Welcome to our Multi-Sectoral Nutrition Resource Review, a curated collection of recent research, tools, news, and events to help you stay on top of developments and evidence in global nutrition programming. Our multi-disciplinary team has developed short summaries to give you an idea of what you'll find when you click on the link to the full resource. Explore by focus areas using the buttons below. Have a resource to share? Let us know ›

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Early Childhood Development Food Security and Nutrition in
Humanitarian Transition
Food Systems Monitoring, Evaluation, and
Learning/Knowledge Management
Nutrition and
Health Systems
Social and
Behavior Change

October 2019

IconEarly Childhood Development

Research Articles

Early Childhood Development and Stunting: Findings from the MAL-ED Birth Cohort Study in Bangladesh

Nahar et al. Maternal & Child Nutrition. 2019, June 25:e12864
  • Early Childhood Development
The global early childhood development and nutrition fields lack robust research in low-income contexts on the link between stunting and child development. A recent study in Bangladesh, where 36 percent of under‐5 children are stunted, explored the differences in child development between non-stunted and stunted. The study found that stunted children had notably lower early childhood development scores than their non‐stunted peers on language, cognitive, social-emotional, and motor scales. In Bangladesh, stunting in young children is associated with poor developmental outcomes.

Improving Parenting Practices and Development for Young Children in Rwanda: Results from a Randomized Control Trial

Abimpaye, Monique, Caroline Dusabe, Jean Providence Nzabonimpa, Richard Ashford, Lauren Pisani. International Journal of Behavioral Development. July 16, 2019
  • Early Childhood Development
The first years of life have long-term impacts on children’s development across language, cognitive, social-emotional, and motor domains, yet evidence on critical parent-young child interactions in low-income settings is scarce. A cluster randomized control trial in Rwanda compared the outcomes of light-touch and full-intervention 17-week courses on parenting skills and child development for families with children aged 6–36 months. The results revealed that children in the light-touch and full-intervention groups scored significantly higher on early childhood development scales across all domains than the control group.

Nutrition, Hygiene and Stimulation Education for Impoverished Mothers in Rural Uganda: Effect on Maternal Depression Symptoms and Their Associations to Child Development Outcomes

Atukunda, P., Muhoozi, G.K.M., Westerberg A.C., Iversen P.O. Nutrients. 2019, 11, 1561.
  • Early Childhood Development
Maternal depression is linked to poor developmental outcomes in young children. A follow-up of an open cluster-randomized trial studied the effects of a parenting education program for mothers in rural Uganda on maternal depression and child development. Participation in the parenting education program was associated with decreased maternal depression scores. Additionally, reduced maternal depression was associated with improved child cognitive and language development outcomes.

Reports and Tools

Nurturing Care Framework for Early Childhood Development: Dissemination and Uptake Since May 2018

WHO, UNICEF, the World Bank Group, the ECD Action Network and the Partnership for Maternal, Newborn and Child Health, June 2019
  • Early Childhood Development
One year after WHO, UNICEF, the World Bank, and partners launched the Nurturing Care Framework, they published this report on efforts by countries around the world to adopt it. To date, 30 countries have begun implementing the Framework and identifying entry points in the health, nutrition, and other sectors to deliver multi-sectoral services. The report provides an overview of uptake at the national, regional, and global levels.

Events

The Science Behind the First 1,000 Days: Linking Nutrition, Brain Development, and Nurturing Care

USAID Advancing Nutrition, September 11, 2019
  • Early Childhood Development
The first 1,000 days between conception and a child’s second birthday is a period of unique development, representing both risk and opportunity. The foundation for a child’s brain is laid during this time, with 799 new neural connections established every second, making it especially vulnerable to external factors, including optimal nutrition, strong social support, and secure attachment. Enhancing the linkages among good nutrition, brain development, and nurturing care can strengthen multi-sectoral programming to improve health and development outcomes. In this webinar, Dr. Sarah Cusick, Assistant Professor in the Department of Pediatrics at the University of Minnesota, provided an overview of how nutrient deficiency in the first 1,000 days can lead to long-term dysfunction and how application of the general principles of nutrient and brain interaction can help inform programming. Patricia Jodrey from USAID’s Child Health Team provided further context through the lens of the Nurturing Care Framework.

IconFood Security and Nutrition in Humanitarian Transition

Research Articles

Effects of Microbiota-directed Foods in Gnotobiotic Animals and Undernourished Children

Gehrig, Jeanette L., Siddarth Venkatesh, How-Wei Chang. Science. July 12, 2019, Vol. 365 (6449)
  • Food Security and Nutrition in Humanitarian Transition
Current treatments for acute malnutrition, including therapeutic complementary foods, are not formulated based on an understanding of how they impact gut microbiota. This may limit their efficacy. This paper examines the links among therapeutic diets, microbiota development, and the growth recovery of children in Bangladesh. It argues that by intentionally identifying and incorporating foods that support healthy microbiota, treatment could be made more effective, affordable, and sustainable.

Leveraging Human Nutrition through Livestock Interventions: Perceptions, Knowledge, Barriers and Opportunities in the Sahel

Dominguez-Salas, Paula, Domitille Kauffmann, Christophe Breyne. Journal of Food Security , August 24, 2019, Vol.11(4): 777–796.
  • Food Security and Nutrition in Humanitarian Transition
Animal source foods can play an important role in improving nutrition, particularly in areas like the Sahel, where livestock is a key dietary resource and source of livelihood. This paper asserts that limited animal source food interventions are incorporated into development programming, using USAID Feed the Future initiatives as an example. The study used interviews and a regional participatory workshop to identify the primary opportunities and barriers for animal source food adoption in development programs based in the West African Sahel. The paper argues that more evidence is needed to effectively link the livestock and nutrition sectors.

Spatial Typology for Targeted Food and Nutrition Security Intervention

Marivoet, Wim, John Ulimwengu, Fernando. Sedano. World Development, August 15, 2019, Vol. 120:62-75
  • Food Security and Nutrition in Humanitarian Transition
Food security programming in developing countries is often challenged by limited access to accurate and current data. This study describes a typology to help programmers identify food security priority areas and target interventions using limited data. The typology classifies interventions based on location and magnitude of nutrition constraints using four indicators: agricultural potential, availability, access, and utilization. This paper suggests that the methodology can be easily adapted to various types of interventions and developing-country contexts to support more focused food security interventions.

IconFood Systems

Research Articles

The Relative Caloric Prices of Healthy and Unhealthy Foods Differ Systematically across Income Levels and Continents

Headey, Derek D., Harold H Alderman. The Journal of Nutrition. July 2019. nxz158.
  • Food Systems
Little is known about the affordability of healthy foods and unhealthy foods in low- and middle-income countries, and how relative price may influence nutrition outcomes. This paper aims to quantify the link between price and dietary indicators and nutrition outcomes. Pulling from existing databases, it determines the relative caloric prices for foods across different categories, such as animal source foods and starchy staples, in 176 countries. The paper then compares food prices across countries to determine if there are associations between affordability and under- and overnutrition.

Trade, Nutrition, and Sustainable Food Systems

Thow, Anne Marie, Nicholas Nisbett. The Lancet. August 31, Vol 394 (10200):716-718.
  • Food Systems
There is global interest in creating trade policy that better supports sustainable and food and nutrition systems. This paper identifies three key starting points to make progress toward this goal: 1) the public health sector should acknowledge that because trade has the potential to enhance as well as hinder health outcomes, it deserves further attention; 2) public health actors need to be better prepared with the right language to push for better policy; and 3) public health actors need to frame nutrition as a social and political issue--not just a technical one--if they want to bring nutrition to the forefront of development.

The Effect of Food Price Changes on Consumer Purchases: A Randomised Experiment

Waterlander, Wilma E., Yannan Jiang, Nhung Nghiem. The Lancet. August 1, Vol. 4(8): 394-405.
  • Food Systems
Governments are increasingly implementing health-related food taxes to reduce consumption of unhealthy foods. Although research indicates that these policies are effective at reducing consumption of a targeted nutrient or food, little is known about their impact on the total diet. This study used a virtual supermarket to emulate different food price and subsidy scenarios and determine the effect of price changes on the consumer's total food basket. The study confirms existing research by demonstrating that food taxes can be used to improve diets, but also indicates a more comprehensive policy approach that combines multiple taxes and subsidies may be most effective.

Reports and Tools

Supporting Nutrition-Sensitive Agriculture through Neglected and Underutilized Species—Operational Framework

Investing in Rural People and Biodiversity International, May 2019
  • Food Systems
Agrobiodiverstiy and neglected and underutilized species have the potential to magnify nutrition-sensitive agriculture and related livelihood outcomes. In this report, Investing in Rural People and Biodiversity International provides an operational framework to help Investing in Rural People project development teams integrate neglected and underutilized species into their activities. Although the guidance is targeted at Investing in Rural People activities, the framework can be more widely used by agriculture and nutrition-sensitive programmers and implementers.

Events

Linking Climate Change, Gender and Nutrition: Approaches, Highlights and the Way Forward

International Food Policy Research Institute, September 17, 2019
  • Food Systems
In this webinar, speakers from the Gender, Climate Change and Nutrition Integration Initiative and the USAID Bureau for Food Security discussed how to integrate resilience, gender, and nutrition into program interventions to maximize development impact. Speakers shared approaches used by the Gender, Climate Change and Nutrition Integration Initiative, which works with USAID headquarters, missions, and partners to ensure they are meeting resilience, nutrition, and gender goals.

IconMonitoring, Evaluation, and Learning/Knowledge Management

Reports and Tools

Capturing Cost Data: A First-mile Problem

World Bank, August 2019
  • Monitoring, Evaluation, and Learning
While there is plenty of guidance circulating on how to conduct a costing analysis, there is limited accessible guidance on how program designers should collect the costing data itself. To remedy this, the Strategic Impact Evaluation Fund of the World Bank is coordinating with other interested groups to develop guidance and case studies on capturing costing data. In this blog post, economist Alaka Holla walks through the preliminary considerations and challenges of collecting cost data.

DataDENT Indicator Mapping Technical Brief

DataDENT, August 2019
  • Monitoring, Evaluation, and Learning
A landscape assessment of nutrition data visualization tools by DataDENT (Data for Decisions to Expand Nutrition Transformation) found that these tools often report on various indicators without uniform definitions. This can lead to differing conclusions and makes it challenging to determine which indicators and tools implementers should use for decision-making and advocacy. In an effort to better understand this challenge, DataDENT summarized the overlaps and differences in indicator definitions across a select set of data visualization tools and nutrition monitoring frameworks. The resulting technical brief links to a blog post and excel spreadsheet of indicators across nutrition data and tools.

Economic Evaluation of Multisectoral Actions for Health and Nutrition

Agriculture, Nutrition & Health Academy, August 2019
  • Monitoring, Evaluation, and Learning
Economic evaluations and metrics related to the costs and benefits of agriculture, food, and livelihood strategies can be highly complex. To bolster understanding of these evaluations, the Agriculture, Nutrition & Health Academy published this technical brief, which discusses economic evaluation typologies, existing economic evaluation guidelines, and the challenges and complexity of cost-benefit measurement in multi-sectoral actions for nutrition and health. The brief also provides researchers with a framework for measuring costs and benefits along the impact pathway and highlights opportunities for further research in light of existing method/metric gaps.

ENN's Multi-Sectoral Nutrition Programme Case Studies

Emergency Nutrition Network, August 2019
  • Knowledge Management
The Emergency Nutrition Network conducted case studies of three “high achieving” SUN countries (Bangladesh, Ethiopia, and Niger) with a strong track record in championing and improving undernutrition at a sub-national level. A synthesis document draws out key lessons and builds on three previous case studies conducted in 2018 in Kenya, Nepal, and Senegal. A brief video also highlights common themes from the six case studies.

Global Data Visualization Tools to Empower Decision-Making in Nutrition

Sight and Life, August 2019
  • Knowledge Management
As part of the Data for Decisions to Expand Nutrition initiative, Results for Development Institute conducted a landscape analysis of global data visualization tools and a literature review of data visualizations. They found that increases in available nutrition data can present challenges such as knowing which data are most critical for decision-making. Data visualization tools should lessen such challenges by serving as the interface between data and data users. After reviewing 22 tools, the authors identified inefficiencies in the data visualization tool landscape. This article suggests ways that improving such tools and their coordination might improve the uptake of data for nutrition decision-making.

Global Health Nutrition Legacy: Save the Children 100 Years

Save the Children, May 2019
  • Knowledge Management
To capture the legacy of its work in global nutrition, Save the Children developed a pithy and colorful report that reviews the organization's efforts to improve the health and nutrition of women, children, and their communities. The document presents global program achievements and leadership, key contributions, and program learning and results. It also outlines priority areas for Save the Children’s next three-year nutrition strategy.

Private Sector in Agricultural Innovation and Development Community of Practice

Capacity4dev.edu, June 2019
  • Knowledge Management
This community of practice, launched in June 2019, showcases examples of and approaches to working with the private sector in international agricultural innovation. Members can discuss topics such as agriculture and rural development, food and nutrition security, and private sector development, and learn about upcoming events. The community is open to the public, but to join the group, potential members must have a Capacity4dev account.

What’s the Cost of Evaluations and Other Surveys?

Data for Impact, April 2019
  • Monitoring, Evaluation, and Learning
Data for Impact helps countries improve their program design, policies, and overall health outcomes through operationalizing the power of data. In this accessible two-pager, Data for Impact provides program implementers with detailed cost and timeline considerations for incorporating evaluations and surveys into program design.

Events

Nutrition 2019 Sessions on Demand

American Society for Nutrition, June 2019
  • Monitoring, Evaluation, and Learning
Professionals who missed Nutrition 2019 in Baltimore, MD, USA, or who would like to find the materials from a session they attended, can find them on the American Society for Nutrition website, where select session recordings are available for free. Topics of interest include “A Cross-Sector Debate to Increase the Consumption of Nutrient Dense Foods,” “Diet Quality, Micronutrient Delivery,” and “Addressing the Four Domains of Sustainable Food Systems Science.” The American Society for Nutrition will continue to post more sessions related to this year’s theme, “Where the Best in Science & Health Meet.”

IconNutrition and Health Systems

Research Articles

Excess Risk of Preterm Birth with Periconceptional Iron Supplementation in a Malaria Endemic Area: Analysis of Secondary Data on Birth Outcomes in a Double Blind Randomized Controlled Safety Trial in Burkina Faso

Bernard et al. Malaria Journal. May 2019. Vol. 18 No. 161
  • Nutrition and Health Systems
To examine the effects of long-term weekly iron supplementation on malaria and genital tract infections in pregnant and non-pregnant women, researchers used secondary data on birth outcomes from a double-blind randomized control trial in Burkina Faso. The analysis examined the effects of long-term weekly iron supplementation on malaria and genital tract infections in pregnant and non-pregnant women. The secondary data researchers examined included ultrasound-dated gestational age, fetal growth, placental malaria, chorioamnionitis, and iron biomarkers. The study found that long-term iron supplementation leads to excess preterm births in the malaria endemic area, especially during the malaria transmission season.

Marketing and Consumption of Commercial Foods Fed to Young Children in Low and Middle-income Countries

Hall et al. (Eds). Maternal & Child Nutrition. June 2019. Vol 15 Issue S4
  • Nutrition and Health Systems
Editorial commentary and supplementary articles on the consumption and marketing of foods fed to young children, including breast milk substitutes, complementary foods, snack foods, and beverages, comprise this journal supplement. The supplement touches on rapidly evolving food environments, television advertisements, monitoring and enforcement of the International Code of Marketing of Breast-milk Substitutes, fortification, and product placement.

Nutritional Interventions for Preventing Stunting in Children (Birth to 59 Months) Living in Urban Slums in Low- and Middle-Income Countries (LMIC)

Goudet, Sophie M., Barry A. Bogin, Nyovani J. Madise, Paula L. Griffiths. Cochrane Systematic Review. June 2019.
  • Nutrition and Health Systems
Researchers systematically reviewed 15 studies conducted in slums or poor urban and periurban areas to determine nutritional interventions that can prevent stunting of infants and young children who are high-risk populations. Despite finding that nutrient supplementation for mothers had no effect on birth weight and length, the authors found that maternal education interventions seemed to improve birth weight. Researchers found inconclusive results around using nutrient supplementation for children and improving health systems to improve stunting status.

Reports and Tools

Addressing Barriers to Exclusive Breastfeeding in Nampula, Mozambique: Opportunities to Strengthen Counseling and Use of Job Aids

USAID’s Maternal and Child Survival Program, June 2019
  • Nutrition and Health Systems
In Nampula, Mozambique, exclusive breastfeeding practices are suboptimal. To reduce breastfeeding challenges in Nampula, the USAID Maternal and Child Health Survival Program conducted a study on the minimum breastfeeding competencies and practical skills needed by Nampula facility- and community-based providers.

The Cost of Not Breastfeeding: Global Results from a New Tool

Walters, Dylan D., Linh T. H. Phan, Roger Mathisen. Health Policy and Planning. July 2019. Vol. 34 Issue 6., pp 407-417.
  • Nutrition and Health Systems
The evidence-based and user-friendly Cost of Not Breastfeeding tool, developed by Alive & Thrive, informs policymakers and advocates of the estimated human and economic costs of not breastfeeding at country, regional, and global levels. The global results from using the tool showed 595,379 childhood deaths and 974,956 cases of childhood obesity can be attributed to not breastfeeding according to recommendations each year. Avoidable morbidity and mortality from not breastfeeding properly translate into global treatment costs, economic losses from premature mortality, and cognitive losses that amount to US$341.3 billion.

Events

Building Healthy Communities at Home and Abroad: Catalyzing the Impact of the U.S. Government’s Efforts to Support Breastfeeding Families

U.S. Government Global Nutrition Coordination Plan, August 13, 2019, Washington, DC
  • Nutrition and Health Systems
As a leader in global nutrition and development, the U.S. Government recognizes the critical role that the 1,000-day window between pregnancy and a child’s second birthday has on child growth, cognitive development, and disease prevention. In honor of World Breastfeeding Week and National Breastfeeding Month, the U.S. Government Global Nutrition Coordination Plan hosted an event in Washington DC on August 2019 to bring together U.S. Government departments and agencies, implementing partners, external stakeholders, civil society, and other breastfeeding advocates. Participants discussed skilled support for breastfeeding as well as U.S. Government investments supporting families to breastfeed in the workplace and in communities.

IconSocial and Behavior Change

Research Articles

Fathers’ Experiences and Perspectives of Breastfeeding: A Scoping Review

Sihota, Harvinder, John Oliffe, Mary T. Kelly, Fairleth McCuaig. American Journal of Men’s Health. May 2019.
  • Social and Behavior Change
The researchers conducted a scoping review across 18 international studies to determine the experiences, roles, and needs of fathers of breastfed infants and how health care providers can use this knowledge to assist, support, and engage fathers. Examining studies that involved fathers in the United Kingdom, North America, Australia, Pakistan, Jordan, and Taiwan, the review found that fathers of children who are breastfed may feel excluded, inadequate, and helpless. To help these fathers, antenatal support and education should be tailored their needs, experiences, and perceptions. Fathers must be recognized as “fundamental members of the breastfeeding triad” and be engaged from the beginning to promote long-term involvement in their children’s nutrition.

Grab a Seat! Nudging Providers to Sit Improves the Patient Experience in the Emergency Department

Orloski, Clinton J., Erica R. Tabakin, Frances S. Shofer, Jennifer S. Myers, Angela M. Mills. Journal of Patient Experience. June, 2019. Vol. 6 No. 2, pp. 110-116.
  • Social and Behavior Change
Are patients in the emergency department more satisfied during a visit if the provider sits and are there ways to encourage providers to sit? These are the questions researchers sought to answer in a prospective, controlled pre-post trial. They found that when a provider sat at some point during the visit, patient satisfaction significantly increased. Satisfaction was measured by patient responses to questions about their provider. When a seat was placed in the room with the provider, the odds of the provider sitting increased by 30 percent.

Is Women’s Empowerment a Pathway to Improving Child Nutrition Outcomes in a Nutrition-Sensitive Agriculture Program?: Evidence from a Randomized Controlled Trial in Burkina Faso

Heckert, Jessica, Deanna K. Olney, Marie T. Ruel. Social Science & Medicine. July, 2019. Vol. 233, pp. 93-102.
  • Social and Behavior Change
Women's empowerment is thought to be a critical component in improving household nutrition. To test this theory, researchers used a cluster-randomized controlled trial in Burkina Faso that examined whether empowering women in four domains--purchasing decisions, healthcare decisions, family planning decisions, and spousal communication--improves child nutritional outcomes. The trial used reduction in wasting and an increase in hemoglobin as proxies for improved nutritional outcomes. The researchers found that all four domains contributed to a reduction in wasting; however, none of the domains contributed to an increase in hemoglobin. These findings should lead future nutrition-sensitive programs to incorporate women’s empowerment mechanisms to improve child nutritional status.

Participatory Agroecological Research on Climate Change Adaptation Improves Smallholder Farmer Household Food Security and Dietary Diversity in Malawi

Kerr et al. Agriculture, Ecosystems & Environment. July 2019. Vol. 279, pp 109-121.
  • Food Systems
  • Monitoring, Evaluation, and Learning
  • Social and Behavior Change
This four-year mixed-methods study examined the effect that agroecological farming practices can have on food security and dietary diversity in Malawi. Intercrops and crop diversification increased household food security. Use of organic soil amendments, which lessen the chance of metal accumulation by plants, resulted in increased dietary diversity. The researchers also found that when spouses discuss farming, they are 2.4 times more likely to have both food security and dietary diversity. Participatory agroecology research approaches that promote farmer experimentation and community-based education on gender equity can improve food security and nutrition.

Using a Gender Lens to Understand Eating Behaviors of Adolescent Females Living in Low-income Households in Bangladesh

Blum et al. Maternal & Child Nutrition. May 2019.
  • Social and Behavior Change
To understand individual, social, and environmental factors that influence eating behaviors of adolescent females in Bangladesh, researchers conducted this qualitative study, which found that household food insecurity, gender norms and discrimination, work and school schedules, and an inferior social position influence girls' level of psychological stress as well as food quality, quantity, and frequency. The study found that household food insecurity, gender norms and discrimination, work and school schedules, and an inferior social position influence their level of psychological stress as well as food quality, quantity, and frequency. To decrease adolescent girls’ vulnerability to undernutrition, the study proposes: 1) policies to increase the age of marriage and reduce adolescent pregnancy, 2) programs to ensure adolescents attending school receive adequate nutrition during the day, and 3) methods for prolonging school education to strengthen their economic viability and alter cultural expectations.

Reports and Tools

Essential Nutrition Actions: Mainstreaming Nutrition throughout the Life-Course

WHO, September 2019
  • Nutrition and Health Systems
  • Social and Behavior Change
The World Health Organization has released updated Essential Nutrition Actions to mainstream nutrition throughout the life-course and support the Global Nutrition Targets 2025. In an easy-to-use format, this document describes actions that can be taken to combat all forms of malnutrition and help decision-makers integrate nutrition interventions into national health policies, strategies, and plans based on country-specific needs and global priorities.