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 Systems Monitoring, Evaluation, and
Learning/Knowledge Management Nutrition and
Health Systems Nutrition in
Humanitarian Contexts Social and
Behavior Change

January 2020

IconEarly Childhood Development

Research Articles

Do Effects of Early Life Interventions on Linear Growth Correspond to Effects on Neurobehavioural Development? A Systematic Review and Meta-Analysis

Prado, Elizabeth L., Leila M. Larson, Katherine Cox, et al. The Lancet, Vol. 7, Issue 10, October 10, 2019
  • Early Childhood Development
Linear growth and child development are often assumed to have common determinants. The authors assess this assumption through a systematic review and meta-analysis of interventions focused on length-for-age or height-for-age Z scores and child development outcomes for children 0-5 years old and during pregnancy. The researchers found that the determinants of linear growth and neurodevelopment are only partly shared; therefore, interventions should target determinants of both, if children are to thrive.

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Reports and Tools

The Case for Early Child Development Programmes (a Review of the Documentary "Brain Matters")

Mushtaq, Ammara, Farooq Kazi. The Lancet Child & Adolescent Health. September 25, 2019. "Brain Matters," Directed by Carlota Nelson, L9 Goodies, 2019. 72 min
  • Early Childhood Development
This “Reflections” article reviews the recently released documentary by Carlota Nelson, Brain Matters. The film focuses on the first three years of life when a baby’s brain is optimized for learning, highlighting evidence that child development interventions during this period yield lifetime developmental benefits. The film details four essential “brain boosting experiences” during this period, including responsive care, language stimulation, opportunities for play, and good nutrition. The review concludes that the film offers a compelling argument in support of ECD programs.

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Nurturing Care for Small and Sick Newborns: Evidence Review and Country Case Studies

Every Preemie-SCALE/Project, Maternal and Child Survival Program, August 2019
  • Early Childhood Development
  • Nutrition and Health Systems
Small and sick newborns face serious risk of developmental delays, but most newborns can survive and thrive, provided they have access to quality nurturing care. This package summarizes nurturing care evidence and best practices for this population. It includes an updated evidence review of the core elements of developmentally supportive, family-centered, and nurturing care; implementation experience from seven countries with high-, middle- and low-income settings; and a gap analysis to inform future research.

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IconFood Systems

Research Articles

Affordability of the EAT-Lancet Reference Diet: A Global Analysis

Hirvonen, Kalle, Yan Bai, Derek Headey, et al. The Lancet. November 7, 2019
  • Food Systems
The EAT-Lancet Commission created a global benchmark diet capable of both sustaining health and protecting the environment, but did not examine the diet’s affordability. This analysis strives to understand the diet’s cost around the world by comparing food price and household income data from 159 countries. Findings show that for 1.58 billion people worldwide, the benchmark diet is too expensive for daily incomes to support.

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Reports and Tools

Empowering Women in Livestock Systems (Infographic)

Feed the Future Innovation Lab for Livestock Systems, November 2019
  • Food Systems
Around the world women make up two-thirds of livestock keepers, yet they often lack access to and control over these resources. This infographic shows different ways women can be empowered across food systems and provides examples of Feed the Future activities working to do so in a variety of countries.

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Guiding Principles for Sustainable Healthy Diets

FAO and WHO, October 2019
  • Food Systems
To celebrate this year’s World Food Day, the United Nations Food and Agriculture Organization and the World Health Organization published this document to provide policy recommendations for food systems that are healthy, environmentally friendly, and culturally and economically sustainable. The recommendations encompass a wide range of topics from nutrient intake goals to exclusive breastfeeding to reducing carbon footprints. The authors hope the guidelines will help facilitate the global drive toward sustainable consumption.

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The State of Food and Agriculture 2019: Moving Forward on Food Loss and Waste Reduction

FAO, October 2019
  • Food Systems
In 2011, the United Nations Food and Agriculture Organization (FAO) estimated that 30 percent of food is lost or wasted globally. The FAO is now in the process of replacing that figure with two Sustainable Development Goal indices that more precisely account for how much food is lost from the farm up to retailers and how much is wasted by consumers or retailers. The 2019 State of Food and Agriculture report includes early estimates using these indices and also analyzes how to address food loss and waste taking into account geography, production vs. consumption, and supply chains.

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Events

Food System Transformations: National Actions in a Globalized World

IFPRI, November 2019
  • Food Systems
As global and regional events contribute to the rapid transformation of food systems in developing countries, country actors are playing an essential role in shaping the future of their own food systems. In this seminar, representatives from Nigeria and Viet Nam discussed their experiences with private sector engagement and policy change respectively. In addition, representatives from the World Bank, USAID, and the CGIAR Research Program on Agriculture for Nutrition and Health spoke about ways to develop food systems that are healthy, sustainable, and equitable.

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Food Systems and Nutrition E-Consultation: Emerging Evidence and Research Opportunities

Agrilinks, November 2019
  • Food Systems
To help uncover research gaps in food systems and nutrition, Agrilinks, USAID Advancing Nutrition, and USAID’s Bureau for Food Security hosted an e-consultation in November 2019. Discussions across four themes focused on an evidence review by the USAID Feed the Future Innovation Lab for Nutrition. Participants from around the world discussed research priorities to build evidence for nutritious food systems, resulting in a collection of useful resources while also shaping the future food systems research agenda.

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IconMonitoring, Evaluation, and Learning/Knowledge Management

Research Articles

The Burden of Child and Maternal Malnutrition and Trends in Its Indicators in the States of India: The Global Burden of Disease Study 1990–2017

India State-Level Disease Burden Initiative Malnutrition Collaborators. The Lancet Child & Adolescent Health, Vol. 3, Issue 12, December 2019
  • Monitoring, Evaluation, and Learning
  • Nutrition and Health Systems
To inform subnational nutrition actions in India, researchers analyzed the burden of disease due to malnutrition and trends in malnutrition indicators from 1990 to 2017 in every Indian state as part of Global Burden of Diseases, Injuries, and Risk Factors Study 2017. Examining trends in relation to Indian and global nutrition targets, the authors found that malnutrition is still the leading risk factor for disease burden in India and the predominant risk factor for death in children younger than 5 years of age. This type of analysis could be useful in other low- and middle-income countries to track and motivate progress toward reducing malnutrition.

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Drivers of Under-Five Stunting Trend in 14 Low- and Middle-Income Countries since the Turn of the Millennium: A Multilevel Pooled Analysis of 50 Demographic and Health Surveys

Argaw, Alemayehu, Giles Hanley-Cook, Nathalie De Cock, et al. Multidisciplinary Digital Publishing Institute, September 5, 2019
  • Monitoring, Evaluation, and Learning
  • Social and Behavior Change
Analyzing data from 50 Demographic and Health Surveys in 14 different countries since 2000, the authors of this study sought to detect trends in stunting and potential contributing factors. Their research found a decreasing trend in stunting among all countries. Factors such as improvement in women’s decision-making, increasing urbanization, and children's access to basic vaccinations were significantly associated with the decreasing trend and reinforce the need for a combination of nutrition-sensitive and -specific interventions. Findings from such analyses may help guide global efforts to reduce stunting and monitor progress against chronic childhood undernutrition.

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The Implications of Three Major New Trials for the Effect of Water, Sanitation and Hygiene on Childhood Diarrhea and Stunting: A Consensus Statement

Cumming, O., B.F. Arnold, R. Ban, et al. BMC Med 17, 173, 2019
  • Early Childhood Development
  • Nutrition in Humanitarian Contexts
  • Food Systems
  • Knowledge Management
  • Monitoring, Evaluation, and Learning
  • Nutrition and Health Systems
  • Social and Behavior Change
With the results from the SHINE and WASH Benefits trials demonstrating limited impact of basic water, sanitation, hygiene (WASH) on childhood stunting, what role does WASH now play in multi-sectoral nutrition programming? Following the studies, the World Health Organization and the Bill and Melinda Gates Foundation convened experts to reach a consensus on five key messages in response to the new evidence. This consensus statement details those five messages.

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Progress in Reducing Child Mortality and Stunting in India: An Application of the Lives Saved Tool

Alderman, Harold, Phuong Hong Nguyen, Purnima Menon. Health Policy and Planning Journal, Vol. 34, Issue 9, November 2019
  • Monitoring, Evaluation, and Learning
The Lives Saved Tool (LiST) enables policymakers and technical stakeholders to estimate the impact of scaling up intervention coverage on undernutrition and mortality. This study used LiST to model the impact of scaling up programs in India between 2006 and 2016 and subsequently compared them to the observed impact during the same time period. Although estimates from the use of the LiST tool were close to actual values observed, there remain challenges with the tool itself and its applications.

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Reports and Tools

The Asia Food Challenge: Harvesting the Future

PWC, Rabobank, and Temasek, November 2019
  • Food Systems
  • Knowledge Management
The authoring organizations of this report foresee significant changes to Asia’s food and agricultural landscapes, with food spending expected to increase by around 7 percent per year over the next decade. As a collective call to action, the report outlines various opportunities for investment and innovation in key cities around Asia deemed “Agri-Food Tech Investment and Innovation Hubs.”

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The Changing Face of Malnutrition: The State of the World’s Children 2019

UNICEF, October 2019
  • Food Systems
  • Knowledge Management
  • Monitoring, Evaluation, and Learning
This year, UNICEF’s flagship report focuses on children, food, and nutrition, providing new data and analysis on malnutrition and making recommendations for keeping food systems anchored in children’s rights. Examining the “triple burden” of malnutrition—undernutrition, hidden hunger, and overweight—the report describes the “broken food system” at the center of the problem and the economic costs of malnutrition. It is accompanied by regional briefs and an interactive web feature.

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Innovations and Tools in Child Growth Measurement and Data Visualization

International Bank for Reconstruction and Development/The Global Financing Facility, November 2019
  • Knowledge Management
Making the case for why we need better tools to measure child growth, this publication presents promising technological interventions. It also outlines major challenges to reliable and accurate measurement and discusses the pros and cons of tools that might both address these challenges and aid in data visualization.

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The State of Food Security and Nutrition in the World 2019: Safeguarding against Economic Slowdowns and Downturns

FAO, IFAD, UNICEF, WFP and WHO, July 2019
  • Nutrition in Humanitarian Contexts
  • Knowledge Management
  • Monitoring, Evaluation, and Learning
The 2019 edition of this annual report indicates that the number of people who suffer from hunger, overweight, and obesity continues to rise, while many people also experience moderate food insecurity. New evidence linking economic downturns to food insecurity and malnutrition is highlighted. To help monitor progress toward ending malnutrition, the report includes estimates of food insecurity prevalence based on the Food Insecurity Experience Scale (FIES). The authors conclude by recommending policies that both address the underlying causes of malnutrition—poverty, inequality, and marginalization—and also safeguard food security and nutrition against economic slowdowns.

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Events

If You Can't Measure It, You Can't Improve It: Experiences and Insights on Social Norms Measurement

The Learning Collaborative to Advance Normative Change, November 2019
  • Monitoring, Evaluation, and Learning
  • Social and Behavior Change
Experts from Drexel University, CARE USA, UNICEF, and Emory University presented an overview on the state of social norms measures, building on the recently published guide titled Resources for Measuring Social Norms: A Practical Guide for Implementers. The panelists also examined advancements in measuring social norms and shared various frameworks for designing measurement tools. Challenges in social norms measurement methods and the monitoring of social behaviors were also discussed.

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IconNutrition and Health Systems

Research Articles

Child-Sensitive WASH Composite Score and the Nutritional Status in Cambodian Children

Manzoni, G., A. Laillou, C. Samnang, et al. Nutrients. September 2019. Vol. 11 No. 9
  • Nutrition and Health Systems
Despite progress in health over the years in Cambodia, the number of malnourished children remains high, which may be associated in part with poor water, sanitation and hygiene (WASH) practices. To address gaps in knowledge on the association between WASH practices and the nutritional status of children, this study analyzed the relationship between WASH child-sensitive composite scores and the wasting child anthropometry indicators. The authors found a significant association, reinforcing existing knowledge of the need to align WASH and nutrition practices.

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Facility‐ and Community‐based Delivery of Micronutrient Powders in Uganda: Opening the Black Box of Implementation Using Mixed Methods

D’Agostino, Alexis, Francis Ssebiryo, Hillary Murphy, et al. Maternal & Child Nutrition. Vol. 15, Issue 55, October 17, 2019
  • Nutrition and Health Systems
  • Social and Behavior Change
The authors of this study sought to fill a gap in the documentation of lessons learned in micronutrient powder (MNP) implementation programs. To do so, they used a mixed method evaluation to compare community- and facility-based delivery of MNP and document users’ experiences. Their findings rely on qualitative and quantitative evidence to show that community-based delivery resulted in significantly higher adherence to MNP programs. They also analyze barriers to MNP use and provide predictors of adherence to MNP programs.

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Impact on Child Acute Malnutrition of Integrating a Preventive Nutrition Package into Facility-Based Screening for Acute Malnutrition during Well-Baby Consultation: A Cluster-Randomized Controlled Trial in Burkina Faso

Becquey, E., L. Huybregts, A. Zongrone, et al. PLoS Medicine. Vol. 16 No. 8. August 2019
  • Nutrition and Health Systems
  • Social and Behavior Change
Community management of acute malnutrition (CMAM) is an effective approach for treating acute malnutrition (AM), but low (50 percent) screening levels for AM impede effectiveness of CMAM. Scaling up screening coverage to 90 percent of acutely malnourished children could save 435,000 lives per year. In this cluster-randomized control trial in Burkina Faso, researchers studied the impact of behavior change communication preventative packages and the use of small-quantity lipid-based nutrient supplements on screening rates. Findings showed that these interventions increased participation in monthly AM screening, thus overcoming a major impediment to CMAM effectiveness. 

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Reports and Tools

Maternal Nutrition Operational Guidance Program Considerations for Low- and Middle-Income Countries

Maternal and Child Survival Program, September 2019
  • Nutrition and Health Systems
Developed by USAID’s Maternal and Child Survival Program, this practical guidance document is meant to help ministries of health, nongovernmental organizations, and implementing partners working in low- and middle-income countries design, implement, and strengthen the delivery of maternal nutrition interventions during pregnancy and lactation within the health system. It includes step-by-step guidance on how to add maternal nutrition interventions, precedent case studies on maternal nutrition, an antenatal care schedule, and quality of care standards, among other resources.

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IconNutrition in Humanitarian Contexts

Research Articles

“System of Hunger”: Understanding Causal Disaster Vulnerability of Indigenous Food Systems

Jackson, Guy, Karen E. McNamara, Bradd Witt. Journal of Rural Studies. November 4, 2019
  • Nutrition in Humanitarian Contexts
Indigenous food systems are vulnerable to hazards that cause food insecurity. In indigenous contexts, particular care needs to be taken to account for unique cultural and social systems. Researchers have looked at the Bedamuni tribe in Papua, New Guinea and developed a food system causal disaster vulnerability framework that can help program planners, nongovernmental organizations, and policy makers reduce vulnerability and increase the resilience of indigenous food systems.

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Reports and Tools

Guidance for Assessing Resilience in Market Systems

USAID, September 2019
  • Nutrition in Humanitarian Contexts
Resilience has become a high-level objective for many nutrition projects. Though most resilience guidance focuses on the household or community, population-level resilience is heavily reliant on the strength and functionality of market systems through periods of shock or stress. This tool provides guidance on integrating market systems resilience into program analysis and implementation.

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Nutrition in Africa’s Drylands: A Conceptual Framework for Addressing Acute Malnutrition (Draft)

Feinstein International Center, Friedman School of Nutrition Science and Policy at Tufts University, October 2019
  • Nutrition in Humanitarian Contexts
East Africa and the Sahel’s drylands present a unique context for implementation. Regime instability, climate change, and shifts in traditional pastoral ways of life mean that stakeholders need a new way to view these regions. This brief examines and expands upon UNICEF’s malnutrition causal framework to respond to these changing circumstances. The new framework captures how climate and conflict are essential in gauging the underlying causes of malnutrition in the region. An accompanying webinar provides further detail.

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Transfers, Nutrition Programming, and Economic Well-being: Experimental Evidence from Bangladesh

IFPRI, October 2019
  • Nutrition in Humanitarian Contexts
Little research has been conducted on how leveraging cash transfers with nutrition interventions could impact household economic well-being. This study examined a program in Bangladesh that offered impoverished women transfers of cash and food with and without nutrition behavior change communication. Findings suggest that cash transfers combined with behavior change communications increase not only consumption at the household level, but also household assets through investments.

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Twin Peaks: The Seasonality of Acute Malnutrition, Conflict, and Environmental Factors

Feinstein International Center, Friedman School of Nutrition Science and Policy at Tufts University, November 2019
  • Nutrition in Humanitarian Contexts
According to a long-held assumption about the seasonality of food security in Chad, Sudan, and South Sudan, the peak of malnutrition happens at the end of the lean season. This report finds that there are actually two peaks, with the worst occurring at the end of the dry season and a smaller peak at the end of the lean season. Other findings reinforce how climate and conflict lead to prolonged shocks to livelihoods.

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IconSocial and Behavior Change

Research Articles

Commonly Applied Social-Behavior Change Techniques Used in Complementary Feeding Programs in Low and Middle Income Countries: A Scoping Review

Webb, Girard A., E. Waugh, S. Sawyer, et al. Maternal and Child Nutrition. August 6, 2019
  • Nutrition and Health Systems
  • Social and Behavior Change
An examination of literature on complementary feeding interventions in lower- and middle-income countries since 2000, this scoping review considered 64 behavior change interventions. Across the interventions, authors identified 28 out of a possible 93 behavior change techniques (BCTs), estimating effectiveness ratios for each. Certain BCTs showed promise and warrant further evaluation. Reviewers called for further implementation science research around BCTs and more publically available intervention details on the use of BCTs to optimize and scale up complementary feeding interventions.

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Degree of Exposure to Interventions Influences Maternal and Child Dietary Practices: Evidence from a Large-Scale Multisectoral Nutrition Program

Suresh, Shalini, Anne Paxton, Bhim Kumari Pun, et al. PLoS ONE. August 26, 2019
  • Nutrition and Health Systems
  • Social and Behavior Change
Suaahara II is a multi-sectoral program created to combat the high prevalence of maternal and child malnutrition in Nepal. Looking at cross-sectional data from an annual monitoring survey, this review analyzes the association between exposure to Suaahara II and dietary diversity, focusing on three behavior change intervention platforms. The authors concluded that interpersonal communication and community mobilization programs are essential precursors for mass media to effectively change behaviors related to dietary diversity.

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Effects of Nutritional Supplementation and Home Visiting on Growth and Development in Young Children in Madagascar: A Cluster-Randomised Controlled Trial

Galasso, Emanuela, Ann M. Weber, Christine P. Stewart, et al. The Lancet, Vol. 7, Issue 9, September 1, 2019
  • Nutrition and Health Systems
  • Social and Behavior Change
In this cluster-randomized control trial in Madagascar, researchers assigned 3,738 mothers who were pregnant or had children under 11 months old to five different intervention groups within a larger scale community-based nutrition program. The groups were used to test growth-monitoring and promotion, varied intensity of nutrition counseling by community health workers, and different lipid-based nutritional supplementation (LNS) interventions. The study found that LNS supplementation over 12 months helped growth only if begun at 6 months of age. Authors suggest that early stimulation messages and home visits did not have an impact due to low uptake of behavior-change messages.

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Ethiopian Mothers' Experiences with Micronutrient Powders: Perspectives from Continuing and Noncontinuing Users

Pelto, Gretel H., Alison Tumilowicz, Courtney H. Schnefke, et al. Maternal & Child Nutrition, Vol. 15, Issue S5. October 17, 2019
  • Nutrition and Health Systems
  • Social and Behavior Change
To respond to deficiencies in the diets of children 0-23 months old, the Federal Ministry of Health in Ethiopia worked with partner organizations to deliver micronutrient powders (MNP) through health extension workers. Researchers conducted ethnographic interviews with caregivers who were part of this trial, focusing on their experiences using MNP and barriers to use. The findings emphasize the need to help caregivers navigate negative child reactions to MNP and call for additional research on taste preferences and mother-child interactions around food with and without MNP in resource‐constrained environments. 

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Information Diffusion and Social Norms Are Associated with Infant and Young Child Feeding Practices in Bangladesh

Nguyen, Phuong H., Edward A. Frongillo, Sunny S. Kim, et al. The Journal of Nutrition. Vol. 149, No. 11. November 2019
  • Nutrition and Health Systems
  • Social and Behavior Change
Researchers conducted two rounds of surveys in 2,000 Bangladeshi households to examine the diffusion of infant and young child feeding (IYCF) messaging through interventions targeting mothers’ social networks. Based on their findings, the authors propose that diffusion of IYCF information through social networks, bolstered by positive social norms for messages promoted over time, will positively affect changes in IYCF practices.

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