Call for Public Comments, Scientific Data, and Information

Comment period: 13 August 2010 to 3 September 2010

Indicators for the Assessment of Vitamin A and Iron Status in Populations in preparation of the WHO Nutrition Guidance Expert Advisory Group (NUGAG) Monitoring and Evaluation (M&E) Subgroup meeting


In 1992 the World Health Assembly urged Member States to "establish, as part of the health and nutrition monitoring system, a micronutrient monitoring and evaluation system capable of assessing the magnitude and distribution of vitamin A and iron deficiency disorders and monitor the implementation and impact of control programmes".

Additionally, in the 2010 draft WHO Strategy on Research for Health1, 'research for health' has been defined to cover five areas of activity, two of which include the measurement of the magnitude and distribution of a health problem and the evaluation of the impact of solutions or interventions on the level and distribution of a health problem. In order to assist Member States in establishing a micronutrient monitoring and evaluation system, WHO produces guidance on the use of indicators for assessing a population's vitamin and mineral status and the application of indicators for monitoring and evaluating intervention programmes.

The current WHO recommendations on vitamin A indicators2 were published more than 10 years ago and are in need of revision and updating in light of new evidence. Current WHO recommendations on iron status indicators are based on consultations that took place in 19933 and 20044. In the latter document, it was stated that in three years time another consultation would be held to evaluate the recommendations made in during the 2004 consultation based on results of recent studies assessing iron status.

As new data are currently available and as some representatives of Member States have come to question the origin of haemoglobin cut-offs to define anaemia and the assumptions used in the estimates, it is prudent that these recommendations be reviewed and updated where necessary.

Updated guidelines on micronutrient indicators aim to provide recommendations to support decision-making on which indicators to use for the assessment of population vitamin and mineral nutrition status and for the evaluation of public health intervention programmes (mainly supplementation and fortification programmes). Indicators may be recommended for single use or for use in combination with other indicators and should be global.

Updated recommendations will be made following the WHO Handbook for Guidelines Development procedures, which promotes transparency of the process and involves a systematic retrieval, assessment and synthesis of available evidence, and consideration of values, preferences, feasibility and costs. The new guidelines are intended to provide practical guidance and clear recommendations to Member States and their partners.