The Manual

This manual contains modules covering all aspects of a cross-sectional micronutrient survey, from planning through implementation to analysing, reporting, disseminating and using the data. The main audience for the manual is programme managers responsible for the design and implementation of a micronutrient survey. Others involved in specific aspects of survey planning and implementation should also find certain procedures and tools useful.

The manual focuses on cross-sectional cluster surveys, which are designed to provide estimates of the prevalence or population status of selected micronutrients. The surveys also provide information on relevant health indicators and estimates of intervention coverage. The manual has limited information about simple random sample surveys, since that method usually only applies to small-scale micronutrient surveys in concentrated populations, for example refugee camps.

Designing and implementing large, population-based micronutrient surveys is a complex and costly activity. Because there is often a programmatic need to study the status of several micronutrients within the same population group, and because most of the costs are incurred during field work (transportation, accommodation, allowances, maintenance of a cold chain for specimens, and other logistical issues) it is common practice to include multiple micronutrients in one single survey. The present manual is written from that perspective.

This manual emphasizes the use of indicators recommended by the World Health Organization (WHO) and other internationally recognized agencies for assessing vitamin and mineral status, for classifying deficiencies at the individual and population levels, for defining public health problems and for monitoring progress toward preventing and eliminating micronutrient deficiencies. Other indicators that may be useful for specific research studies but that are not suitable for large cross-sectional surveys are not included in this manual. It is important to recognize that recommended methods to assess the micronutrient status of a population change frequently. The information contained in this manual is current at the time of publication and will be updated when appropriate to reflect changes.

Where possible, this manual has drawn from existing survey resources, including the Multiple Indicator Cluster Surveys (MICS) and the Demographic and Health Surveys (DHS). The manual is organized as a series of stand-alone modules for each of the key aspects to be considered when planning and implementing a micronutrient survey, and when carrying out data management, analysis and reporting. The modules are available individually on line and have been assembled in this manual. The manual may be used in its entirety for planning a micronutrient survey, or individual modules may be referred to as needed. Each module discusses specific considerations and is designed to guide the user through these at every step in the process.

The manual is complemented by an online toolkit that provides additional resources, including standardized tools and examples of how they have been used in the field. Links to relevant tools are provided throughout this manual.

The following table provides a short description of each module. Programme managers, responsible for designing and implementing micronutrient surveys, should read and become familiar with every module. In addition, as suggested on the table, certain specialists will find specific modules most useful.