Key indicators (to be read in conjunction with the guidance notes)

1. Diagnosis and treatment: diagnosis of some micronutrient deficiencies is possible through simple clinical examination. Indicators of these deficiencies can then be incorporated into health or nutritional surveillance systems, although careful training of staff is required to ensure that assessment is accurate. Other micronutrient deficiencies cannot be identified without biochemical examination. In such instances, case definition is problematic and in emergencies can often only be determined through the response to supplementation by individuals who present themselves to health staff. Treatment of micronutrient deficiencies or those at risk of deficiency due to disease should take place in the health system and within feeding programmes.

2. Preparedness: strategies for the prevention of micronutrient deficiencies are given in General nutrition support standard 1. Prevention can also be achieved through the reduction of the incidence of diseases such as acute respiratory infection, measles, parasitic infection, malaria and diarrhoea that deplete micronutrient stores (see Control of communicable diseases standards). Treatment of deficiencies will involve active case finding and the development of case definitions and protocols for treatment.