Research priorities for improving infant and young child feeding in humanitarian emergencies

Abstract

Background: There are many challenges during emergencies to ensure that optimal infant and young child feeding is protected, promoted and supported, but there is a dearth of evidence on strategies and programmes to improve Infant and Young Child Feeding in Emergencies (IYCF-E) and a need to determine research priorities. Methods: Based on interviews with key informants who are experts in the subject, we developed a list of 48 research questions on IYCF-E. A framework, following the Child Health and Nutrition Research Initiative method to set priorities in child health research, was developed to rank the research questions. Four criteria were applied to create a ranking based on answerability, operational relevance, disease burden reduction and prevention, and originality. Using an on-line survey, prioritisation of research questions was done by 27 people from 14 NGOs, universities and research institutions, and UN organisations. Results: The top-ten research questions identified focused on the following:• Use of cash-transfer to buy breast-milk substitutes;• Effectiveness of complementary feeding strategies;• Long-term effect of IYCF-E interventions;• Design of IYCF-E programmes in a context where breastfeeding rates are low and breast milk substitutes use is high;• Design of effective re-lactation interventions;• Provision of psychological support to young children's care-takers;• Determination of number of beneficiaries and coverage of IYCF-E programmes;• Pros and cons of distributing ready-to-use infant formula compared with distributing powdered infant formula plus kit for safer use of BMS, when use of infant formula is necessary;• Assessment of the impact of specific IYCF-E programmes on nutritional status, morbidity and mortality;• Linking and mainstreaming IYCF-E interventions with other sectors such as health, WASH, food security and child protection. Conclusion: The questions found by this study could form the basis of future research on IYCF-E and could be integrated into the agenda of relevant stakeholders. Results of studies based on these questions will be fundamental to fill the evidence gap in IYCF-E, improve IYCF-E programming and ultimately contribute to the reduction in morbidity and mortality among infants and young children in humanitarian emergencies.

Setting global research priorities for child protection in humanitarian action: Results from an adapted CHNRI exercise

“…Aligned with prior CHNRI studies in humanitarian contexts [ 14 ], interviews were held via Skype with experts notified in advance that they would be requested to provide their opinions on the most important areas for investment to improve the state of evidence in the field of child protection in humanitarian settings in the next 3–5 years. Participants were encouraged to follow up by email in the event they were able to generate further ideas after the interview had concluded.…”

“…Aligned with the CHNRI methodology [ 13 – 20 ], every research question was provided a priority score under each of the four judging criterion, calculated by taking the point totals and dividing them by the maximum number of points available, after excluding from the denominator those who did not answer the question or reported they were insufficiently informed, a percentage was calculated [ 14 ]. For each question, the overall Research Priority Score (RPS) was then calculated by taking the mean of the total priority scores for each judging criterion, as calculated above.…”

Conserved and variable: Understanding mammary stem cells across species

“…Interruption of breastfeeding due to catastrophe or illness of mother or infant is one of the obstacles for successful breastfeeding . In mice, interruption of lactation results in milk accumulation and the lack of suckling stimulus leads to rapid involution of the secretory epithelium, mostly due to apoptosis .…”

Research agenda-setting on cash programming for health and nutrition in humanitarian settings

“…Advice of the AG was to consider the relationship between CTP for health and/or nutrition in all types of humanitarian settings in LMICs and limit research ideas to the next 5 years. There was an agreement to use a similar methodological approach to the Child Health and Nutrition Research Initiative (CHNRI) (Rudan et al 2006;Rudan et al 2008), described as a common and comprehensive way to develop health research priorities at the global level (Viergever et al 2010;Rudan 2016) and previously used in the humanitarian field (Tol et al 2011;Morof et al 2014;Prudhon et al 2016). …”