Nigeria Food Consumption and Nutrition Survey by International Institute of Tropical Agriculture

Nigeria Food Consumption and Nutrition Survey 2001-2003 IntelViewer's Manual

Maziya-Dixon, B., F. Onyezili, E.B. Oguntona, S.E. Harris, R.A. Sanusi, S. Nokoe, V. Manyong, D. Almustafa, and 1.0. Akinyele

ÂŠ International Institute ofTropical Agriculture (IiTAl, 2006 Ibadan, Nigeria Telephone: (2342) 2412626 Fax: (2342) 2412221 E-mail: iita@cgiar.org Web: www.iita.org To Headquarters from outside Nigeria:

do Lambourn (UKl Ltd Carolyn House 26 Dingwall Road, Croydon CR9 3EE, UK Within Nigeria:

PMB 5320, Oyo Road Ibadan, Oyo State ISBN 978131313 7 Printed in Nigeria by IITA Correct citation: Maziya-Dixon, B., Onyezili, F., Oguntona, E.B., Harris, E., Sanusi, R.A., Nokoe, S., Manyong, V., Almustafa, D., and Akinyele, 1.0. 2006. Nigeria Food Consumption and Nutrition Survey 2001-2003. Food Instrudion Booklet. Ibadan, Nigeria. 136pp.

Preface This publication is the official reference manual used by the Interviewers during the conduct of the Nigeria Food Consumption and Nutrition Survey (NFCNS) 2001-2003, which was conducted by the Intemationallnstitute of Tropical Agriculture <liTAl,lbadan in collaboration with the Federal Ministry of Health, National Planning Commission (NPO, and national institutes and universities. The United States Department of Agriculture, Agricultural Research Services, Beltsville Human Nutrition Research Center - The Community Nutrition Research Group (CNRG) provided technical assistance. The manual aims at: familiarizing the interviewer with the philosophy and objectives of the Nigeria Food Consumption and Nutrition Survey 2001-2003; providing explanations for implicit terminology; guiding the interviewer to adequately prepare for and carry out the required fieldwork, including questionnaire completion and sample collection; ensuring uniformity and consistency in the performance of the survey exercise; ensuring that quality and valid data are collected; ensuring that correct administrative procedures are followed to make for a thorough and successful survey. Included is information on background, introduction, and overview of the survey, purpose of the manual, preparation for the field, reaching the respondents, contact with respondents, survey sampling frame and design, administering the questionnaire, pregnant women, focus group discussion, quality control procedures, administrative procedures, and appendices containing checklist of materials for interviewers before going to the field, survey questionnaire, protocols for anthropometry and collecting biological samples, and weights of foods measured with local utensils. The NFCNS 2001-2003 is the first nationwide food consumption and nutrition survey. The survey measures the nature and extent of food insecurity at the household level, adual food consumed by children under age 5, their mothers, and pregnant women, nutritional status of women and children, vitamin A, iron, zinc, and iodine status of children under age 5, women and pregnant women, children from food intake and biochemical indices, provides information on home health practices, and food processing (including food fortification). Copies of this publication may be requested from IITA PMB 5320, Oyo Road, Ibadan, Oyo State, Nigeria ITelephone 02-2412626; Fax 02-2412221; Email: iita@ cgiar.org) or can be downloaded from the Internet: at www.iita.org iii

Acknowledgement The International Institute of Tropical Agriculture (IITA> gratefully acknowledges the support from the United States Agency for Intemational Development under grant no. 59-3148-0-013 and LAG-G-00-93-00042-00; and the United States Department of Agriculture under grant no. 58-4001-0-F161. We are most grateful to Ms C. Jackson and Ms L. Adams for their unflinching support. Similarly, IITA appreciates the contribution of the United Nations Children's Fund and the support of Dr K, Varnomelingen and Prof. F. Onyezili. Between October 2000 and June 2001, several individuals participated and spent time in planning, designing, and colleding data. We acknowledge Dr Ellen Harris, Assistant Diredor, Beltsville Human Nutrition Research Center, for her technical input and guidance.

Contents Preface ........................................................................................................................ Acknowledgement ................................................................................................. List of acronyms ...................................................................................................... Glossary........................................................................................ ...............................

iii iv VIII

Background ................................................................................................................. Why do we need to conduct a food consumption and nutrition survey? ......................................................................................................... Goal ........................................................................................................................... Purpose..........................................................................................................................

Specific objectives ............................................... ..................................... .............

Scope of the survey ..............................................................................................

Introduction and overview of the survey.......................................................

Introduction .............................................................................................................

Beneficiaries .............................................................................................................

Pilot Study ........................................... ....................................................................

Purpose of the manual ........................................................................................... Purpose ...............................................................................................................

5 S

Overview of interviewer responsibilities ........................................................

Preparation for the field

..................................................................................

What you will receive ... ........................................................................................

Organize your assignment

Reaching the respondents

Roles of the Federal Government (NPc) Roles of the LGAs ..............................................................................................

8 8 8

Roles of Zonal Coordinators ..............................................................................

Roles of State Supervisors ..................................................................................

Roles of Field Teams ............................................................................................

Contact with respondents ...............................................................................

Contact with respondents ................................ ...................................................

Questions that are likely to be asked by respondents ..............................

Roles of the State Governments ......................................................................

Household eligibility criteria

.........................................................................

Refusal

Difficulties in locating the household

Difficulty in finding people at home

Survey sampling frame and design

Sampling procedure

Selection of states

Local government areas (LGAs)

...........................................................

...........................................................................

.......................................................................................

Enumeration area (EA) Household listing

Selection of eligible households

...........................................................

Administering the questionnaire .....................................................................

Selection of persons for 24-hr dietary recall and anthropometry study .......................................................................

Selection of persons for biochemical measures ..............................

Pregnant women

.......................................................................................

Pilot study ...............................................................................................................

Administering the questionnaire Locating the sample households

Administering the questionnaire .....................................................................

Pregnant women

•••...•.............•...................................................._...••..•.............

24-hr dietary recall protocol for pregna nt women Biochemical measurements

...............................................................................

Focus group discussion guide

68 68 68

...............•......................................................

Quality control procedures ....................................................................

Role5 and responsibilities of survey team members

.................... .

.................................................................................................

Field editing

Validation of field data

...........................................................................

Field observations ...................................................................................... Feedback from monitoring team/focal persons Fine tuning procedures and specifications

............................ ..

.......................................

75 75 75 75

Admin istrative procedures

Admin istrative procedures related to fieldwork

76 .......................................

................................................................................

Administrative procedures related to personnel Interviewers' profile

................................ _........................................................

78 79 79

................................................................................................._ ............ .

Contract letter ..............................................................................__ .. Accommodation Transportation Appendices

..... .

...................... _.. _.................................................... _..â&#x20AC;˘.

....... .

2 Table for random numbers .............................................................................

Nigeria food consumption and nutrition survey 2001

....................... .

24Âˇhr dietary recall protocol for the pregnant woman ........................ .

105

Protocol for taking anthropometry ............................................................. ..

111

Protocol for collecting biological samples

115

Weights of foods measured with local utensils

Checklist of materials for interviewer before going to the field

.................................................

119

Tables 1. Agroecological zones <AEZs) showing states in each zone and number of principal food crops <PFCs) per zone .....................................

2. Distribution of sample by LGA categories and states .............................

3. Listing of selected states and local govemment areas..............................

4. Weights of foocs cooked at home and those purchased from canteen/restaurants

124

Figures 1. The different AEZs and the food crops grown in each zone ............... 2. Map of Nigeria showing the different principal food crops (PFCs) ....

15 15

3. Child weight measurement using electronic scale (UNISCALEl .......... 63,113 4. Child length measurement for infants and children 0-23 months .... 64,114 5. Child height measurement for children 24 months and older ............ 64,114

vii

List of acronyms ARS

Agricultural Research Services

BCG

Bacillus Calmete Guerin

BMS

Bench Mark Survey

DPT

Diphtheria, Pertussis, and Tetanus

Enumeration Area

FAO

Food Agriculture Organization

FCNS

Food Consumption and Nutrition Survey

FGD

Focus Group Discussion

FGN

Federal Government of Nigeria

FMOH

Federal Ministry of Health

Household

HHH

Household Head

IITA

International Institute of Tropical Agriculture

LGA

Local Government Area

MICS

Multiple Indicator Cluster Survey

NEPA

National Electric Power Authority

NDHS

National Demographic and Health Survey

NPC

National Planning Commission

OMNI

Opportunities for Micronutrients Interventions

ORT

Oral Rehydration Therapy

ORS

Oral Rehydration Solution

PHC

Primary Healthcare Centre

PIC

Participatory Infomnation Collection

UNICEF

United Nations Children's Fund

USAID

United States Agency for International Development

USDA

United States Department of Agriculture

REB

Rural Electrification Board

VIP

Improved Ventilated Pit Latrine

WHO

World Health Organization

VIII

Glossary Economic rights: The degree of freedom the woman enjoys in choosing what she engages herself in within or outside the vicinity of her residence to generate income, as well as what she does with such income. Empowerment: Includes the degree of confidence which the woman enjoys in choosing her views and in taking decisions affecting her as well as the household. Enumeration Area (EAl: An EA is a cluster of about 500 people with defined geographical boundaries. The number of households within the area determines the size of the enumeration area. Exclusive Breast Feeding (EBFl: Feeding the child with breast milk alone (without water, glucose, infant formula, herbal mixtures, e.g., 0900, etc.l for the first six months of life. Food instruction booklet: A booklet used by the interviewer in association with the 24-hour recall to coiled descriptions and amounts of food consumed by the respondents. Food intake: All beverage (except water) and food consumed; excludes inedible parts of foods such as bones, uneaten portions, and vitamin and mineral supplements. Food availability The duration in which the household can obtain food items. Food security: Refers to availability and adequacy of various foods within the household. Growth monitoring: Monthly weighing of a child and recording on the growth chart. Household: All persons who regularly share a house. Household membership is based on the place where a person usually lives or sleeps, where the person is free to return, eat from the same pot and has a recognized head at any time. Household head: An adult male or female who is acknowledged by the household as their head, someone who leads the members of the household in discussions and decisions with regard to household matters. Household respondent: A person who answers the household questionnaire, usually the main meal planner/preparer or a person knowledgeable about the household charaderistics such as income, not necessarily a sample person. Household questionnaire: The part of the survey questionnaire that gathers information on socioeconomic data including income, and is administered in person to a knowledgeable household respondent, not necessarily a sample person. ix

Measuring guides: A set of tools used in conducting the intake interview C24-hour dietary recall) to help respondents estimate the quantities of foods and beverages consumed. Nonrespondent: A sample person who did not complete an interview. Proxy: A knowledgeable adult who completes the dietary intake interview for children under 5 years. Reproductive rights: Refers to the degree of freedom the woman enjoys to choose whether or when to have a baby, as well as the support she receives during pregnancy, the prenatal, and postnatal periods. Respondent: a household member who was selected to respond to the interviewer's questions, participate in the intake component of the survey, and provide at least I day of the dietary intake data. Sample person: a household member selected to participate in the individual intake component of the survey. 24-hour dietary recall: a recall of beverages (excluding water) and food consumed during the day preceding the interview. Workload: is defined as sum total activity other than rest and sleep.

Background Why do we need to conduct a food consumption and nutrition survey? The current data used in nutrition circles in the country are often fairly old and drawn from different surveys of different methodologies and techniques, or notably focused on specific aspects of nutrition. Some of such data include the Nigeria Demographic and Health Survey (NDHS 1990>, the Participatory Information Collection (PIC 1993), the Opportunities for Micronutrient Interventions (OMNI 1993), the Multi-Cluster Indicator Survey (MICS 1995), and the Benchmark Survey (BMS 1996) reports, among others. Even the most recent findings of MICS (1999), the Baby Friendly Hospital Initiative Impact Evaluation (BFHI 1999), and the Health Survey (NDHS 1999) fell short of covering all the relevant aspects of nutrition. The shortcomings of some of these surveys are that they had objectives other than nutrition but included some of the nutrition indicators as secondary foci. Others fell short technically because of the limitations posed by the need to combine biochemical techniques with participatory social sector and scientific methods in eliciting holistic nutrition data. Generally, most of these surveys which attempted to address nutrition indicators used classical techniques that had little or no community participation : a key aspect of current techniques for eliciting information and feedback to beneficiaries as active participants in the development process. Further, the changing socioeconomic conditions have not only dimmed the relevance of these information sources but also made some of them obsolete and at times misleading as programming and planning tools. It is therefore pertinent to undertake a holistic national survey to generate, in a participatory manner, very current data in all aspects of nutrition covering food security, health and healthy environment in nutrition and care for both planning and programming in Nigeria. The information should also be useful to all agencies with primary and secondary mandates and foci in nutrition. Goal The overall goal objective of the Food Consumption and Nutrition Survey (FCNS) is to determine the nutritional status and nutrient intakes of the rural and urban populations in Nigeria. Purpose Assess the extent and nature of food insecurity in Nigeria. Conduct food consumption survey and undertake anthropometric and a biochemical assessment to determine the nutritional status of women and children under 5 years old.

Collect information and awareness from households on home health practices and food processing . Specific Objectives Determine the nature and extent of food insecurity and actual food consumption patterns. Using quantitative methodologies, assess the nutritional status of women and children . Determine the micronutrients (vitamin A, iron, zinc, and iodine) status of women and children from food intake and biochemical indices. Elicit from household and communities information on home health practices, and food processing (including food fortification). Use the results to design appropriate intervention strategies to address the identified problems.

Scope of the survey The scope of the survey is national, covering 12 states, representing a third of the total states of the federation, 72 local government areas (LGAs), 216 enumeration areas (EAs), and 30 households from each EA

Introduction and overview of the survey Introduction The success of a nutrition survey is hinged on a clear understanding of the philosophy of the survey and the nature of the data to be collected and the way it should be collected. As an interviewer on the Food Consumption and Nutrition Survey (FCNS), you have a very important role in the success of the survey. It is therefore very important that you study this document and obtain a clear understanding of the information contained in it. It is also expected that you will evaluate field procedures and respondents and suggest changes and improvement for the main study. We look forward to your participation in this important study. Food Consumption and Nutrition Survey: 2001 is a national study for which data on the nature and extent of food security, food intakes, anthropometric and biochemical parameters will be collected and used to determine the nutritional status of women and children in rural and urban populations. A critical component of FCNS is the food intake portion of the 24-hour dietary recall questionnaire. Respondents are requested to recall what they ate the day before the interview. A guidebook called the food instruction booklet (RB) accompanying this manual is used as aid to interviewers in obtaining detail information on both the types of food eaten and the amount. Examples of probes that can be used to elicit the required infomnation are in FIB. The data collection instrument (questionnaire) covers a wide variety of topics. For example, the household (HH) composition has questions covering the names of persons who regularly live in HH; their sex, age, relation to household head, education, eligibility to provide information or/and sample. In addition, socio economic characteristics of HH are covered. Other topics included are food security, household food consumption expenditure and food-related coping strategies, assessment of nutritional status, and health and care issues. Beneficiaries The primary beneficiaries of this survey are children under 5 years, pregnant women, and nursing mothers in Nigeria. Through this survey, information on their rlutritional status will be available. This information will enable policymakers, researchers, and developmental agencies to formulate poliCies and sustai nable interventions that will improve the nutritional status of these target groups. Pilot study For a study of this magnitude and importance, it is essential to test all aspects of the materials and procedures to be used before the main study begins. The pilot study

tests the use of the questionnaire, procedures designed for use in the main study, and logistics. The results of the pilot study and the experience of using these tools and procedures will enable us to modify and improve them for the main study. The pilot study will be conducted in each zone. One LGA and one EA will be selected in each zone. Ten households will be interviewed in each selected EA making a total of 40 households. All parameters will be taken during the pilot study.

Purpose of the manual Purpose This manual will be used for the pilot study and the Nigeria Food Consumption and Nutrition Survey 2001 . Upon completion of the pilot study, changes to the manual will be made accordingly. The purpose of this interviewer's manual is to: Familiarize the interviewer with the philosophy and objectives of the Nigeria Food Consumption and Nutrition Survey 2001. Provide explanations for implicit terminology. Guide the interviewer to adecuately prepare for and carry out the required fieldwork, induding Questionnaire completion, and sample collection. Ensure uniformity and consistency in the performance of the survey exercise. Ensure that quality and valid data are collected. Ensure correct administrative procedures are followed to make for a thorough and successful survey. Overview of interviewer nesponsibilities It is expected that the interviewer will: Become thoroughly through home study and attendance at training sessions familiar with the questionnaire. Assemble and organize survey materials before fieldwork. Be able to locate sample addresses and households. Enumerate members of the household and select sample persons. Administer questionnaires to the appropriate persons. Conduct preliminary quality checks on data collected and response status. Comply with administrative procedures for retuming completed questionnaires. Maintain regular contact with the supervisor. Undertake any other related duties assigned by the supervisor.

Preparation for the field What you will receive You will receive the following supplies: Writing materials and manuals (in a bag) Clip board Pencil Pen/biro Eraser Pencil sharpener Questionnaire booklet Interviewer's manual <1M) Food instruction booklet (FIB) Interviewers' logbook Household listing forms Anthropometric equipment UNICEF unit scales for measuring weight Height meter for measuring height or length 24-hr dietary recall Kitchen scales for weighing up to 5 kg Calibrated measuring spoon, cup, and glass Biological samples Sample collection kits for urine and blood sample (for use by medical laboratory technologist team for biological samples). A letter of introduction and an identity card. Check that the supplies listed above are complete and the equipment are functioning properly. If one is missing or it's not functioning properly, contact your su pervisor immediately.

Organize your assignment It is important that you plan your work to maximize efficient use of your time. Completion of each questionnaire should not exceed 40 minutes. Plan a travel route that would enable you to cover most households within a short distance. Each day before going to the field, check your supplies or items to avoid waste of valuable time. In particular, check your questionnaire for pt'inting defects or m issing pages. Check the scales and if necessary, recalibrate the scales. Keep all your materials secure. You will be responsible for accounting for all materials/items supplied, indud ing questionnaires, even those you have not used. Before going to the field, please go through the checklist of materials provided in Appendix 1 to make sure you take all what you will need for the field work.

Reaching the respondents This chapter focuses mainly on how to reach the respondents and roles of the different members of the survey team, which will include the role of the Federal, (NPc), state, and local governments; EAs; zonal coordinators; state supervisors; and interviewers. Roles of the Federal Government (NPO Obtain ethical clearance for the survey from the Federal Ministry of Health Write to the state governments providing detailed information on the survey and identifying the LGAs and EAs to be involved Initiate social mobilization at the national level Procure of approved EAs

Roles of the State Governments Provide LGAs and EAs with information on the survey Lead social mobilization of state, LGAs, and EAs Provide logistical assistance to the survey field teams Roles of the Local Governments Lead in social mobilization of identified EAs Assist in identifying local guides in the selected EAs Assist with logistics for survey field teams Roles of zonal coordinators Liaise with state governments to ensure preparedness Liaise with state supervisors to ensure preparedness Liaise with principal investigator to assure preparedness Participate in identifying of enumeration areas and local guides Participate in social mobilization at state, local government area, and enu meration area levels Roles of the state supervisors Liaise with state governments and zonal coordinators to ensure preparedness Participate in identifying EAs and local guides Participate in social mobilization at state, LGA, and EA levels

Roles of interviewers Identify local guides dentify households in EAs assisted by the local guides Be satisfactorily identified by households (mode of introduction) Identify the respondents Establish adequate rapport with households and respondents (the dos and don'ts)

Contact with respondents How you present yourself at the door of the respondents usually determines how successful you will be with the interviews. Since it is your first opportunity to describe the survey to a respondent, familiarity with the introouction is important. This introduction is printed below:

Greeting for the time of the day (m local parlance). I am (your name) and we are members of a national food consumption and nutrition sUlVey team for the Federal Govemment of Nigeria that you have been told about. It has been noticed that young children and their mothers have deficiencies that may interfere with their health and welf-bein'J which need to be corrected Your household has been selected to participate in this sUlVey. This wilf involve you answering some questions, and we toking some measurements and samples. An experienced and quolified person wilf take these measurements and samples. The procedures are quic~ and vel}' safe, but some may be slightly uncomfortable such as taking blood and uone samples. Your answers wilf be combined with those from other households to make conclusions in which, I assure you, no person or family WIll be identified Our results are important in makIng decisions on how we can improve the health of our children. I am glad to answer any questions you may have.

Remember to communicate with the respondents in the language they speak or understand well and show your letter of introduction/identity card. You may need to satisfy the curiosity of most respondents and answer some questions about the survey. Listen patiently to the respondents' questions/concerns and provide only the information needed to remove any doubts and create a conducive atmosphere for the survey. Do not volunteer extra information that could be misunderstood or could confuse the respondent. If you do not know the answer to any question, admit that you do not know but offer to obtain an answer.

Questions likely to be asked by respondents Here are some possible questions from respondents, and suggested answers.

What is the survey about? The Federal Govemment and other organizations wor1<ing in Nigeria are interested in collecting information that will help them assist in improving the health and well-beng of Nigerians. Whom do you work for? I work for the survey team covering 72 local government areas and 216 enumeration areas. Our project coordinator is Dr B. Maziya-Dixon of the International Institute of Tropical Agriculture (JITAl, Ibadan. If you like, I can give you her contact address.

Why did you select me?Your household was selected randomly from a list of all households in your enumeration area in the LGA. How long will this take? The first part (household composition) should take about 15-20 minutes. If there is someone eligible in your household, the rest of the interview with him or her will take about 1 hr 30 minutes.

What are you going to ask me? I just have questions about the number of people in your household, where you live, what you eat, how you feel, who takes care of the baby, where do you go when you do not feel well. A member of my team will take measurements and collect some samples. What are you going to do with the information? The information will be used to compile summaries, which will assist government and other agencies in setting up policies and programs that will improve the health and welfare of the people. Your answers will be kept strictly confidential and your identity will not be revealed. What do I get from this? You and your household are likely to benefit from programs initiated by the government and other agencies that will address identified problems. In addition, you will also participate in the fomnulation of such programs.

On the average, the most productive times for contacting respondents at home are from 5.30 to 7.30 am in the morning and from 4.00 to 7.00 pm in the evenings. Of course, this will vary with area and occupation of the respondents. Late afternoons and evenings are the most productive times in most cases. Wherever possible, make contact with a neighbor to find out when the respondent is likely to be home.

Household eligibility criteria To qualify for enumeration, a household should have a: mother child of this mother aged less than five years. Where the mother has more than one child aged less than 5 years old, the youngest child should be selected for sampling. In a household where there is more than one eligible mother and child pair, the youngest mother and her child should be selected. Refusal In a study of this nature, if the public is adequately mobilized to understand its importance to the nation and the long-term benefits to the people as the recipients, a well trained interviewer who is professional and confident will largely receive warm and positive responses from all households. However, you may find some few respondents who may not cooperate. In such a case, you will need to use your initiative to decide the next step to take. If the person refuses to take part but does not object to your conducting the interview with someone else, you should continue the interview with another knowledgeable household member. But if the person refuses to take part in the exercise and objects to your conducting the interview with someone else, accept the refusal. apologize for taking their time, document the refusal information, and leave the door open for another interviewer to contact the household. Difficulties in locating the household Although the listing will be conducted with great care, there is always the possibility that you will encounter a problem locating or identifying sampled households. To avoid difficulty in locating the households, enumerators are encouraged to work closely with local guides and enumeration area leaders. If, even with the help of the local guide and leader, the sampled household cannot be located, review the listing sheets and maps carefully before leaving the area. If your best efforts fail, sketch a map of the immediate area and contact your field supervisor. If you are positive that you are in the right area and the household does not exist, document this finding and provide explanation of what you think might have happened, if possible. Difficulty in finding people at home This can largely be avoided if a prior arrangement is made with the enumeration area leader or opinion leader who will help to sensitize the people for the interview. People in this category could be reached early in the moming before they go out for their businesses or towards evening when they might have returned. In a rare case, where the household to be sampled has moved away, it should be indicated so. We expect that in most cases you will be able to complete the questionnaire with a household member in one visit.

When this is not possible with one visit, you are required to make two more visits in order to complete the questionnaire. II the members of the household at the sampled address are not there the first time you try to establish contact, you should try again at a different time and day. On the second unsuccessful attempt, you should contact a neighbor in an attempt to obtain information about the best time to contact the household. If the third (final) attempt with the respondent is also unsuccesslut report the case to your supervisor. Another household may be sampled from the list 01 households in the enumeration area.

Survey sampling frame and design Introduction The design targets the whole Of Nigeria. Considering obvious and documented relationships among: the agroecological zone and type of farming systems, crops grown and food consumed, type Of food consumed (intake) and micronutrient deficiencies. Nigeria was initially stratified according to major agroecological zones and predominant food crops within agroecological zones. Owing to lack of information on the principal variables Of interest in the study, a sample size consistent with the cost Of survey and availability of resources was aimed at. It is postulated that a large sample size, spread across agroecological and food type zones shall be fairly representative Of the whole country. Sampling procedure A stratified multistage procedure, with stratification at two levels, i.e., agroecological zone <AEZl and principal food crops (PFO were used. Figure 1 shows the different AEZ while Figure 2 shows the crops grown within each AEZ. AEZ 1 is essentially a dry savanna zone, while AEZ2 and AEZ3 are predominantly moist savanna, and humid forest zones respectively. The PFCs range from mainly cereal food crops to root crops and their combinations. Three PFCs were identified in each of AEZ 1 and AEZ2, while 4 PFCs were identified in AEZ3 ITable 1>. Table 1. Agroecological zones (AEZs) showing states in each zone and number of principal food crops (PFCs) per zone.

PFC1 PFC2 PFC3

Sokolo Kalsina Yobe

Zamfara Gombe

Kebbi Jigawa Borno

Taraba Kwara

Adamawa-S Kogi

Benue

Anambra Cross River

Imo Abia

i Enugu Ebonyi

Kana

Niger-N Bauchi Adamawa-N

AEZ2 PFC5 PFC6 AEZ3

PFC10

Akwalbom

Agroecologlcal zones

C2l "'~-

Oner Savanna McMsI Savanna

,(J) I ".

Figure 1. The different AEZs and the food crops grown in each zone.

M _

C,oP'P"'.

systems

c:::as-~eI'Y.m

rn~ EJ ~Im'FI\,I~路 ~ M.&l.-sGrghtlmfCaHIe

!IJllD ..............,..".. Jot

<OIIO"'

lIIO

G Y~~

Figure 2. Map of Nigeria showing the different principal food crops (PFCs)

Selection of states In each PFC, a random sample of one of the states within the particular PFC was taken (with the exception of a PFC in zone 3 where 2 states, due to the larger number of states present were taken). Selection probabilities of states ranged from 1/18 to 1/48 (i.e., proportional to sizes of sub groups). Twelve states were selected.

Locol Govemment Areas (LGAJ Presently there are about 774 LGAs in Nigeria. Within each selected state, a listing of LGA was obtained, grouped according to the level of urbanization (urban, medium and rural) by Nigeria's Federal Office of Statistics. One consideration formed the basis for the selection of the LGAs. This was the need to ensure that the LGAs represent a range of rural/medium/urban conditions. For ease of coordination, the states selected were placed in their respective zones as follows: Zone 1: Barno, Taraba, and Nasarawa

Zone 3: Kwara, Osun, and Edo

Zone 2: Kebbi, Kaduna, and Kana

Zone 4: Bayelsa, lmo, and Akwalbom

From each selected state, sampling was done such that all the 3 LGAcategories (rural, medium, and urban) were represented. Further stratified sampling with probabilities proportional to number of LGAs in each category was adopted, subject to additional conditions that a minimum of one LGA from each group within LGA and a maximum of 18 for all the states making up a particular zone were selected. The practical method for achieving this involved random selection of one from each of the 36 categories <12 states times 3 LGA groups), and the allocation of the remaining 36 samples proportionately to the total population of LGA groups. Sample sizes, for this stage of sampling, are given in Table 2, while a listing of the selected LGAs are given in Table 3. Table 2. Distribution of sample by LGA categories and states. Zone

AEZ Two Two

State Urban Nasarawa 1 1 Taraba

One

8arno

Two One

Kaduna Kebbi

One

Medium

Rural 2

Total 4

3 3

6 8

1 2 3

2 2

Kana

2 1 3

5 4 9

Three Three

Osun Edo

3 3

7 6

Two

Kwara

2 2 2

3 24

8 3 7 72

Three Imo Three Bayelsa Akwalbom Three LGA categories selected

Table 3. Listing of selected states and local government areas. State

Code

Selected

Status

State

Code

LGA Zone 1 Nassarawa

Taraba

Borno

Zone 3 Osun

Keana

rural

Nassarawa Keffi

urban

Wamba

rural

Bali

medium

Gassol Ussa Jalingo Sardauna Ardo Kola

rural rural urban medium rural

Maiduguri M on~uno

urban medium

11 12 13 14 15 16

Dam oa

medium

medium rural rural urban

Kwara

Oshogbo Ifa South Ifedayo lIa Ife East Irepodun Ola oruwa

urban medium rural urban medium rural rural

44 45 46 47 48 49

Etsako West

Egor Etsako East Orhionmwon Esan West Ovis S.W.

med ium rural rural urban medium rural

50 51 52 53 54

Oyun Ekill Offa

medium rural urban

Irorin West

medium rural

Owerri Municipal

urban

medium rural rural

18 19

Makarfi

medium

20 21

Kauru Kaduna south Lere

rural urban

Oru East Isu

medium

Ohaji

med ium rural

Zone 2 Kaduna

Edo

37 38 39 40 41 42 43

Abadan Bayo Biu Gubio Kwaya Kwar

Status

LGA

01 02 03

07 08 09 10

Selected

Irepodun

Zone'"

Imo

Egbema

Kajuru

rural

Dandi Birnin-Kebbi Baguda Gwandu

rural urban medium rural

Aboh-Mba ise Okigwe Orsu Njaba

urban

Yenagaa Sagbama Ekeremor

urban medium rural

Ellnan Ikono Ibesikpo Asutan

medium medium rural

69 70 71 72

Ikot路Ekpene Itu

Kebbl

Kano

25 26 27

61 62 Bayelsa

63 64

28 29 30 31 32

Kura Tofa Tudun-Wada

33 34 35 36

Rano Gwarzo Bagwai Takai

Kano Municipal

Blchi

urban medium medium rural urban med ium rural rural rural

65 Akwalbom

67 68

Nsit-Ubium

Okobo

medium rural rural

urban medium rural rural

Enumeration Area (EAJ The EA is the smallest geographical cluster of household as delineated by the National Population Commission for purposes of enumeration. The number of households within the area determines the size of the enumeration area. The population of each of the enumeration areas will be obtained from Ihe LGA headquarters.

To facilitate the actual location of ruraVmedium/urban LGA from selected LGAs; the enumeration areas (EAs) that fall entirely within a selected LGA will be sampled . A comprehensive list of all the enumeration areas (EAs) in selected LGAs will be obtained from the National Population Commission (NPO. Three EAs will be randomly selected from among the list of EAs that are within a selected LGA. It is from these selected EAs, that a further breakdown of EAs will be made for the selection of households.

Household listin9 The household (HHl unit represents the smallest unit to be observed. A household is defined as a family unit that feed from the same pots and has a recognized head of authority. You will receive a detailed EA map and a household listing form to record information on the entire households in the EA. The EA map will indicate where to start the listing and numbering and where to stop. A list of all the households in each enumeration area will be made and every housing unit should be given a "FCNS", serially. Th is should be boldly written on a conspicuous part of the house. Detailed information (addresses) of the households is to be properly documented so they can be identified or located. Households with below five-year old children, women of childbearing age and/or pregnant women will be identified during household listing, and shall constitute the target population .

Selection of e/i91ble households A modified form of stratified quota sampling, with random components, will be used to select eligible HHs from the target population generated in 6.2.4. A random order of eligible HHs in each EA will be obtained using either a table of random numbers or the 'hat method'. You will then visit HHs in the random order generated. Where there is non-response (e.g. unwillingness to be interviewed, absence of HH head, empty HH, etc.) you will ignore the HH and move to the next on the list until the sample of size 30 eligible HH in the EA has been obtained or the population of eligible HH exhausted. In this way, non路response may be minimised, though you should expect to move back-and forth in the EA. The latter is minimised by splitting the eligible HH into 2 on spatial-basis for 2 teams (e.g. stream running across EAl and the sample of size 30 split proportionately to the size of the strata. Altematively the number of HH may be split exactly into 2 and each team allowed to quota sample a maximum of 1 5 HH. The modified quota method is illustrated below.

Example of quota sampling procedure

A Household listed by FCNS numbers, Consider HHs with the assigned FCNS numbers arranged spatially in the order shown

03 09

05 11

10 15

07 13

23 24 25

B. Eligible HH is underlined

02 08

14 19

20 23

24 27

25 28

C. The eligible HHs are then randomised and their order noted. (i) Hat method: Place numbers in a hat and take them out one at a time. Assume the order is as follows: 32

20 [In practice, you will pick up one and visit, then pick up the next from the hat etc} (ii). Table of random numbers. Select any column of the random number table randomly. Let's assume it is the 6th column. Run through the column circling the number corresponding to eligible HH numbers. When you reach the end of column 6, continue on column 7 from the top and maintain this consistency. Continue with the process until the sample size is achieved or end of target. !If you continue from the bottom, move up to the top and then continue from the top of 8 to its bottom etc} In the example, the numbers that appear in the table are in the following order: The only unit in column 6 is 20 and then from the top of column 7 etc.32, 22, 10, 21 11,02,30,13,08,12,04,09,29 [In practice, you will identify the first and then move on to the next without necessary having to print them out. Your guide is the table.l (iii). This is the order <IJ for hat method and (ii) for the random table method for one team with an intended sample size of 5.

D. Selecting the 5 The interviewer goes to FCNS 32. If available or HH head is willing, information is obtained and then move on to 29. The process continues until the sample of size 5 has been obtained or the end of the population reached. In the example, the numbers that appear in the table are in the following order: The only units in column 6 are 12, 02, and then from the top of column 7 etc. 06, 01, and from column 8 we get the 5 one, 03. (Note that once a number is selected, it is not selected again even if il appears several times in the randam table).

Table of random numbers Tables of random permutations and random digits 299

TableA.3 Random Digits

70 95 60 66

20 86 92 31 05

20 Il 58 99 95

17 51 64 74 58

31 70 91 4.5 39

83 20 65 88 94 48 6794 20 25

85 60 64 47 96

66 88 65 79 89

23 62 43 51 Il

81 37 73 26

35 57 32 53

26 22 36 62 26

43 03 13 85 29

56 89 76 24 16

34 22 71 58 94

78 54 95 54 19

65 94 40 29 01

SO 83 34 64 40

80 31 10 56 45

17 43 13 41 07

78 25 93 42 95

70 25 00 01 26

12 05 65 72 47

91 76 30 10 67

69 17 59 48 70

99 SO 39 88

62 55 44 95 72 71

75 70 86 05 08

16 32 75 24 47

SO 83 90 44 26

69 36 73 21 18

49 78 2042 52 04 66 58 37 40

56 32 16 57 94

67 33 54 91 S2

49 79 08 38 24

43 09

13 68 48 67 35

66 88 89 97 44

61 44 57 52 37

33 59 87 66 H

53 35 59 45 35

18 \7 89 29 20

36 97 96 74 65

03 61 76 67 89

02 29 01 59 65

77 70 56 89 6792 95 07 09 49

88 86 62 49 70

45 74 25 05 34

53 51 68 58 54 70 7006 6702

63 75 52 70 33

30 36 88 35 39

89 93 28 21 04

66 \3 05 35 40

42 33 61 26 01

03 31 17 18 51

93 28

44 54 II 27 17 86 91 59 58 75

12 43 64 41 70

7J 03 87 21 96

97 14 06 98 70

00 31 01 67 24 00 77 52 36 29

32 48 45 57 411 34 60 27 93 93

23 12 55 9N 15 45 M 16 1000

31 93 ]4 06 51

08 69 SO 83 34

07 02 38 81

94 lI2 23 12 77 58 92 37 28 93

03 21 90 51 48

96 19 38 97 44

49 78 67 27 66 53 83 711 13 02

n 86 45 12 49

61 47 85 70 32

09 68 61 73 82 35 39 20 51 90

01 98 92 33 37 33 77 72 71 05

80 89 53 55 82

27 48 42 19 38

97 49 13 18 17 79 97 27 56 06

53 91 34 26 63

79 38

17 25 25 17 07

25 82 89 67 40

'12 06 29 49 50

67 24 15 56 77

73 89 84 97 60

29 57 77

86 00

65 71 17 56 87

48 29 55 03 07

51 06

79 91 84 52 36 44

37 2S

Taken , by permiss ion of University College , London, and the authors , from Tables of random sampling numbers, Tracts for computers , No. XXIV, by M.G. Kendal l and B. Babington Smith , Cambridge University Press, 1939

A CJ Zone1 _ "'""2

_Zon..

D "'""3

In practice, you will identify the first and then move on to the next without necessarily having to print them out. Your guide is the table. This is the order for the random table method for one team with an intended sample size of 5. If none or some of the 5-selected EHH are unavailable, selection continues from the last number (i.e., 03) until the maximum of 5 or end of EHH listing is reached. Administering the questionnaire The interviewer goes first to FCNS 07, HH 02 where EHH 12 is based. If available or HH head is willing, information is obtained, and the interviewer then moves on to EHH 02 (located in FCNS 0 I , HH 04). The process continues until the sample of size 5 has been obtained or the end of the population has been reached. You will receive a detailed EA map that will enable you to do the household listing of the entire households in the EA. The EA map will enable you to locate the household, and information on household (HH) listing form will assist you to locate the HH. Once in the EA, you should carefully go through the household listing form to obtain the address and other description of the HH to enable you to locate it. From this collection of addresses and locations, a sample will be drawn. In order to locate the sampled household, you will need to understand the definition of household in the context of the survey.

Who qualifies as a household member>

The following individuals shou ld be counted as household members: Persons who usually live in the sampled household and who are living at home at the time of the contad; or temporarily absent at the time of your contact (e.g., on vacation, short-term hospitalization). Domestics and other employees who usually live and sleep with the household. Who does not qualify os a household member>

The following persons do not qualify as household members: Persons temporarily visiting the household who have a usual place of residence elsewhere to which they are free to retum at any time. Persons who take their meals with the household but usually lodge or sleep elsewhere; domestic employees or other persons employed in the household who live in a separate house. Example of Household listing Form Household Listing Form Page ...... of ... pages

State: ........ , ..... .. . .

Zone: ..................... .

EA: ....... ... ..... ..... .. ..

~ ~.j'l 01

r""~

LGA:

.~.

I.....,. ~路~~~"

"!' 01

Proxy

3 Ikot Rd . Room 3

Edo Udo

~~~~d.

Josef John

108Ajeg 5 1

Ebi Nwosu

Resp.

108Ajeg 51

Emma Use

Proxy

108Ajeg SI

Ibrahim Isa

3~~e:uRes.

John Uga

Proxy

Frank Uga

Proxy

Resp.

1 3~~::es.

Ch ief Res ,

Issa Abubaka

Proxy

Chief Res , Uzoku

Zenaib Ida

Resp .

Uzoku

Selection of persons for 24-hour dietary recall ond anthroporr>emc study From each eligible HH selected in selection of eligible households, mothers with paired children below the age of five, and pregnant women will be identified. One of such paired mothers and children below the age of five will be selected using the criterion of youngest child from each HH.

Selection of persons for biochemical measures Blood samples for biochemical analysis will be obtained from persons selected as for selection of persons for 24-hour dietary recall and anthropometric study.

Pregnant women Five pregnant women will be randomly selected from the antenatal clinic (serving the EAl and eligible HHs in each EA. Pilot study For a study of this magnitude and importance, it is essential to test all aspects of the materials and procedures to be used before the main study begins. The pilot study will test the use of the questionnaires and procedures designed for use in the main study, and logistics. As part of the planning process, a pilot study duplicating the planned survey design on a small-scale was conducted from March to April 2001 . The project coordinating team members will review the planning of the pilot study. The pilot study will be conducted in each zone. One LGA and one EA will be selected in each zone. Ten households will be interviewed in each selected EA. making a total of 40 households. All parameters will be taken during the pilot study. To capture experiences and provide a feedback on procedures and materials, interviewers will maintain a logbook as part of their review of completed questionnaires and submit a debriefing questionnaire. Field observations by state supervisors will provide additional information for identifying areas for improvement.

Administering the questionnaire The questionnaire for the food consumption and nutrition survey has six sections: Questionnaire identification Household/demographic information Food security Assessment of nutritional status (24-hour dietary recall) Health and care Anthropometric and biochemical measurements Each section has segments, all of which must be completed by the interviewer, not the respondents. The questionnaire identification section is of critical importance, requiring 10 pieces of information, 8 of which are to be completed before the interview begins. Locating the sample households To locate the sample households, the interviewers are strongly advised to introduce themselves to the community leaders of the EA, and possibly employ the services of a local guide. In addition to the guide, the selected households will be located using the sample household listing form completed earlier and a map for each EA that will be provided by the supervisor. Administering the questionnaire For clarity, the components of this section are addressed in sections corresponding to the section number as it is in the questionnaire. However, the box in the top right hand corner (address, state, LGA, and EAl should be completed and written in words before proceeding to Section 1.

Section 1.

Questionnaire identification (page 1 of the questionnaire)

This section is to be filled daily by the Stote Supervisor before sharing the questionnOires between the two field teams and before going to the field. Area code: The area code will consist of an eight digit code comprising of the two-digit code identifying the state. local government area, enumeration area, and questionnaire number respectively (see questionnaire code list). State: Two-digit code identifying the state within the zone <see questionnaire code list!. Write the name of the state in the questionnaire identification mainframe. LGA: Two-digit code identifying the LGA (see questionnaire code list). Write the name of the LGA in the questionnaire identification mainframe. Sector: Two-digit code identifying the EA as urban, medium, or rural (see questionnaire code list). Write the identity of the EA ("urban" "medium" or "rural") in the questionnaire identification mainframe. EA: Two-<iigit code identifying the EA within the LGA (EA codes 01, 02, 03 are assigned alphabetically within LGAJ. Write the name of the EA in the questionnaire identification mainframe. Household listing: Every housing unit in the selected enumeration area should be given a "FeNS" number, serially. This should be boldly written in a conspicuous part of the house. Housing umi no. (or FeNS no): Two-digit code identifying the housing unit within the enumeration area. After the FeNS number is written on the housing unit, the last two numbers should be entered as the code. The full FeNS number should be entered in the questionnaire identification mainframe. Write the prefIX and the code number in the questionnaire identification mainframe. Housing units have been preselected by a modified form of stratified quota sampling with random components. Household number within housing unit: The sample household within the housing unit should be identified with a two digit serial number (01 , 02, 03, etc.) to be determined during the household listing exercise. The letters "HH" should prefix this household number. Only eligible households are sampled (see household eligibility criteria, page 12). Household head: The first and surnames (family name) of the head of the household should be entered in the questionnaire identifKation mainframe (during the interview). Address: The location where the interview is conducted (e.g., number of house, street name. area name, and questionnaire number) should be written in words at the top right hand corner of the page.

Number of persons in household: The total number of persons who regularly

live in the household should be entered on the questionnaire identification mainframe after completing the household composition table. Response slatus: This section of the questionnaire must be filled just before leaving the household . The team leader or member who was recording during the interview should fill the name and date. The time when the interview began should be recorded on the top left side of page 1 of the questionnaire below the box for recording zone code.

Example of (front cover) of the questionnaire

Food Consumption and Nutrition Survey Questionnaire This section to be filled out daily by the State Supervisor, before shoring the questionnaires between the field teams and before going to the field Area Code (for official use only)

I Zone

I 0

ITime interview started

! 2.30pm

Address: ... Ebasi Compound

lsi Street, Uyo

State: Akwa lbom LGA: Okleu

EA: Oblnwa Questionnaire no: I

Section 1. Questionnaire identification Name/no.

Code

State

Akwa Ibom

LGA

Okitu

Sector (rural/medium/urban)

Medium

Obinwa

Housing unit no. or FeNS no.

FeNS 19B

Household head

UdoEdem U

Address

3 Ebasi Compound. lsi Street, Uyo

No. of persons in HH

9 (complete after form on household composition)

HH no. within housing unit

HH_03 of FeNS 19B

Slate codes: Nasarawa (Oll. Taraba (02), Barno (03), Kaduna (04), Kebbi (05), Kana (06), Osun (07), Edo <OB) Kwara (09), Imo (10), Bayelsa (11), Akwalbom (12) LGA codes: See end of questionnaire. Codes from 01-72 Sector codes: Rural (Q 1), Medium (02), and Urban (03)

Response status 1. Completed

3. Not at home

5. HH not located

2. Partly completed

4. Refused

6. Moved away

..... .. .......... ...... ..... . ......

7. Other: specify

No. of visits Length of interview (in minutes)

Data collection Name Date --_

185

Field editing

Office editing

Data entry

- K Mefful- 28/05101

..... --

--------. - - - -

~------

Section 2.

Household/demographic information (page 2 of the questionnaire)

Household composition This section should be administered to the HH (male or female). A household consists of a person or group of persons who live together in the same house (or compound), acknowledge one adult male or female as the head of household, share the same housekeeping arrangement that are catered for as a unit. Column A: The line no. of the last entry on the household composition table is the number of persons in the household. This number should be recorded on the questionnaire identification mainframe. Column B: Begin by listing the HH, then follow in the order: 1.

Men

Women

Boys

Girls List names beginning with first name, then sumame/family name. Column C: Indicate sex of each household member. Column D: Age: Exact age should be inserted . Where respondents cannot give their exad ages, use community historical maps (important historical events) to estimate their ages. The age of a child who is less than five years old should be recorded in months, e.g ., 36 mo. for a 3路year old child. Column E: Record relationship of household member to the household head <See legend at bottom of form). Column F: Marital status of household member (see legend at bollom of form). Column G: Education refers to incomplete and completed primary and secondary school, and postsecondary school. It also includes formal and informal education undertaken outside the household. Where a child is still in nursery school, it should be recorded as 1 (no education) (see legend at bollom of form). Column H: Eligibility: Identify the woman and her child less than 5 years old for sampling <see page 12). Eligible HH should be advised of possible revisit to coiled additional information. (Circle the seleded ticked () pair to be sampled).

Example of fonn for of household/demographic infonnation 2.1 Household composition.

Relation to head Head =1 Spouse = 2 Son = 3 Oaughter 4 Relation 5

= = Others =6

Marital Status

Education No education = 1 Pry. school (not completed) =2 Pry. school (completed ) = 3 Sec. school (not completed) 4 Sec. school (completed) =5

Married: 1

Divorced 2 Separated 3

Wldow=4 Never married

-= 5

Post. sec. -= 6

Age of children under 5 years should be recorded in months.

Socioeconomic characteristics This section shou ld be administered to the head of household. Row 1: Primary occupation of head of the household - Only one code (of the primary occupation) should be entered, to ind icate respondent's major source of income. Row 2: Primary energy source - This refers to electricity source, if any, and only one primary source should be indicated. Row 3: Primary source of water - Where the source of drinking water is different from the source of water for other domestic uses, the primary source of water for domestic use should also be indicated (but in parenthesis). Row 4: Primary method of refuse disposal - The interviewer should observe to see if respondent's answer contradicts facts on ground, and reconcile by gentle probing. Row 5: Main type of toilet - The interviewer should differentiate between a simple pit latrine (the more common), and a ventilated improved latrine. Row 6: Estimated annual income - Wherever possible, all incomes in the household in one month should be added up to obtain an estimated average income which is multiplied by 12 to give approximate annual income of household. It may be best to ask this question last in this section by gentle probing .

Example of fonn to be filled. Socioeconomic characteristics of household (to be administered to HHH Primary occupation of head of household

- Farming - Trading - Civil servant - Artisan - Fisherman - Other (specify)

energy source

source

No electricity Personal generator Rural Electricity Board PHCN Solar Energy

- Borehole - Pipe borne water - Rain water harvest - Others (specify)

(2) (3) (4) (5) (0)

(1 ) (2) (3) (4) (5)

water

- Spring/river - Well

(1 )

Primary method of refuse disposal

- Bush - Refuse dump - City service

(2) (3) (4) (5) (6) (7)

(1 ) (2) (3)

Main type of toilet - Pit latrine - VIP latrine - Water system - River

(2) (3) (4) (5)

- Other (specify)

(6)

i household 25-34.99 35-44.99 45-54.99 55 and above

Food security (page 4 of the questionnaire) This section is made of 3 separate but related parts, food items consumed at home, food consumed away from home and food-related coping strategies. The interviewer will ask relevant questions and fill in the answers given. The time for all 3 parts should not exceed 40 minutes. Food security refers to availability and adequacy of various foods within the household while Food Availability in this context means the duration in which the household can obtain food items. Food Affondability refers to duration in which the household has econom ic access to the food items. Household food security: food items consumed at home The purpose of this section is to track the availability, affordability, quantity, and costs of food items consumed in the household. Preferably, the woman should answer the questions in this section. In cases where somebody else buys the food, then that person should respond to questions in this section . Note the quantity of food referred to here before the whole household; it is better estimated as raw portion. All the foods are already put into food groups, below which we have food items. Interviewer should complete the column(s) on food availability/affordability first.

Column A: foods Always begin from cereal, and take every group one after the other. Do not skip or jump; go from cereals through roots and tubers to fats and oils. Where interviewers are not sure where other foods mentioned belong, please consult the Food Instruction Booklet.

Column B: Food availability Ask this question: "For how many months in a year is (name of food item) available in the market for purchase or in the farm?" You can give the options to the respondents to pick one. In each group, probe for other food items in the group that are common, is it eaten in the area, and ask how much of the year they are available for consumption .

Column C: Food aHordabiliCy "For how many months in a year is (price of food item) affordable to the household: Record the number of month against the particular food item.

Columns D and ÂŁ: Frequency of consumption Interviewer should complete the column(s) on frequency of consumption last. Ask: "How often do you consume/eat (name of food) in a week? If consumption is more

than once daily, tick; if otherwise, write the number of times in Arabic numerals (1, 2, 3, etc.) in the appropriate column in front of the food item. ColumnF

Describe the food e.g., yam, gari, pounded yam, rice (what was the size before cooking?). Emphasis should be on units. Columns G and H

It is also good to know the proportion of food from market and that from own production, e.g. 2 out of 10 or 4 out of 10, etc. The total of Column G and H should be 10. Note to the interviewer. Apply the participatory rural appraisal (PRAl technique to allow the respondent to easily answer the question about the proportion of food for Columns G and H as follows: Step 1: Collect 10 stones (or any other object such as palm nuts) of the same size and show them to the respondent. Step 2: Ask the following question: "Assume that the total quantity of food (give the name of the food in column a) eaten in the last one week is equal to these 10 stones, please take out of these 10 stones those stones you think correspond to the proportion of food from own production." Step 3: Write the number in the cell under column. Step 4: Ask the respondent to confirm that the remaining stones will correspond to the food from the market. This probing question could allow the respondent to eventually revisit the answer given at step 2 above if the respondent over- or underestimated proportion of food from own production. Step 5: Write the number for proportion from the market in the cell under Column h. Step 6: Remember that the total of Columns G and H should be 10. Columns I and J:

The cost of these food items is very important. whether or not they are obtained from own farm or purchased. This will help estimate quantity etc. The cost of processing should also be included, e.g., the cost of milling maize grain to make okamu.

noor

No. of days/ Available (b) Affcwd able (e) week (0.7 ) (d)

More than once daily (YIN ) (e)

Frequency of consumption

Note : Interviewer should please fill data in unshaded spaces only.

umers: (Speclry)

VVIlI:!al _ llour

vvneat: grain

-.real-

-",ce: Impo-"""

Kice: domes Ie

oce

grains

Mllter:

Millet

.,orgnum : nour

.,orgnum ::;orgnum: grams

Maize: gram Maize: green Maize: flOur

MaIze

verea s

Foods {al

IndICate no. of months in the year for which food is:

Food availability! affordability

Within last year (period : 1 year)

Proportion (out Proportion (out Quantity eaten in last one week of 10) from own of 10) from (specify unit) (f) production (g) market (h)

---

. _." .

----- -- -

If purchased , If own production . please state cost of purchase please estimate market value(N) (il (N) Ul

Within last week (period 1 week)

Please indicate the types, quantities, and availability/affordability of food items cooked and eaten by people in this household in the last one week in the following table: -

Food security (respondent: head of the household or meal plannerlpreparer)

...,

(b)

..â&#x20AC;˘.

Affordable (c)

No. of days/week (0-7) (d)

- --

More than once daily (YIN) (0)

Frequency of consumption

Note: Interviewer should please till data in unshaded spaces only.

Others (specify) _

Cocoyam (corms)

Irish potato

Sweetpotato

Potato

Yam flour

Yam tubers

Yam/yam products

Others (specify)

Ga,; (uncooked)

CasSBva tubers

products

Cassava/cassava

Roots and tubers

Foods (a)

Available

food Is:

in the year for which

Indicate no. of months

FOOd availabilityl aft'ordabilily

Within last year (period: 1 year)

Proportion Quantity eaten (out of 10) Proportion from own (out of 10) In last one week (specify production from market (g) unit) (h)

If purchased , please state cost of market value purchase (N) (i) (N) G>

tfown proouction , please estimate

Within last week (period: 1 week)

Mordable (c) (0-7) (d)

days/week

No. of

More than once daily (YIN) (e)

Frequency of consumption

Note: Interviewer should please fill data in unshaded spaces only

Green Ripe

Banana

Bamba","ul (shelled) other food groups: Plantain Green Ripe

Egusi (melon shelled)

Soybean ftour

Soybean grams

Groundnul (Sheled )

Legumes: Cowpea grains

Foods (a)

Available (b)

Indicate no. of months in the year for which food is:

Food availabilityl aHordability

Within last year period: 1 year)

Proportion (oul of 10)

from own production (g)

one week (specify unil) (f) (h)

from market

Proportion (oul of 10)

If purchased. coslof

please state

(N)(i)

(N) U)

market value purchase

please estimate

If own production ,

Within last week (period: 1 week)

Quantity eaten in last

-0

Affordable (e)

No. of days/week (0-7) (d) once daily (YIN) (e)

More than

Frequency of consumption

Note: Interviewer should please fill data in unshaded spaces only.

Tomato Pepper Cucumber t,;abbage t;arrots

UKra

Others (specify) Non-leafy Vegetables

Cochorus

Green leafy vegetables Water leaf Bitter leaf Spinach Pumpkin

Foods (aJ

Available (b)

Indicate no. of months in the year for which food is:

Food availability! afford ability

Within last year (period: 1 year)

Proportion Quantity eaten (out of 10) from own In last one week (specify production unit) (I) (g) Proportion (out of 10) from market (h)

If purchased ,

please state cost of market value purchase (N) (I) (H) (j)

estimate

please

tfOWn prOdUction,

Within last week (period: 1 week)

No. of Anordable days/week (e) (0-7) (d)

(yIN) (0)

More than once daily

Frequency or consumption

Note Interviewer should please fill data in unshaded spaces only

Others (specify)

Pineapple

Guava

Papaw

Mango

Orange

Fruits and products:

Others (specify)

Non-leafy Vegetables

Foods (a)

Available (b)

Indicate no. of months in the year for which food is:

Food availabilityl a"o,<lability

Wtthln last vear (period: 1 year)

in last one weeK (specify unit) (f)

from own production (g)

Quantity eaten (out or 10)

Proportion Proportion (out of 10) from market (h)

If own production , please estimate market value (/>I) (i)

Within last week (peri<x:l: 1 week)

(N)

cost of purchase

If purchased . please state

.I>

(b) (YIN) (e)

Note: Interviewer should please flll data in unshaded spaces only.

'----- .

Yoghurt

Cheese

Tinned milk

Fresh milk

Dairy prooucts:

Eggs

Crayfish

Shrimps

Fish

Poultry meat

Bush meat Snails

Munon I Goat Pork

Beer

Meat and products

Foods (a)

once dally

More than

No. of daysiweek (Q.7) (d)

Available Affordable (e)

Frequency of consumption

food is:

in the year for which

Indicate no. of months

Food availabilityl affordability

Within last year (period: 1 year)

in last one week (specify unit) (D

Quantity eaten

(9)

production

ProportJOn (out at 10) from own

Proportion (out of 10) from market (h)

If purchased, please state cost of

purchase (N) U)

If own production . please estimate

market value (N) (i)

Within last week (period: 1 week)

...

Available (b)

Affordable (c)

days/week (0-7) (d)

No. of More than once daily (YIN) (e)

FreQuency of consumption

Note: Interviewer should please fill data in unshaded spaces only.

Others (specify)

Coffee

Tea

Cocoa

Beverages:

01l1e,. (specify)

Vegetable 011

Fats and oils: Red palm 01 , Groundnut oil

utnars (specify)

Bakery products: Bread Biscuits

Foods (a)

Indicate no. of months in the year for which food is:

Food availabilityl alfordability

Within last year (period: 1 year)

(specify unit) (I)

one week

Quantity eaten In last

(g)

Proportion (out of 10) from own production

(out of 10) from market (h)

Proportion

(N) (i)

market value

estimate

If own production, please

Within last week (period: 1 week)

(N) G)

cost of purchase

please state

If purchased,

Food security: Food items consumed away from home (pages 11 of the questionnaire) The purpose of this section is to capture the food items and the expenditure on such food items consumed by household members away from home on particular days within the last one-week. Column 0: Always begin with the names of household members who ate away from home in the last seven days. Do not skip or jump; Go from one member to another on the list of members indicated. Where respondent is not sure, please allow him to consult the household member concerned. Indicate the serial number of each household member who ate away from home within the last week starting from the first household member concerned.

For these members ask which day(s) they ate away from home and record the response on the appropriate day(s). For example, if the household member ate outside the home only one day of the week, tick Day 1. If they ate for two days, put the responses in Day 1 and Day 2, tick day 1 and Day 2. If they ate for seven days, then tick all seven days from Day 1 to Day 7. Complete the questions for the first household member who ate away from home before you go to the next household member who also ate away from home. Column b: For each day ticked, and for each household member, indicate the name(s) of food eaten on that day in column b. For example, if the household member ate rice and beans in Day 1, indicate nce/beans in Column b against the name of the household member. Column c: Ask if the food item was purchased or not purchased. If purchased (write Y> and if food item was not purchased (write N), Column d: For this food item, ask for the amount paid (Naira) for the purchased food or estimated market value for un purchased food, Complete this for each food item consumed away from home for each member for that day, After the list has been exhausted for that day, ask same questions on other days of the week.

........

Food name (b) YI N (e)

Food

Dlr2

.. -~

Cost(N) (d)

Cost (N) name (d) (b)

Pu rchased?

YI N (e)

Purchased?

Food name (b)

DIr' -

Purchased? YIN (e)

YIN (e)

Cost (N) (d)

.....

Purchased? YI N (e)

Purchased? Cost (N)(d) YIN (e)

Cost (N)(d)

Food name (b)

- -DIr路 --

Cost (N)(d)

. _.

Food name (b)

Dlr7

Food Purchased? name (b) YI N (e)

.DorS

Purchased?

Cost (N)(d)

Siale household member that consumed foods away from home during the lasl one week.

anname (a)

Household member

.,.,.

Household Food member and name name (a) (b)

DIrt

Please indicate day of the week. name of food consumed. whether purchased or not and the actual cost for purchased food items or estimated cost for unpurchased food items.

Food consumed away from home within the past one week

Food-related coping strategies (page 13 of the questionnaire) Tact is needed when asking the lead ing question in this section. Read out every strategy presented in Column b 0-1 2) and wait for response after each strategy. Identify those strategies that are employed and tid< under Column

Do not omit any of the 1 2 options listed and see bottom of this page for a definition of ' street foods'. In eliciting infonmation on who gets the least share of food in the household, you should exercise care not to be suggestive. The strateg ies indude: Rely on less preferred food Rely on less expensive foods Borrow food stuff/money to buy food Purchase food on credit Rely on relatives or friends Limit portion of food at meal times Ration money to HH members to buy street foods Limit your own intake to ensure ch ildren get enough Reduce the number of meals in a day Skip whole day(s) without eating Others <Specify) What are your coping strategies? What are the ways and means by which the HH obtains food when there is not enough money or food available to eat? Begin with a general question, e.g., would you say that in this HH there is always enough food or money to buy food for all' Then check through to see where the response falls. Where the response is not any of those listed, write under ' others'. Street foods: Ready to eat food that is purchased from street vendors.

Example of form to be filled for food-related coping strategies (Respondent: Head of the household or meal planner/preporer)

When there is limited food in the household, what do you do to solve the problem?

No.,.)

SII...,...(tI)

Rely on less preferred foods

Rely on less expensive foods

Borrow money to buy food stuff

Borrow food stuff

J:l '~~

Purchase food on credit

Rely on help from relative or friend outside the household

Limit portkms at meal times

Ration money to household members to buy street foods

limit your own intake to ensure that ch ildren get

enough

10.

Reduce number of meals eaten in a day

11 .

Skip whole day(s) without eating

12.

Others (speCify)

Assessment of nutritional status: 24-hour dietary recall (page 14 of the questionnaire) This section is divided into 2 parts, 24-hour dietary recall for mother and children under the age of 5. The 24-hour dietary recall is a complete record of every food item eaten by the respondent the previous day before the interview day. This segment should be administered to the mother/child pair. Be familiar with the instruction booklet (FIB). Note the place where food was eaten, and the time. Assign an item number to each food and obtain a detailed description of the meal/snack ingredients, method of preparation, and additions such as sweeteners, etc. Obtain an estimate of the amount of each food item consumed. Remember to administer this questionnaire to each of the 5 selected pregnant women per EA. How to conduct the 24-hour recall for the mother (Respondent: mother

with an underage five-chi/d) General prlndples The 24-hour dietary recall is one of the quantitative methods of assessing an individual's dietary intake. The objective is to obtain information on the respondent's exact food and fluid intake during the previous 24 hours. Since questions of a personal nature are going to be asked, it is important that the interviewer displays a friendly and diplomatic disposition. A pleasant and conducive environment is also important, preferably, away from distractions and hunnan traffic. It is important that the respondent be allowed to sit down or continue with minor chores during the interview if it is impossible for her to remain idle during the interview period.

Preliminaries It is important that both interviewer and respondents arrive at a mutual convenient time. However, in doing so, it is important that as much as possible, the respondent should not be given an advance warning that a 24-hour dietary recall will be conducted. It is also important that the interviewer: Introduces his/herself Shows identity card and introduction letter Establishes a rapport with the respondent Explains the objectives and rationale of the exercise to the respondent (and perhaps also the spouse)

Emphasizes the importance of accurate recollection Assures the respondent of the confidentiality of their responses. Some do 5 and don'ts It is important that at all times during the interview, the interviewer must: Endeavor to gain the confidence of the respondent's e.g., using warm greetings (preferably in the local language), presenting a diplomatic and professional demeanor. Focus on and empathize with the respondent. Always listen attentively to the respondent. Focus on the details required i.e., the description of the food and the exact amount eaten. Show interest and convey understanding at all times. Maintain a nonjudgmental attitude to all answers provided by the respondent. It is also important that the interviewer avoids doing anything that could upset the respondent or compromise the quality of information obtained during the interview. In this respect, interviewer should NOT: Talk down to (like a senior talking to a subordinate) any respondent at any time during the exerdse Comment negatively about the living environment of the respondent or the community Offer finandal or other inducement in exchange for information Cross-examine the respondent Make quick assumptions and conclusions (i.e., always clarify from respondent about what you think they mean) Provide information for the respondent Make judgmental statement or show judgmental attitude to any answers The IntelVlew Having gone through the preliminaries and introduction and also ensured that everything required for the interview is ready, the interview can then begin. In general, the 24-hour recall technique is conducted in four stages, using a standardized protocol. Stage one: Recall of foods and drinks consumed (Column a and b) In this stage, the respondent will I>e requested to recall, as much as possible, all the foods and drinks consumed in the previous 24-hour in a sequential manner. It is therefore customary to start in the morning. A typical question to start with:

"I would like you to tell me what you had to eat and/or drink after you woke up yesterday morning?"

Column a. Record the first item recalled as item number 1 in this column. The numbering should be done serially. It is recommended that the interviewer complete each row for each food/drink and addition before listing the next item. Column b. The name of the food/drink and addition mentioned should immediately be written in this column. This should correspond to the item number recorded in Column a. Once that has been recorded, you can then proceed to ask the next question: 'What did you have next? Enter the response in Column a as item number 2 and the name of the food/drink should be entered in Column b. This last question can then be repeated as necessary, until the time given reaches 24 hours. Questions about specific meals (e,g" breakfast, lunch, snacks or dinner) should be avoided, (See FIB for details of prompts).

Stage two: Description of foods and drinks consumed (see FIB) (Column d Each time the interviewer collects infomnation on the list of what was consumed by the respondent further probes on the full description of the foods and drinks should be undertaken using the relevant food group sections in FIB. Cooking methods or recipes and brand names, if possible, should be requested. Guides for the appropriate prompts for specific foods are in FIB.

Column c: Detailed information on cooking methods or recipes and brand names, if possible, should be requested and entered in this column .

Column d. Did you eat that food at home? Record name of place where the food/ drink was taken e,g., restaurant, street food, etc. Column e. What was the time or and when was that? Record the time when the' food was taken, e.g., am, pm. Stage three: Estimation of amounts (Column

This is a critical stage of the recall process. Using different prompts, the interviewer should elicit infomnation on the amount of each item of food consumed and record in Column f. If liquid, volume should be used. The interviewer should show several cups or glasses of different sizes and known volume to the respondent and inquire if any of the sizes represents the amount consumed . The equivalent weight of the amount corresponding to that size cup or glass should be recorded in the last column (Column g) of the dietary recall form.

Column f.' Record amount of each food item eaten For weight. food models and portion size of predetermined weights for homeprepared meals should be used. The interviewer should show them as appropriate to the respondent. If a Iruit for example, different sizes 01 oranges, pawpaw, mango, or banana should be shown to the respondent who will pick the appropriate size to be recorded by the interviewer. For meals, portion size could be determined either by asking for the price of the food combination, if purchased from a vendor, or by showing portion sizes for the respondent to pick one or using different bowl sizes to estimate weights. For estimating these weights, a table has been provided in Appendix 7.

Stage four: Review of data (Column g) At the end of the interview, a recap should be given to the respondent to reconfirm choices made, and have been correctly recorded . This can be achieved using a statement such as 路1 will read back to you what I have recorded to make sure that I have not made any mistakes: A question to elicit information from the respondent on the use of vitamin and mineral supplements, if it was a feast day, if they were ill and the consumption of fermented beverages (e.g., Nono, Burukutu, Pito, etc.) should follow this. If the answer is "Yes路, record each item on a separate line in the category column, and complete using Column C, and C, of FIB. As a final check, the interviewer should scan the recall in case any food groups have been omitted. Since this is a once and for all interview, it is necessary for the interviewer to inquire whether the day recalled was a normal (usual) day. If the answer is in the affirmative, then the interviewer should thank the respondent politely for his or her cooperation . If the answer is in the negative, the interviewer should ask for what a day would be (repeat the process).

Column g. Interviewers are not to enter the weight equivalent of foods. This will be done centrally by the zonal coordinator.

Example of a filled form: Section 4: Assessment of nutritional status (mother with an under age 5 child) Example of filled form: 24-hour dietary recall for the mother Date: 11 -05-2001

Day of the week: Thursday

Questionnaire no ': 18

Name of subjed: Alhaji Chukuwu Akiode

Twenty four-hour dietary recall for the mother (continued) Date: 11-05-2001

Day of the week: Thursday

- --

Questionnaire no': 18

no.c-I 1

..... .....,..,... .....

Name of subjed: Alhaji Chukwu Akiode

Pap +

--tel....

Sugar +

Granulated. while

3 ISp

14 .4

Akara

Brown bean akara

6 pes

302

Fa dJlk1

-lilt

(d)

Maize pap, white

Home

-0-

-II) 7.40am

...." (I)

.......1/11

4 ssp

756

Fried in palm oil Purchased. N5Ipiece

Amala +

Amala, while yam flour

Model 3

1016

Ewedu Soup +

Ewedu leaves boiled.

3 ssp

195.6

Slew +

in wa ter, potash +

1 ssp

48.4

1 medium fish

67.7

Rsh

Home

2.30pm

Fermented locust ~

, N?

San N1 Ewedu N5

Slew contains Tomato N 10 Pepper N6

Onions N2 Palm oil N20

Sail N1 Maggi N2

â&#x20AC;˘

Cocacola

Bottled CocacoIa

Shop

3.0Spm

350C.C

356.4

Rice +

White, imported

Home

8.00pm

Model 3

8 1.

Stew +

Plain stew

3 ssp

145.2

1 Was food Intake usual? (YIN)

4 Probe for supplements (Iron, aobmalana, vitamins, othef supplements) (YIN )

If no, how was it unosual?

2. Was ~ a feast day? (YIN)

If yes. specify

3 Probe for sk:kness (YIN). II yes, did SICkness anect appetite (YIN)

5 Probe for fermented beverages

If yes. how? Increase or clectease

~"""""

â&#x20AC;˘ Should come from page 1 of questionnaire (Ooestlonnalre no.) J

00 not fiI this column 01 the fOlm

Twenty four-hour dietary recall for the mother (continued) Date: 11-05-200 1

Day of the week: Thursday

Questionnaire no' : 18

Name of subject: Alha ji Chukwu Akiode

", "

~ ~

' ",' :t;;"i '.' >"- <J

"' 1.!:~

Chicken

~" !~'&;~ :-..:.t. r·:

1 th~h

Leg , thigh of local

40.1

,;;

Chicken Stew - left over From

• Probe for supplements (iron, antima-

1. Was food intake usual? (YIN) Y

lalia, vitamins, other

If no, how was it unusual? -

2 Was it a feast day? (YIN)

supplements) (YIN) N N

If yes. specify

'Of fermented

3. Probe for sICkness (YIN): If yes, did sickness affect appetite? (YIN) N

5. Probe ""mod

If yes, how? Increase or decrease

Occasionally

• ShoUd rome !rom page 1 01 quntionnaire (Questionnaire no ) Do not fil !hIS ooIumn of the fomI

beverages con-

How to conduct the 24-hour recall lor the under-5 child (page 16 01 the questionnaire). Respondent: mother of the under 5 child or suitable proxy The proxy interview for an infant or child under 5 years may be the parent, grandparent. or any other person knowledgeable about the child's feeding/intake. If the infant or child has more than one caring for himlher, both may need to help complete the interview. If the sample child is under 1 year old, you may use this introdudion: As with the standard introdudion, explain the information you need and define the time frame for the proxy. Since infants frequently have feedings at night, it is important that the proxy understands the time frame. You may start by saying, 'Today is (OAYl. I would like you to tell me everything the baby had to eat and drink all day yesterday, starting at midnight. Indude everything the baby had at home and away from home, including snacks, bottles, and breast milk: Use the Food Instrudion Booklet for corred probes and quantity documentation. Interviewing children: All children must be interviewed with a proxy. The preferred choice to help the respondent is the person primarily responsible for preparing the meals for the child. One of the interviewer's tasks is to assess who is the best respondent or combination of respondents for the child. We assume that a child younger than 5 years cannot reliably report for themselves. Although they may contribute useful information, data on their intake will normally be obtained from one or more proxy respondents.

24-hour dietary recall protocol for the mother and under-S child Now I would like you to tell me everything (Name of baby!Child) had to eat and drink all day yesterday, from midnight to midnight. Include everything the child ate and drank at home and away, including snacks and drinks (and bottles or breast mil k>. Date: ...... . ... ......................... ...

Day of the week: ................ .

Questionnaire no ,: ..................•...

Name of subject: ..... .... ... .....

....

111m (-)

FGcddIII*

.....

D:IIM.affoOll ...... (d) (q .

. . . . . (11)

nn.(e)

== =ar

F-

. 1. Was food intake usual?(Y/N) If no , how was it unusual?

4. Probe for supplements (i ron. antimalaria, vitamins, other supplements) (YIN)

2. Was feast day? (YIN)

If yes, specify

3. Probeforsickness? (YIN):It yes ,did sickness affectappetlte? (YIN) If yes, how? Increase or decrease

5. Probe for fermented beyer· ages consumed

• Should ooma from page 1 of questionnaire (Questionnaire no ) l

00 no! fill this column of the form

Health and Care (page 17 of the questionnaire) Child health This section of the questionnaire deals with the assessment of the state of health of the child and should be administered to the mother of the under-5 child. It covers the preventive measures that are being taken to ensure that the child stays healthy and the treatment that is given to the child when he or she falls sick. The section has 6 component parts - numbered 1-6. Wants to know if the child had been sick during the last two weeks. It requires a Yes or No answer. Wants to know how often the child has had the listed sicknesses this year. You should indicate the number of times against the illness, where applicable. Where other sicknesses outside these common ones are mentioned, they should be specified. Note that regardless of whether the child had been sick or not in the last twoweeks (i.e., answer to question 1 is No) this question (number 2) should be answered. Remember to use the local names of the sicknesses when dealing with an illiterate mother. In this segment which deals with where the child received treatment, you should tick ( ) the appropriate response. Note that some illiterate mothers in the rural setting could refer to a chemist (the owner of a medicine shop) as a doctor, which may give the impression that the child received attention in a hospital by a qualified medical practitioner. Where you suspect this, please probe further to get the true picture. Tick as appropriate Tick the appropriate box For this question, physical examination of the health card of the child is required.

Example fonn for child health (respondent: mother of the under-5 child) Now I am going to ask you questions about your child Code 1. 2.

Has the child been sick during the last two weeks? How often was the child down with each of the following sicknesses this year? (State number of times)

Yes (1)

No (0)

Yes (1)

No (0)

Number Malaria

Dian11ea

Measles Cough without fever

Whooping cough Others (specify)

Where did the child receive treatment?

Nowhere (1)

Traditional healing home (2) Primary health care (3) Chemist shop (4)

Hospital (5) Private clinic

(6)

Others (specify) (7) not applicable (0)

Do you use the following? 8. Prevention of malaria

Insecticides

Bed nets Windows/door netting

Others (Specify)

b. Treatment of diarrhea

ORS Home made salt solution

Does the child have a health card?

Which of the following immunizations has the child had?

BGGIOrat polio at birth OPT/Oral polio 41

DPT/Ornl polio -2 DPTlOrnl polio -3 Measles None

Care for women (respondent: mother of the under-5 child) (page 18 of the questionnaire) This segment should be administered to the sampled mother in the household. Interviewer should exercise extra sensitivity in eliciting information for this segment and, as much as possible encourage information to be volunteered, not extracted from the respondent. Workload: is defined as sum total activity other than rest and sleep. Empowerment: includes the degree of confidence which the woman enjoys to express her views and make decisions affecting herself as well as the household. The interviewer should make an effort not to influence the response in anyway, for example, showing of concern or a questioning. Reproductive rights: include the degree of freedom the woman enjoys to choose whether or when to have a baby, as well as the support she receives during pregnancy, the prenatal. and postnatal periods. â&#x20AC;˘

The interviewer should differentiate between improved food share arising from recognition and support of the pregnancy by the household and increased food intake necessitated by increased appetite during pregnancy. Economic rights: include the degree of freedom the woman enjoys to choose what she engages herself in within or outside the vicinity of her residence to generate income, as well as what she does with such income. The interviewer should differentiate traditions, which are imposed by the head or other members of the household from traditions, which are cultural practices of ethnic, religion, or other groups.

Example questionnaire for care for women (Now' am gaing to ask you same

questions about yaurseJn Empowerment 1.

Code

If you are sick, how often do you d iscuss it with your husband .

Always

If one of your children is sick, how ofte n do you disc uss it with your husband?

Always

If there is a disagreement in decision-making, what does your husband do gene rally?

How often does your workload allow you some time to rest?

(2)

Sometimes Never (0)

(1 )

(2)

Sometimes

(1 )

Never (0 Overrides (3) Takes my opinion

(2 )

Reconsiders his position Not applicable (0)

(1)

More than twice per week (3) Twice a week Once a week Never (O )

(2) (1 ) Yes (1 )

Reproductive rights Have you heard of child-spacing? 1. Do you discuss ch ild-spacing 2. with your husband?

What kind of support do you e njoy during pregnancy?

• Antenatal care • Husband • Extended family • Increased financial support • Reduced HH chores ~

Improved food share

Others (Specify) ~

None

(0)

Example questionnaire for care for women (continued) Economic rights/food share

Are you allowed to engage in income-generating activities?

What is your occupation?

Is there a tradition you respect in food sharing in the family?

4. 5.

Yes (1)

(0 )

Yes (1 )

(0)

If yes, does the trad ition restrict vou choice? If sometimes, food is not enough who takes the least share?

Self (1) Girls

(2)

Boys (3) Husband (4)

Others (specify) (0) 6.

Is your food share improved during pregnancy?

Education

How does the community view women 's education?

Encouraged (1 ) Discouraged

Tabooed 2.

When resources are limited, who is given preference in education?

(2)

(3)

Others (specify) (4) Girls (1) Boys (2 ) Mothers (3)

Fathers (4) Boys/girls equally (5)

The most intelligent (6) Others (specify) (7)

Infant feeding practices <respondent: mother of the under-5 child) (page 19

of the questionnaire) This section is administered to the mother who has the under-S child. It is to elicit information concerning how children aged 0-12 months are fed and cared for. Are you aware of exclusive breast feeding (EBFl? If answer is No, it is necessary to explain EBF. Your last child was exclusively breast-fed for how many months? If the answers

o months, this means that the child was not exclusively breast fed. Are you aware of growth monitoring? Growth monitoring is explained or defined under "glossary", the answer is Yes/No. Did you monitor the growth of your child using a growth monitoring chart or are you weighing your under-S child once every month? <Yes/No)

Example questionnaire for infant feeding practices Now I would like you to answer a few questions about how you feedlfed your baby: Infant feed practices

路".1

Anlyou_at-

When did you start giving your youngest child any路 thing (even water) other than breast milk?

II IIIIIII?

Your last child was exclusively breast fed fori

No (0)

*(1)

o months

(0)

3 months (1) 6 months

(2)

o months

(0)

1 months (1 ) 2 months

(2)

3 months (3) 4 months (4) 5 months (5)

Are vou aware of child-orowth monitorino?

Did you monitor the growth of your child using a chart?

6 months Yes (1) Yes (1 )

6) No (0) No (0)

The purpose of this question is to check the validity/accuracy of question 2 above .

Hygiene practices (page 19 of the questionnaire; respondent: mother of the

under-5 child) This segment consists of a single question and a series of observations. which should be made discreetly or quietly. The question should be addressed to whoever in the household is in charge of food preparation. Do not lead respondents on by reading out the options, otherwise you might. How do you preserve (keep) foods that are not to be eaten immediately? Write out any method not in the list beside others. Write legibly (the rest you need do here is observe) Hygiene spot checks There are 9 things you have to observe and write if they are present, tick Yes if present and No if absent. Note: Your observation should be unobtrusive, unnoticed, and casual Look at the mother-child pair and notice whether they are UNTIDY. Look at where you are seated in the house, whether it is UNTIDY or needs to be swept

Do you see stagnant water or animal droppings in the house? Any open garbage container or unwashed cooking utensils or plates in the house? You can pretend you need to use the toilet in order to find out whether or not a toilet faci lity exists. Do not use this method in every HH (it may be suspicious. it is

applicable only to number 5) Example fonm for hygiene practices (page 19 of the questionnaire) Hygiene practices (Respondent: mother of the under-5 child)

With regard to food, that is cookedlleft over or not consumed No>. 1.

•

0pIIana

How do you preserve (keep) food that is not to be consumed immediately?

Code

In the open: • open (1 ) • covered

(2)

Cupboard

(3)

Kept warm

Fridge

(4)

(5)

Others (specify) (0) Hygiene spot check (this section is to be filled after discreet observation

Code Yes (1 ) ,

Are there open garbage containers in the house?

Are there unwashed cooking/eating utensils in the house?

No (0)

Do not know

Is the container for drinking water uncovered? ,

Is the primary carer for the child untidy (hands. clothes and nails)

Is the youngest child untidy (hands, clothes and nails) Does the inside of the house need to be swept? Were animal droppings observed in the house?

Was stagnant water observed around the house?

Comments:. ____________________________________________________

Anthropometric and biochemical measurements (page 20 of the questionnaire) Anthropometric measurements Anthropometry deals with measurement of body sizes and proportions. Such measurements when put against age (e.g., weight for age and height for age) or against each other (e.g., weight for height> can yield good indicators for assessing nutritional status. In this survey, you (interviewer) are required to measure or obtain information on the following and enter them at the appropriate spaces:

Age The ages (years) of every selected mother The ages (months) of their under-5 children

Weight The weights (kg) of every selected mother The weights (kg) of their under-5 children (see Figure 3 for infants) The birth weight (kg) of the children where it is available (check from birth card if it is available).

Height The heights (em) of every selected mother The heights (cm) of their children (see Figures 4 and 5) See protocol for anthropometric measurements in Appendix 5.

Figure 3. Child weight measurement using electronic scal. (UNISCALE).

Figure 4. ChUd length measurement for infants and children 0-23 months .

Figure 5. Child height measurement for children 24 months and older.

Take note of the following precautions that need to be taken when taking measurements:

Weight measurements Check proper functioning of the scale Remove all additional weight sources (shoes, pocket materials, etc.> Ensure calmness during weighing The reader of the scale should be property positioned besides the subject to accurately read the scale to the nearest 0.1kg.

Heights measurements Surface being used must be upright and subject must stand on a flat surface No shoes or caps Headboard should be adjusted to the level of the scalp Reading is to be taken to the nearest 0.1 cm When making the measurements, avoid indecent exposures!!! Example for anthropometric measurements

(kg)

IRecord time when interview finished.

Biochemical measurements (page 20 of the questionnaire) The medical personnel in the team will collect the following samples employing the necessary safety procedures (including the use of gloves) and minimal discomfort to the respondents. See protocol for biological collection in Appendix 6. These samples will be collected at a central point (health facility) nearest to the enumeration area. Blood .... ml of blood from each selected mother .... ml of blood from the under-S child of the mother selected above .... ml of blood each from each of the pregnant women in that will be selected from the antenatal clinic in each of the EAs Urine .... ml of urine from each selected mother .... ml of urine from each under-S child of the selected mother .... ml of urine from the selected pregnant women in the EA. Specimen bottles are provided for collecting the samples. Example of biochemical indices to be measured

Medical team to collect biological samples (blood and urine) from eligible mother and child (and label appropriately)

See Manual page 107-112

Serum retinol Urinary iodine Serum zinc concentration Serum ferritin

Sample labeling and handling All samples collected must be correctly labeled immediately after collection, indicating name, age, sex, and questionnaire identification code. All samples collected in the field should be processed immediately as described in the protocol <Appendix 6).

Handling of emergency sliuatians In case of medical emergency, the medical personnel on the team should give needed first aid and, if necessary, refer to a health establishment. Documenting problems All situations you encounter which will prevent you from completing the questionnaire should be fully documented on the logbook, This will provide your supervisor with the information she/he needs to determine what to do next with the case, Food and salt sample collection Food samples prepared and consumed by the household members should be collected from surveyed households for chemical analysis, Priority shall be given to analyzing foods that meets the following criteria: Foods that have inadequate or nonexistent data for the food component of interest Have inadequate data on the concentration of the food component in foods as eaten Form a significant component of the diet of the study communities Contribute significantly to the intake of the dietary component in the local diet. Collected samples shall be stored in a freezer until taken to UTA for analysis, Where food samples can not be collected, a recipe will be collected and food items will be prepared and analyzed for the different nutrients, Salt samples will be collected for the analysis of iodine in selected household, markets, and supermarkets,

Pregnant women A separate sample of five pregnant women per selected EA will be selected for biochemical and 24-hour dietary recall. A local clinic or health center within a selected EA is to be visited on antenatal day and five pregnant women selected randomly from all the visiting pregnant women. Where an EA has more than one clinic or health center, one of them is to be visited to sample the pregnant women. Biochemical and dietary intake will be taken and recorded as in the mother and child pair. Before conducting the 24-hr dietary recall and collecting biochemical samples, you need to collect some information below. 24-Hour dietary recall protocol for the pnegnant woman After recording the infomnation, administer the 24-hour dietary recall <Appendix 4) and collect biochemical samples as you did with the mother. Biochemical nneasunements The medical technologists in the team at the health center will collect the following samples employing the necessary safety procedures (including the use of gloves) and minimal discomfort to the respondents. See protocol for biological collection in Appendix 6. Blood

___ml of blood each from each of the pregnant women

Unne ___ml of urine from the selected pregnant women Specimen bottles are provided for collecting the samples.

24-Hour dietary recall protocol for the pregnant woman Day of the Week: ......... .

Date: .. ..... .. ... .. .

Subject ID no: .... .. .. .... ....age .. .. ... .. gestation ... ... .. . LMP路 ........ EDD路路 ....... .. .. . Name of subject: ................... .. .. parity ... ............ .. Occupation .............. ............ .

Tine

Amount (how muchcldyau Weight equIv.' eduIIIyeal

(e)

drink?) (f)

118m Food/drink

no. (e)

IIdcIItIon (b)

Dllialplluil d food

or drink (e)

"'-

.... (d)

1. Was food intake usual? (YI N )

If no, how was it unusual?

4. Probe for supplements (iron , antimalaria , vitamins, other supplements) (YIN)

2. Was it a feast day? (YIN)

tf yes. specify

3. Probe for sickness (YIN): If yes, did sickness affect appetite? (YIN)

5. Probe for fermented beverages consumed

If yes, how? Increase or decrease 1

(g)

00 not fill this column of the form

. LMP = Last menstrual period

.. EDD = Expected date of delivery

Parity: Number of children delivered

Example for biochemical measurements

Medical personnel to collect biological sample (blood and urine) from eligible pregnant (and label appropriately) See Manual page 107-112

Serum retinol Urinary iodine Serum zinc concentration Serum ferritin

Sample labelmg and handling All samples collected must be correctly labeled immediately after collection indicating name, age, sex, and questionnaire identification code. All samples collected in the field should be processed immediately as described in the protocol <Appendix 6).

Focus group discussion guide Focus group discussion (FGDl guide The focus group discussion guide is a set of short questions to be used for guiding a discussion with a selected community group. The purpose of FGD will be to appraise community opinion on issues not covered by the household questionnaire, such as HIV issues, food processing, complementary feed, etc. In other words, FGD is expected to complement the household questionnaire. One FGD will be conducted per enumeration area making a total of 216 FGDs. For this exercise, it will be useful to have a battery operated audiocassette recorder to record proceedings. However, it is important to ask participants for permission to record the proceedings. The following questions are simply guides to the themes of discussion. In the report for FGD, clearly identify the "group focus", the size, any prevailing situation, location, and time. Themes

Breastfeeding: awareness of minimal feeding practise to cover items 1, 2, 5 of the guide. Infant feeding and complementary foods (CFl: Complementary foods are foods that are given to infants when breast milk only is not enough. There are usually given from age 4 months. Awareness and practices of growth monitoring, how do we recognize that a child is growing well, i.e., the child is having enough food, appropriate for growth? Family planning and child-spacing (planned parenthood): How can a woman be able to breastfeed as long as she desires without the fear of another pregnancy? What do you do? Uses of maize and preferences if any, for certain varieties, etc., e.g., white versus yellow varieties. Most complementary foods are maize-based. Awareness, preventive measures, and community attitude to HIV/AIDS infection. Awareness on foods that give you good sight etc. (micronutrient deficiencies). Is there any other thing that you would like to tell us, ask, or suggest? Thank you.

Quality control procedures Roles and responsibilities of survey team members

PoncipallnvestigatorlProject Coordinator Responsible for the smooth running of project activities (planning, administration, and project execution) Provides necessary facilities for the project Chief accounting officer Receives data and ensures their analysis Monitors implementation of the project in all the zones Compiles and submit project reports to donor agencies Provides linkage between stakeholders, sponsors, and all partners

Zonal Coordinotors Responsible for: implementation of project activities in each state within their zone; reports to the project coordinator, monitors supervisors and interviewers, supervises proper and accurate collection of data, delivers and retrieves completed questionnaires, retrieves samples and materials not utilized in the field from state supervisors, pays allowances to field staff, renders accounts to the project coordinator. The zonal coordinators will also be responsible for the preparation and submission to the project coordinator fortnightly, a progress report for their zone, and at the end of the data collection, a comprehensive report consistent with the format in Appendix 8.

State Supervisors State Supervisors are to: Obtain copies of EA maps from the Principal Investigator/Project Coordinator through the zonal coordinators to assist in identifying selected households Select interviewers in consultation with zonal coordinator Meet with the local government areas chairpersons and community leaders in each enumeration area to inform them of the purpose of the survey, its relevance to the community, and obtain their approval for the survey Meet with community leaders to plan the activities in the communities associated with the survey Collect equipment. materials, and questionnaires needed for the survey from the zonal coordinator and supply the interviewers Together with the interviewers, select the eligible households for the survey by using the chosen sampling design

During fieldwork Assign responsibilities to the interviewers Validate about 10% of the interviews held by each interview team to ensure constancy in interview methods with the respondents Review questionnaires as they are completed to ensure they are neat and legible, all the information is being properly collected and recorded, and no information is missing Investigate any high levels of nonresponse for interview teams Check that interviewers are not replacing participants who are difficult to contact with other people or fabricating data Answer questions and resolve problems daily and give feedback to the interviewing team on the progress of the survey Ensure that the community is satisfied with the survey procedures throughout the period the interviewers are in their area Keep the interview teams on schedule Collect the completed questionnaires and give them to the zonal coordinator In selecting the interviewers, select interviewers who: Are literate and numerate, preferably with at least a high school education Are fluent in the local language Have a thorough knowledge of the state and its food culture Preferably have some previous field experience Are able to establish and maintain an easy rapport with strangers Are able to empathize with the respondent Are mature and have the ability to handle difficult situations Are able to live in a rural environment when necessary The state supervisors will be answerable to the zonal coordinators and will be involved in training of interviewers, conducting pilot study, organizing and supervising interviewers to ensure accurate administration of questionnaire, collection, storage and transmission of questionnaires and samples (biological, food and salt) to the project coordinator through the zonal coordinator. The state supervisor will be responsible for the preparation and submission of a weekly progress report to the zonal coordinator.

Interviewers The interviewers will report to the state supervisors; conduct household listing; administer the questionnaires, collect samples; transmit samples, questionnaires, and materials not utilized to the state supervisor. The team leader of the interview team

will be responsible for the preparation and submission of a daily progress report and data collected to the state supervisor.

Project Coordination/Management Team This team will consist of the principal investigator/prolect coordinator, a representative from the National Planning Commission, UNICEF, and USAID. The team's responsibility will be mainly planning of project activities.

Project Monitoring Team This team will consist of the principal investigator/project coordinator, National Planning Commission, UNICEF, Federal Ministry of Health, and two members from the collaborating institutions, The team will be responsible for monitoring of project activities during zonal training and data collection. Field editing It is important that a number of steps are taken to ensure that the data being collected in the field are valid. These steps include: Field editing Validation of field data by state supervisors Field observations by focal persons and a central monitoring team Feedback from monitoring team/focal persons Fine tuning procedures and specifications The interviewer should carry out a preliminary check on the completed questionnaire before signing the data collection column on the response status. He should also check other documents including the labels on the samples collected in the field before forwarding them to the state supervisor. This field check must be done as soon as possible after completing the interview and this in any case must happen ~ the next day's interview. The focal person will carry out the office editing and sign the appropriate column before dispatching the questionnaire and samples to the national project secretariat. The purpose of the editing is to: Pick out and correct or explain errors and omissions in recording. Common errors include ticking wrong boxes or columns and inserting wrong codes. â&#x20AC;˘

Reconcile inconsistencies in the entries, which definitely resulted from a mistake by the interviewer. This is possible because the information is still fresh in the interviewer's memory. Enumerator errors should be noted in the enumerators' logbook and reported to the supervisor. Learn from mistakes made so that they are not repeated. Ensure legibility of the written responses.

Validation of field

data

The state supervisor is to carry out field validation to ensure that the selected LGAs are those that have Deen done and that correct procedure were followed during the interview. Field observations During the survey, the state supervisor, zonal coordinator, and the central monitoring team will conduct in-person observations to ensure uniformity in what is being done and that correct procedures are used. Field findings/difficulties can De used to further evaluate procedures and designs. Feedback from monitoring teamlfocal persons Following the assessment of completed questionnaires and field observations, problems noticed should De immediately communicated to the state supervisor with suggested solutions. Upon review by supervisor, zonal coordinator and principal investigator, corrections will be communicated to the interviewers. Fine-tuning procedures and specifications It is not possible in a national survey of this nature to anticipate every situation that may arise during data collection. A pilot study will De conducted to fine tune survey operations as much as possible. However, if it Decomes necessary, provision will be made to modify or add to the procedures and questionnaire specifications during the national survey.

Administrative procedures Administrative procedures are defined as those activities to be undertaken in addition to completing the interviews and editing your work. These procedures begin when the questionnaires are completed, the biological samples collected, editing and field checks are completed by the interviewing team. Administrative pno<:edures related to fieldwork The completed questionnaires are sent to the supervisor on a daily basis. Incidents in the interviewers logbook, e.g., problems on the field and questionnaires yet to be completed should be reported to the supervisor on a daily basis. Problems that need urgent remedies should be brought to the immediate attention of the supervisor. Unused materials (e.g., uncompleted questionnaires, scales, sample kit, etc.) should at the end of the survey be returned to the zonal coordinator by the state supervisor. The zonal coordinator, will in turn, ensure that they are returned to the principal investigator. The zonal coordinator is responsible for transmitting all survey documents and materials to the principal investigator. Administrative procedures related to personnel Interviewers' profile form

Each interviewer shall fill a profile form that covers basic information about each person . This form will form part of the survey report. Below is an example of the profile form that you will fill before zonal training.

Interviewers profile Name____________________________________________________ S~te

__________________________________________________

Affiliation (Institution) Present address,_____________________________________________

Highest level of education after high school __________________________ Experience (activities of the last 5-10 years) in bullet form

Contract letter Below is an example of a contract letter that you will sign before beginning the fieldwork. 14 May 2001 Interviewer' name_ _ __ _ __

Cio Dr R.A. Carrington State Supervisor Department of Nutrition University of Ibadan College of Medicine Ibadan, Oyo State Dear _ ___________________ I have pleasure, on behalf of the survey coordination/management team, to offer you a short term contract as an interviewer on the Nigeria Food Consumption and Nutrition Survey 2001 which, will take place May-July 2001. You will be responsible to the State Supervisor. This contract is subject to the terms and conditions stipulated below. Terms of appointment: This contract covers the data collection (field research) period of the survey Maintenance allowance Your allowance will be Naira 00,000 for the period of the fieldwork. Your zonal coordinator will provide for group transport during fieldwork. You will receive half (50%) of your salary at the beginning of the fieldwork and the other half (50%) at the end of the survey subject to satisfactory performance on the field and quality of data as evaluated by your state supervisor and zonal coordinator. If the terms of this contract are acceptable to you, please countersign the other copy of this letter and return it to your state supervisor together with the profile form and 2 passport pictures. Yours sincerely,

Agnes Adu Principal Investigator Crop Improvement Division Agricultural Research,College, Ibadan

Accommodation Hotel accommodation should be moderately priced. When selecting a hotel, consider its location in relation to the EA you will be visiting. To do this, you should study the area and locate a suitable hotel during mobilization. If the accommodation is not adequate for whatever reason, for instance, the hotel is not centrally located or is too expensive, discuss the situation with your state supervisor. Since you will be reporting to your supervisor on a regular basis while you are in the field, it is imperative that your supervisor is informed about where you are staying.

TranspOITalion Personal automobile travel When using your own automobile on survey business, you will be reimbursed 5 Nairal km. You are expected to carry at least the minimum amount of insurance nequired where you reside. The organization is not liable for your car insurance. Local public transportation When using public transport such as taxis and buses, always request a receipt. You will be reimbursed 2 Nairalkm.

Appendices Appendix 1 Checklist of materials for interviewer before going to the field Writing materials and manuals Clip board Pencil Pens/birDs Erasers Pend I sharpeners Questionnaire booklet Interviewer's Manual (1M) Food Instruction Booklet (FIB) Interviewers' logbook Household listing forms Anthropometric equipment UNICEF unit scales for measuring weight Height meter for measuring height or length 24-hour dietary recall Kitchen scales for weighing up to 5 kg Calibrated measuring spoons, cups, and glasses Biological samples Sample collection kits for urine and blood samples A letter of introduction and an identity card.

Appendix 2 Table of random numbers Tables of random permutations and random digits 299 Table A .3 Random Digits

n 06 29 49 50

67 24 15 56 77

13 89 84 97 60

29 57

71 93 28

44 35 57 32 53

26 22 36 62 26

43 03 85 29

56 89 76 24 16

34 22 71 58 94

78 54 95 54 19

50 83 34 64 40

80 31 10 56 45

70 25 ()() 01 26

12 05 65 72 47

91 76 30 10 67

69 17 59 48 70

99 50 39 88 72

62 55 44 95 71

75 16 70 32 86 75 05 24 08 47

5069 83 36 90 73 44 21 26 18

49 79 08 38 24

J3 68 48 67 35

66 88 89 97 44

61 44 57 52 37

37 25 43 09

53 35 59 45 3S

18 17 89 29 20

36 97 96 14 65

03 61 76 61 89

88 86 62 49 70

45 74 25 05 34

53 51 68 58 54 70 7006 67 02

63 75 52 70 33

89 93 28 21 04

66 13 05 35 40

42 33 61 26 01

03 31 17 18 51

79 91 84 52 3644 70 95 60 66

23 12 98 45 16 ()()

31 08 93 69 3450 06 83 51 34

51 07 02 38 81

06 81 37 73 26

23 62 43 51 13

49 78 67 27 83 18 13 02

32 86 45 12 49

61 47 85 70 32

17 78 43 25 IJ 93 41 42 07 95 56 67

09 61 82 .1 9 51

611 73 35 20 90

01 98 92 33 37 33 77 72 71 OS

80 89 53 55 82

27 48 42 19 38

49 20 52 66 37

18 42 04 58 40

97 73 17 97 56

53 91 34 26 63

79 38 97 86

17 25 25 17 07

25 82 89 67 40

02 29 01 59 65

77 70

71 17 56 87

56 67 95 09

66 88 65 79 89

48 29 55 03 07

03 21 90 51 48

79 27 06

8S 60 64 47 96

97 14 06 98 70

94 82 23 12 77 58 92 37 28 93

III

83 20 65 88 94 48 6794 20 25

73 03 87 21 96

32 48 45 57 48 34 60 27 93 93

31 70 91 45 39

12 43 64 41 70

00 31 01 67 24 00 77 52 36 29

96 19 38 91

92 " 31 99 05 95

17 51 64 74 58

44 54 II 27 17 86 91 59 58 75

55 15 64 10

66 53

32 33

16 54 57 91 94 52

89 92 07 49

20 20 86 13

59 87 66 33 30

36 88 35 39

65 94 40 29 01

Taken, by permission of University College, London, and the authors, from Tables of random sa mpling numbers , Tracts for computers , No. XXIV, by M.G. Kendall and B. Ba bingto n Smith. Cambridge University Press, 1939

Appendix 3: Survey questionnaire Nigeria Food consumption and Nutrition Survey 1 00 1

This seaion is to be filled out by the State Supervisor doily before dividing the questionnoires between the fiefd teoms ond before going to the field. Area code (fOf' offidal use only)

J I Zone

r .

I .

ITime interview started Address . .... .. ..... .. ..... ... ....... .

State LGA

EA Questionnaire no .... .... .. .. .. . Section 1: Questionnaire identification Name/no .

Code

State LGA Sector (ruraUmediumlurban) EA Housing unit no. or FCNS no. Household head Address No. of persons in HH HH no. w ith in housing unit

of FCNS

State codes: Nasarawa (01), Taraba (02), Barno (03), Kaduna (04), Kebbi (05), Kana (06), Osun (07), Edo (08) Kwara (09), Imo (10), Bayelsa (Ill, AkwalbOf'n (2) lGA codes: See end of questionnaire. Codes from 01-72 Sector codes: Rural (Oil, Medium (O2l, and Urban (03) 82

Response status 1. Completed 2. Partly completed

3. Not at home 4. Refused 7. Other: specify .......

5. HH not located 6. Moved away

. ........ ..

.......

... .

No. of visits length of interview (i n minu tes ) Data collection

Field editing

Office editing

Data entry

Name Date

_._ - _.

. _...._-

- --- - -

- -------_._.

._---

Household/demographic information

(Respondent: Head of

household/suitable proxy) We would like to determine if any members of your household are eligible to participate_To do this, we would like to ask you some questions about the people who stay with you_

Household compostion (listing order. - mole, female, boy, girl)

Rahltion to head Head =1 Spouse = 2

Son

Marital status Married Oivorced = 2 Separated = 3

Daughter

Wldow=4

=5 =6

R~tion

Others

Educahon No education = 1 Pry. school (not completed) = 2 Pry scI100l (completed) 3 Sec. school (not completed) = 4 Sec. school (completed) 5

Never married

Post sec. =6

Inlonna! = 7 Age of children

under~5

should be recorded in roonths.

Socioeconomic characteristics of household(Respondent: Head of household/suitable proxy) We would like to know more about your household, and would like to begin by talking about what you do for a living.

....

'~,:

R .~

household

Primary energy source

Primary source of water for drinking and other domestic

uses (If source of drinking water is different from the one used for domestic uses, write code for domestic use in bracket)

:r.

~i ::~ ~~

- ". Primary occupation of head of

Primary method of refuse disposal

Main type of toilet

Estimated annual income of household

.~ :!1!~':~' .. ,-...... ___ I~

Farming

(1 )

Trad ing

(2 )

Civil servant

(3)

Artisan

(4 )

Fisherman

(5)

Other (specify)

(0)

• No electricity

(1 )

• Personal generator

(2 )

• Rural Electricity board

(3)

• Power holding company of Nigeria

(4)

• Solar Energy

(5 )

• Pondllake

(1 )

• Spring/river • Welt

(2) (3)

• Bore hole

(4 )

• Pipe-borne water

(5)

• Rain water harvest

(6)

• Other,; (specify)

(7)

• Bush and others

(1 )

• Refuse dump

(2)

• City service

(3)

• Bush • Pit latrines

(1 )

• VIP latrines

(3)

• Water system

(4)

• Rivers

(5)

• Other,; (specify )

(6)

(2)

5-14.99 thousand Naira

(1 )

15-24.99

(2 )

25-34.99

(3)

35-44 .99

(4)

45-54 .99

(5)

55 and above

(6)

- _.-¥ ,: -";'l;:} , ........

(b)

Available (c)

I Afforable (0- ) (d)

da~s/week

No. of (YI N) (e)

More than once daily

Frequency of consumption

Note Interviewer should please fill data In unshaded spaces only.

(a)

food Is:

Indicate no. of months in the year for which

affordabUity

Food avallabilltyl

in the last one week in the following table:

fnr"'ClfY unit)

Quantity eaten In last one Week (9)

Proportion fout of 10) rom own production Proportion market (h)

rom the

fout 0(10)

(N) (I)

chase (N) 0)

If own production, If purchased, please please slate estimate market value cost of pur-

Please indicate the types, quantities, and availability/affordability of food items cooked and eaten by people in this household

Food security (Respondent: Head of the household or meal planner/preparerJ

<X>

Others (specify)

Sweetpotato Irish potato Cocoyam (corms)

Yam/yam products Yam tubers Yam flour Potato

Cassava/cassava products Cassava tubers Garri (uncooked) Others (specify)

Roots and tubers

Afforable

(c)

Available

(b)

Indicate no. of months in the year for which food is:

Food availabililyl affordability

"'<~ -;, ,.•• -!JIt,o:~_

w-'\·. ..",....~.,.--~~!~., .

,. ...'-',.~~-,,'

""~lj"~'

.)1,

Foods (a)

--;,....

• ,-,",

.,.

,.:.

(

~ "

~ IiiIt

.... .,. . ..

"" ... t4

-•. ~~t!:

If purchased , please state cost of purchase (N) 0)

. "'II ' ;' . .t"

Ifown production , Proportion please Frequency of consumption Quantity eaten in last (out of 10) Proportion estimate one Week from own (out of 10) market No. of daysl More than (specify produ ction from the once daily value (N) week (0·7) unit) (I) (YI N) (e) market (h) (i) (9) d

".'

• -' . -1

';,.., .

co co

Note: Interviewer should please fiU data In unshaded spaces only.

Foods (a)

Quantity Frequency of consumption eaten In r-------r-------~--------_r------~ last one No. of daysl More than Week Available I Affordable week (0-7) on ce daily (soeci (b) (c ) (YIN) (e)

Food availabilityl affordability Indicate no. of months in the year for which food is:

If own production, Proportion please If purchased , (out of 10) Proportion estimate please state from own (out of 10) market cost of production from the value (9) market

'"'"

Foods (a )

I (b)

Available

No. of days! week (0-7) (d)

(c)

More than once daily (YIN) (e)

IFrequency of consumption

IAffordable I

Indicate no. of months in the year for which food is: Quantity eaten in last one Week (specify unit) (I)

Ifown production, please Proportion (out of 10) Proportion estimate from own (out of 10) market value production from the market (h) (N) (i) (9)

please state cost of purchase (N) U)

'"a

Available (b) (c) week (0-7) (d)

I Affordable I No. of days!

Note Interviewer should please fill data in unshaded spaces only.

Foods (a)

once daily (YIN) (e)

More than

Food availabilityl affordability Indicate no. of months In the year for which food Is: I Frequency of consumption Quantity eaten in last one Week (specify unit) (D (9)

production

(out of 10) from own

Proportion Proportion (out of 10) from the market (h)

If own production , please estimate market value (N) (i)

If purchased , please slate cost of purchase (N) 0)

meat

roducts

(

•

...

~:,..>,

. .-

.......~

•

"'."

..... .,

•. J

No. of days! week (0·7) (d)

Available Affordable (c) (b)

.... -Io,4C:'!."

:~ l;':'-·":.~

More than once daily (Y!N) (e)

Frequency of consumption Proportion eaten in last (out of 10) from own one Week production (specify (9) unit) (f) Quantity

.\~~~:.~

State household member that consumed foods away from home during the last ONE week

Yoghurt

Cheese

Tinned milk

Fresh milk

Oai

E s

era Ish

Shrim s

Fish

Poult

Snails

Bush meat

Pork

Muttonl oat

Beef

Meat and roducts

Foods (a)

.r~ !f1>--' '

Indicate no. of months in the year for which food is:

Food availability! affordability

,,_

Proportion (au I of 10) estimate from Ihe markel market (h) value (N) (i)

If purchased, please slale coslof purchase (N)

1~ :'. :"-:. ~ :"'.'•. " .

If own production , please

- ~ ..

-0

Available (b) I(c)

Frequency of consumption Quantity eaten in last More than l one Week once daily (specify (YI N) (e) unit) (I)

Note IntervIewer should please fiU data In unshaded spaces only.

Foods (a)

Indicate no. of months in the year for which food is:

Food availabilityl affordability If own production. Proportion please from own (out of 10) estimate production from the market (9) market (h) value (N) (i) Proportion (out of 10)

If purchased please state cost of purchase (N) Gl

\.oJ

Cost I Food name I Purchased? (N) (d) (b) YI N (e)

YIN (e)

I Purchased? Cost I Food name (N) (d) (b) Pu rchased? YI N (e)

(N) (d)

Cost

State household member thaI consumed foods away from home during the last one week .

Household member no, Food name and name (b)

Food consumed away from home within the past one week (continued)

(b)

Food name

YI N (e)

Cost (N) (d)

I Purchased?

Cost Food name I Purchased, (N) (d) (b)

State household member that consumed foods away from home during the last one week .

YI N (e)

Purchased?

(N) (d)

Cost

Purchased? name (b) YI N (e)

I Food

Please indicate day of the week. name of food consumed. whether purchased or not and the actual cost for purchased food

Food consumed away from home within the past one week

Food-related coping strategies (Respondent: Head of the household or meal planneripreparerJ When there is limited food in the household, what do you do to solve the problem?

Assessment of nutritional status (Mother with an under-5 child) Now we would like you 10 lell us everything you had to eat and drink after you woke up yesterday morning. Include everything you ate and drank al home and away, even snacks, tea, or coffee, etc.

Twenty four-hour dietary recall for the mother Date: . ... ... .. . .. .. . ....... . ....... . .................. .

Day of the week: .. .. .... .. , .... .

Questionnaire no' : .... .. .. .. .. .. ..... ..... .. ..

Name of subject: .. .... .. .... , .. ..

1. Was food intake usual? (YIN) If

4 . Probe for supplements (iron , antimalaria. vitamins. other supplements) (YIN)

no, how was it unusual

If yes. specify.

consumed . increase or decrease? 1

Should come from page 1 of questionnaire (Questionnaire no.)

not

fill this column of the fonn

Twenty four-hour dietary recall for the mother (continued) Date: ......... .... .. .. .... .. ...... .... ................ .

Day of the week:

Questionnaire no': .... .. ..... ............... .

Name of subject: ................ .

If no, how was it unusual

2. Was ita 3. Probe for sickness (YIN): If yes, appetite? (YIN)

consumed.

If yes , how; increase or decrease? 1

Should come from page 1 of Questionnaire (Questionnaire no.) 00 not fill th is col umn of the form

Twenty four-hour dietary recall for the under-S child (Respondent: Mother of the under-5 child or suitable proxy) Now I would like you to tell me everything (name of baby/child) had to eat and drink after he/she woke up yesterday. Include everything your child ate and drank at home and away, including snacks and drinks (bottles or breast milk!. Date: ......................................

Day of the week: ....... , .... .... .. , .... .

Questionnaire no ': .................. ..

Name of subject: ... .......... ........... .

i was breastfed for the first 6 months. (YIN)

appetite? (YIN) If yes, how; increase or decrease?

6. Probe for fermented beverages consumed .

Health and care (Respondent: Mother of the under-5 child) Now I am going to ask you some questions about your child. Child health Code 1.

Has the child been sick during the last two weeks?

How often was the child down with each of the following sicknesses this year? (state number of times)

Yes (1)

No (0)

Yes (1)

No (0)

Freeuencv Malaria Diarrhea Measles

Cough without fever Whoopino couoh Others (soecifvl

Where did the child receive treatment? (Multiple responses possible)

Nowhere (1) Traditional healinQ home (2)

Primary Health Care (31 Chemist shop (4) Hospital (S)

(61 Private clinic Others (specifvl (7) Not aoolicable to

Do you use the following for:a . Prevention of malaria?

Insecticides Bed nets

WindowsJDoor netting Others (Specify) b. Treatment of diarrhea?

ORS Home made salt solution Others (specify)

Does the child have a health card?

Which of the (ollowing immunizations has the child had?

BGG/Orat polio at birth OPT/Oral polio - 1 OPT/Oral polio -2 OPT/Oral polio -3 Measles None

Care for women (Respondent: Mother of the under-5 child) Now I am going to ask you some questions about yourself.

t 1.

:{"'J-- 1.'''''

-''''-:v. •

If you are sick , how often do you discuss it with your husband?

Always

(1)

(0) (2)

Always

If one of your child ren is sick, how often do you discuss it with

Sometimes

your husband?

Never

If there is a disagreement in decision making. what does your husband do generally?

-:"'I.li"<,!,6~

(2)

Sometimes Never

Ji;:'~

(1 )

(0)

Overrides

(3)

Takes my opinion

(2)

Reconsiders his position

(1 )

Not applicable

How often does your workload allow you some time to rest?

.....

, 1.

Have you heard of child-spacing?

Do you discuss child-spacing with your husband?

What kind of support do you enjoy duri ng pregnancy?

(0) More than twice per week (3) Twice a week

(2)

Once a week

(1 )

Never

(0) -'.'.'

• Antenatal care

Increased financial support

Reduced HH chores , Improved food

· thers (Specify) • None

~~~,....... -.~"

Care for women (Respondent: Mother of the under-5 child) continued

If sometimes, food is not enough who takes the least share?

In this household, when resources are limited , who is given preference in education?

100

Infant feeding practices (Respondent: Mother of the under-S child) Now I would like you to answer a few questions about how you feedlfed your baby. 1.

Are you aware of exclusive breastfeeding?

When did you start giving your youngest child anything (even water) other than breast milk?

Your last child was exclusively breast-fed for how lon971

Are you aware of child-growth

Yes (1)

o months 3 months 6 months months 1 months 2 months 3 months 4 months 5 months 6 months Yes ( 1)

No (0) (0)

(1) (2) (0) (1) (2) (3) (4) (5) (6) No (0)

monitoring? 5.

Did you monitor the growth of your child using a chart?

Yes (1)

No (0)

The purpose of this question is to check the va lidity/accuracy of question 2 above .

101

Hygiene practices (Respondent: Mother of the under-S child) With rega rd to food, that is cooked/ left over or not consumed I

NO.

InmcalOrs

up Ions

How do you preserve (keep) food that is not to be consumed immediately?

In the open - open

I \..ooe

In the open - covered

Cupboard

(3)

Kepi warm

(4)

(1 )

(2)

Fridge (5) Others (specify) (0) Hygiene spot check (this section is to be filled after discreet observation):

Code Yes (1)

, , ,

路路路路

No (0)

Do not know

Are there open garbage containers in the house? Are there unwashed cooking/ eating utensils in the house? Is the conta iner for drinking water uncovered?

Is the primary care for the child untidy (hands, clothes, and nails)? IS

tne youngest

c n ~a

untlay (nanos,

clothes. and nails)?

Does the inside of the house need to be swept? We re animal droppings observed in the house? Was stagnant water observed around the house?

Comments, if any: _ _______________________

102

Hygiene practices (Respondent: Mother of the under-Schild) With regard to food, that is cookedlleft over or not consumed

Anthropometric and biochemical measurements (Respondent: Mother and child under-5 child) \''-;~

,-.~.

.-,

."?"'":.~~:;,\,:,"

:('1.: ....

..,.....~,.~

Indices

~;.~

Mother

~ I

....

Tick : Male

tnme when interview finished.

Medical team to collect biological samples (blood and urine) from eligible mother and child (and label appropriately) See interviewer's manual pages 126-131

Anthropometric measurements Biochemical mearsurements (Respondent: Mother and child under the age ofS) Serum retinol Urinary iodine Serum zinc concentration Serum ferritin

103

Kaduna

Makarfi

medium

urban

Imo

i rural

rural

104

Appendix 4 Survey questionnaire for pregnant women Nigeria Food consumption and nutrition survey 2001 Questionnaire for pregnant women This section to be filled by the intelViewer doily before going to the field

Area code (for official use only)

I Zone I Time interview started Address ...................... .

State LGA

EA Questionnaire no........... .

Questionnaire identification

Address

Stale codes: Nasarawa (01). Taraba (02). Bomo (03). Kaduna (04), Kebbi (05), Kano (06), Osun (07), Edo (08) Kwara (09), lmo ( 10), Bayelsa ( 11), Akwalbom (12) lGA codes: See end of questionnaire. Codes from 01-72 Sector codes: Rural (0 1). Medium (02). and Urban (03)

105

Response status. I . Completed 2. Partly completed

3. Not at home 5. HH not located 4. Refused 6. Moved away 7. Other: specify ........ .. .. ...... . .. .. ... ... .. . ..

No. of visits Length of interview (in minutes) Data collection

Field editing

Name Date

106

Office editing

Data entry

24-hour dietary recall protocol for the pregnant woman Date: .............. .

Day of the Week: ........................ "

Subject 10 no: ............ age ...... gestation ...... LMP"....... EDO路路................................ . Name of subjed: ..... ..... ... . .. parity ................. Occupation ............. "." ...... "... .

If no, how was it un usual?

supplements (iron. antimallaria. vitamins. other

2. Was it a feast day? (YIN )

If yes, specify

3. Probe for sickness (YI N): If yes, did sickness affect appetite? (YIN)

5. Probe for fermented beverages consumed

1. Was food intake usual? (YIN)

If yes, how; increase or decrease? I

Should come from page 1 of questionnaire (Questionnaire no.).

Do not fililhis column o f the form

. LMP - EOD

=Last menstrual period =Expected dale of delivery 107

24-hour dietary recall protocol for the pregnant woman Date: ............ .................

Day of the week: .......... ... .

Questionnaire no ': ............ ubjed 10 No: ............... .age ....................... . Gestation ........ LMP路......... EOO.... .. Parity ............... occupation ....... .

Name of subjed: ........................ .

1. Was food intake usual? (YIN) If no, how was it unusual?

4. Probe for supplements (iron, antimalaria , vitamins. other

2. Was it a feast day? (YIN )

If yes, specify.

for sickness (YIN ): If yes, did sickness affect increase or decrease? 1

Should oome from page 1 of questionnaire (Questionnaire no.)

00 nol fill this column of the form

. LMP = Las! menstrual penod - EDD

=Expected dale of detivery 108

for fermented bever-

Biochemical measurements

Medkal personnel to collect biologkal sample (blood and urine) from eligible pregnant woman (and label appropriately) See manual pages 126-131

Serum retinol Urinary iodine Serum zinc Serum ferritin

109

110

Appendix 5.

Protocol for taking anthropometry (adapted from Gibson 1993)

Weight measurement For infants and children, a pediatric scale should be used where possible, with a scale pan large enough to support the weight of the child. In the field, a suspended spring balance and a weighing sling may be used. After slipping the subject into the sling, record the weight as soon as the indicator on the scale has stabilized.

For older children and adults, use a bathroam scale The scale should be calibrated regularly and whenever it is moved to another location. Place the scale on a hard flat surface. Calibrate the scale with known weights and zero it after every subject. Ask the subject to stand unassisted, in the center and to look straight ahead, standing relaxed but still. Record any signs of visible edema, if present. Record the body weight to the nearest 0.1 kg.

Height measurement Clothing should be minimal when measuring height so that posture can be clearly seen. Shoes and socks should not be worn. Ask the subject to stand straight feet together, knees straight, and heels and buttocks and shoulder blades in contact with the vertical surface e.g., wall. Make sure the arms are hanging loosely at the sides with palms facing the thighs; the head is not necessarily in contact with the vertical surface. For younger subjects, it may be necessary to hold the heels to ensure they do not leave the ground. Record the height to the nearest 0.1 cm. Take note of the following precautions that need to be taken when taking measurements:

Wei9ht measurements Check proper functioning of the scale. Remove all additional weight sources (shoes, pocket materials, etc.). Ensure calmness during weighing. The reader of the scale should be properly positioned besides the subject to accurately read the scale to the nearest 0.1 kg,

111

Heights measurements Surface being used must be upright and subjed must stand on a flat surface. No shoes and caps. Headboard should be adjusted to the level of the scalp. Reading is to be taken to the nearest 0.1 em. In cases where large amounts of adipose tissue prevent the heels, buttocks, and shoulders from simultaneously touching the wall, subject should simply be asked to stand ered. How to measure the length/height of an infant Place the infant on a length mat or any flat surface with a measuring device marked in centimeters. Place the infant facing upwards (on his/her back> ensuring that the heels are level with the zero mark of the measuring device, with the toes pointing straight upwards. Press down the knees of the infant to touch the flat surface with the hand by the sides. Adjust the neck and head so that the child is looking up and absolutely flat. Take the length by placing a headboard or ruler against the SGllp. How to take the weight of an infant Weigh the mother and the infant together and then the mother alone, using a weighing scale. Subtract the weight of the mother alone from the weight of the mother and the infant to get the infants' weight.

112

Figure 3. Child weight measurement using electronic scale (UNISCALE).

113

Figure 4. Child length measurement for infanls and children 0-23 months.

Figure 5. Child height measurement for children 24 months and older.

114

Appendix 6.

Protocol for collecting biological (blood and urine) samples

Blood samples for ferritin, zinc, and vitamin A Once blood is removed from the body, vitamin A as well as carotenoids is susceptible to losses that can be minimized by rapid separation of serum from red blood cells, protection from light, handling in an air, (oxygen) free atmosphere, such as under nitrogen; and immediate analysis of freezing. Since field conditions do not always allow ideal conditions to be met, alternative procedures have been devised, which minimize extrinsic error in estimating true vitamin A levels. The preferred and alternative procedures, as well as improper techniques are summarized in Table 1. Samples should be protected from exposure to air, and from light and warming from the time of collection to the completion of the analysis. In the case of unavoidable delay in centrifuging blood, place the blood samples in an insulated cooler with wet ice, seal with quality stoppers, transport to the laboratory, and separate the serum soon after arrival. Special care must be taken to prevent hemolysis during transportation, particularly when traveling on rough roads where shaking becomes critical. Suspending the cooler with samples in the vehicle may minimize this risk. Serum specimens must be stored under an inert gas at -8째C (freezer compartment of a regular refrigerator) for up to five days. Then, the samples, while maintained in a frozen state, should be transported to liTA. Table 1. Collection and handling of blood samples.

Milking or squeezing the finger or other tissue from which blood is being drawn. Use of water-soluble ink and labels

Venous blood in containers pennanently labeled

Blood without anticoagulant for obta ining serum 1

Plasma ca n be used

Use of hemolyzed blood

Centrifuge immediately after clotting

Cool whole blood to 1-4 째C; replace air with inert gas, stopper, and ship to

Centrifuging more than 24 hours after blood collection

the laboratory. Avoid he moIysis. Do not freeze . Urx>n arrival, centrifuge immedi-

. Prevent Analyze serum immediately after centrifugation

of the

Store at -20째C or lower When possible, measure the exact aliquots to be used and freeze them . Minimize air head space. When feasible , d isplace the air atmosphere in the tube an inert

Repeated freezing and thawing .

Vacuta iner with disposab le needles is recommended

Adapted from biochemical methodology for the assessment of vitamin A status . IVACG, 1982

115

list of items Items for serum/blood collection Butterfly needle (23G, /'J Syringes (Sml, P) Plain glass tubers (4-6 mil Transport tubes (Eppendorf save lock tubes 1.5 ml) Tourniquet Gloves 700/0 Ethanol 0.

Resealable plastic bags Black xylene-free permanent markers for labelling Dry-ice for shipping to keep samples at 20 路C Sterile 21 G needles (2 units/person) Vacutainers with clot extractors Urine bags for collecting urine samples Paper-tape Of cellotape to be used with aluminium foil for wrapping of vials Deionized water Sulfuric acid for acidification

Items for urine collection Urine collection bags Gloves Plastic transport tubes or vials (5- 10 ml with screw top) Xylene-free permanent markers Resealable plastic bags

116

Collection and handling of blood samples: The specimen of choice for the analysis is venous blood. Venipuncture is the method of obtaining it. The subject should be comfortably seated or supine, if sitting is not easible, and should have been in this position for 10-20 minutes before the specimen is drawn. The median cubital vein in the antecubital fossa or crook of the elbow and the dorsal side of the hand are the preferred sites for collecting venous blood in both children and adults. The skin over the area of intended vein puncture is cleaned with cotton wool saturated with 70% ethanol solution. The skin is allowed to dry in air. A tourniquet is applied 4-6 inches (10-15 crn) above the intended puncture site to obstruct venous return and hence distend the veins. A tourniquet should not be left in pOSition for more than two minutes. A sterile, sharp 23G butterfly needle (Abbot), with a 5ml syringe (Promexl attached is used to obtain venous blood from children and adults. 3ml of venous blood are withdrawn from each subject. When blood collection is complete, the tourniquet should be released and then the needle is withdrawn. Dry gauze is held firmly over the puncture site for 10-15 minutes. This is transferred into a vacutainer with clot extractor (4-6 ml tubes) and left to stand for about two hours. Separate the serum from the blood cells by centrifugation at 2500 rpm for 10 minutes. Meanwhile, keep it cold and covered. Decant the senum into Eppendorl save lock tubes (size 1.5 mil and label for the individual. The serum should be enough to analyze for: - O.3ml/300 microlitres for serum retinol - 0.5ml/500 microlitres for serum zinc - 0.2ml/200 microlitres for serum ferritin Storage of samples: Samples are stored at minus 20째C before dispatch. Transport should be on dry ice to last the entire journey to the laboratory for analysis. Samples for vitamin A must be protected from light by wrapping samples in aluminium loil and storing in a dark cooler box. Labelling: Before collecting the sample, the phlebotonist verifies the identity of the subject by requesting the subject to hand over the slip given to the subject by the interview team. The label should contain the following: LGA code, EA code, questionnaire number, and subject (mother, child, or pregnant woman). 117

Examples of labelling samples: L.G

Q.no.

Subject

written as 20101 M

written as 72325C

written as 30205P

Transport of samples: Use resealable plastic bags for keeping batches of samples. Seal all samples tubes and keep out of direct sunlight. Keep cool and transport on dry ice and send by courier service. Collection and handling of urine samples Adequate quantity of casual urine is collected using a clean cup. This is transferred to sample bottles. 5ml of urine are placed in nongraded 5-1 Oml transport tubes with tight screw caps. Each sample is well labeled with Name, Age Sex, and Questionnaire Identification number. Note: Use xylene-free permanent marker for marking bottle, tubes, and labels. Samples should be kept at - 20째c. Use resealable plastic bags for keeping batches. The urine sample is for analysis of urinary iodine. Note: all samples to be handled with an operator wearing gloves. References National Committee for Clinical Laboratory Standards. 1977. Standard procedure for the collection of diagnostic blood specimens by venipuncture. NCClS standard. ASH-3. Pages. 479-80 in: Textbook of clinical chemistry Tietz (ed). Saunders Company. Gibson, R.S. 1990. Principles of nutritional assessment. Pages 527-30. University press.

118

Oxford

Appendix 7. Table I. Weights of foods measured with local utensils .

..... +t . . . (EUt)(g)

Food .... Maize grain

1512.5

148.6

Not-in-use

Maize flour

1139.6

110.5

Not-in-use

Raw rice

1644.4

160.8

Not-in-use

Raw beans

1587.5

151 .7

Not-in-use

Sorghum grain

1486.2

136.9

Not-in-use

Gari

1122.5

110.8

Not-in-use

Sugar granules

1801 .5

176.8

19.7 (teaspoon 4.8)

Wheat flour

1135.0

112.8

Not-in-use

Yam flour

1185.4

117.06

Not-in-use

M elon seed

1252.4

11 2.5

Not-in-use

(ungrounded ) Melon seed (grounded)

834 .5

81 .2

Not-in-use

Ground dry pepper

725.8

Not-in-use

87.5

Not-in-use

Ground dikanut

Not-in-use

Ungrounded dikanut

1250.2

120.0

Not-in-use

Powdered milk

1128.7

111 .8

14.06

Millet

1148.4

118.5

Not-in-use

266.4

25.5

Not-in-use

Zobo flower

Curry

Not-in- use

Not-in-use

8.0

Margarine

Not-in-use

24.43

Coffee

Not-in-use

9.2 (teaspoon 2.2)

Beverage

Not-in-use

8.8

Crayfish

Not-in-use

46.0

Not-in-use

Salt

2468.4

250.5

28.7 (teaspoon 6.85)

NB ' The measurements were taken in heaps, as it is the common practice in Nigeria .

119

Table 2. Weights of foods w ith different sizes.

45.85

56.72

1016.3

1532.25

2294.35

2856.62

371 .2

629.05

902.35

1209.5

Banana

Pineapple Pawpaw

1548.5

2325.0

Cocoyam

Irish polalo

23.67

66.2

87.4

125.2

Sweetpotato

60.8

145.2

225.4

302.5

Green pepper

22.6

45.4

62.3

85.6

Yam

Cabbage Onion

Kolanut

1302

3600

76.4

152.85

1500

2200

16.5

56.5

2.2

3.5

119 4.2

4280 202

2950 212.5 6 .8

Raw plantain

96.25

185

240

298

Roasted planlain

88.3

135

256

410

108.32

209.3

238.4

262.6

Rawokro

12.2

18.5

23.6

Kufikufi

3.0

4.8

6 .5

8.2

Raw egg

28.5

42.2

53.8

60.6

Cooked egg

25.2

39.7

45.2

56.5

Fried egg

32.6

47.4

58.6

67.2

Tomato

16.8

128

Carrol

1700

2450

4500

5700

148

235

320

480

Orange

Waler melon Cucumber

120

Table 3. Weith of food items with different measuring tools.

Palm oil

Schnapps bottle (full) Schnapps bottle (1 14)

625 400

790 418

Vegetable oil

Schnapps bottle (full) Lucozade bottle (full ) Lucozade boltle (114)

725 680 198

800 780 194

Kum.rzaki

1.5 Ragotis bottle 0.75 Ragolis bottle N5 pack

246

235

Nona

N 15 per wooden spoon

200

193

Zobo

NS pack

268

262

Soy milk

35 ml plastic bottle N5 pack

246

NSO stick (vein) N100 stick

48 76.5 119 151

Killishi

N20 N50 N100

32 55.8 124

Bread

N5 N10 N20 N30 N50 N80 1 slice of NSO pack N100 slice 1 slice of N100 pack

55 135 241 312.5 575 612 28 925 33.7 (21 slices)

Chicken/turkey (without bone)

Average size al home Piece in a canteen

40.1 38.5

Fish (with bone)

Average size at home

67 .7 41 .5

Suya

N20 stick N50 stick

N10 piece Meat

Average size at home

32 24.9

N1D piece

N5 piece

19.5 (weight varies with

proportion of lean to fat

and vein .

121

Table 3. Weights of food items with d ifferent measuring tools continued.

~Wara路

Nl0 wrap N10 wrap (fried)

26.73 16.25

Robo

Nl0 wrap (5 pieces)

12 2.5

Local cheese

1 Piece

1 PIece

110 26.5

Doughnut

Nl0 piece

134

Chinchin

N5wrap

Gala

1 piece

Meat pie

N20 size N25 size

162 174

Buns

NS size

635

Puff路puff

N5 size

7756

Fried yam

NS size Nl size

36 10.75

Akara

N5 size Nl size

50.33 12.5

Fried plantain

Nl size

Groundnut

N5 wrap

Nl0 wrap

216 48.2

AgidVeko

NS size

425.5

Moin-moin

NS size Nl0 size

79.7 110

Popcorn

NS size

Dankuwa

Nl size NS size

12 32

Fura

N5 size

100

Dodo-Iklre

N20 wrap (4 PieceS)

122

Table 3. Weights of food items with different measuring tools continued .

Cooked melon seed

One serving spoon

Cooked okro

One serving spoon

Cooked vegetable soup

One serving spoon

65.2

Cooked stew

One serving spoon

48.4

Cooked dikanut soup

One serving spoon

48.0

123

Table 4. Weights of foods cooked at home and those purchased from canteen/restaurants .

Ama/a

349.7

626.5

1016.2

180

252

Eba

339.3

615.7

994.1

170

272

Tuwo

110.2

346.8

554.2

102

188

Furu

108.7

215.4

330

114

186

Pounded yam

182.5

354.8

816.4

195.3

Cooked rice

280.9

500.1

814 .3

178

Cooked beans

225.4

417.5

665.9

102.4

182.8

The models 1, 2. and 3 are weights of representatives of foods (or a child . woman, and man respectively.

124

Appendix 8 FCNS. Format of coordinators' progress report and end of fieldwork report The Coordinator in each of the four zones for the survey is expected to submit to the PI a comprehensive progress and end of fieldwork technical report at the end of the survey. This report, including some preliminary analysis of data wherever possible, should be submitted in three weeks interval (progress report>, and no later than 14 days after fieldwork, under the following headings: Overview of the survey The strategy used to mobilize the EAs, including Adequacy or otherwise of mobilization effort Lessons learned Recommendations for improvement Roles and responsibilities of each member of the field team, including Specific roles assigned to each member of the field team Indication of how these roles were played out on the field Lessons leamed Suggestions to optimize the utilization of team members and improve costeffective during fieldwork The household-listing exercise, including Procedure adopted for random sampling of eligible households Logistic and other problems encountered, and remedies adopted Lessons leamed Recommendations for improvement Questionnaire administration, including What quality checks were used to ensure the integrity of the questionnaire administration process, and compliance with laid down procedure Which were the most difficult segments of the questionnaire, what was the nature of the difficulty in each case, and how was it surmounted

125

Time taken to complete each segment of the questionnaire Suggestions for improving the quality of data from questionnaire administration Anthropometry, including Problems encountered and remedies adopted lessons learned Recommendations for improvement Collection and processing of biological samples, including Problems encountered and remedies adopted Lessons learned Recommendations for improvement Budget for the survey, including Full retirement of all funds received Adequacy or otherwise of estimated budget for the survey Problems encountered administering funds and remedies adopted Lessons leamed Recommendations for improvement Prelim inary analysis of data from survey, wherever possible, capturing emerging patterns and suggesting plausible reasons Summary of critical issues requiring action, to make for a hitch-free survey

126