Capacity Building Toolbox

SMART manual
Standardized Training Package (STP)
Emergency Nutrition Assessment (ENA)


Capacity Building Toolbox

SMART Methodology provides a basic, integrated survey method for assessing nutritional status and/or mortality rate in emergency situations and for surveillance purposes (if used at equal time intervals).

In order to prepare survey managers and field teams with the knowledge and skills to carry out a SMART survey, you will need to use the components of the Capacity Building Toolbox:

1. The SMART methodology manual.

2. The Standardized Training Package (STP).

3. Emergency Nutrition Assessment (ENA) software.

Manual

The SMART manual:

  • deals specifically with nutrition and mortality surveys, including sampling, nutritional measurements, and mortality rates. 
  • describes general survey procedures & provides information on how to collect data necessary for planning direct interventions in emergency settings or for surveillance.
  • provides step-by-step instructions for analyzing survey data using Emergency Nutrition Assessment (ENA) software and procedures for food security assessments (which have yet to be piloted).

Measuring Mortality, Nutritional Status, and Food Security in Crisis Situations: SMART Methodology. SMART Manual Version 1 published in 2006.

For other nutrition manuals, please refer to Resources.
 

Modules

The Standardized Training Package (STP) is a set of modules which aide with the instruction and comprehension of the SMART methodology, and is meant for various audiences including survey teams, managers, and for regional training needs. The STP includes PowerPoint presentations, exercises, case studies and annexes, as well as short videos, pre- and post- tests, and module assessments for extra practice.

Released in October 2010, this training package was developed by ACF-CA with the CDC in order to help the international community improve nutrition and mortality survey quality and harmonize the procedures and tools used throughout the entire survey process-from planning a survey to final report writing. The Standardized Training Package includes the most up-to-date information from the TAG and the field.

When planning your training activity, it is important to understand what type of skills your participants need in order to ensure that they have the knowledge required for their responsibilities during the survey process.

Use the table below to assess what sections of the training package may be relevant to different types of survey team members. In the same way that training can provide base skills in specific concepts, remember that knowledge and skills can change over time and staff may need refresher training.


Module Name Objectives Link
1 Overview of Nutrition and Mortality Surveys Determine the relevance to conduct a survey according to the context.
Define the survey objectives in a clear and precise way.
List the key steps to undertake a cross-sectional survey.
Download
2 Survey Teams Define clearly the role of the survey manager.
Structure a competent, efficient, and reliable survey team.
Define the roles of every survey team member.
Download
3 Sampling Decide when and how to apply each sampling method.
Understand which factors influence sample size.
Use these factors to determine sample size appropriately with ENA software.
Download
4 Survey Field Procedures List the daily verifications to do before leaving to the survey area.
Choose the most appropriate method for household selection and apply it properly.
Enumerate the basic procedures to follow once on the field and before leaving it.
Manage most common special cases that might be encountered on the field.
Download
5 Anthropometry Apply the right anthropometric measurement procedures for children 6-59 months.
Build and use an events calendar to estimate the age of children from 6-59 months.
Use the weight for height reference tables to determine the nutritional status of measured children.
Use ENA Data Entry Anthropometry screen appropriately.
Explain the different graphs and results shown on the ENA Anthropometry Results screen.
Download
6 Standardization Test Identify the objectives and the principles of the standardization test.
Describe the procedures for the standardization test.
Enter the data of the standardization test into ENA.
Interpret the results and decide on the appropriate solutions.
Download
7 Plausibility Check for Anthropometry Interpret the different parts of the plausibility report for anthropometry.
Use parts of this plausibility check for the supervision of teams during data collection.
Use the evaluation done by this plausibility report to make objective and informed judgment about the quality of their survey.
Download
8 Mortality Assess the need of undertaking a mortality survey.
Articulate clear mortality survey objectives.
Identify which mortality indicators to collect during a survey.
Define a recall period according to survey objectives.
Use SMART standardized mortality questionnaires.
Download
9 Interpretation of Results and Reporting Identify the factors to consider for the interpretation of survey results.
List the essential elements for a complete survey report.
Download

 

About ENA

ENA (Emergency Nutrition Assessment)software is a user-friendly analytical program recommended by SMART. It is used to make nutrition and mortality surveys and assessments in emergency situations and for surveillance purposes as easy and reliable as possible.

ENA software has the ability to generate automatic standard tables and graphs for anthropometric indices, plausibility check reports, and to create a general survey report with automatic analyses.

Analysis of survey data by ENA software does not determine cause and effect between the different components of SMART (nutrition, mortality & food security). Contextual information is essential in order to properly interpret your results.

The table below gives a brief summary of major changes among the different versions of ENA. Please note that ENA 2011 is the recommended version to use and it can be downloaded from the menu on the left.

 

 
ENA
ENA Beta
ENA Delta
ENA 2011
Version October 2007 November 2008 November 2010 July 2011
Sample size calculation Number of children or persons Conversion into HH number Conversion into HH number Conversion into HH number
Cluster selection Only main clusters selected Automatic selection of reserve clusters Automatic selection of reserve clusters Automatic selection of reserve clusters
Statistical analysis of other variables No No Statistical calculator available for extra analysis Descriptive statistics, weighted analysis possible
Plausibility report Few statistical tests More statistical tests; scoring system More statistical tests; scoring system Automatically added when exported to Excel
Mortality HH data entry HH data entry Individual and HH data entry Individual and specific HH data entry
Food Security No No Yes Yes
Flags SMART Flags only for W/H More options for flags range selection More options for flags range selection More options for flags range selection
Analysis for MUAC Data No No MUAC data automatically analyzed Fully integrated and  data automatically analyzed
Graphs for Anthropometric results Only Gaussian curve provided Also, cumulative distribution and Probability Plot graphs Also, cumulative distribution and Probability Plot graphs Also cumulative distribution and Probability Plot graphs
Languages File needs to be downloaded Option available in the Extras Option available in the Extras Option available in the Extras


ENA Software

Download the latest version of ENA 2011 (August 4th, 2014) at:

http://www.nutrisurvey.de/ena2011/ena2011.exe

Open the ena2011.exe file. Select ‘RUN’. A grey box with “ena2011” should appear - take note of where the software will be saved and follow installation instructions. A desktop shortcut should be installed automatically. If not, locate where ena2011.exe (ENA 2011) was installed on your computer and copy it to your Desktop so that it will be easier to access.

The software is improved and updated very regularly, so please check back often.

Epi Info Software

To compensate for the few shortcomings of ENA (limited capacity to analyze additional variables collected and to manage data from other programs, the interface for data entry on a spreadsheet), the Center for Disease Control and Prevention (CDC) created one software package that combines ENA and Epi Info. Epi Info is a public domain software package designed for the global public health community of practitioners and researchers. It provides for easy questionnaire and database construction, data entry and analysis with epidemiologic statistics, graphs and maps.

The purpose of Epi Info/ENA software is to make analysis of nutrition and mortality data collected in field surveys as easy and reliable as possible. The combined software, Epi Info/ENA, provides an opportunity to enter data with Epi Info, evaluate the results with ENA, and do further statistical analyses with Epi Info. This hybrid software package allows you to:

  • Program data entry forms
  • Generate anthropometric scores using both WHO and NCHS growth standards.
  • Produce automate analyses of key mortality and nutrition indicators.
  • Conduct automated plausibility and data quality checks.
  • Generate reports that include results of these automated analyses.

To install

        1. Please click here to download and install Epi Info Version 3.5.3, which is compatible with ENA software. You must first download Epi Info separately in order to be able          to download and use the combination ENA/Epi Info software.

        2. After you have downloaded the Epi Info file, please install the following file.

Epi Info/ENA is automatically saved in a subdirectory of Epi Info (it should be C:\epi_info\ena). Make sure that the installation directory is found in this C:\ drive, otherwise problems will arise later on with its use. Take note that all your data for the surveys will be stored inside the ena.mdb file within C:\epi_info\ena.

To download the Mortality component of Epi Info/ENA software and the manual to learn how to use the hybrid software, please visit the CDC website below. You will also find4 demo films to teach you how to use the software.

http://www.cdc.gov/globalhealth/gdder/ierh/ResearchandSurvey/enasoftware.htm  

Combination Epi Info/ENA Software

Combination Epi Info/ENA Software

To compensate for the few shortcomings of ENA (limited capacity to analyze additional variables collected and to manage data from other programs, the interface for data entry on a spreadsheet), the Center for Disease Control and Prevention (CDC) created one software package that combines ENA and Epi Info.  Epi Info is a public domain software package designed for the global public health community of practitioners and researchers. It provides for easy questionnaire and database construction, data entry and analysis with epidemiologic statistics, graphs and maps.

The purpose of Epi Info/ ENA software is to make analysis of nutrition and mortality data collected in field surveys as easy and reliable as possible. The combined software, Epi Info/ ENA, provides an opportunity to enter data with Epi Info, evaluate the results with ENA, and do further statistical analyses with Epi Info. This hybrid software package allows you to:

  • Program data entry forms.
  • Generate anthropometric scores using both WHO and NCHS growth standards.
  • Produce automate analyses of key mortality and nutrition indicators.
  • Conduct automated plausibility and data quality checks.
  • Generate reports that include results of these automated analyses.

To install:

  1. Please click here to download and install Epi Info Version 3.5.4, which is compatible with ENA software.  You must first download Epi Info separately in order to be able to download and use the combination ENA/Epi Info software.
  2. After you have downloaded the Epi Info file, please install the following file.

Epi Info/ ENA is automatically saved in a subdirectory of Epi Info (it should be C:\epi_info\ena).  Make sure that the installation directory is found in this C:\ drive, otherwise problems will arise later on with its use. Take note that all your data for the surveys will be stored inside the ena.mdb file within C:\epi_info\ena.

To download the Mortality component of Epi Info/ ENA software and the manual to learn how to use the hybrid software, please visit the CDC website below. You will also find 4 demo films to teach you how to use the software.

http://www.cdc.gov/globalhealth/gdder/ierh/ResearchandSurvey/enasoftware.htm

Standardized Training Package Videos

These videos complement the STP modules. They will help guide you through and clarify various topics.
 

Module 2: Survey Teams
Survey Interviewing Tips: Communication Skills for a successful interview.

 

Module 5: Anthropometry
Taking Anthropometric Measurements: Age, sex, height, weight, oedema and MUAC.

 

Module 6: Standardisation Test
Conducting a Standardisation Test: Organisation skills for a successful survey.

 

Sampling Paper

To help you better understand the sampling module of SMART:

Sampling Methods & Sample size calculation for the SMART methodology


SMART Methodology - 2012