Standardized Monitoring and Assessment of Relief and Transitions (SMART)
An Interagency Initiative
Improving the Monitoring, Reporting and Evaluation of Humanitarian Assistance
The Standardized Monitoring and Assessment of Relief and Transition (SMART) program is an interagency initiative to improve the monitoring, reporting and evaluation of humanitarian assistance interventions. The program will pilot an approach to routinely collect, analyze and disseminate information on the nutrition and mortality experience of populations served by humanitarian interventions. The program will advocate the interpretation of health/nutrition data in the context of food security and vulnerability analysis.
As a start, the program is addressing health and nutrition indicators that are commonly used in the acute phase of an emergency. It is envisioned that this initiative will provide the foundation and the network among organizations to develop commonly shared indicators for transition, and/or other indicators needed for emergencies that deal with other aspects of humanitarian assistance.
The program will provide implementing partners and the broader humanitarian community with a wide range of tools to support humanitarian program assessment, monitoring and evaluation. A website has been established that that serves two purposes:
· The site serves as an organized workspace and knowledge repository to be used by core organizations and individuals involved in this program.
· The site serves the specific needs of the Information Management Group to design a toolkit that will enable implementing partners to collect, analyze and use relevant data. In addition, there will be an approach for the analysis and dissemination of program field data to the wider humanitarian community.
The SMART initiative will develop information management tools for field reporting, web-based forum for posting survey results, and a listserve for field practitioners to have direct, immediate access to the pool of experts. Technical experts from various organizations have been drawn together to provide technical support to implementing partners. As a start, the Technical Advisory Group (TAG) will advocate a standardized methodology for measuring health and nutritional status of populations in emergencies, and pilot test the application of this methodology in a few selected countries.
The SMART workshop, July 23 - 26, 2002, Washington D.C., is the first effort to address the need to establish a generic standardized methodology and is the result of many organizations working together. The consultations leading to this workshop have highlighted the need to address several other issues that will be addressed in follow-up workshops and meetings.
SMART is envisioned as an evolving interagency initiative with organizations invited to work together and contribute to its development. The workshop brings organizations together to work jointly on a common identified problem. The organizers hope this is just the beginning of many collaborative advances to be made in the future.
During the last few years, donors have come under pressure to report on results of programs. USAID and State Department's Bureau of Population, Refugees, and Migration (State/PRM), the two USG agencies responsible for providing relief overseas, discussed for some time the need to coordinate on performance indicators. Implementing partners encouraged this coordination effort and the adoption of commonly shared indicators to facilitate data collection and reporting to several donors. In consultation with technical agencies, a small set of indicators was selected in 1999 that could be used to measure overall progress in relief situations. The indicators are Crude Mortality Rate (CMR) and nutritional status of children under five.
Crude death or mortality rates (CDR or CMR) are the most critical indicators of a population's improving or deteriorating health status and the category of data to which donors and relief agencies most readily respond. A CMR not only indicates the current health state of a population but also provides a baseline against which the effectiveness of relief programs can be followed. If CMR remains low, it indicates that people are not dying from a wide variety of causes including shelter, food, water, sanitation, epidemics, etc. CMR is relevant to USAID and State/PRM in respect to their programs that address critical, physical needs of populations in crisis (and does not address the protection issue that is of equal importance to State/PRM).
In addition to CMR, USAID adopted nutritional status of children under five. Acute malnutrition in children under five is closely associated with risk of death. Since severely malnourished children die without timely and appropriate interventions, efforts have been made to integrate mortality analysis with nutritional status to ensure there is no masking of the true nutritional status. If CMR and nutritional status are improving or getting back to international standards, most of the humanitarian assistance support systems are working. While not adequate to manage emergency situations (and implementing partners collect several other indicators to manage each specific situation), these two indicators help track the cumulative effect of the relief effort on the most vulnerable populations.
Review of Progress - Process
Nutritional status of children under five has been used as a performance indicator by USAID's Office of Food for Peace since 1997 when this was included as one of its Strategic Objective indicators for Title II emergency food aid. The Office of Food for Peace invested considerable time in the consultative process with its implementing partners to jointly select indicators that they would report on. Other selected indicators reflected values and core principles important to the PVO community, that is, the "do no harm" approach to implementing emergency food aid programs.
Since CMR data collection was new to its implementing partners, the Office of Food for Peace supported the field testing of the methodology that combined CMR data collection with the existing nutrition survey protocol. The pilot test, undertaken by World Vision/Sudan in 1999, demonstrated that this methodology was feasible and do-able by PVOs. Implementing partners requested technical assistance and training to be able to adopt this methodology. Since then, efforts have been made to coordinate on establishing methodologies and to provide technical support to PVOs/NGOs.
As a joint USG policy advocacy effort, USAID and State/PRM consulted donors and international organizations on the adoption of nutritional status and CMR as commonly shared indicators. Organizations consulted as part of the USG mission to partners in Europe (January 2002) supported the effort. There was broad consensus on the need to improve technical capacity of implementing partners to ensure nutrition/health data is reliable: an investment is needed to ensure that programs have the capacity to carry out, analyze, interpret and report on survey findings. This requires training and the provision of technical support to PVOs/NGOs and other implementing partners. There was consensus on the need to standardize survey methodologies among organizations conducting nutrition surveys. All organizations expressed interest in participating in a training workshop. Some organizations expressed the view that food security, vulnerability and livelihoods analysis should be integrated as part of nutrition data analysis and interpretation.
A recent positive development of the several years of advocacy effort is the willingness of implementing organizations, technical agencies and donors to work together to resolve technical problems in collecting reliable data in emergencies, standardize methodologies, and strengthen the technical capacity of all partners.
The recommended generic survey methodology will be field tested in a few selected countries where data will be collected and analyzed as a joint effort, and appropriate interventions will be introduced. Follow-up surveys will be undertaken in each site every six months so trends can be monitored. The pilot test will demonstrate whether these indicators are the most critical ones for measuring overall progress in relief situations. It will also review other indicators that should be included without a burden to implementing partners, for example, the feasibility of integrating food security and vulnerability analysis. It will also demonstrate the feasibility of a collaborative approach to gathering data in emergencies with representative sites selected by participating organizations.
For policy and decision makers, this will provide an improved understanding of humanitarian assistance needs and emergencies that require attention, including those that are less visible, based on real time information that is reliable. This effort will facilitate decision making and the provision of timely, appropriate assistance to the most vulnerable groups.
Humanitarian Assistance Advisor
Bureau for Policy and Program Coordination
July 22, 2002
 Noji, E., Monitoring and Evaluation in Complex Humanitarian Emergencies, Emergency and Humanitarian Action, WHO, Geneva. 1998.
 Organizations consulted:
Rome: WFP, FAO
Geneva: UNHCR, IFRC, ICRC, WHO, RNIS (ACC/SCN), The Sphere Project
Brussels: European Union, Medecins sans Frontiers, Medecins du Monde, Centre for Research on the Epidemiology of Disasters (CRED)