Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?

Ruel, Marie T.; Alderman, Harold

doi:10.1016/s0140-6736(13)60843-0

Cited by 1,421 publications

(1,552 citation statements)

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“…To help ameliorate the current unacceptably high burden of undernutrition among children under the age of 5 years, the Government of Ethiopia has launched a national nutrition programme (June 2013-June 2015 prioritizing nutrition as a viable strategy for the country's growth and development plans (6) . Among other things, a reduction in the burden of child undernutrition requires nutrition programmes targeted on the basis of nutritional vulnerability and burden (7) . Targeting based on vulnerability and burden would help reach households that are most likely to benefit from these programmes.…”

Section: Introductionmentioning

confidence: 99%

Local spatial clustering of stunting and wasting among children under the age of 5 years: implications for intervention strategies

Gebreyesus

Mariam

Woldehanna

et al. 2015

Public Health Nutr.

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Objective: The present study aimed to evaluate the clustering of undernutrition indicators of children under the age of 5 years in relation to different scales. Design: A community-based cross-sectional study design was employed. We collected anthropometric data, geographic locations/elevations of households and other data from visited households. We used a retrospective purely spatial Poisson probability model to identify and locate clusters (high rates) of stunting and wasting using the software SaTScan™ version 9·1·1. We ran a logistic regression model to help evaluate the causes of clustering. Settings: Six villages in the Meskane Mareko District (38·45763°E, 8·042144°N) of southern Ethiopia. Subjects: We surveyed 2371 children aged <5 years, who were found in 1744 households. Results: We found a micro-level variation in the risk of stunting and wasting within the studied district. We found the most likely significant clusters for wasting and severe wasting in two of the six villages. For stunting, a single large cluster size of 390 cases (304·19 expected) in 756 households was identified (relative risk = 1·48, P < 0·01). For severe stunting, a single cluster size of 106 cases (69·39 expected) in 364 households was identified (relative risk = 1·69, P = 0·035). Conclusions: We conclude that the distribution of wasting and stunting was partly spatially structured. We identified distinct areas within and between villages that have a higher risk than the underlying at-risk population. Our analysis identified the spatial locations of high-risk areas for stunting that could be an input for geographically targeting and optimizing nutritional interventions. KeywordsClustering Undernutrition Stunting Wasting EthiopiaThe burden of undernutrition has declined progressively in developing countries, with the rate of reduction varying by region. The largest reductions have been in Asia, whereas a modest reduction in prevalence is documented in Africa (1) . Ethiopia has documented a significant decline in the prevalence of both stunting and underweight over the past 14 years (between 2000 and 2014). For example, the prevalence of stunting decreased by 31 % (from 58 % to 40 %), while the prevalence of underweight decreased by 39 % (from 41 % to 25 %), between 2000 and 2014 (2-5) .Although this is significant progress in the reduction of stunting and underweight prevalence, the current prevalence levels are still considerable. Based on the WHO recommended criteria for assessing the severity of stunting and underweight at the population level, the country is classified under a medium to high grade (prevalence range of 20-40 % for stunting and 10-30 % for underweight). To help ameliorate the current unacceptably high burden of undernutrition among children under the age of 5 years, the Government of Ethiopia has launched a national nutrition programme (June 2013-June 2015 prioritizing nutrition as a viable strategy for the country's growth and development plans (6) . Among other things, a reduction in the burden of ch...

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Section: Introductionmentioning

confidence: 99%

Local spatial clustering of stunting and wasting among children under the age of 5 years: implications for intervention strategies

Gebreyesus

Mariam

Woldehanna

et al. 2015

Public Health Nutr.

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“…Nevertheless, these results point to the potential of nutrition-sensitive agricultural programmes to improve women’s control over and ownership of assets, and to change gender norms around land and asset use, control and ownership. These positive changes, in turn, could be related to positive changes in maternal and child health and nutrition outcomes in the short or long term (Ruel & Alderman, 2013). …”

Section: Discussionmentioning

confidence: 99%

“…The programme may also improve maternal and child health and nutrition outcomes through increasing women’s access to and control over resources (Ruel & Alderman, 2013). These include resources such as additional income from the sale of products from home/village production activities, improved knowledge, skills and self-confidence in agriculture, health and nutrition gained through trainings, or increases in bargaining power through the programme’s transfer of productive assets.…”

Section: Study Design and Methodologymentioning

confidence: 99%

“…Ruel and Alderman (2013), for example, identify six pathways through which agricultural interventions can impact nutrition: (1) agriculture as a source of food for own consumption; (2) agriculture as a source of income; (3) the impact of agricultural policies on prices of food and non-food crops; (4) the effect of women’s social status and empowerment on their access to and control over resources; and (5) the impact of women’s participation in agriculture on their time allocation; and (6)on their own health and nutritional status (vi).…”

Section: Introductionmentioning

confidence: 99%

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Can Integrated Agriculture-Nutrition Programmes Change Gender Norms on Land and Asset Ownership? Evidence from Burkina Faso

Bold

Dillon

Olney

et al. 2015

The Journal of Development Studies

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This article uses a mixed-methods approach to analyse the impact of an integrated agriculture and nutrition programme in Burkina Faso on women’s and men’s assets, and norms regarding ownership, use and control of assets. We use a cluster-randomised controlled trial to determine whether productive asset transfers and increased income-generating opportunities for women increase women’s assets over time. Qualitative work on gender norms finds that although men still own and control most assets, women have greater decision-making power and control over home gardens and their produce, and attitudes towards women owning property have become more favourable in treatment areas.

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“…The movement was a response to the 2008 Lancet series on maternal and child nutrition which showed that there was an unacceptably high burden of undernutrition among women and children (2)(3)(4)(5)(6) . The 2008 series and its sequel in 2013 (7)(8)(9)(10) both demonstrated that undernutrition, especially stunting, was clustered in a few high burden countries. The series further identified the existence of proven nutrition-specific interventions which should be implemented at scale, together with the other nutritionsensitive strategies in a policy environment which calls for partnerships in efforts across implementing agencies.…”

Section: The Scaling Up Nutrition Movementmentioning

confidence: 99%

Capacity for scaling up nutrition: a focus on pre-service training in West Africa and a Ghanaian case study

et al. 2015

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The 2013 Lancet series on maternal and child nutrition is identified and advocated for improved institutional and human capacity in nutrition towards scaling up nutrition (SUN) in countries with high stunting rates. Of the fifty-four countries with high burden of child undernutrition who have committed to the SUN movement, thirty-six are in Africa. In the present paper, the academic platform of the SUN movement in Ghana presents an overview of nutrition pre-service capacity in West Africa with a focus on Ghana. The present paper is based on the findings of a sub-region-wide assessment of degree programmes in nutrition in West Africa, plus another report on pre-service nutrition capacity in diploma awarding nursing and nutrition programmes in Ghana. Although there is inadequate evidence on pre-service nutrition training in the sub-region, the two reports provide useful evidence for action, including inadequate number and distribution of pre-service nutrition training programmes, low nutrition graduate output, poor quality of the programme curriculum and instruction, and sub-optimal capital investment. The present paper calls for urgent action to improve pre-service nutrition capacity building as a critical step towards SUN in West Africa.

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Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition?

Cited by 1,421 publications

References 91 publications

Local spatial clustering of stunting and wasting among children under the age of 5 years: implications for intervention strategies

Local spatial clustering of stunting and wasting among children under the age of 5 years: implications for intervention strategies

Can Integrated Agriculture-Nutrition Programmes Change Gender Norms on Land and Asset Ownership? Evidence from Burkina Faso

Capacity for scaling up nutrition: a focus on pre-service training in West Africa and a Ghanaian case study

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