Is anyone aware of software packages that are useful in the management of a feeding program? 

- There seems to be different options available that focus on the statistical/survey side, but I am looking more for something that helps on an individual/ clinical level. - Something that combines
1) Basic individual stats (dates, visits, z scores, weights, length/height etc) ,
2) Basic cohort stats (eg current number of MAM, SAM, deaths/discharges in a period,)
3) Other, individualised non-numerical data (Demographics, risk factors, clinic visit complaint, treatment given, socioeconomic issues identified etc).

WHO Anthro is okay with the z scores and graphing it, but not great with any additional data. Other database-like software is good with the other stuff, but lacks the z-score calculation function.
Even something like Excel would be okay for the other data, but that in turn also isn't great with z-score tracking.(I guess the simplest solution would be if there is way to use a spreadsheet like excel to auto-calculate and graph the z-scores?)

I look forward to hear from colleagues with experience with the various options available.

Sam,

Our company is working on such a software package. We were approached by several NGOs needing a very similar tool as you are describing above. Please go to our website, www.sharemy.health, and submit a support ticket asking for Clayton. I am happy to provide any additional details for those interested.

Here are some details regarding our application that is web and mobile based:

  1. HIPAA & GDPR compliant
  2. Collects demographic information such as DOB, Address, Contact information, etc.
  3. Provides nutrition screening results for Height, Weight and MUAC including the general category (i.e. Mild Stunting) and the z-scores in each area.
  4. Nutrition Intervention tracking such as Vitamin A supplements, Deworming pills, MMS, etc.
  5. Community/Organizational analytics

This is just a brief list of our core functionality. We are continuing to grow into areas such as vaccine management and intervention adherence.

I hope this is helpful and we get a chance to collaborate.

Clayton

Answered:

1 year ago

A recent posting which describes software to calculate anthropometric indices mentioned "mild stunting". To my knowledge, such a condition does not exist. The categories of stunting are defined statistically; that is, where an individual child falls on the distribution of anthropometric indices for the WHO standard population. Any child with a height-for-age more than 2 standard deviations below the WHO standard population median is defined as stunted. Thus, even though all children in the WHO standard population received "optimal" nutrition and health care, a small minority are defined as stunted: that is, those in the bottom 2.5th centile. In addition, degrees of stunting are defined: moderate stunting is a height-for-age less than 3 standard deviations but more than 2 standard deviations below the WHO standard population median, and severe stunting is a height-for-age more than 3 standard deviations below the WHO standard population median. No international consensus recommendations or guidelines with which I am familiar define "mild stunting" nor recommend the use of this category.

Remember that in a normal distribution, the range of data values defined by the mean minus 1 standard deviation to the mean plus one standard deviation includes 67% of the values (or in our case, children in the survey sample), and the range defined as the mean minus 2 standard deviations to the mean plus 2 standard deviations defines 95% of the children. By simple subtraction, we see that the range between mean minus 2 standard deviations and mean minus 1 standard deviation (the false definition of "mild stunting") includes 14% of children. Therefore, defining "mild stunting" as a height-for-age z-score >= -2 but < -1 automatically defines 14% of the children in the WHO standard population as "mildly stunted". If we include mild stunting in the overall prevalence of stunting, 16.5% of children in the WHO standard population would be defined as stunted. This is obviously absurd; 16.5% of "normal" children cannot be stunted. The same mistake has been made for wasting. In the not too distant past, nutrition surveys have included calculation of the prevalence of "mild wasting" defined as a weight-for-height z-score >= -2 and < -1. These surveys then reported the prevalence of overall wasting which included severe, moderate, and mild bundled together. As you can imagine, this caused panic among naïve readers who did not understand why the reported prevalence of wasting was so high. 

Perhaps the fault lies with the existing terminology: if there is a severe and a moderate, there must be a mild, yes? But this is not true in this case. Perhaps we should refer to stunting grade 2 for severe, stunting grade 1 for moderate, and stunting grade 0 for not stunted. Although it is probably too late to change the basic terminology, please never define "mild" stunting, wasting, or underweight, and certainly never include a "mild" category in calculations of the prevalence of overall stunting, wasting, or underweight.

Bradley A. Woodruff
Technical Expert

Answered:

1 year ago
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