Module 3: Anaemia – Standardised Expanded Nutrition Survey

OBJECTIVES

The standard target groups to routinely include in an anaemia assessment in refugee contexts are: children aged 6-59 months and non-pregnant women of reproductive age between 15-49 years (including lactating women).

The objectives of Module 3 are as follows:

Primary objective

To measure the prevalence of anaemia in children aged 6-59 months and in women of reproductive age between 15-49 years (non-pregnant).

Secondary objective

To determine enrolment into antenatal care (ANC) and coverage of iron-folic acid supplementation in pregnant women.

KEY MESSAGES

Data on the prevalence of anaemia is essential to collect in refugee settings for monitoring purposes. This module is only intended to be used for assessing anaemia status of populations through SENS surveys and is distinct from assessment in a clinic or hospital.
Data should be collected on the prevalence of anaemia among children aged 6-59 months and nonpregnant women of reproductive age (15-49 years). Although rare, other age groups are sometimes also included when justified.
Standard questionnaires should be used for the collection of anaemia data.
Standard methods should be followed for measuring haemoglobin (Hb) using the HemoCue machine and for standardising the process to maintain the quality, reliability and usability of the results.
Hb concentrations should be reported in g/dL for consistency purpose. Prevalence of anaemia should be reported by categories (mild, moderate and severe). Overall prevalence of anaemia in children 6-59 months should be reported using two cut offs: Hb<11 g/dL and Hb<10 g/dL.
Providing good quality training to survey teams collecting Hb data, supervising them well, and checking the quality of the equipment and measurements on a regular basis throughout the survey will help ensure that the anaemia data are reliable.
There are standard ways of reporting anaemia results that should be followed in all SENS survey reports produced in refugee contexts.

CAUTION!

There will be Antenatal Care Clinic (ANC) in most refugee settings to take care of and follow-up on pregnant and lactating women. A SENS survey is a good opportunity to ask about enrolment of the surveyed pregnant women into the ANC running in the area and ask if they are receiving iron-folic acid supplementation. This will only provide a rough estimation of the coverage of such programmes due to
the small sample size of pregnant women found during SENS surveys, but can still highlight problems. This is why this objective should always be worded as a secondary objective.
Sample size requirements for SENS anaemia assessment in children aged 6-59 months: Select one of the scenarios (detail can be found in guidance) based on the survey design and the number of children aged 6-59 months calculated with ENA for SMART software.

Downloads

Module 3