INTRODUCTION,
Despite all effort undertaken both nationally and internationally, poor nutritional status is still a fundamental cause of disease and shortened life span. Most people are aware that many factors are either directly or indirectly responsible for under nutrition, including insecure food supply, lack of basic education, inadequate health services, deteriorated environment, low income, and inadequate empowerment. The factors contributing to malnutrition vary from community. However, poverty is nearly always an underlining factor.
DEFINITION OF TERMS
Ø Nutritional Assessment is the process of monitoring changes in the nutritional status of an individual or population over a period of time.
Ø Nutritional Status is the condition of the body as a result of the intake, absorption and use of nutrition and the influence of the disease related factors.
PURPOSE OF NUTRITIONAL ASSESSMENT
1. Nutritional assessment is a vital indicator for the overall health and welfare of population especially where regular demographic and health survey are lacking.
2. It is critical for making decision that will assist in improved nutrition outcomes of a population.
3. It can be used in crisis mitigation especially as an early warning indicator to respond to threats such as drought or disease out breaks.
4. Data collected assists in providing baseline information on nutrition, socio-economic factors, demographic characteristics, food security and cultural aspects of a population.
5. Information is important for decision making on program planning, management, monitoring and evaluation.
TYPES OF DATA
1. Quantitative (numeric)
2. Quantitative ( narrative)
STEPS IN CONDUCTING SURVEY
1. Planning the survey
2. Administering the survey; partner, contact, training and tool pre-testing data collection, data management, report and presentation.
WHEN TO CONDUCT SURVEY/ASSESSMENT
1. At the beginning of a nutrition project cycle to provide baseline information for program formulation.
2. During initial phase of emergency situation to measure nutritional status and plan a short term at response.
3. During the course of the nutrition program to assess and monitor the impact.
4. Monitor progress (regular monitoring of the situation).
5. At the end of the project cycle to evaluate its extent and impact.
6. Any other time deemed necessary to establish a baseline.
HOWTO MEASURE
There is not one single parameter that serves as the only and best parameter to discover malnourished patients with risk for malnutrition. The most important goals of nutritional assessments are;
1. In time discovery of malnourished patients or patients at risks so the dietician can star her nutritional treatment as soon as possible.
2. To determine the quantity of malnutrition, so an adequate definition of the individual nutrition need is possible.
3. Diagnosis purpose
4. Monitoring of changes in nutritional state during nutritional intervention.
5. Collecting data for scientific research
6. Attention for the nutritional status of a patient in hospital
7. Improvement of accomplishment of nutritional assessment measurements
8. It can be used for patients at rise of malnutrition and patients in whom nutritional assessment can contribute to determination of the diagnosis.
TOOLS FOR ASSESSMENT
· Bio chemical data
Laboratory tests based on blood and urine can be important indicants of nutritional status, but they are influenced by non-nutritional factors as well lab results can be altered by medications, hydration status, and disease status or other metabolic process, such as stress. As with the other areas of nutrition assessment, biochemical data need to be viewed as a part of the whole.
· Clinical data
Clinical data provides information about the individual’s medical history, including acute and chronic illness and diagnosis procedures, therapies or treatment that may increases nutrient needs or induce malabsorption current meditations need to be documented, and both prescription drugs and over the counter drugs, such as laxatives or analysis, must be included in the analysis. Vitamins, minerals, and herbal preparations also need to be reviewed. Physical signs of malnutrition can be documented during the nutrition interview and are an important part of the assessment process.
· Dietary data
There are many ways to document dietary intake. The accuracy of the data is frequently challenged. However, since both questioning and observing can impact the actual intake. During a nutrition interview, the practitioner may ask what the individual ate during the previous twenty-four hours, beginning with the last item eaten prior to the interview. Practitioners can train individuals on completing a food diary, and they can request that the record be kept for either three days or one week. Documentation shoulders include portion sizes and how the food has prepared. Brand names or the restaurant where the food was eaten can assist in assessing the details of intake.
During the nutrition interview, data collection will include questions about the individual’s lifestyle including the number of meals eaten daily, where they are eaten and who prepared the meals, information about all allergies, food intolerances, and food avoidances, as well as caffeine and alcohol use, should be collected.
NUTRITIONAL ASSESSMENT OF INDIVIDUALS
To prepare a nutrition assessment, the assessor, usually a registered dietician or a physician trained in clinical nutrition, uses;
1. HISTORICAL INFORMATION
One step in evaluating nutrition status is to obtain information about a person’s history with respect to health status, socio economic status, drug use diet. An estimate of energy and nutrient intake from diet history, confirm or rule out the possibility of suspected nutrition problems.
2. ANTHROPOMETRIC DATA
A second technique that may help repeal nutrition problems in the taking of measure such as; height and weight.
The ancestors’ compares measurement taken on an individual with standards specific for sex and age or with previous measures on the same individual. Measurements out of the with expectations may reveal such problems as growth failure in children, wasting or swelling of body tissues in adults, and obesity, conditions that may reflect nutrient deficiencies or excess.
3. PHYSICAL EXAMINATION
A third nutrition assessment technique is a physical examination that looks for clues to poor nutrition status. Every part of the body that can be inspected can offer such clues; the hair eyes, skin, posture, tongue, fingernails and others.
4. LABORATORY TESTS
A fourth way to detect a developing deficiency, imbalance or toxicity state is to take samples of body tissues or fluids (blood or urine) analyze them in the laboratory and compare the results with normal values for a similar population. A goal of nutrition assessment is to uncover early signs of malnutrition before symptoms appear. Laboratory tests are useful this way and can also confirm suspicious raised by other assessment methods.
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