPI Info Analysis

Unlike Excel, this type of analysis can calculate confidence interval easily. You can
find it under File icon.

ANNEX 1
Plausibility check:
Anthropometric Indices out of usual range (mean -3,0, mean +3,0):
Line 104:
Line 193:
Line 282:

WHZ (4,187), probably height is incorrect

WHZ (3,562), probably weight is incorrect
HAZ (3,413), probably age is incorrect

25

Line 363:
Line 497:
Line 647:
Line 703:
Line 754:

WHZ (-3,318), probably weight is incorrect

HAZ (3,674), WHZ (-3,272), probably height is incorrect
HAZ (-5,486), probably age is incorrect
HAZ (4,397), WHZ (-4,491), probably height is incorrect
WHZ (-3,267), probably height is incorrect

Age distribution:
Month 6 : ######
Month 7 : ##############
Month 8 : ##########
Month 9 : #############
Month 10 : #####################
Month 11 : #################
Month 12 : ################
Month 13 : ##########
Month 14 : #############
Month 15 : ######################
Month 16 : ###############
Month 17 : #################
Month 18 : #####################
Month 19 : ################
Month 20 : ###############
Month 21 : ##################
Month 22 : #######################
Month 23 : #####################
Month 24 : ################
Month 25 : ######################
Month 26 : ##################
Month 27 : ######
Month 28 : #########
Month 29 : ############
Month 30 : ###########
Month 31 : ########
Month 32 : ########
Month 33 : ########
Month 34 : ###########
Month 35 : ############
Month 36 : #########
Month 37 : ###########
Month 38 : ################
Month 39 : ###############
Month 40 : #########
Month 41 : #############
Month 42 : ################
Month 43 : ##############
Month 44 : ################
Month 45 : ######
Month 46 : ############
Month 47 : #######
Month 48 : #############
Month 49 : ##############
Month 50 : #########
Month 51 : #######
Month 52 : ##############
Month 53 : ###########
Month 54 : #########

26

Here, the software indicates

that a lot of cases were
59months old, each case
being noted by a #
according to its age in month.
In this example, age 59
months has the majority of
cases. It would be appropriate
to verify if that is the case.

Month 55 : ###########
Month 56 : ############
Month 57 : #########
Month 58 : ######
Month 59 : #############################################################

Digit preference Weight:

Digit .0
Digit .1
Digit .2
Digit .3
Digit .4
Digit .5
Digit .6
Digit .7
Digit .8
Digit .9

Here, Ena software tells you if the teams measure

repeatedly the weight and rounded or not to .0 or .5 .
In this example, it is obvious that the teams rounded
often to .0 and .5. There is a digit preference, so you
will have to go back and review where the mistake
occurs.

: #############################
: #####
: ##
: ########
:#
: ##########################################################
: ######
: ####
:############
: ########

Digit preference Height:

Digit .0
Digit .1
Digit .2
Digit .3
Digit .4
Digit .5
Digit .6
Digit .7
Digit .8
Digit .9

: ##############################################################
: ##########
: #############
Here, the Ena software tells you if the
: #####
teams rounded or not to a certain digit
: #########
preference decimal when they took the
: ####################################
height/length. It is obvious that they
: #############
: #####
rounded to .0 and 0.5, so you will have
: #######
to go back and review where the mistake
:#
occurs.

Standard deviation of WHZ:

Standard Deviation SD: 0,929 (The SD should be between 0.8 and 1.2)
0,929 is the SD of our survey, in this case is between 0,8 and 1,2. It is ok
Prevalence (< -2) counted: 2,5%
2,5 % is the % of children wasted in the survey
Prevalence (< -2) calculated with current SD: 2,9%
2,9% is the prevalence of wasting with SD of 0,929

27

Prevalence (< -2) calculated with a SD of 1: 3,9%

3,9% is the prevalence of wasting with a SD of 1

Standard deviation of HAZ:

Standard Deviation SD: 1,206 (The SD should be between 1.10 and 1.30)
Prevalence (< -2) counted: 64,6%
Prevalence (< -2) calculated with current SD: 61,0%
Prevalence (< -2) calculated with a SD of 1: 63,1%
Skewness and Kurtosis of WHZ:
Skewness of WHZ: 0.078 => probably not skewed (value < 2*(6/n))
(Skewness characterizes the degree of asymmetry around the mean, positive skewness indicates a long right tail,
negative skewness a long left tail)
Kurtosis of WHZ: -1.478 => probably kurtosis problem (value > 2*(24/n))
(Kurtosis characterizes the relative peakedness or flatness compared with the normal distribution, positive
kurtosis indicates a relatively peaked distribution, negative kurtosis indicates a relatively flat distribution)

See the graphic below which illustrates when we have a not skewed (green graphic), but kurtosis (red
graphic) of WHZ.

Poisson distribution of clusters for WHZ:

number of clusters
1
2
3
4
5
6
7
8

children/cluster with WHZ < -2:

children/cluster with WHZ < -2:
children/cluster with WHZ < -2:
children/cluster with WHZ < -2:
children/cluster with WHZ < -2:
children/cluster with WHZ < -2:
children/cluster with WHZ < -2:
children/cluster with WHZ < -2:

28

The software indicates how many

wasted children you have in your
clusters using the #.
In this example, it tells you that:
3 clusters each have 10 wasted
children.
2 clusters have each 12 wasted
children,
1 cluster has 13 wasted children, etc.,
etc.

9 children/cluster with WHZ < -2:

10 children/cluster with WHZ < -2:
11 children/cluster with WHZ < -2:
12 children/cluster with WHZ < -2:
13 children/cluster with WHZ < -2:
14 children/cluster with WHZ < -2:
15 children/cluster with WHZ < -2:
16 children/cluster with WHZ < -2:
17 children/cluster with WHZ < -2:
18 children/cluster with WHZ < -2:
19 children/cluster with WHZ < -2:
20 children/cluster with WHZ < -2:
21 children/cluster with WHZ < -2:
22 children/cluster with WHZ < -2:
23 children/cluster with WHZ < -2:
24 children/cluster with WHZ < -2:
Detailed Team Evaluation

###
##
#
###
####
##
#

Team
1
2
3
4
Digit preference Weight (%):
.0 :
6
4
10
9
.1 :
8
14
11
8
.2 :
9
10
9
17
.3 :
9
8
15
8
.4 :
13
10
11
13
.5 :
13
11
6
10
.6 :
8
14
7
9
.7 :
7
8
8
7
.8 :
14
8
9
8
.9 :
13
14
12
11
Digit preference Height (%):
.0 :
10
5
25
13
.1 :
10
10
12
15
.2 :
14
11
14
13
.3 :
13
6
11
17
.4 :
8
11
8
9
.5 :
11
12
3
11
.6 :
9
12
8
8
.7 :
8
11
5
3
.8 :
9
6
5
7
.9 :
7
15
8
4
Global malnutrition (WHZ < -2):
SD
0,81
0,79
0,82
0,87
Prevalence (< -2) counted:
%
7,1
9,1
7,7
11,6
Prevalence (< -2) calculated with current SD:
%
8,3
8,4
11,1
13,6
Prevalence (< -2) calculated with a SD of 1:
%
13,2
13,7
15,7
17,1
Stunting (HAZ < -2):
SD
1,60
1,24
1,30
1,55
Prevalence (< -2) counted:
%
18,1
15,6
9,8
16,7
Prevalence (< -2) calculated with current SD:
%
17,9
15,5
14,6
16,4
Prevalence (< -2) calculated with a SD of 1:
%
7,0
10,4
8,4
6,4

The software also gives detailed

information per team.
Here, it tells you digit preference
per team for weight.

it also does the same with height.

SD found by each team for Global

Malnutrition

% of children with Global Malnutrition *

Prevalence of wasting with current SD
Prevalence of wasting with SD of 1
SD found by each team for Stunting
% of children with Stunting *
Prevalence of stunting with current SD
Prevalence of stunting with SD of 1

* This is the data we should consider as valid.

29

Poisson distribution of clusters for WHZ:

1
2
3
4

number of clusters
children/cluster with WHZ < -2: ###############
children/cluster with WHZ < -2: #############
children/cluster with WHZ < -2: ###
children/cluster with WHZ < -2: #

30

(Same as above Poisson

distribution of clusters
WHZ)