Nutrition Resilience could be described as being achieved when a person, population or system has the capacity to mitigate, adapt and transform in response to shocks and stresses without long term impact on their nutritional status.
The aim of the CMAM surge model is to strengthen the capacity of government health systems to effectively manage increased caseloads of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM), during predictable emergencies without undermining ongoing health and nutrition systems strengthening efforts. It is based on one of the fundamental principles of CMAM; that early detection of malnutrition leads to improved treatment outcomes and fewer cases of SAM, as children are treated before their malnutrition becomes severe.
The pilot project was initiated by Concern in collaboration with the SCHMT as well as health facility staff in May 2012,
Future Health System evidences on malnutrition and the need for adopting a multi-sectoral approach through convergence between nutrition sensitive & nutrition specific interventions.
This document discusses the importance of implementation research in nutrition to address challenges in scaling up nutrition interventions. It provides context on global nutrition targets that most countries are not on track to meet. Implementation research is defined as the systematic approach to understanding and addressing barriers to effective implementation of nutrition policies and strategies in different contexts. The document outlines key questions implementation research can help answer related to design, delivery, scale-up, impact pathways, and cost-effectiveness of nutrition programs. It also describes common methods and tools used in implementation research like process evaluations, costing studies, and experimental design studies.
Lessons in the Integration of CMAM & IMCI Activities_Swedberg_5.12.11CORE Group
This study evaluated the effectiveness of a community-based program for managing severe acute malnutrition (SAM) in Bangladesh. 261 community health workers were trained to screen, assess, and treat children aged 6-36 months with SAM. Preliminary results found high recovery rates and low mortality. Early identification and treatment of SAM and illness likely contributed to the positive outcomes. Coverage was also high due to the decentralized network of health workers and community mobilization around SAM. While facility-based care had low uptake and high default rates, community-based management integrating outpatient and inpatient care was an effective strategy for ensuring treatment of SAM cases.
This document summarizes the findings of a survey on the Social & Behaviour Change Communication strategies under India's POSHAN Abhiyaan program. The survey interviewed over 2,300 pregnant and lactating women across 4 states. It found that home visits and health facilities had the highest reach but recall of messages was lower for platforms like VHSNDs. Knowledge and practice of complementary feeding and hygiene was lowest. Frontline workers focused more on what behaviors to do rather than how or why. Recommendations included adding messaging on priority topics, training workers on higher quality counseling, and increasing highest reach platforms like home visits during POSHAN Maah activities.
This document summarizes the coordination of maternal and child health activities in 10 counties in Kenya through the Right Start Project. It outlines progress made in reducing child mortality and increasing access to skilled birth attendants. However, there are still high rates of preventable morbidity and mortality due to barriers to quality healthcare. The Right Start Project aims to address these challenges through partnership-driven activities like capacity building, health systems strengthening, and high impact interventions. The goal is improving maternal, newborn and child health and nutrition outcomes through coordinated efforts across 10 counties.
This document summarizes a systematic review of 117 peer-reviewed articles on social and behavior change communication (SBCC) approaches to improving maternal, infant, and young child nutrition practices. The review found that:
- Interpersonal communication approaches, like home visits and peer counseling, were the most commonly used and consistently reported some of the greatest positive changes in nutrition practices.
- Over half of the interventions targeted only one audience, such as pregnant/lactating women or caregivers.
- A variety of SBCC approaches have been found effective depending on context, including timing, frequency, intensity, duration and quality of the intervention.
- Further research is still needed to evaluate the relative effectiveness, complementarity and costs of
JPAL SA_Urvashi Wattal_Global evidence on cash transfers nutritionPOSHAN
Cash transfer programs can improve household food consumption and diet diversity, but their impact on child anthropometric outcomes is inconsistent. While some studies find cash transfers increase birth weight and child height, effects on child food intake are rarely reported. The size, timing, and frequency of cash transfer benefits are important design features, but often are not well-aligned with nutrition goals in India. Implementation challenges include delays in payments, insufficient transfer amounts to cover costs of participation, and infrequent payment schedules that do not support early childhood nutrition.
The aim of the CMAM surge model is to strengthen the capacity of government health systems to effectively manage increased caseloads of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM), during predictable emergencies without undermining ongoing health and nutrition systems strengthening efforts. It is based on one of the fundamental principles of CMAM; that early detection of malnutrition leads to improved treatment outcomes and fewer cases of SAM, as children are treated before their malnutrition becomes severe.
The pilot project was initiated by Concern in collaboration with the SCHMT as well as health facility staff in May 2012,
Future Health System evidences on malnutrition and the need for adopting a multi-sectoral approach through convergence between nutrition sensitive & nutrition specific interventions.
This document discusses the importance of implementation research in nutrition to address challenges in scaling up nutrition interventions. It provides context on global nutrition targets that most countries are not on track to meet. Implementation research is defined as the systematic approach to understanding and addressing barriers to effective implementation of nutrition policies and strategies in different contexts. The document outlines key questions implementation research can help answer related to design, delivery, scale-up, impact pathways, and cost-effectiveness of nutrition programs. It also describes common methods and tools used in implementation research like process evaluations, costing studies, and experimental design studies.
Lessons in the Integration of CMAM & IMCI Activities_Swedberg_5.12.11CORE Group
This study evaluated the effectiveness of a community-based program for managing severe acute malnutrition (SAM) in Bangladesh. 261 community health workers were trained to screen, assess, and treat children aged 6-36 months with SAM. Preliminary results found high recovery rates and low mortality. Early identification and treatment of SAM and illness likely contributed to the positive outcomes. Coverage was also high due to the decentralized network of health workers and community mobilization around SAM. While facility-based care had low uptake and high default rates, community-based management integrating outpatient and inpatient care was an effective strategy for ensuring treatment of SAM cases.
This document summarizes the findings of a survey on the Social & Behaviour Change Communication strategies under India's POSHAN Abhiyaan program. The survey interviewed over 2,300 pregnant and lactating women across 4 states. It found that home visits and health facilities had the highest reach but recall of messages was lower for platforms like VHSNDs. Knowledge and practice of complementary feeding and hygiene was lowest. Frontline workers focused more on what behaviors to do rather than how or why. Recommendations included adding messaging on priority topics, training workers on higher quality counseling, and increasing highest reach platforms like home visits during POSHAN Maah activities.
This document summarizes the coordination of maternal and child health activities in 10 counties in Kenya through the Right Start Project. It outlines progress made in reducing child mortality and increasing access to skilled birth attendants. However, there are still high rates of preventable morbidity and mortality due to barriers to quality healthcare. The Right Start Project aims to address these challenges through partnership-driven activities like capacity building, health systems strengthening, and high impact interventions. The goal is improving maternal, newborn and child health and nutrition outcomes through coordinated efforts across 10 counties.
This document summarizes a systematic review of 117 peer-reviewed articles on social and behavior change communication (SBCC) approaches to improving maternal, infant, and young child nutrition practices. The review found that:
- Interpersonal communication approaches, like home visits and peer counseling, were the most commonly used and consistently reported some of the greatest positive changes in nutrition practices.
- Over half of the interventions targeted only one audience, such as pregnant/lactating women or caregivers.
- A variety of SBCC approaches have been found effective depending on context, including timing, frequency, intensity, duration and quality of the intervention.
- Further research is still needed to evaluate the relative effectiveness, complementarity and costs of
JPAL SA_Urvashi Wattal_Global evidence on cash transfers nutritionPOSHAN
Cash transfer programs can improve household food consumption and diet diversity, but their impact on child anthropometric outcomes is inconsistent. While some studies find cash transfers increase birth weight and child height, effects on child food intake are rarely reported. The size, timing, and frequency of cash transfer benefits are important design features, but often are not well-aligned with nutrition goals in India. Implementation challenges include delays in payments, insufficient transfer amounts to cover costs of participation, and infrequent payment schedules that do not support early childhood nutrition.
Assessing the impact on child nutrition of Ethiopia’s Community-based Nutriti...essp2
The document summarizes an evaluation of Ethiopia's Community-based Nutrition (CBN) program conducted by Tulane University. The CBN program was implemented in rural areas through volunteer community health workers and health extension workers to monitor child growth, hold community conversations, and conduct home visits. The evaluation found the CBN program was associated with reductions in stunting and severe stunting compared to expected trends. Children in areas with more contact from health workers through the CBN program saw greater improvements in nutrition indicators. However, overall participation levels in the CBN program were low at 30%, suggesting increased community engagement is needed as the program expands its coverage across Ethiopia.
This document discusses considerations for research design and implementation to study the effectiveness of nutrition programs. It describes plans to conduct an observational study with randomized site selection in Nepal and Uganda to examine the impact of multiple existing nutrition programs. The study will collect annual panel survey and cohort data on demographics, agriculture/food security, gender roles, diet/nutrition, and health from 4,500 households across different ecological zones and exposure levels to nutrition programs. Key outcomes of interest include nutrition status, maternal and child health, and exposure/uptake of various sectoral interventions related to agriculture, health, and livelihoods. The document emphasizes understanding effective cross-sectoral coordination and transmission of programs to end users.
The Effect of Implementation Strength of Basic Emergency Obstetric and Newbor...JSI
The study examines the effectiveness of a BEmONC initiative in Ethiopia by analyzing the relationship between implementation strength, measured by a index of facility inputs and service delivery processes, and facility delivery rates and need for BEmONC services. The results show that strengthening implementation through improved training, supplies, and referral linkages was associated with increased facility deliveries and met need for BEmONC. However, the study has limitations including potential selection bias and temporal ambiguity between variables. Overall, the findings suggest that fully implementing BEmONC packages can boost utilization of life-saving maternal and newborn services at primary health centers.
1) The document discusses a study conducted in Rajasthan, India that examined the dietary patterns and nutrient intake of pregnant and lactating women.
2) It found very high nutrient gaps, especially in fat, calcium, zinc, vitamins A and C. The women's diets did not significantly change during pregnancy due to food taboos and beliefs.
3) Based on the findings, the study developed evidence-based food-based recommendations using locally available foods to help address the nutrient gaps identified. However, affording a nutritionally adequate diet may still be challenging for many households.
Global trends show increased focus on and endorsement of community health worker (CHW) programs to strengthen health systems and achieve health goals. Assessments of CHW programs find that factors like inadequate training, supervision, supplies and low status limit their quality and effectiveness. A global consultation identified key priorities for CHW programs including fully integrating CHWs into national health workforce plans, involving stakeholders, and ensuring adequate and ongoing support through training, supervision and incentives. Supporting CHWs as integral parts of health systems with clearly defined roles and career opportunities can help address current challenges and optimize their impact.
Designing CCT Programs to Improve Nutrition ImpactFAO
Presentación de James Garrett and Lucy Basset, International Food Policy Research Institute IFPRI, durante el Tercer Seminario de Transferencias Condicionadas de Ingresos, realizado en Santiago de Chile el 01 y 02 de Diciembre de 2008.
Nutrition as part of ICCM: Evidence, Challenges and Future Directions of Re...CORE Group
1) Integrated Community Case Management (ICCM) uses community health workers to treat common childhood illnesses and malnutrition where access to health facilities is limited. However, the extent to which ICCM programs actually implement nutrition interventions is unclear.
2) A review of ICCM and nutrition integration programs found that ICCM can achieve high coverage and quality of care for severe acute malnutrition, and may be cost-effective, but questions remain around motivation, policies, protocols, intervention bundles, and health systems support.
3) To address remaining evidence gaps, organizations will launch a desk review, convene a follow-up meeting, and prepare operational research plans generated through collaboration between ICCM and nutrition communities.
Evidence & Implementation of Strategies to Strengthen Health ServicesIDS
This presentation was given by Peters to the International Health Economics Association Conference 2009 in Beijing. It is research conducted as part of the Future Health Systems Research Programme Consortium www.futurehealthsystems.org.
Gender research in the CGIAR Research Program on Agriculture for Nutrition an...CGIAR
The document summarizes recent gender research from the Agriculture for Nutrition and Health program. It finds that women's time, workload and control of resources directly influence agricultural interventions' impacts on nutrition. Studies show empowerment and nutrition outcomes depend more on how programs are implemented than the type. Gender is being integrated into research design, implementation and evaluation with the goals of improving understanding of gender's role and designing more empowering and nutritious programs. Challenges include limited gender research capacity, but partnerships aim to address this through training and research on topics like women's time and domestic violence.
Integrated Community Case Management_FriedmanCORE Group
This document reviews operational experiences linking nutrition and integrated community case management (iCCM). It identifies four typologies of experiences: 1) advising caregivers on feeding sick children within iCCM; 2) linking iCCM with social and behavior change activities on nutrition; 3) assessing and referring children with acute malnutrition through iCCM; and 4) treating uncomplicated severe acute malnutrition at the community level. The review finds some evidence that each typology can increase coverage of nutrition services, but also identifies challenges and questions remaining around quality of care, costs, and impact on child health outcomes. The conclusions emphasize that the appropriate approach depends heavily on contextual factors like community health workers' existing responsibilities and the political environment.
A Breast Cancer Patient Information & Support Program In A Managed Care E...betsymullen
The program provided social support and information to breast cancer patients in a managed care setting using a multidisciplinary approach based on the Health Belief Model. Key components included a program coordinator, information resources, and mentors for patients called "Breast Buddies." An evaluation survey of patients 4 months after diagnosis found higher ratings of pre-surgery care, information provision, and emotional support compared to patients who did not participate. Participants also reported higher overall satisfaction with their breast cancer care. The annual cost was $25,000 to $75,000 to provide services to several hundred new breast cancer cases each year.
1) Abdullah Baqui leads research activities at Johns Hopkins Bloomberg School of Public Health to develop, test, and implement cost-effective maternal and newborn health interventions in low-resource settings.
2) Through partnerships like PROJAHNMO in Bangladesh, Baqui's research has demonstrated that community-based packages reducing neonatal mortality by 34% and early postnatal home visits reducing mortality by 2/3.
3) Evaluation of large-scale programs in India and Tanzania provide feedback to improve coverage, quality, and health impacts and identify barriers to care seeking like inadequate resources, quality of care, distance to facilities and costs.
NSF Smart and Connected Health Visioning MeetingSherry Pagoto
This document discusses how technology can help address challenges with behavioral strategies for managing obesity and preventing diabetes. It summarizes that:
1. While behavioral strategies were shown to be effective in 2001, they are still not widely available due to being too expensive and burdensome to implement.
2. Technology can help reduce the burden and costs of interventions by automating delivery and removing clinic visits, though current uses focus on automating rather than innovating.
3. Technology also has potential to speed up clinical testing of new strategies and advance understanding of behavior change through data collection and analysis, but challenges remain around recruitment, participation, and accuracy of self-monitoring data.
4. More work is needed examining how
Going to Scale with Effective Community-based Primary Health Care Kureshy and...CORE Group
The document summarizes the key findings and recommendations of an expert panel on community-based primary health care (CBPHC) in improving maternal, neonatal, and child health. The panel recommends that CBPHC should be a priority for strengthening health systems, achieving universal health coverage, and ending preventable child and maternal deaths. Resources for CBPHC need to increase and be tracked at national levels. Communities are an undervalued resource and their full participation through partnerships with health systems is essential to effectively reach those most in need. Prioritizing CBPHC in populations with the highest mortality can achieve greater impact.
Wash, Nutrition and ECD Matter_Julia Rosenbaum_4.25.13CORE Group
The document discusses the importance of integrating water, sanitation, hygiene (WASH), nutrition, and early childhood development (ECD) interventions. It notes that diarrhea is a leading cause of child mortality, contributing to 11% of under-5 deaths, and that undernutrition contributes to one third to one half of child mortality. There is a vicious cycle between undernutrition and diarrhea, as undernourished children are more susceptible to diarrhea and diarrhea causes children to eat and absorb nutrients less. The document advocates for recognizing the interconnections between WASH, nutrition, and ECD and provides some program examples that have integrated these areas.
Review the Effectiveness of Community-based Primary Health Care in Improving ...CORE Group
Review the Effectiveness of Community-based Primary Health Care in Improving Child and Maternal Health: Leveraging Results for Advocacy HENRY PERRY and PAUL FREEMAN
Lessons Learned Collecting Most Significant Change Stories in an Impact Evalu...MEASURE Evaluation
This document summarizes the use of Most Significant Change (MSC) stories to evaluate a nutrition program in Malawi. It finds that MSC stories revealed improvements in household health status and nutrition knowledge as the most significant impacts according to participants. Stories also highlighted increased time and money savings from healthier children. However, the process uncovered challenges like the education level of data collectors and issues using stories to identify program needs. Overall, MSC provided insights into what matters to participants, though the method may need adjustments for different contexts.
Savings Groups as a Platform for Multi-dimensional Programming JENNINE CARMIC...CORE Group
Savings groups plus provides a review of the evidence on savings-led microfinance paired with cross-sectoral development initiatives. The evidence base is limited in size and mixed in outcomes. For health interventions, positive impacts were found for health education and demand creation, while behavioral changes showed mixed or promising results. Food security and nutrition outcomes were mostly positive. Impacts on child protection, well-being, and education were mixed. Gender equality and women's empowerment saw some positive results. More rigorous research with improved study designs is needed to draw stronger conclusions.
This document analyzes nutrition interventions within India's policy framework, specifically in Rajasthan. It summarizes two interventions: 1) Direct nutrition-based interventions like counseling, supplementary food, and micronutrient supplements with a total cost of Rs. 14,144 per beneficiary and benefit-cost ratio of 6. 2) Community-based treatment of children with severe acute malnutrition using ready-to-use therapeutic foods with costs ranging from Rs. 5,853-12,937 per child and benefit-cost ratios ranging from 2.2 to 11.3 depending on assumptions. The document outlines the costs, expected benefits in mortality and morbidity avoided, and benefit-cost ratios of these interventions.
This document discusses dietary assessment and counseling in dental practice. It describes how diet can impact oral health through oral environment and general nutrition. Methods for assessing dietary intake include 24-hour recalls, dietary records, and food frequency questionnaires. BMI is used to screen for weight categories in children and teens. Dietary intake is evaluated for cariogenic potential and nutritive value, then counseling is provided to help motivate patients to modify their diet and improve oral health.
Assessing the impact on child nutrition of Ethiopia’s Community-based Nutriti...essp2
The document summarizes an evaluation of Ethiopia's Community-based Nutrition (CBN) program conducted by Tulane University. The CBN program was implemented in rural areas through volunteer community health workers and health extension workers to monitor child growth, hold community conversations, and conduct home visits. The evaluation found the CBN program was associated with reductions in stunting and severe stunting compared to expected trends. Children in areas with more contact from health workers through the CBN program saw greater improvements in nutrition indicators. However, overall participation levels in the CBN program were low at 30%, suggesting increased community engagement is needed as the program expands its coverage across Ethiopia.
This document discusses considerations for research design and implementation to study the effectiveness of nutrition programs. It describes plans to conduct an observational study with randomized site selection in Nepal and Uganda to examine the impact of multiple existing nutrition programs. The study will collect annual panel survey and cohort data on demographics, agriculture/food security, gender roles, diet/nutrition, and health from 4,500 households across different ecological zones and exposure levels to nutrition programs. Key outcomes of interest include nutrition status, maternal and child health, and exposure/uptake of various sectoral interventions related to agriculture, health, and livelihoods. The document emphasizes understanding effective cross-sectoral coordination and transmission of programs to end users.
The Effect of Implementation Strength of Basic Emergency Obstetric and Newbor...JSI
The study examines the effectiveness of a BEmONC initiative in Ethiopia by analyzing the relationship between implementation strength, measured by a index of facility inputs and service delivery processes, and facility delivery rates and need for BEmONC services. The results show that strengthening implementation through improved training, supplies, and referral linkages was associated with increased facility deliveries and met need for BEmONC. However, the study has limitations including potential selection bias and temporal ambiguity between variables. Overall, the findings suggest that fully implementing BEmONC packages can boost utilization of life-saving maternal and newborn services at primary health centers.
1) The document discusses a study conducted in Rajasthan, India that examined the dietary patterns and nutrient intake of pregnant and lactating women.
2) It found very high nutrient gaps, especially in fat, calcium, zinc, vitamins A and C. The women's diets did not significantly change during pregnancy due to food taboos and beliefs.
3) Based on the findings, the study developed evidence-based food-based recommendations using locally available foods to help address the nutrient gaps identified. However, affording a nutritionally adequate diet may still be challenging for many households.
Global trends show increased focus on and endorsement of community health worker (CHW) programs to strengthen health systems and achieve health goals. Assessments of CHW programs find that factors like inadequate training, supervision, supplies and low status limit their quality and effectiveness. A global consultation identified key priorities for CHW programs including fully integrating CHWs into national health workforce plans, involving stakeholders, and ensuring adequate and ongoing support through training, supervision and incentives. Supporting CHWs as integral parts of health systems with clearly defined roles and career opportunities can help address current challenges and optimize their impact.
Designing CCT Programs to Improve Nutrition ImpactFAO
Presentación de James Garrett and Lucy Basset, International Food Policy Research Institute IFPRI, durante el Tercer Seminario de Transferencias Condicionadas de Ingresos, realizado en Santiago de Chile el 01 y 02 de Diciembre de 2008.
Nutrition as part of ICCM: Evidence, Challenges and Future Directions of Re...CORE Group
1) Integrated Community Case Management (ICCM) uses community health workers to treat common childhood illnesses and malnutrition where access to health facilities is limited. However, the extent to which ICCM programs actually implement nutrition interventions is unclear.
2) A review of ICCM and nutrition integration programs found that ICCM can achieve high coverage and quality of care for severe acute malnutrition, and may be cost-effective, but questions remain around motivation, policies, protocols, intervention bundles, and health systems support.
3) To address remaining evidence gaps, organizations will launch a desk review, convene a follow-up meeting, and prepare operational research plans generated through collaboration between ICCM and nutrition communities.
Evidence & Implementation of Strategies to Strengthen Health ServicesIDS
This presentation was given by Peters to the International Health Economics Association Conference 2009 in Beijing. It is research conducted as part of the Future Health Systems Research Programme Consortium www.futurehealthsystems.org.
Gender research in the CGIAR Research Program on Agriculture for Nutrition an...CGIAR
The document summarizes recent gender research from the Agriculture for Nutrition and Health program. It finds that women's time, workload and control of resources directly influence agricultural interventions' impacts on nutrition. Studies show empowerment and nutrition outcomes depend more on how programs are implemented than the type. Gender is being integrated into research design, implementation and evaluation with the goals of improving understanding of gender's role and designing more empowering and nutritious programs. Challenges include limited gender research capacity, but partnerships aim to address this through training and research on topics like women's time and domestic violence.
Integrated Community Case Management_FriedmanCORE Group
This document reviews operational experiences linking nutrition and integrated community case management (iCCM). It identifies four typologies of experiences: 1) advising caregivers on feeding sick children within iCCM; 2) linking iCCM with social and behavior change activities on nutrition; 3) assessing and referring children with acute malnutrition through iCCM; and 4) treating uncomplicated severe acute malnutrition at the community level. The review finds some evidence that each typology can increase coverage of nutrition services, but also identifies challenges and questions remaining around quality of care, costs, and impact on child health outcomes. The conclusions emphasize that the appropriate approach depends heavily on contextual factors like community health workers' existing responsibilities and the political environment.
A Breast Cancer Patient Information & Support Program In A Managed Care E...betsymullen
The program provided social support and information to breast cancer patients in a managed care setting using a multidisciplinary approach based on the Health Belief Model. Key components included a program coordinator, information resources, and mentors for patients called "Breast Buddies." An evaluation survey of patients 4 months after diagnosis found higher ratings of pre-surgery care, information provision, and emotional support compared to patients who did not participate. Participants also reported higher overall satisfaction with their breast cancer care. The annual cost was $25,000 to $75,000 to provide services to several hundred new breast cancer cases each year.
1) Abdullah Baqui leads research activities at Johns Hopkins Bloomberg School of Public Health to develop, test, and implement cost-effective maternal and newborn health interventions in low-resource settings.
2) Through partnerships like PROJAHNMO in Bangladesh, Baqui's research has demonstrated that community-based packages reducing neonatal mortality by 34% and early postnatal home visits reducing mortality by 2/3.
3) Evaluation of large-scale programs in India and Tanzania provide feedback to improve coverage, quality, and health impacts and identify barriers to care seeking like inadequate resources, quality of care, distance to facilities and costs.
NSF Smart and Connected Health Visioning MeetingSherry Pagoto
This document discusses how technology can help address challenges with behavioral strategies for managing obesity and preventing diabetes. It summarizes that:
1. While behavioral strategies were shown to be effective in 2001, they are still not widely available due to being too expensive and burdensome to implement.
2. Technology can help reduce the burden and costs of interventions by automating delivery and removing clinic visits, though current uses focus on automating rather than innovating.
3. Technology also has potential to speed up clinical testing of new strategies and advance understanding of behavior change through data collection and analysis, but challenges remain around recruitment, participation, and accuracy of self-monitoring data.
4. More work is needed examining how
Going to Scale with Effective Community-based Primary Health Care Kureshy and...CORE Group
The document summarizes the key findings and recommendations of an expert panel on community-based primary health care (CBPHC) in improving maternal, neonatal, and child health. The panel recommends that CBPHC should be a priority for strengthening health systems, achieving universal health coverage, and ending preventable child and maternal deaths. Resources for CBPHC need to increase and be tracked at national levels. Communities are an undervalued resource and their full participation through partnerships with health systems is essential to effectively reach those most in need. Prioritizing CBPHC in populations with the highest mortality can achieve greater impact.
Wash, Nutrition and ECD Matter_Julia Rosenbaum_4.25.13CORE Group
The document discusses the importance of integrating water, sanitation, hygiene (WASH), nutrition, and early childhood development (ECD) interventions. It notes that diarrhea is a leading cause of child mortality, contributing to 11% of under-5 deaths, and that undernutrition contributes to one third to one half of child mortality. There is a vicious cycle between undernutrition and diarrhea, as undernourished children are more susceptible to diarrhea and diarrhea causes children to eat and absorb nutrients less. The document advocates for recognizing the interconnections between WASH, nutrition, and ECD and provides some program examples that have integrated these areas.
Review the Effectiveness of Community-based Primary Health Care in Improving ...CORE Group
Review the Effectiveness of Community-based Primary Health Care in Improving Child and Maternal Health: Leveraging Results for Advocacy HENRY PERRY and PAUL FREEMAN
Lessons Learned Collecting Most Significant Change Stories in an Impact Evalu...MEASURE Evaluation
This document summarizes the use of Most Significant Change (MSC) stories to evaluate a nutrition program in Malawi. It finds that MSC stories revealed improvements in household health status and nutrition knowledge as the most significant impacts according to participants. Stories also highlighted increased time and money savings from healthier children. However, the process uncovered challenges like the education level of data collectors and issues using stories to identify program needs. Overall, MSC provided insights into what matters to participants, though the method may need adjustments for different contexts.
Savings Groups as a Platform for Multi-dimensional Programming JENNINE CARMIC...CORE Group
Savings groups plus provides a review of the evidence on savings-led microfinance paired with cross-sectoral development initiatives. The evidence base is limited in size and mixed in outcomes. For health interventions, positive impacts were found for health education and demand creation, while behavioral changes showed mixed or promising results. Food security and nutrition outcomes were mostly positive. Impacts on child protection, well-being, and education were mixed. Gender equality and women's empowerment saw some positive results. More rigorous research with improved study designs is needed to draw stronger conclusions.
This document analyzes nutrition interventions within India's policy framework, specifically in Rajasthan. It summarizes two interventions: 1) Direct nutrition-based interventions like counseling, supplementary food, and micronutrient supplements with a total cost of Rs. 14,144 per beneficiary and benefit-cost ratio of 6. 2) Community-based treatment of children with severe acute malnutrition using ready-to-use therapeutic foods with costs ranging from Rs. 5,853-12,937 per child and benefit-cost ratios ranging from 2.2 to 11.3 depending on assumptions. The document outlines the costs, expected benefits in mortality and morbidity avoided, and benefit-cost ratios of these interventions.
This document discusses dietary assessment and counseling in dental practice. It describes how diet can impact oral health through oral environment and general nutrition. Methods for assessing dietary intake include 24-hour recalls, dietary records, and food frequency questionnaires. BMI is used to screen for weight categories in children and teens. Dietary intake is evaluated for cariogenic potential and nutritive value, then counseling is provided to help motivate patients to modify their diet and improve oral health.
This document discusses assessing dietary intake and nutritional status in dental practice. It describes how body mass index (BMI) is calculated and interpreted for children and teens to screen for weight categories. It also discusses various methods for assessing dietary intake, including 24-hour recalls, dietary records, and food frequency questionnaires. The objectives and process of evaluating dietary intake and nutritive value are outlined.
Nutirtion as an input and outcome of resilience2020resilience
This document discusses integrating nutrition into resilience programming. It notes that many countries face high levels of food insecurity and malnutrition, and that resilience efforts cannot succeed without also addressing nutrition. The document calls for making resilience programs more nutrition-sensitive by strengthening nutrition in policies and information systems, and by designing multi-sectoral prevention, preparedness and response efforts based on nutritional vulnerability analyses. Key actions include monitoring nutritional status indicators, integrating nutrition education into programs, and linking social protection to resilience and nutrition frameworks.
Food insecurity remains a global challenge. Achieving food security requires accurately measuring the incidence, nature, and causes of food insecurity. This allows for prioritizing interventions and targeting assistance. Conceptual frameworks help analyze the complex underlying causes of food insecurity and guide appropriate responses. Understanding factors like availability, access, utilization, and stability is key to selecting interventions to address problems like inadequate food, care practices, or health environments.
Guidelines for the management of severely acute malnourished childrenSM Lalon
This document provides guidelines for managing severely acute malnourished (SAM) children aged 6-59 months in both facility-based and community-based settings. SAM is a major public health problem that increases child mortality and morbidity. Early identification and treatment of SAM can help reduce complications and death. The guidelines outline procedures for assessing and admitting SAM children based on weight-for-height criteria and presence of edema. Facility-based care focuses on stabilizing children with medical complications, while community-based care provides outpatient treatment for children without complications. Key principles of management include treating hypoglycemia, hypothermia, dehydration and infection, as well as starting feeding and providing follow-up care.
This document provides an introduction and background on the Supplemental Nutrition Assistance Program Education (SNAP-Ed). It discusses food insecurity in the United States and the role of SNAP-Ed in improving nutrition and dietary behaviors. The author conducted a policy review of existing SNAP-Ed programs from the USDA database to assess their effectiveness. Ten programs from various states were randomly selected and evaluated based on their inclusion of topics like food budgeting, food labeling, food safety and their impact on behaviors such as fruit/vegetable consumption and sugar intake. The results found that programs addressing these topics showed high rates of effectiveness. The document concludes that SNAP-Ed can help participants make long-term healthy dietary changes through nutrition education
Roy 10b comparative analysis and applications of nutritional assessmentSizwan Ahammed
The document discusses various methods for assessing nutritional status and needs of populations, including anthropometric, biochemical, dietary, and food basket menu assessments. Anthropometric assessments measure indicators like weight, height, and skin fold thickness to determine nutritional status. Biochemical tests diagnose micronutrient deficiencies by measuring levels of nutrients like iron, vitamin A, and iodine. Dietary assessments evaluate food intake and nutrient adequacy through food recall surveys or dietary diversity scores. Food basket menu assessments ensure optimal food distribution and nutrition in emergency settings. Combined assessments inform appropriate action by identifying problems, evaluating programs, and influencing policies.
Mannan 6b anthropometricand nutritional status indicatorsSizwan Ahammed
The document summarizes concepts and measurement of nutrition status. It discusses various indicators used to assess malnutrition including anthropometric measurements like stunting, wasting, underweight; BMI; and biochemical indicators of micronutrient deficiencies. Stunting, wasting and underweight are defined based on height-for-age, weight-for-height, and weight-for-age z-scores. Mid-upper arm circumference is also used. The most common micronutrient deficiencies are vitamin A, iodine and iron which are measured using biochemical indicators like serum retinol, urinary iodine and serum ferritin levels respectively.
1. Nutrition surveillance systems collect, analyze, interpret and report on nutritional status data to inform emergency response strategies. They vary based on context and resources.
2. Key challenges include ensuring reliable, timely data and effective links between data and action. Interpreting data requires understanding local contexts and underlying causes of malnutrition.
3. The objectives of surveillance systems are advocacy, identifying responses, triggering actions, targeting at-risk areas, and identifying malnourished individuals. Representative data that monitors standard indicators is most useful.
Opportunities for nutritional monitoring and implementation zambiaAg4HealthNutrition
The document discusses opportunities for nutritional monitoring and implementation at the national level in Zambia. It outlines how household surveys conducted by Zambia's National Statistical Office collect data on nutrition levels, food consumption, and malnutrition. This data provides opportunities to monitor nutritional status over time and evaluate the impact of nutrition programs and policies. While the surveys have limitations, they represent the most reliable way to collect household data on a large, representative scale and allow ongoing assessment of implementation efforts.
- India's state of Andhra Pradesh has seen economic growth but still struggles with malnutrition. The state government launched a Nutrition Mission to improve nutrition during the first 1000 days of life but coverage remains low.
- Two potential solutions are analyzed: direct nutrition interventions like counseling, supplementary food, and supplements; and community-based treatment of severe acute malnutrition using therapeutic foods.
- Costs per beneficiary are estimated at Rs. 12,885 for direct interventions and Rs. 5,287-12,371 for malnutrition treatment. Benefits include increased productivity and reduced mortality and morbidity, with benefit-cost ratios of around 9 for direct interventions but only 2-7.5 for malnutrition treatment.
Nutritional Assessment METHOD POWER POINT.pptMoamoiAddoo
This document provides information on nutritional assessment methods. It discusses direct and indirect assessment methods. Direct methods include anthropometric, biochemical, clinical, and dietary assessments. Anthropometric assessments measure body dimensions and proportions. Key anthropometric measurements discussed are head circumference, length/height, weight, and indices derived from these measurements. The document outlines several methods to classify nutritional status based on anthropometric indices, including Gomez, Wellcome Trust, and Waterlow classifications. It also discusses using anthropometry to assess body composition in adults.
The document discusses the Coping Strategies Index (CSI), a tool used to measure household food access and insecurity. The CSI identifies common coping strategies communities employ during food shortages and assigns weights based on perceived severity. It is constructed through focus groups to compile an area-specific list of strategies with frequency and severity scores. A CSI score is then calculated by combining frequency and severity values, with higher scores indicating greater food insecurity. While useful for emergency assessments and targeting, the CSI provides a localized measure and its results may not be comparable across communities without standardization.
This document discusses reducing the global rate of low birth weight by 30% by 2025. It provides background on low birth weight, noting that 15-20% of births worldwide have low birth weight. Interventions discussed include improving maternal nutrition, treating conditions like preeclampsia, and increasing access to quality healthcare. Cost-effective community interventions are also presented, such as nutrition programs, smoking cessation support, and improved antenatal care. The document emphasizes the need for a comprehensive, evidence-based global strategy to address the multifactorial causes of low birth weight.
XNB151 Week 5 Reference standards and advice 2013ramseyr
This document discusses several topics related to nutrition monitoring and dietary guidance. It explains how food composition tables can be used to determine nutrient intake from foods and monitor nutrient intake at the individual and population level. It also describes Australian food composition tables (NUTTAB) and limitations. Dietary guidelines are outlined as a tool to guide healthy food choices and provide recommendations on number of servings from different food groups. Reference values for assessing nutrient adequacy are also defined, including estimated average requirement, recommended dietary intake, adequate intake and upper limit. Metrics for assessing growth, weight status and obesity in children and adults are also covered.
Livestock-Climate Change CRSP Annual Meeting 2011: RPRA Project Update (S. Mc...Colorado State University
An overview of the Livestock-Climate Change CRSP RPRA (Risk, perception, resilience and adaptation to climate change in Niger and Tanzania) Project and update on the project's current status. Presentation given by S. McKune (University of Florida) at the Livestock-Climate Change CRSP Annual Meeting, Golden, CO, April 26-27, 2011.
Presented by Jonathan Wadsworth and Franck Berthe (World Bank Group) at the CGIAR Antimicrobial Resistance Hub Launching, ILRI Nairobi, 21-22 February 2019
early detection,maintainn ing health ,prevention of mal nutrition ,early diagnosis , requirement assessment ,reducing work load of health care worker ,important aspect of health system,building healthy nation
Similar to Nutrition Resilience Model v.4 Karamoja (20)
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdfDr Rachana Gujar
The "Comprehensive Rainy Season Advisory: Safety and Preparedness Tips" offers essential guidance for navigating rainy weather conditions. It covers strategies for staying safe during storms, flood prevention measures, and advice on preparing for inclement weather. This advisory aims to ensure individuals are equipped with the knowledge and resources to handle the challenges of the rainy season effectively, emphasizing safety, preparedness, and resilience.
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Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
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DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
2. Measuring
Resilience
Nutrition status indicators good for resilience
indicators because
Undernutrition is an unambiguous marker of
poverty and deprivation (causal framework),
Livelihood programmes often tend to target
better off households so changes in livelihoods
based resilience indictors may not show the
impact of the programme on the most deprived,
Undernutrition is a good indicator to bring
gender issues into focus. A women’s livelihood
status is one of the most important influences
on a child's nutritional status.
Undernutrition
3. Measuring
Resilience
Chronic undernutrition is standard Nutrition
Development Indicator.
Used in many Resilience programmes as an
impact indicator.
Chronic malnutrition improves ~1pp/year if good
integrated programme implemented.
Age and height difficult to get quality measures.
Stunting most appropriate for end programme
monitoring of Resilience programmes.
Acute and chronic undernutrition different
manifestations of same causal factors.
Acute undernutrition trends can also be used for
monitoring more regularly.
Chronic and Acute
Undernutrition
4. Desired 5 year Goal.
PRESENT SITUATION DESIRED SITUATION.
Continued reduction in maximum
GAM Prevalence by 1.5% a year
from 21% in 2014 to 13.5% in
2019.
Continued reduction in maximum
SAM Prevalence by 0.5% a year
from 4% in 2014 to 1.5% in 2019.
0
5
10
15
20
25
30
35
2009
2010
2011
2012
2012b
2013
2014
Prevalence%
2009-2014
Yearly Max. GAM and SAM Prevalence
GAM. SAM. Linear (GAM.) Linear (SAM.)
5. What is special about the Nutrition
situation in Karamoja?
CHANGEABLE SITUATION FOR GAM
AND SAM
EXAMPLE
Acute Undernutrition improving 2009
– 2014
6 year average is 23.3% GAM and
4.6% SAM
Very changeable
18 % difference between highest and
lowest GAM and 8.4% for SAM.
Up to 16.7% GAM and 6.3% SAM
difference between years.
N=22
0
5
10
15
20
25
30
35
2009
2010
2011
2012
2012b
2013
2014
Prevalence%
2009-2014
Yearly Max. GAM and SAM Prevalence
GAM. SAM. Linear (GAM.) Linear (SAM.)
6. Change and Resilience
CHANGES’ IMPACT ON RESILIENCE
Shocks are inherent to Karamoja
nutrition system – cause negative
changes in facility, community,
household and for an individual.
Negative changes in Karamoja
nutrition system are caused by many
small shocks , a few medium shocks
and rare big shocks.
Each shock challenges the nutrition
systems capacity to cope.
Many shocks to the nutrition system
synergistically combine also combine
with stresses to challenge
development progress.
PROPOSED DEFINITION FOR
NUTRITION RESILIENCE IN KARAMOJA
Nutrition Resilience could be
described as being achieved when
a person, population or system
has the capacity to mitigate,
adapt and transform in response
to shocks and stresses without
long term impact on their
nutritional status.
7. Measuring
Resilience
Change for nutrition can also be measured by
looking at anthropometric indicators.
GAM and SAM are most changeable and easily
measured so can also be used for yearly
monitoring of progress.
Example goals:
Reduce 5 year variability of GAM and SAM from
18% and 8% by half to 9% and 4% respectively.
Reduce average annual variability in GAM and SAM
from x% and X% by half to x% and x% respectively.
Measuring
Change
8. Development Pathways, Shocks, Stresses.
Population in Karamoja experiences
constant stresses (chronic) on their
development pathway.
Also experience regular shocks (acute)
e.g. drought.
Long term trends in either indicator
indicate long term trends in nutrition
system represented by the causal
framework.
Therefore, trends in chronic and acute
undernutrition can be used to
measure longer term impact of
resilience programming.
9. Nutrition
Resilience
Programming
Combination of three types of programming at
district, facility and community levels:
Chronic Nutrition Insecurity – Positive
development pathway. (reduction of impact of
stresses)
◦ Nutrition system strengthening, community based
nutrition, facility based nutrition services, Nutrition
Sensitive and Specific programming. = good
programming.
Acute Nutrition Insecurity – Reduce negative
impacts of shocks on development pathway.
Emergency – Respond to large extra-ordinary
shocks to save lives.
◦ General Food Distribution, Cash transfers, emergency
OTPs and SFPs, mass screening.
SO WHAT ARE NUTRITION RESILIENCE
INTERVENTIONS?
10. Acute
Nutrition
Insecurity
Models
Facility Based Surge Models.
Small and medium shocks happen at a local level
affecting one or a group of Health Facilities offering
Nutrition services. (idiosyncratic)
A shock on the facility causes challenges to the
facilities nutrition services to cope. Usually this
involves an increase in numbers attending the
service producing challenges to:
Human resources availability and capacity
Supply Resources
Space
The challenges result in reduced quality and
coverage of the service.
The facility surge model uses data and thresholds
on admissions and capacity to monitor a shocks
effect on the system and to predefine the response
of the health facility and the DHT and external
stakeholders.
Facility Based
Surge Models.
12. Acute
Nutrition
Insecurity
Models
Community based nutrition
programme:
Integrated (specific and sensitive)
Prevention + Promotion,
Referral and follow up.
In process of being defined in Karamoja.
Work in progress.
Capacities and vulnerabilities, barriers and
promoters etc. Formative research.
Methodologies
Linkages
To adapt for Acute Nutrition Resilience
Risk Informed
Context specific
Capacity based
E.g. Diarrhoea
COMMUNITY BASED
MODELS