After testing the method in a highly urbanised area (Addis Ababa, Ethiopia), we wish to carry out the next field test in a different context. Looking at countries where HelpAge is working, we thought of doing it in rural Kenya, but most of the rural population are pastoralists/semi-nomadic, which would mean that the method would need to be specifically adapted for this. We would like to test it in a stable rural population. The Philippines? Our country office in Ormoc is warning us that people in the cyclone-affected areas are really tired and wary of surveys…
Our Tanzania office is answering positively to our request. It is an opportunity to gather interesting information about older people. There are several districts in rural Tanzania where HelpAge has very good local partners. In the end we decided to target the district of Kibaha, in the Pwani region, West of Dar es Salaam. This district has a total population of 70,210 inhabitants (2012 census), with around 8 per cent being aged 60 years or more, and it is largely rural. HelpAge has a long term partner working with the communities, the Good Samaritan Social Service Trust.
For this project, we are also developing a partnership with the Tanzania Food and Nutrition Centre, a semi-autonomous government institution under the Ministry of Health and Social Welfare, whose mission is to provide expert guidance to actors at various levels through research, advocacy, education and training, for the provision of quality nutrition services to the Tanzania community in the prevention and control of all forms of malnutrition.
We also need to get the ethical clearance from the Medical Research Coordinating Committee, at the National Institute for Medical Research (NIMR).
We are planning to start the survey at the end of August. In preparation, we have worked on the questionnaire, which needed to be modified after the first field survey. By comparing the two methods, RAM-OP and SMART, we noticed that some answers were extremely different from one survey to the other, which could be attributed to the questions being too subject to personal interpretation. We thus introduced some more thorough indicators. For example, we replaced the question “Do you have poor eyesight?” by testing for visual impairment. With some advice from the International Centre for Eye Health at the London School of Hygiene & Tropical Medicine, we are going to use the “tumbling E” at two meters. Similarly, we have replaced a question about whether the person is “confused, or having troubles in understanding or answering the questions” by a 5-question dementia test, inspired by the work of the 10/66 Dementia research Group. This is very challenging, as the questionnaire is getting bigger, but also more thorough. The field test in Tanzania, using a questionnaire translated in Swahili, will tell us about the advantages and difficulties.
HelpAge International, Valid International and Brixton Health are developing an innovative method of assessing the needs of older people in emergencies, including their nutritional needs. The Rapid Assessment Method for Older People (RAM-OP) is meant to offer a simple, quick, reliable, robust and cost effective method for assessing the nutritional status and vulnerabilities of older people in emergencies.
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