USAID Advancing Nutrition has compiled resources on capacity strengthening; early childhood development; food systems; knowledge management; monitoring, evaluation, and learning; nutrition and health services; nutrition in humanitarian contexts; and social and behavior change. Many resources also provide insights about programming in the context of COVID-19. Have a resource to share? Let us know ›

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Capacity Strengthening Early Childhood
Development Food Systems Knowledge Management Monitoring, Evaluation,
and Learning Nutrition and
Health Systems Nutrition in
Humanitarian Contexts Social and
Behavior Change

December 2020

IconCapacity Strengthening

Research Articles

Research, Development and Capacity Building for Food and Nutrition Security in Sub-Saharan Africa

Jideani, Afam I. O. International Journal of Food Studies, October 2020
  • Capacity Strengthening
Improving food and nutrition security requires broad access to secondary, tertiary, and vocational education and skill development training, and women’s leadership and engagement in training. It also requires commitment to research and development, biotechnology, indigenous knowledge, and information and communication technologies. Greater financial and technical support will strengthen national and regional institutions, increase agricultural output, and improve the efficiency of delivering goods and services.

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A Review of Leadership and Capacity Gaps in Nutrition-Sensitive Agricultural Policies and Strategies for Selected Countries in Sub-Saharan Africa and Asia

Aryeetey, Richmond, Namukolo Covic. Food and Nutrition Bulletin, September 2020
  • Capacity Strengthening
In assessing the degree to which agricultural policies, programs, and investments are nutrition-sensitive, authors argue that there is limited capacity to translate policy and program instruments into effective action. This article is behind a paywall.

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Reports and Tools

An Approach to Building Equitable Global Health Research Collaborations

Murray, Megan, Joel Mubiligi. Annals of Global Health, October 2020
  • Capacity Strengthening
The authors present a model for developing productive, equitable research partnerships between researchers and practitioners from high- and low-income countries. Model elements include mission and goal alignment, meaningful training and mentoring, capacity building, and co-authorship principles.

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Transforming Capacity-Strengthening in an Era of Sustainable Development

Heerdegen, Anne Christine Stender. International Journal of Public Health, October 2020
  • Capacity Strengthening
District health managers (DHMs) are charged with turning policies and resources into accessible and high-quality health services, but resource uncertainty and limited decision-making authority limit their ability to do so. Successful capacity strengthening requires understanding individual, organizational, and contextual factors that influence the work of DHMs. Collaborating with DHMs and other local stakeholders using a systemic and participatory approach will generate culturally appropriate and contextualized approaches to reduce bottlenecks and inefficiencies.

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Events

Decolonizing Global Health: Perspectives from Nurses and Midwives

Seed Global Health Frontline Health Workers Coalition, IntraHealth International, and the Nurses Lead | Midwives Lead, September 2020
  • Capacity Strengthening
Panelists discuss the history of communities most affected by interventions being left out of priority setting, funding structures, program design, and implementation. They outline steps to dismantle these inequities and ensure that future policy and programmatic work is community-led, responsive, and people-centered. This is a webinar.

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USAID Local Capacity Development Policy

United States Agency for International Development Learning Lab, October 2020
  • Capacity Strengthening
Core local development policy principles include responding to local priorities, leveraging local strengths and assets, being mindful of and mitigating unintended consequences of engagement, and nurturing local ownership through partnerships based on mutuality. 

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USAID Local Capacity Development Policy Webinar

United States Agency for International Development Learning Lab, October 2020
  • Capacity Strengthening
This presentation discusses the rationale for and development of the agency-wide local capacity development policy cited above. Core policy principles include developing diverse capacities by responding to local priorities, leveraging local strengths and assets, being mindful of and mitigating unintended consequences of engagement, and nurturing local ownership through partnerships based on mutuality.

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IconEarly Childhood Development

Research Articles

Differential Influences of Early Growth and Social Factors on Young Children’s Cognitive Performance in Four Low-and-Middle-Income Birth Cohorts (Brazil, Guatemala, Philippines, and South Africa)

Richter, L.M., F. M. Orkin, L.S. Adair. et al. SSM-Population Health, December 2020
  • Early Childhood Development
Research demonstrates that parental education and household resources have a greater impact on childhood cognition than birth weight and early linear growth. Improving children’s cognitive functioning requires multi-sectoral interventions to strengthen parental education and economic wellbeing.

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Group Sessions or Home Visits for Early Childhood Development in India: A Cluster RCT

Grantham-McGregor, Sally, Akanksha Adya, Orazio Attanasio, et al. Pediatrics, December 2020
  • Early Childhood Development
This randomized control trial found that weekly home visits and mother-child group sessions, both of which included nutritional education, had an equal effect on cognition and language. Because of their lower per-child cost, group sessions are more scalable than home visits. This article is behind a paywall.

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Reorienting Nurturing Care for Early Childhood Development during the COVID-19 Pandemic in Kenya: A Review

Shumba, Constance, Rose Maina, Gladys Mbuthia, et al. International Journal of Environmental Research and Public Health, September 2020
  • Early Childhood Development
To mitigate the effects of COVID-19 on children and their caregivers, authors advocate for full financing and operationalization of service provision that transcends COVID-19 barriers and addresses health, social and child protection, economic protection, and child development. Recommended strategies include providing cash transfers and essential supplies to vulnerable households, strengthening community-based platforms for nurturing care, and conducting research on the social, mental, and physical health consequences of the pandemic.

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Reports and Tools

Advocacy Toolkit – Nurturing Care

World Health Organization, UNICEF, and World Bank, October 2020
  • Early Childhood Development
The toolkit provides materials for those seeking to advocate for increased attention to and investment in early childhood development include country profiles, case studies, examples of advocacy best practices, key messages, quotes that capture the critical elements of nurturing care, a detailed explanation of nurturing care, and answers to frequently asked questions.

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Monitoring Children's Development in Primary Care Services

World Health Organization, October 2020
  • Early Childhood Development
This report presents guidance on multi-domain developmental assessments, observation and screening for cerebral palsy, vision and hearing difficulties, and the integration of family and community factors in developmental counseling and monitoring. It also calls for services that support early childhood development to be organized according to the continuum of care, and for caregiver mental health.

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IconFood Systems

Research Articles

Food Systems Everywhere: Improving Relevance in Practice

Brouwer, Inge D., John McDermott, Ruerd Ruben. Global Food Security, September 2020
Food systems frameworks require greater consistency. Beyond food production, agri-food supply chains, and the market and institutional food environment, a greater understanding of the social, economic, biological, and psychological determinants of food choices is important. Other important factors for decision makers to understand are the relationships among nutrition, health, and the burden of diseases; the political economy; power dynamics; and gender differences.

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The Trade-Offs of Healthy Food from Sustainable Agriculture in the Global South

Balié, Jean. Global Food Security, September 2020
  • Food Systems
The framework addresses policy trade-offs between food security, prosperity, environmentally significant policy and market reforms, and tailored public interventions. Policymakers must make decisions about which targets should be met first and which have to be postponed. This article is behind a paywall.

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Reports and Tools

Future Food Systems: For People, Our Planet, and Prosperity

The Global Panel on Agriculture and Food Systems for Nutrition, September 2020
  • Food Systems
Food systems require fundamental transformation to promote sustainable healthy diets for all, and must focus on food availability, accessibility, affordability, and desirability. While much focus is on low- and middle-income countries (LMIC), high-income countries also have a vital role, particularly when their decisions affect LMICs. Policies must make sustainable, nutrient-rich, and staple goods available to all, ensure value chains improve accessibility and lower costs, and empower consumers to make informed choices to increase demand for healthy, sustainable diets.

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A Research Vision for Food Systems in the 2020s: Defying the Status Quo

Fanzo, Jessica, Namukolo Covic, Achim Dobermann, et al. Global Food Security, September 2020
  • Food Systems
Food systems research and science to ensure that food is accessible, sustainable, safe, healthy, and equitable is critical and must be quickly translated into policy and action. COVID-19 further highlights the importance of governance, efficiency, resilience, functionality of food systems, and the strong interconnections between food and health. Research should focus on price volatility, ethics, governance, biofuels, biodiversity and ecosystem services, drivers of dietary choice, high-tech agriculture, zoonotic diseases, and social protection.

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IconKnowledge Management

Research Articles

Challenges and Opportunities in Measuring Knowledge Management Results and Development Impact (Part 2)

Knowledge Management for Development Journal, September 2020
  • Knowledge Management
These papers discuss a framework for measuring the impact of organizational learning and adaptive management, the benefits of using a relative return on investment paradigm, knowledge management (KM) solutions as applied to work processes, measuring KM capacities to strengthen health systems, the institutionalization of KM strategies in agricultural research, and the use of critical discourse analysis for policy analysis and mentoring in KM.

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Reports and Tools

CLA in the Time of COVID-19: Adapting, Pivoting and Partnering to Maintain Nutrition Progress

United States Agency for International Development Learning Lab, October 2020
  • Knowledge Management
The USAID framework for Collaborating, Learning, and Adapting supports partners to adapt during unanticipated challenges using real-time evidence. This blog post describes how USAID Advancing Nutrition used the CLA framework to create an internal COVID-19 task force and working groups that monitored and disseminated emerging information, synthesized best practices for virtual engagement, developed guidance for remote data collection, and helped project teams develop new skillsets to support quick pivots in operational and technical work in response to the pandemic.

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Dangerous Assumptions #1: More Income = More Food and Nutrition Security?

WOTRO Science for Global Development, September 2020
  • Knowledge Management
There is a lack of consensus about whether income alone leads to greater food and nutrition security. Some argue that higher incomes lead nations to focus on other priorities at the expense of food production and nutrition, while others believe that higher incomes lead to greater access to inputs and land, which in turn leads to higher-quality food production. Experts agree that when women have access to their own income, food and nutrition security increase for the entire family. This is a 27-minute podcast.

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Stronger With Breast Milk Only

UNICEF, World Health Organization, Alive & Thrive, Le Fonds Français Muskoka, Italian Agency for Development Cooperation, Bill & Melinda Gates Foundation, n.d.
  • Knowledge Management
This initiative promotes giving babies breastmilk only from their birth through the first six months of life. Materials include presentations, calls to action, questions and answers, and fact sheets. All materials are available in English and French.

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Events

Revisiting the Evidence on Kwashiorkor Malnutrition

Tufts Friedman School of Nutrition Science and Policy, October 2020
  • Knowledge Management
Researchers and practitioners review recent evidence related to kwashiorkor, including  treatment, diet, and associated biochemical mechanisms, overt signs, and the metabolic and biochemical characterization of kwashiorkor. This is a series of three webinars.

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IconMonitoring, Evaluation, and Learning

Research Articles

Catch-up Growth is a Better Indicator of Undernutrition than Thresholds for Stunting

Scheffler Christiane, Barry Bogin, Michael Hermanussen. Public Health Nutrition, September 2020
  • Monitoring, Evaluation, and Learning
This cross-sectional study among rural and urban populations with different socio-economic status found that the catch-up growth spurt following a nutrition intervention is a more sensitive indicator of past undernourishment than static thresholds for stunting. Absence of catch-up growth following re-feeding strongly indicates non-nutritional causes of stunting, including education levels and social, economic, political, and emotional circumstances.

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Double Burden of Malnutrition: A Systematic Review of Operational Definitions

Davis, Jennie N., Brietta M. Oaks, Reina Engle-Stone. Current Developments in Nutrition, September 2020
  • Monitoring, Evaluation, and Learning
While most double burden of malnutrition definitions include overweight and obesity variables, they diverge in their use of thinness, wasting, underweight, stunting, anemia, and micronutrient deficiency measurements. Clear, specific definitions will improve data comparability across populations, future surveillance efforts, intervention implementation and evaluation, and program and policy development.

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Micronutrient Fortification of Commercially Available Biscuits Is Predicted to Have Minimal Impact on Prevalence of Inadequate Micronutrient Intakes: Modeling of National Dietary Data from Cameroon

Haile, Demewoz, Hanqi Luo, Stephen A. Vosti, et al. Current Developments in Nutrition, August 2020
  • Monitoring, Evaluation, and Learning
Biscuit fortification is uncommon and unlikely to reduce dietary inadequacy of studied micronutrients in the absence of large-scale food fortification programs. As voluntary fortification becomes increasingly common, modeling studies could guide efforts to ensure that fortified products align with public health goals.

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Variability in Haemoglobin Concentration by Measurement Tool and Blood Source: An Analysis from Seven Countries

Rappaport Aviva I., Crystal D. Karakochuk, Sonja Y. Hess, et al. Journal of Clinical Pathology, October 2020
  • Monitoring, Evaluation, and Learning
Analyses found large variability in haemoglobin concentration measured on capillary or venous blood and using HemoCue Hb 201+ or Hb 301 or automated haematology analyser. It is unclear whether the variation is due to differences in equipment, differences in capillary and venous blood, or factors affecting blood collection techniques. Please note that this resource is behind a paywall.

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Within-Person Variation in Nutrient Intakes across Populations and Settings: Implications for the Use of External Estimates in Modeling Usual Nutrient Intake Distributions

French, Caitlin D., Joanne E Arsenault, Charles D Arnold, et al. Advances in Nutrition, October 2020
  • Monitoring, Evaluation, and Learning
Using external estimates of within- and between-person variation in nutrient intakes in lieu of collecting multiple days of dietary intake data causes a high degree of uncertainty in resulting models of usual nutrient intake distributions. Single-day dietary studies should complete sensitivity analyses to determine the robustness of prevalence estimates to changes in the variance ratio.

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Reports and Tools

DHS Survey Design: Modules (FAQ)

The DHS Program, n.d
  • Monitoring, Evaluation, and Learning
Several topic-specific questionnaire modules can be added to the standard DHS questionnaire modules. These include those focusing on accident and injury, adult and maternal mortality, disability, domestic violence, female genital cutting, fistula, the food insecurity experience scale, newborn care, non-communicable diseases, out-of-pocket health expenditures, and maternal health care. This document summarizes the benefits and limitations of doing so.

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Questionnaire Modules: Food Insecurity Experience Scale (FIES from FAO)

Food and Agriculture Organization of the United Nations, The DHS Program, October 2020
  • Monitoring, Evaluation, and Learning
The FIES questionnaire comprises eight questions that measure moderate and severe household food insecurity. The module asks respondents to self-report their access to food of sufficient quantity and quality for the last 12 months. Questions focus on a lack of money and resources to obtain food. Please select the Food Insecurity Experience Scale (FIES from FAO) module, from the Download publications dropdown menu.

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IconNutrition and Health Systems

Research Articles

Characteristics and Outcomes of Neonatal SARS-CoV-2 Infection in the UK: A Prospective National Cohort Study Using Active Surveillance

Gale, Chris, Maria A. Quigley, Anna Placzek, et al. The Lancet Child & Adolescent Health, November 2020
  • Nutrition and Health Systems
This study, conducted among babies with confirmed SARS-CoV-2 infection in the first 28 days of life who received inpatient care, found that infection following birth to a mother with perinatal SARS-CoV-2 infection was unlikely, and vertical transmission rare. This supports current international guidance to avoid separation of mother and baby.

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Combined IYCF with Small-Quantity Lipid-based Nutrient Supplementation Is Associated with a Reduction in Anemia

Addo, O. Yaw, Lindsey M. Locks, Maria Elena Jefferds, et al. The American Journal of Clinical Nutrition, September 2020
  • Nutrition and Health Systems
Researchers analyzed data from 2,995 children after an intervention area received enhanced infant and young child feeding counseling and daily small-quantity lipid-based nutrient supplementation for infants 6–12 months and a control area received the standard counseling package without the nutrient supplementation. The study found that the enhanced counseling and nutrient supplementation intervention using the existing health care delivery platform was associated with a reduction in prevalence of anemia and improvement in mean hemoglobin. There was no impact on stunting, wasting, and underweight indicators in the intervention or control groups, but children in the intervention group receiving three or more months of the nutrient supplementation showed improvements in length-for-age and weight-for-age scores as well as hemoglobin.

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Insights on Exclusive Breastfeeding Norms in Kinshasa: Findings from a Qualitative Study

Wood, Francine E., Anastasia J. Gage, and Dieudonné Bidashimwa. BMC Pregnancy and Childbirth, October 2020
  • Nutrition and Health Systems
Focus group discussions with young first-time mothers (FTMs), male partners, mothers, and mothers-in-law to identify norms that influence exclusive breastfeeding found important barriers. For instance, FTMs believed exclusive breastfeeding was uncommon and would result in social sanctions from the community. Trust in and desire to please mothers, friends, and others in their social networks also influenced decision-making. The authors conclude that to promote exclusive breastfeeding it is critical to assess cultural beliefs, target sensitization efforts to key influencers, and increase FTMs’ self-efficacy.

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Reports and Tools

Field Exchange 63

ENN, October 2020
  • Nutrition and Health Systems
The articles in this South Asia edition focus on integrating nutrition interventions into primary health care to prevent and treat wasting, integrating management of children with acute malnutrition in pediatric inpatient facilities, supporting healthy growth in infants in low-resource settings, integrating screening for acute malnutrition into the vitamin A supplementation campaign in the Rohingya camps during COVID-19, exploring the role of multiple micronutrient supplementation in pregnancy, and more.

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WHO Antenatal Care Recommendations for a Positive Pregnancy Experience: Nutritional Interventions Update: Multiple Micronutrient Supplements during Pregnancy

World Health Organization, 2020
  • Nutrition and Health Systems
This guideline includes updated recommendations include multiple micronutrient supplements and vitamin D supplements during pregnancy.

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Events

Nutritional Interventions: Multiple Micronutrient and Vitamin D Supplements during Pregnancy

IBP Network, World Health Organization, and UNICEF, October 2020
  • Nutrition and Health Systems
This guideline includes updated recommendations include multiple micronutrient and vitamin D supplement during pregnancy. Viewers must request an invitation to watch this webinar but there is no fee to do so.

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IconNutrition in Humanitarian Contexts

Research Articles

Fortified Blended Flour Supplements Displace Plain Cereals in Feeding of Young Children

Cliffer, Ilana R., William A. Masters, Beatrice L. Rogers. Maternal & Child Nutrition, September 2020
  • Nutrition in Humanitarian Contexts
Lipid-based nutritional supplements and fortified blended flours are widely used to increase nutrient density of children's diets and improve health. Due to their small stomach size and rapid growth velocity, infants need higher nutrient density foods than do other family members. While foods premixed with fortificants can meet infant needs, their effectiveness is compromised by displacement of other food. Fortified cereals improve diet quality more than other supplementation strategies by displacing plain cereal without altering breastfeeding or other intakes.

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Improving Nutritional Status among Urban Poor Children in Sub-Saharan Africa: An Evidence-Informed Delphi-Based Consultation

Mutisya, Maurice, Oonagh Markey, Emily K. Rousham, et al. Maternal & Child Nutrition, November 2020
  • Nutrition in Humanitarian Contexts
Little is known about how urbanization influences infant and young child (IYC) feeding practices, and evidence-based interventions to improve IYC health/nutrition among the urban poor are lacking. To maximize effectiveness, future complementary feeding interventions should include an assessment of diet quality and consider nutrition-sensitive factors during development and evaluation.

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Reports and Tools

Experiences of the Integrated Management of Acute Malnutrition (IMAM) Programme in Nepal: From Pilot to Scale Up

Haag, Karan Courtney, Anirudra Sharma, Kedar Raj Parajuli, et al. Field Exchange 63, October 2020
  • Nutrition in Humanitarian Contexts
This program addresses severe wasting in the context of humanitarian crises. Sustainability relies on a government-owned and -managed approach, a strong policy framework, national and devolved governance architecture, commitment and dedicated financing, and services integrated within a well-developed community health system and delivered by skilled government health workers. Ongoing challenges include supply chain management of ready-to-use therapeutic food, case identification, continuing low treatment coverage, and management of moderate wasting.

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Global Nutrition Cluster | Roles and Responsibilities of Nutrition Cluster Partners within the Cluster Approach at Country Level

Global Nutrition Cluster, September 2020
  • Nutrition in Humanitarian Contexts
This graphic provides guidance on partners' roles in needs assessment and analysis, strategic response planning, resource mobilization, implementation and monitoring, operational peer review, and evaluation. It also provides detailed steps for coordination, information management, and preparedness. Available in English and Arabic.

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IconSocial and Behavior Change

Research Articles

Bringing Greater Precision to Interactions between Community Health Workers and Households to Improve Maternal and Newborn Health Outcomes in India

Smittenaar, Peter, B.M. Ramesh, Mokshada Jain, et al. Global Health: Science and Practice, October 2020
  • Social and Behavior Change
Community health worker (CHW) presence, number, and timing of visits, counseling, and behavior change messaging strategies, and focus on specific household members are associated with recommended maternal and newborn care practices, including early initiation of and exclusive breastfeeding. Counseling, training, strong supervision, and tools that can help CHWs prioritize and track beneficiaries and suggest behavior change strategies are critical.

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Counseling Is a Relationship Not Just a Skill: Re-Conceptualizing Health Behavior Change Communication by India’s Accredited Social Health Activists

Ved, Rajani, Kerry Scott, Global Health: Science and Practice, October 2020
  • Social and Behavior Change
The ability of accredited social health activists to improve health outcomes depends on their relationships with families and the support from the health system. Training to improve interpersonal communication and develop strong relationships with community members will improve their efficacy as health behavior change communicators.

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Reports and Tools

Program Guidance Engaging Family Members in Improving Maternal and Child Nutrition

USAID Advancing Nutrition, September 2020
  • Social and Behavior Change
Due to their influence on decision-making, there is a strong case for engaging fathers, grandparents, and other key family members in maternal and child nutrition programs. Their involvement increases awareness of recommended practices and can increase supportive attitudes and behaviors including exclusive breastfeeding and complementary feeding practices.

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