The surveillance of Severe Pediatric undernutrition (SSPUN) in Miami: A community approach to a multi-level population-based nutrition surveillance

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)


International Studies

First Committee Member

Enrique Baloyra - Committee Chair


A global nutrition surveillance model developed by a joint committee of international organizations in 1976 was used to guide the implementation of the Surveillance of Severe Pediatric Undernutrition (SSPUN) in Miami, Florida, in 1988. The model was developed by the Food and Agriculture Organization (FAO), the World Health Organization (WHO), and the United Nations Children's Fund (UNICEF). SSPUN was funded by a cooperative agreement between the Centers for Disease Control and the Florida Department of Health and Rehabilitative Services.The specific aims of this work were to (1) determine the feasibility of using the model to guide the implementation of a multi-level nutrition surveillance, (2) compare and contrast the model's objectives with those of SSPUN, (3) use the model and its objectives to evaluate the project's shortcomings and successes, (4) share the experience acquired through this feasibility study with interested organizations, and (5) make recommendations to improve both model and project according to findings.The model was found to still be a useful guide for the execution of SSPUN. The structure of the project was adequate to achieve its stated objectives: to determine the prevalence of severe pediatric undernutrition (SPUN) in Miami, and to characterize SPUN by assessing its association with risk factors. The project's contributions were in the use of microcomputers for nutrition surveillance at the community level, and in recognizing the most inexpensive and efficient implementation strategies. The conclusions from the evaluation of the project, and the feasibility study generated recommendations for a permanent multi-level SSPUN Project and the prevention and amelioration of consequences of SPUN. Three major groups of recommendations were developed. The first was directed towards increasing the accuracy and representativeness of the collected information; the second suggested measures to improve the timeliness of a SSPUN surveillance; and the third included recommendations for comprehensive nutrition intervention.


Health Sciences, Nutrition; Health Sciences, Public Health; Sociology, Ethnic and Racial Studies

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