The Micronutrient Survey Manual: A Manual for Assessing Vitamin and Mineral Nutritional Status and Interventions Using Cross-sectional Surveys

Abstract

Objectives: An important component of public health nutrition programs is the periodic assessment of vitamin and mineral nutritional status and coverage of micronutrient interventions.  Performing high quality cross-sectional surveys can be enhanced by the availability of guidance on steps in survey methods, sample size, sampling methods, data collection, analysis and interpretation, dissemination of results, and appropriate feedback to improve intervention programs. A manual to assist implementers is described. Methods: A previously published manual, "Indicators and Methods for Cross-Sectional Surveys of Vitamin and Mineral Status of Populations", by the Centers for Disease Control and Prevention (CDC) and the Micronutrient Initiative (MI) served as the basis for this newer manual. New technical partners, WHO and UNICEF, have collaborated in the development of this up-to-date "Micronutrient Survey Manual". Results: In addition to updated resources for the assessment of anemia and iodine, iron, and vitamin A deficiencies, the manual has added information on folate and zinc deficiencies. Program indicators for assessing fortification of staple foods, point-of-use fortification with micronutrient powders, micronutrient supplementation, and dietary counselling are included. The manual contains detailed information on biologic sample collection and processing, sample size calculations, and analysis of survey data. Quality assurance throughout the survey process is emphasized. The issues of ethics, confidentiality, and informed consent are addressed. Conclusions: The "Micronutrient Survey Manual" can assist survey managers to improve the validity, efficiency, and standardization of cross-sectional surveys to better serve public health practice.