Jefferds Maria Elena D, Flores-Ayala Rafael
IMMPaCt, Division of Nutrition, Physical Activity and Obesity, CDC, Atlanta, Georgia, USA.
Matern Child Nutr. 2015 Dec;11 Suppl 4(Suppl 4):229-33. doi: 10.1111/mcn.12118.
Lack of monitoring capacity is a key barrier for nutrition interventions and limits programme management, decision making and programme effectiveness in many low-income and middle-income countries. A 2011 global assessment reported lack of monitoring capacity was the top barrier for home fortification interventions, such as micronutrient powders or lipid-based nutrient supplements. A Manual for Developing and Implementing Monitoring Systems for Home Fortification Interventions was recently disseminated. It is comprehensive and describes monitoring concepts and frameworks and includes monitoring tools and worksheets. The monitoring manual describes the steps of developing and implementing a monitoring system for home fortification interventions, including identifying and engaging stakeholders; developing a programme description including logic model and logical framework; refining the purpose of the monitoring system, identifying users and their monitoring needs; describing the design of the monitoring system; developing indicators; describing the core components of a comprehensive monitoring plan; and considering factors related to stage of programme development, sustainability and scale up. A fictional home fortification example is used throughout the monitoring manual to illustrate these steps. The monitoring manual is a useful tool to support the development and implementation of home fortification intervention monitoring systems. In the context of systematic capacity gaps to design, implement and monitor nutrition interventions in many low-income and middle-income countries, the dissemination of new tools, such as monitoring manuals may have limited impact without additional attention to strengthening other individual, organisational and systems levels capacities.
监测能力的缺乏是营养干预措施的一个关键障碍，限制了许多低收入和中等收入国家的项目管理、决策制定以及项目成效。2011年的一项全球评估报告称，监测能力的缺乏是家庭强化干预措施（如微量营养素粉或脂质营养补充剂）面临的首要障碍。最近发布了一份《家庭强化干预措施监测系统开发与实施手册》。该手册内容全面，阐述了监测概念和框架，还包括监测工具和工作表。该监测手册描述了为家庭强化干预措施开发和实施监测系统的步骤，包括确定并让利益相关者参与进来；制定项目描述，包括逻辑模型和逻辑框架；明确监测系统的目的，确定用户及其监测需求；描述监测系统的设计；制定指标；描述综合监测计划的核心组成部分；以及考虑与项目发展阶段、可持续性和扩大规模相关的因素。整个监测手册使用了一个虚构的家庭强化案例来说明这些步骤。该监测手册是支持家庭强化干预措施监测系统开发与实施的有用工具。鉴于许多低收入和中等收入国家在设计、实施和监测营养干预措施方面存在系统性能力差距，在没有额外关注加强其他个人、组织和系统层面能力的情况下，传播新工具（如监测手册）可能影响有限。
