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A health worker at Mulago antenatal clinic collecting blood sample from a pregnant woman for haemoglobin estimation during one of the days of the routine ANC visits
Photo Credit: SPRING/JSI

The USAID Advancing Nutrition Anemia Task Force (ATF) was created to develop a new approach to address the global challenge presented by anemia. Recognizing that anemia is a multi-dimensional condition affected by both internal (biological, genetics, health/infections, and nutrition) and external (socio-demographic, behavioral, food systems, and physical) environments, the ATF proposes taking an ecological approach that addresses both these environments. The ATF acknowledges the need to understand both these environments to describe the etiology of anemia, assess anemia (both clinical and population surveillance) and develop context-specific, equitable interventions.

The ATF approach is intended to: (1) improve rigor and reproducibility of research on the biology and etiology of anemia; (2) improve precision of assessment measures at both individual and population levels; and (3) support the translation and implementation of new evidence and intervention choices.

Members of the ATF presented their work during a past webinar hosted on behalf of the Global Nutrition Coordination Plan’s Ecology of Parental, Infant, and Child (EPIC) Nutrition subgroup. In addition to the presentation of the overarching conceptual ecological framework and a review of the evidence regarding our current understanding of the biology, etiology, assessment and intervention options, the previous webinar highlighted the application of the ecological approach to the assessment of anemia, using a novel algorithm that may be applied in clinical settings to diagnose anemia and at the population level to assess its prevalence. The approach includes a comprehensive assessment of all leading causes of anemia such as infections, inflammation, dietary deficiencies, blood loss, and inherited blood disorders– and offers a framework to interpret the results of the assessment in population surveys.

This webinar, built on the past webinar and featured researchers and program managers from low- and middle-income countries that shared their experiences on assessment and interpretation, including their opinions on the feasibility of the ATF approach to assessment.

View Part I of the Webinar Series

Webinar Recording

Webinar Resources:


  • Lindy Fenlason (moderator) is a senior nutrition and capacity building advisor at USAID where she primarily focuses on the intersections of health and nutrition. She is a pediatrician by original training and has obtained additional training and certifications in public health, nutrition, and coaching. She has worked in various resource-challenged settings and her work over time has focused on best practices in global clinical care and programming for child health, HIV, education, and the malnutrition spectrum—from traditional undernutrition of wasting and underweight to the under/inadequate nutrition of obesity and the rise in noncommunicable diseases, and the micronutrient deficiencies found across the spectrum.
  • Anne Williams is an adjunct assistant professor at Emory University. Her research focuses on optimizing nutritional assessment and improving maternal nutrition. Her work in Tanzania, Kenya, Malawi and Rwanda focuses on improving nutritional outcomes for women and children. In Bangladesh, her experience has served to improve nutritional status and school attendance for adolescent females through an integrated health program that includes WASH and menstrual hygiene. She is exploring spatial analysis to improve guidance to reduce multiple forms of malnutrition simultaneously using nationally representative data sets that measure multiple micronutrients, anthropometry and non-communicable disease risk factors at the individual level. 
  • James Wirth is a managing director at GroundWork-Health. He is an international nutrition specialist, focusing on the design and implementation of national public health and nutrition surveys, research on the determinants of stunting and anemia, and monitoring and evaluation systems. He has conducted case control studies examining the association between inflammation and enteropathy on child growth, and has conducted multiple national micronutrient and nutrition surveys. James is a member of the steering committee of the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project, and has managed qualitative program evaluations related to food fortification and humanitarian response. 
  • Maria Elena Jefferds is a lead epidemiologist and team lead of the International Micronutrient Malnutrition Prevention and Control Program (IMMPaCt) at the Centers for Disease Control and Prevention (CDC). Dr. Jefferds has expertise in behavioral science; the design, monitoring and evaluation of micronutrient and nutrition programs; population-based surveys, assessments, and surveillance, including the assessment of hemoglobin to diagnose anemia in survey settings.
  • Yi-An Ko is a research assistant professor at Emory University. Her work focuses on the development, application, and interpretation of a variety of statistical methods in biomedical research. Most of it concentrates on study of biomarkers and risk factors for cardiovascular diseases. Her research interests include gene-environment interactions, analysis of high-dimensional data, and developing novel analytical strategies to understand the etiology and pathogenesis of complex diseases.
  • Naveen Paudyal is nutrition officer with UNICEF Nepal. He has more than 23-years of experience in the field of nutrition as an iodine deficiency disorder monitoring officer, nutrition consultant, and nutrition officer. He is the founding member of the Nutrition and Dietetic Association of Nepal and is also a member of Nepal Food Scientist and Technologist Association (NEFOSTA). He has led the design and implementation of large scale surveys like the MNP/IYCF follow up Survey 2016 and Nepal National Micronutrient Status Survey 2016.
  • Mireya Palmieri Santisteban is the director of the health and nutrition epidemiological surveillance system (SIVESNU) in Guatemala. As an expert in food and nutrition security, she has held management positions at the Institute of Nutrition of Central America and Panama (INCAP) since 1982. She has participated in research, technology transfer and training activities on issues related to the evaluation of economic, social, nutritional and health interventions. Currently, she works in INCAP's Nutrition and Micronutrients Unit, leading SIVESNU.
  • Aminata Koroma is the director of food and nutrition in the Sierra Leone Ministry of Health and Sanitation. She provides strategic leadership, technical guidance, and policy direction to the Government of Sierra Leone on food and nutrition issues with a focus on the reduction of the high prevalence of all forms of malnutrition in the country. An accomplished academic; she holds an advanced degree with several other professional certificates on topics such as equal employment opportunity and affirmative action training for managers, health care in developing countries, emergency management, operational research, and breastfeeding practice and policy. 
  • Dan Raiten is the program director for nutrition at the Eunice Kennedy Shriver National Institute of Child Health and Human Development in the National Institutes of Health. Educated in history and political science and animal science/agriculture, Dr. Raiten received his doctorate in Human Nutrition from Pennsylvania State University and followed that with a postdoctoral fellowship at the Child Study Center of Yale University Medical School. He currently manages a portfolio of extramural grants covering all aspects of nutrition, maternal and child development and serves as content expert on numerous U.S. government and international technical working groups.