Improving Nutritional Status through Monitoring and Evaluation: The Design of a Nutrition Surveillance System in Belize

Chronic micronutrient deficiencies can lead to a number of poor health outcomes, including stunting and night blindness. In Belize, the stunting rate of children under 5 years is 18%, with rates as high as 45% in the heavily Mayan region of Toledo. Coupled with low exclusive breastfeeding rates and micronutrient deficiencies, malnutrition poses a significant challenge to the health of women and children in Belize. There are a number of interventions in place to help reduce the prevalence of micronutrient deficiencies, but little monitoring of these activities. The purpose of this project was to design a nutritional surveillance system that would provide the Ministry of Health and its stakeholders with more streamlined data, leading to a greater impact on national nutrition policies. Working under the guidance of the Maternal and Child Health department, the authors designed the system to use both qualitative and quantitative data to track nutritional outcomes. The addition of quantitative data, such as blood work and laboratory monitoring of all iron-fortified products, strengthen current monitoring activities. These quantitative indicators provide empirical evidence for the impact of current supplementation and fortification initiatives, and assess the feasibility of further food fortification projects. The rigorous monitoring practices of a nutrition surveillance system should be maintained in order to provide policy makers with the most accurate information for directing resources and writing policies to target the populations most vulnerable to malnutrition.