May 2021

IconCapacity Strengthening

Reports and Tools

Case Studies Show How Medical Colleges in India Can Improve the Quality of MIYCN Service Delivery

Alive & Thrive, February 2021
By revising the undergraduate curriculum and updating service delivery protocols at hospitals, medical colleges are building the capacity of future generations of medical practitioners to deliver evidence-based maternal nutrition and infant and young child nutrition services.

Global IYCF e-Learning Course Reaching Health Workers Around the World

Alive & Thrive, February 2021
This free course, based on the World Health Organization’s Combined Course on Growth Assessment and Infant and Young Child Feeding Counselling and supplemental content, has been adapted to deliver an immersive, interactive e-learning opportunity. While participants report that the course is of high quality and enrollments are increasing, few finish the course. Assessment of whether low completion rates are due to course length, difficulty, and/or limited internet access is ongoing. It is available in French and English.

Towards Reimagined Technical Assistance: The Current Policy Options and Opportunities for Change

Gates Open Research, December 2020
Current efforts to reimagine technical assistance (TA) largely focus on existing challenges with different types of TA and the development of an ideal model, with little attention paid to decision-making and trade-offs in implementation. This article analyzes TA as a policy option for governments and details the limitations, required enabling environment, and practical implications for different TA models to help governments and donors design better TA programs.

Events

How to Work with USAID

USAID, January 2021
USAID representatives discuss agency priorities, the types of partners it supports, and how to find funding opportunities.  The goal of the New Partnerships Initiative is to multiply its development impact by elevating local leadership, fostering creativity and innovation, and mobilizing resources across the Agency’s programs. This is a webinar.

Local Means Local: New Tools for Strengthening Community-Led Development

Movement for Community-led Development, January 2021
Recent research about community-led development (CLD) includes analysis of when this model has worked well, its impact on outcomes, and how to adapt existing evaluation methods to capture the complexity and multi-dimensional nature of CLD. The presenters introduce an assessment tool to improve and strengthen program design and a quality appraisal tool to ensure evaluations uphold CLD principles. This is a series of two webinars.

IconEarly Childhood Development

Research Articles

Adapting an Evidence-Based, Early Childhood Parenting Programme for Integration into Government Primary Health Care Services in Rural Bangladesh

Mehrin, Syeda Fardina, Jena Derakshani Hamadani, Nur-E Salveen, et al. Frontiers in Public Health, January 2021
Reach-Up and Learn, an evidence-based home-visiting program focused on early childhood development, has been adapted for routine delivery in community clinics. Iterative piloting identified challenges in incorporating the program into existing workloads and promoting mothers' engagement. This led to simplifying the content and structure, using more hands-on learning strategies, providing incentives to community members, and conducting motivational meetings. Authors conclude that incorporating participant feedback is critical as pilots scale.

Child Health Redesign

The BMJ, March 2021
Greater understanding of the interconnectedness of maternal, newborn, child, and adolescent health led the World Health Organization and UNICEF to shift away from an exclusive focus on under-5 survival and toward an integrated ecological life course perspective. Authors call for greater integration of disability in children and adolescents into the global health agenda.

Father Involvement in the Care of Children Born Small and Sick in Rwanda: Association with Children's Nutrition and Development

Oryono, Andrew, Boniface Iraguha, Ancille Musabende, et al. Child: Care, Health and Development, February 2021
Paternal involvement in the care of children in rural Rwanda born preterm, low birth weight and/or with hypoxic ischemic encephalopathy is limited. Significant factors associated with father involvement included smaller household size, maternal engagement in decision-making and learning activities, and being on‐track in developmental milestones for problem solving. The number of activities a father engaged in was significantly associated with the child's overall development. This article is behind a paywall.

Influence of Enhanced Nutrition and Psychosocial Stimulation in Early Childhood on Cognitive Functioning and Psychological Well-Being in Guatemalan Adults

Ramírez-Luzuriaga, María J., Ann M. DiGirolamo, Reynaldo Martorell, et al. Social Science & Medicine, April 2021
Findings from Guatemala suggest childhood nutritional supplementation and psychosocial stimulation have long-lasting effects on cognitive ability, executive function, and psychological well-being in adults.

Events

Caring for the Caregivers: A Path Towards Playful Parenting

International Step by Step Association, March 2021
Building frontline worker skills to deliver strengths-based counseling increases caregiver confidence and well-being and helps caregivers develop stress management, self-care, and conflict-resolution skills. This is a webinar.

IconFood Systems

Research Articles

Planting Seeds of Change: Reconceptualizing What People Eat as Eating Practices and Patterns

Olstad, D.L., S.I. Kirkpatrick, International Journal of Behavioral Nutrition and Physical Activity, March 2021
While language focusing on food consumption as an individual behavior encourages interventions to educate individuals to make better choices, language of eating practices and patterns invokes a socioecological frame that regards consumption practices as enmeshed within broader social contexts. Shifting language away from individual behaviors may more effectively address the root causes of unhealthy eating patterns, encourage sustained dietary change, and reduce dietary and health inequities.

Reports and Tools

Affordability of Nutritious Foods for Complementary Feeding

Global Alliance for Improved Nutrition, UNICEF, March 2021
Inadequate quantity and quality of foods during the complementary feeding period impact growth and development and have immediate and long-term consequences. Affordability assessments indicate that liver, small fish, dark green leafy vegetables, milk, and eggs are the most affordable sources to address nutritional shortfalls. Collective action to reduce the prices of these foods and raise incomes is critical; social protection services, improved access to fortified foods, and increasing home production of nutritious foods are also important strategies.

Comprehensive Nutrient Gap Assessment (CONGA): Micronutrient Gaps During the Complementary Feeding Period

Global Alliance for Improved Nutrition, UNICEF, March 2021
The Comprehensive Nutrient Gap Assessment tool identifies micronutrient gaps and provides guidance about how to use various types of evidence to assess the significance of nutrient gaps in a given population as well as the best sources of those nutrients.  This briefing series summarizes the results of CONGAs of the complementary feeding period in multiple countries in Eastern and Southern Africa and South Asia.

Harnessing Aquaculture for Healthy Diets

Global Panel on Agriculture and Food Systems for Nutrition, February 2021
Aquaculture can contribute to building resilient food systems, improving nutrition, and providing employment and export earnings. Aquaculture products should be integrated into agriculture and trade policies, national food-based dietary guidelines, and nutrition and health policies and strategies.

Healthy Diet: A Definition for the United Nations Food Systems Summit 2021

United Nations Food Systems Summit 2021, March 2021
This brief places health-promotion, disease prevention, and food safety at the center of defining a healthy diet and urges translation of this definition into specific food-based recommendations. The Food and Agriculture Organization and World Health Organization developed guiding principles to ensure culturally appropriate, sustainable, affordable, and healthy diets that align with these principles and form the basis for interventions.

Minimum Dietary Diversity for Women: An Updated Guide to Measurement: From Collection to Action

FAO, 2021
Authors discuss high quality methodologies to collect, analyze, interpret, and present data on women’s dietary diversity for use in research, impact assessment, and large-scale health and nutrition surveys. Discussions about, and appropriate application of, data to inform policy and programming decisions as well as monitoring and evaluation of nutrition outcomes at global, regional, and country levels is encouraged.

IconKnowledge Management

Reports and Tools

2021: Make-or-Break Year to Keep Nutrition Promises to Mothers and Children

Shawn Baker, February 2021
Fortifying foods with essential vitamins and nutrients, supporting mothers to breastfeed, treating acute malnutrition, and providing nutrient supplements to mothers and children are proven, cost-effective solutions, but this work remains underfunded, limiting the ability to scale interventions. The COVID-19 pandemic has disrupted every system working to improve nutrition, but better knowledge of what works, how much it costs, how to scale and measure progress exist.

COVID-19 & Nutrition: Crisis and Opportunity

Harvard Center for International Development, February 2021
As incomes have declined during the pandemic, families cannot afford nutritious foods while producers and sellers struggle to stay afloat. Health systems are overwhelmed,  families are reluctant to seek healthcare, and efforts to stop the spread of COVID-19 are decreasing coverage of other life-saving care. USAID Chief Nutritionist Shawn Baker shares data on the impacts of COVID-19 on nutrition as well as insights about how USAID and partners are using data to adapt programming and ensure more effective, coordinated responses to this crisis. This is a podcast.

Global Financing for Nutrition: 45% ≠ 1%

Shawn Baker, March 2021
More than 45 percent of infant and young child deaths are attributable to undernutrition. However, as this article points out, donor funding for nutrition services is less than 1 percent of donor investment in development as a whole. Despite proven solutions to screen and treat children, underfunding hinders large-scale progress with enormous consequences. A range of stakeholders—from governments, development banks, and civil society to philanthropies and the private sector—play a critical role in increasing funding for nutrition.

How Nutrition-Sensitive Agriculture Programs Can Realize both Nutrition and Gender Equality Goals

CGIAR Generating Evidence and New Directions for Equitable Results, February 2021
Ensuring gender transformative outcomes of nutrition-sensitive agriculture programs (NSAPs) requires being intentional about empowering women and transforming gender relations as well as recognizing potential trade-offs between women’s different roles and the unintended consequences of NSAP participation. Using evidence-based strategies to build women’s capacity, address exclusionary gender norms, reach men and communities, and monitor progress by using appropriate and inclusive indicators and methodologies are critical.

Micronutrient Forum 5th Global Conference: CONNECTED 2020

Micronutrient Forum, November 2020
Recently made available to the public at no cost, conference research tracks explore Micronutrient Biology and Status Assessment, Efficacy and Safety of Micronutrient Interventions, Program Effectiveness, Designing an Enabling Environment for Micronutrients, and Food Systems. Slideshows and other written materials accompany recorded presentations. Although access to conference materials is free, registration is required.

Opinion: Protecting Nature's Perfect Food System

Devex, March 2021
Alive & Thrive’s Cost of Not Breastfeeding tool demonstrates the importance of breastfeeding to increase economic productivity and reduce healthcare costs. It also points to the multifaceted approaches required to address social and cultural factors, health care practices and policies, inadequate paid leave policies and legislation, aggressive marketing of breast milk substitutes, knowledge gaps, and inadequate skilled support.

Small-Scale Farmers Developing Resilience to COVID-19

International Fund for Agricultural Development, March 2021
Speakers shed light on how small-scale farmers are dealing with COVID-19, risks to food security for mothers and children, the importance of bringing digital services to farmers, and the advantages of poultry farming over other types of livestock farming. This is a podcast.

Why Tackling Malnutrition Matters for Women's Empowerment

Global Nutrition Report, March 2021
While gender equality and women’s empowerment are associated with improved child nutrition, early childhood nutrition also contributes to strong and healthy women. Interventions such as supplying pregnant women with prenatal vitamins can make a significant difference to their financial security and economic empowerment. A growing number of countries are adopting feminist foreign policy agendas and COVID-19 response plans.

Events

The Lancet Series on Maternal & Child Undernutrition Progress

The Lancet, March 2021
Multi-sectoral nutrition leaders discuss how the evidence base for nutrition; health; food systems; social protection; and water, sanitation, and hygiene interventions has evolved since the first Lancet Series on Maternal & Child Undernutrition was published in 2013. They also identify priority actions to regain and accelerate progress within the next decade. This is a webinar.

IconMonitoring, Evaluation, and Learning

Research Articles

Assessing Nutrient Gaps and Affordability of Complementary Foods: New Methods and Their Application in Different Settings

Nutrition Reviews, April 2021
This series of articles focuses on nutrient gaps and the affordability of nutritious foods during the complementary feeding period in South Asia and Eastern and Southern Africa, as well as the Comprehensive Nutrient Gap Assessment method for identifying the public health significance of nutrient gaps.

International Values for Haemoglobin Distributions in Healthy Pregnant Women

Ohuma, Eric O., Melissa F. Young, Reynaldo Martorell, et al. EClinical Medicine, December 2020
Given the increased risk of maternal and neonatal mortality that anemia poses, this study aims to help inform re-examination of WHO hemoglobin cut-off points for defining anemia in pregnancy. The research produced international, gestational age-specific, smoothed centiles for maternal hemoglobin concentration compatible with better pregnancy outcomes as well as with adequate neonatal and early childhood morbidity, growth, and development up to two years of age.

Introduction to the SIMPLE Macro, a Tool to Increase the Accessibility of 24-Hour Dietary Recall Analysis and Modeling

Luo, Hanqi, Kevin W. Dodd, Charles D. Arnold, et al. The Journal of Nutrition, March 2021
Information on long-term dietary intake is often required for nutrition research or program planning, but surveys routinely use short-term assessments such as 24-hour recalls. Methods to reduce the impact of within-person variation in 24-hour recalls typically require extensive training and skill. Developed to facilitate analysis and modeling of dietary data to inform nutrition research, programs, and policy, the Simulating Intake of Micronutrients for Policy Learning and Engagement (SIMPLE) macro is a dietary software tool to increase the accessibility of 24-hour analysis. The authors explain the theory behind the tool and provide examples of potential applications.

Mobilising Evidence, Data, and Resources to Achieve Global Maternal and Child Undernutrition Targets and the Sustainable Development Goals: An Agenda for Action

Heidkamp, Rebecca A., Ellen Piwoz, Stuart Gillespie, et al. The Lancet, March 2021
New evidence from national and state-level success stories in stunting reduction reinforces the need for multisectoral actions to address underlying determinants of undernutrition and identifies key features of enabling political environments. Well-resourced nutrition data and information systems are essential to support this work. 

The State of Evidence and Experiences in Double Fortified Salt (Iodized Salt with Iron)

The Journal of Nutrition, February 2021
Articles focus on iron fortification practices and the implications of adding iron to salt, and whether double fortification salt (DFS) with iron and iodine reduce anemia, iron deficiency anemia, iron and iodine deficiencies, and functional outcomes. Other investigations evaluate large-scale DFS programs, the potential of iodine and iron DFS to increase population iron status compared with iron-fortified staple foods, and challenges and evidence for policymakers considering iodized salt as a vehicle for iron fortification.

Events

From Programs to Policies: Translating Nutrition Indicators

1,000 Days, March 2021
Programmers often need technical, project-specific data to evaluate the effectiveness of an evaluation, while advocates frequently use more easily explicable data to illustrate trends at the macro level. Presenters discuss the difficulties of aligning these data and whether there are more effective ways to do so to better ensure nutrition data are useful and accurate both on the ground and at the policy level. This is a two-part webinar.

Remote Developmental Evaluation: A Guide for Funders and Practitioners

Blue Marble Evaluation, February 2021
Developmental Evaluation (DE) seeks to improve programs by strengthening innovation and adaptation. The COVID-19 pandemic has forced a shift from embedding evaluators to engaging remotely. This guide captures broadly applicable learnings and methods for successfully implementing remote DEs. This is a webinar.

IconNutrition and Health Systems

Research Articles

The Quality of Maternal Nutrition and Infant Feeding Counselling During Antenatal Care in South Asia

Torlesse, Harriet, Rukundo K. Benedict, Hope C. Craig, et al. Maternal & Child Nutrition, February 2021
The effectiveness of approaches to develop frontline worker capacity in counseling on maternal nutrition and infant feeding during antenatal care in South Asia is unclear. At the same time, unequal access to services as well as the duration and frequency of counseling contacts constrain counseling quality. Assessing the format, duration, frequency, and content of training and supportive supervision; integrating indicators of quality counseling into monitoring; conducting surveys and program evaluations; and understanding how best to assess and strengthen quality are high priorities.

Series on Maternal and Child Undernutrition Progress

The Lancet, March 2021
Three new papers build upon findings from the 2008 and 2013 Series. They conclude that despite modest progress, maternal and child undernutrition remains a major global health concern. Previously highlighted interventions, especially those delivered within the first 1,000 days of life, effectively reduce stunting, micronutrient deficiencies, and child deaths, but program delivery has lagged behind the science and greater financing is needed to scale up proven interventions.

Volunteer Community Health and Agriculture Workers Help Reduce Childhood Malnutrition in Tajikistan

Yorick, Roman, Faridun Khudonazarov, Andrew J. Gall, et al. Global Health: Science and Practice, March 2021
Community volunteers specializing in maternal, newborn, and child health, water, sanitation, and hygiene activities, and agriculture are an effective workforce to improve individual knowledge, attitudes, and practices that result in better nutrition and improve the dietary diversity of women and children.

Events

Adolescent Nutrition: Current Progress and Looking Ahead

Emergency Nutrition Network, UNICEF, Save the Children, February 2021
Presenters provide an overview of adolescent nutrition status across seven global regions, discuss how adolescents experience nutrition across the world, and present youth-led solutions to improve nutrition in Indonesia.

IconNutrition in Humanitarian Contexts

Reports and Tools

Emergency Nutrition Network Field Exchange

Emergency Nutrition Network, January 2021
Focused on wasting, this edition demonstrates the continued innovation and adaptation of nutrition actors to evolving contexts and challenges. A special section highlights the community-based management of acute malnutrition (CMAM) Surge model, a health systems strengthening approach that has shown promise at health facility and district levels. Successfully addressing pandemics, food systems, and climate change requires the integration of nutrition interventions.

Humanitarian Response Plan - South Sudan

United Nations Office for the Coordination of Humanitarian Affairs, March 2021
Response priorities include reducing morbidity, incidents of human rights violations, and gender-based violence. Also critical are ensuring safe, equitable, and dignified access to cross-sectoral services to address basic needs; identifying strategies to assist those vulnerable to crisis as they seek to recover; seeking solutions to displacement; and building resilience to shocks and stresses.

The Quality-of-Care Agenda in Fragile, Conflict-Affected and Vulnerable Settings

WHO, March 2021
The World Health Organization worked with partners to develop a technical package that outlines eight interdependent elements for action planning. These include service priorities and quality goals, shared local understanding of quality, stakeholder mapping and engagement, situational analysis, governance for quality, interventions for quality improvement, health information systems and quality assessment, and quality measurement. Local expertise and experience are critical to adapt the approach to local settings.

Rapid Scale Up Crucial to Meet Humanitarian Needs in Ethiopia’s Tigray: Joint UN-Government Mission

UN News, February 2021
The World Food Program is working with the Ethiopian government to improve transportation capacity, deliver humanitarian assistance and emergency food relief, and launch a supplementary feeding program to support nutritionally vulnerable children as well as pregnant and lactating women. The United Nations Special Adviser on Prevention of Genocide calls on authorities to establish mechanisms to address the root causes of ethnic violence, build national cohesion, and promote reconciliation.

IconSocial and Behavior Change

Research Articles

Exploring the Influence of Social Norms on Complementary Feeding: A Scoping Review of Observational, Intervention, and Effectiveness Studies

Dickin, Katherine L., Kate Litvin, Juliet K McCann, et al. Current Developments in Nutrition, January 2021
Social norms and cultural beliefs can be influential barriers or facilitators for adopting improved complementary feeding (CF) practices, but guidance to address norms and beliefs is limited. Evidence suggests that addressing social norms through effective, multifaceted, and culturally relevant interventions including community engagement and mass media is a feasible and effective component of programs to improve CF practices.

Grandmothers—A Neglected Family Resource for Saving Newborn Lives

Aubel, Judi. BMJ Global Health, February 2021
Grandmothers play important roles in newborn care.  Grounding newborn research and interventions within a family systems framework that reflects local family structures and dynamics may be more influential in saving lives than strengthening health systems.

Reports and Tools

Aligning Best Practices and Addressing Misinformation for Optimal Infant Feeding During the COVID-19 Pandemic

PATH, January 2021
This brief discusses hospital best practices to encourage breastfeeding and ensure lactation success for COVID-19 infected mothers and their newborns. It also addresses whether COVID-19 can be passed from mother to infant at delivery, whether rooming-in and breastfeeding with an infected mother are safe, and whether it is safe to use donor milk during the pandemic.

Gender Training for Nutrition Programs Package

USAID Advancing Nutrition, March 2021
Training and supporting materials prepare participants to identify key gender concepts, describe why gender analysis is important, explain how to conduct a gender analysis, and complete a gender integration action plan.

Getting Practical: Integrating Social Norms into Social and Behavior Change Programs

Breakthrough ACTION, January 2021
While social and behavior change program implementers may be aware that social norms are powerful influencers of behaviors and outcomes, many are unsure about how to integrate social norms-shifting programming into program design. The Getting Practical: Integrating Social Norms into Social and Behavior Change Programs tool was developed for country-level program planners, designers, and monitoring and research staff to address gaps between formative social norms research and other phases of the program design cycle to allow for adaptive programming. This is a webinar.