Module 2. Indicators of programme coverage, specimen selection, management and analysis

Assessing indicators of programme coverage

Collecting specimens for assessing biomarkers

Location for collecting samples and data

Selecting laboratories to test specimens


The overall objectives of the micronutrient survey describe the populations to be included, as well as the micronutrients and programme process indicators to be assessed (see Module 1, Planning and designing a micronutrient survey). The subsequent steps determine the type of samples and specimens required, and how they will be collected, transported, stored and analysed. Development of recommendations concerning most biomarkers 1 and food nutrients requires analysis in a laboratory setting with specialized equipment and training. These are described in more detail in Module 3: Biomarker selection and specimen handling.

Decisions made during the planning process will influence the survey outcome, protocol development, draft budget, and equipment and supplies needed. Some points to consider:

  • program coverage indicators will require knowledge of national and large-scale nutrition interventions, and may reflect a national nutrition policy;
  • the selection of indicators will be based on the feasibility of collecting required food samples and biological specimens, maintaining a cold chain if required, access to appropriate laboratory capacity either in the country or internationally, and available budget; and
  • the survey scope may need to be adjusted, depending on the cost of collecting, transporting, and analysing the samples and specimens required to assess the chosen indicator(s).

Module 3: Biomarker selection and specimen handling describes the options and main factors to consider in making these decisions.

Ordering equipment and supplies is an important determinant of the survey timeline, as described further in Module 9, Survey equipment and supplies and should be done well in advance of the survey. At the same time, if this is done too early there is a risk of exceeding expiration dates on the supplies purchased (for example, cuvettes for a portable photometer).

  1. In this context, a biomarker is a measurable indicator of micronutrient or related health status. 

  • HemoCue Hb Testing QC form

    Quality control form used by phlebotomists to test the operation of the HemoCue prior to going into the field each day

  • Quality assessment system

    Document provides useful information for laboratories in low-resource settings about the minimum components of quality assurance

  • Questionnaire for laboratory evaluation

    Document can be used by survey coordinators and external quality control programs to assess the capacity and needs of laboratories engaged in the biological assessment of micronutrients