The document discusses using nutritional assessment data for policy and programmatic applications. It provides examples of how food and nutrition indicators can be used to define trends, identify causes, and monitor and evaluate programs. While food availability may be improving, dietary adequacy does not always equal nutritional status due to issues like poor diversity and gaps. Presenting and interpreting nutritional data makes a difference, as averages can hide disparities. Dietary intake assessments are key to understanding individual nutrition.
Here is a Power Point that I recently finished for a project in one of my classes at Devry. The assignment called for a very generic style but I just couldn't do that. I have to spice it up a bit.
Improving nutrition through increased utilisation of local agricultural biodiversity in Kenya. Presentation given by Gudrun Keding, Postdoctoral Research Fellow, Bioversity International.
Find out more about this research:
http://www.bioversityinternational.org/news/detail/improving-nutrition-through-local-agricultural-biodiversity-in-kenya/
Here is a Power Point that I recently finished for a project in one of my classes at Devry. The assignment called for a very generic style but I just couldn't do that. I have to spice it up a bit.
Improving nutrition through increased utilisation of local agricultural biodiversity in Kenya. Presentation given by Gudrun Keding, Postdoctoral Research Fellow, Bioversity International.
Find out more about this research:
http://www.bioversityinternational.org/news/detail/improving-nutrition-through-local-agricultural-biodiversity-in-kenya/
Using a community-based early childhood development center as a platform to p...IFPRIMaSSP
Presented by Dr. Aulo Gelli, International Food Policy Research Institute (IFPRI) at IFPRI Malawi workshop and policy dialogue, 'Nutrition-sensitive social protection and integrated programs in Malawi: Evidence from a longitudinal study in Zomba spanning the 2016-17 food crises,' in Lilongwe, Malawi, May 17, 2018.
Year 1 Impact Results: Pre-school meals as a platform for behavior change at ...IFPRIMaSSP
Presented by Dr. Mangani Katundu, Associate Professor, Chancellor College, at IFPRI Malawi workshop and policy dialogue, 'Nutrition-sensitive social protection and integrated programs in Malawi: Evidence from a longitudinal study in Zomba spanning the 2016-17 food crises,' in Lilongwe, Malawi, May 17, 2018.
Nutrition-sensitive food systems: from concepts to practice: Resources for de...Francois Stepman
15 May 2017. Brussels. Infopoint Lunchtime Conference: presentation by Cristina Amaral, Director, FAO liaison office with the European Union and Belgium
Charlotte Dufour, FAO Nutrition policy and programme officer
Domitille Kauffmann, FAO Nutrition and resilience and capacity development advisor
Presented by Muntita Hambayi
Presented at Report Launch "Mapping Linkages Between Agriculture, Food Security and Nutrition in Malawi"
Ufulu Gardens, 28th April, 2015
Livestock-Climate Change CRSP Annual Meeting 2011: Integrating Human Nutritio...Colorado State University
Tips for integrating human nutrition into research on the interaction between livestock/agricultural production and climate change; overview of the Global Livestock CRSP's ENAM project in Ghana. Presentation given by G. Marquis (McGill University) at the Livestock-Climate Change CRSP Annual Meeting, Golden, CO, April 26-27, 2011.
Former Dietary Guidelines Advisory Committee members discussed the role nutrition science and research plays in shaping U.S. food policy issues, such as the Dietary Guidelines for Americans, and the impact on consumers and industry.
Key Takeaways:
The role federal agencies play in making food and nutrition policy recommendations
Insights into the science and process related challenges faced when creating the DGAC Report
Thoughts from past DGAC members on the newly released 2015 DGAC Report
Jody Harris - Stories of Change in Nutrition: the Case of ZambiaIFPRI SIG
"Stories of Change in Nutrition: the Case of Zambia" - Jody Harris
SIG 2015 Workshop "Integrating Multi-level Governance into the Post-2015 Development Agenda: Opportunities, Trade-offs, and Implications", Nov 9-10, 2015
CORE Group Fall Meeting 2010. HKI’s Enhanced Homestead Food Production model: Linking food production to nutrition outcomes. - Victoria Quinn, Helen Keller International
Using a community-based early childhood development center as a platform to p...IFPRIMaSSP
Presented by Dr. Aulo Gelli, International Food Policy Research Institute (IFPRI) at IFPRI Malawi workshop and policy dialogue, 'Nutrition-sensitive social protection and integrated programs in Malawi: Evidence from a longitudinal study in Zomba spanning the 2016-17 food crises,' in Lilongwe, Malawi, May 17, 2018.
Year 1 Impact Results: Pre-school meals as a platform for behavior change at ...IFPRIMaSSP
Presented by Dr. Mangani Katundu, Associate Professor, Chancellor College, at IFPRI Malawi workshop and policy dialogue, 'Nutrition-sensitive social protection and integrated programs in Malawi: Evidence from a longitudinal study in Zomba spanning the 2016-17 food crises,' in Lilongwe, Malawi, May 17, 2018.
Nutrition-sensitive food systems: from concepts to practice: Resources for de...Francois Stepman
15 May 2017. Brussels. Infopoint Lunchtime Conference: presentation by Cristina Amaral, Director, FAO liaison office with the European Union and Belgium
Charlotte Dufour, FAO Nutrition policy and programme officer
Domitille Kauffmann, FAO Nutrition and resilience and capacity development advisor
Presented by Muntita Hambayi
Presented at Report Launch "Mapping Linkages Between Agriculture, Food Security and Nutrition in Malawi"
Ufulu Gardens, 28th April, 2015
Livestock-Climate Change CRSP Annual Meeting 2011: Integrating Human Nutritio...Colorado State University
Tips for integrating human nutrition into research on the interaction between livestock/agricultural production and climate change; overview of the Global Livestock CRSP's ENAM project in Ghana. Presentation given by G. Marquis (McGill University) at the Livestock-Climate Change CRSP Annual Meeting, Golden, CO, April 26-27, 2011.
Former Dietary Guidelines Advisory Committee members discussed the role nutrition science and research plays in shaping U.S. food policy issues, such as the Dietary Guidelines for Americans, and the impact on consumers and industry.
Key Takeaways:
The role federal agencies play in making food and nutrition policy recommendations
Insights into the science and process related challenges faced when creating the DGAC Report
Thoughts from past DGAC members on the newly released 2015 DGAC Report
Jody Harris - Stories of Change in Nutrition: the Case of ZambiaIFPRI SIG
"Stories of Change in Nutrition: the Case of Zambia" - Jody Harris
SIG 2015 Workshop "Integrating Multi-level Governance into the Post-2015 Development Agenda: Opportunities, Trade-offs, and Implications", Nov 9-10, 2015
CORE Group Fall Meeting 2010. HKI’s Enhanced Homestead Food Production model: Linking food production to nutrition outcomes. - Victoria Quinn, Helen Keller International
Your clients (be they individuals or in-house counsel) will appreciate you putting your best foot forward in the mediation process. It can save you client valuable money and resources.
We learn meditation, follow it for some time and then quit. This is so common things to happen with a great number of people across the world. Here I list 15 steps that can help you avoid this situation. Your technique or method of meditation could be any. Check this out.
Meditation is an experience of relaxing the body, quieting the mind, and awakening the spirit. Meditation encourages a deepening of consciousness or awareness, and also facilitates a deeper understanding of self and others.
Strengthening nutrition-sensitivity of social protection programmes in India:...Transform Nutrition
This presentation by Suman Chakrabarti, IFPRI was shown at the Transform Nutrition - Evidence for Action regional meeting in Kathmandu, Nepal on 8 July 2017. This one-day event shared Transform Nutrition evidence on key issues related to nutrition policy in Nepal, Bangladesh and India, lessons on strategies for change from other contexts and discuss the relevance and applicability of the research findings to policies/programmes that aim to address nutrition in South Asia.
Helping countries improve nutrition outcomes through agriculture and food - w...Francois Stepman
11 December 2017. Brussels. DevCo Infopoint. Countries are seeking to improve nutrition through multiple sectors, including agriculture and food systems. This requires navigating dietary transitions, strengthening country ownership of programmes and investment decisions, working with public and private partners, and better understanding drivers that shape demand. These are key considerations for lesson learning moving forward.
Introduction: Bernard Rey, Deputy Head of Unit, DEVCO C1- Rural Development, Food Security, Nutrition
Panel discussion:
John McDermott, Director, CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)
Namukolo Covic, Senior Research Coordinator, IFPRI, Addis Ababa, Ethiopia
Roseline Remans, Research Scientist, Bioversity International, Brussels
Thom Achterbosch, Senior Researcher, Wageningen Economic Research, International Policy
Please find also the link to the video of the conference:
https://ec.europa.eu/europeaid/news-and-events/agriculture-nutrition-outcomes-countries_en
Contribution of indigenous fruits and vegetables to dietary diversity and qua...Bioversity International
Presentation given by Dr. Bruce Cogill at the International Horticultural Congress 2014.
The world has a historically unprecedented abundance of food, though contemporary food systems face numerous new challenges from population growth, natural resource
depletion, and rapid dietary transitions away from diverse, locally-sourced and sustainable mix of foods towards diets dominated by homogenous, highly-processed, energy-dense, and animal-source foods The alarming increase in diet and lifestyle-related non-communicable diseases (NCDs) alongside persistent poverty and undernutrition demands a reassessment of dietary choices, guidelines, policies and programmes.
This presentation presents 5 case studies on the contribution of diverse foods, particularly indigenous fruits and vegetables, to culturally-acceptable, cost-effective, sustainable, and nutritious diets.
Read more about our work on diet diversity for nutrition and health here: http://www.bioversityinternational.org/research-portfolio/diet-diversity/
Understanding sustainable diets - Four papers, three published in high impact peer-reviewed journals, further our understanding of sustainable diets. Find out more here: http://www.bioversityinternational.org/news/detail/understanding-sustainable-diets/
Presented by Stacia Nordin, FAO
Presented at Report Launch "Mapping Linkages Between Agriculture, Food Security and Nutrition in Malawi"
Ufulu Gardens, 28th April, 2015
Severe Acute Malnutrition (SAM) and Nutrition Rehabilitation Centre (NRC)- Dr...Yogesh Arora
A presentation on severe acute malnutrition and nutritional rehabilitation center. Various preventive, promotive, and curative aspects of SAM are discussed in this presentation.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Sanghvi 9 linking dietary intakes with nutritional assessment
1. Module 5: Nutritional assessment in
policy and programmatic application
By
Tina G. Sanghvi, PhD Senior Country Director Alive & Thrive, FHI360
Training on Assessment of Nutritional Status 18-22 December 2011
Date : 22 December 2011,
Venue: FPMU Meeting Room
The Training is organized by the National National Food Policy Capacity Strengthening Programme (NFPCSP) . The NFPCSP is jointly
implemented by the Food Planning and Monitoring Unit (FPMU), Ministry of Food and Disaster Management and Food and Agriculture
Organization of the United Nations (FAO) with the financial support of the EU and USAID.
2. Acknowledgements
• M. Ruel, IFPRI. Nutrition and economic growth A&T
Partners’ Meeting Hanoi, September 2011
• Lalita Bhattacharjee, FSNSP Dissemination Workshop.
December 13 December 13, 2011.
• Mahbub Hossain, BRAC. FSNSP Dissemination
Workshop. December 13, 2011
• John B. Mason. Keynote paper: Measuring hunger and
malnutrition.FAO Symposium 2002
• IFPRI. Alive & Thrive Baseline Survey 2011.
• Haider, Sanghvi et al. Alive & Thrive Formative Research
on IYCF. 2009.
Module 5: Program and Policy Application, Tina Sanghvi PhD
3. Session Overview
• Uses of data for policy & programs
– Examples
• Why dietary adequacy does not always equal
nutritional status
– Examples
Module 5: Program and Policy Application, Tina Sanghvi PhD
4. Indicators – Country Investment Plan
Key Indicators Baseline (‘07-’10) Final ‘15-’16)
Overall goal:
% People undernourished 27 17.5
% Child stunting 43 25
% Child underweight 41 33
Outcome/impact:
Food availability (food supplies) (rice supply & share)
Food access (income)
- Poverty rate < 2022 kcals/day 40 24
- Poverty rate < 1805 kcals/day 19.5 14
Food utilization
- Minimum acceptable 42 56
complementary feeding
(quantity & quality of CF 6-23 m)
Module 5: Program and Policy Application, Tina Sanghvi PhD
5. Uses of data for policy & programs
• How food & nutrition assessments are used:
– Define trends to trigger action
– Identify causes to design interventions
– Monitor & evaluate effects of programs & policies
• Choice of indicators & interpretation are key
Example: In Bangladesh, food and poverty trends
have improved. Fertility & mortality rates have
declined but malnutrition is stagnant. This is
triggering actions to find out the causes, evaluate
past programs and strengthen nutrition
interventions, e.g. CIP, NFP, POA, National
Nutrition Service to evaluate their future effects
Module 5: Program and Policy Application, Tina Sanghvi PhD
6. METHODS OF ASSESSING FOOD
SECURITY& NUTRITION & THEIR USE
Method Use
Trends analysis Research into Evaluation
causes
(1 ) FAO: DES/CV Main use: global and Not very useful except Not very useful
dietary energy supply regional level; always for broad inter-country
(coefficient of variation) under-estimates trends
(2) Household income Useful: national and Can be useful Useful
and expenditure survey subnational level
(3) Food consumption/ Useful: now available at Main use Main use
the national level, thus
individual intake (24- very useful, captures
hour) intra-HH food distrib.
(4) Anthropometry Useful at all levels, but Useful for physical Useful but should also
(mother, child weight & for physical malnutrition malnutrition not food have food security
height) and not food security security indicators
(5) Qualitative method Useful: national and Useful Useful
(food habits) subnational level
7. Questions that can be addressed by
different methods
Method Use
Trends analysis Causal analysis Evaluation
(1 ) FAO: DES/CV Is the supply of food in Is the cause of food Are food supply
dietary energy supply terms of calories/ insecurity & policies/programs
(coefficient of variation) energy improving to undernutrition due to working? Impact of
meet needs, if overall food supply?
climate change/
equitably distributed?
disasters on supplies?
(2) Household income Are no. of food secure Is the cause of Are programs working
and expenditure survey HH (in energy and problems due to low to reach the poor?
nutrients) improving? expenditures on food?
(3) Food consumption/ Are mothers and young Is the problem food Are programs for
children consuming availability/access or women and young
individual intake (24-hr) more adequate diets? dietary habits? children working?
(4) Anthropometry Is nutritional status No Does the program
(mother/child wt, ht) improving? improve nutrition of
mothers & children?
(5) Qualitative method Are food habits Are habits a barrier? Does the program
(food habits, frequency) improving? improve food habits?
8. How we present and interpret data
makes a difference: examples
Module 5: Program and Policy Application, Tina Sanghvi PhD
9. Trends in food intake (gms/capita/day)
All Urban Rural
1991-92 886 938 878
1995-96 914 931 911
2005 949 952 946
2010 1000 985 1005
•Intakes improving faster in rural areas,
•Averages hide disparities among economic groups
Module 5: Program and Policy Application, Tina Sanghvi PhD
10. Food available in grams per head per day
1050
1000
950
All
Urban
900
Rural
850
800
1991-92 1995-96 2005 2010
Module 5: Program and Policy Application, Tina Sanghvi PhD
12. Trends in food content adequacy
(gms/capita/day)
Food Recom. 2005 2010 Trend
Rice 390 440 416
Wheat 100 12 26
Vegetables 225 220 236
Pulses 30 14 14
Oil 20 16 21
Fish 45 42 49
Meat/eggs 34 20 25
Module 5: Program and Policy Application, Tina Sanghvi PhD
13. Content of food basket: improving
diversity
500
450
400
350 Rice
300 Wheat
250 Vegetables
200
Pulses
150
100 Oil
50 Fish
0 Meat/eggs
2005 2010
Module 5: Program and Policy Application, Tina Sanghvi PhD
14. Content of food basket: gaps in diversity
500
450
400
350 Recom.
300
250 2005
200
150 2010
100
50
0
Module 5: Program and Policy Application, Tina Sanghvi PhD
15. Dietary intake assessment is key
• RAP –low cost, primary method for collecting dietary data
(locally available /commonly consumed foods, dietary
habits, behaviour)
• Household surveys – provide data on foods consumed by
HH not individuals
• Point to which foods are major contributors to nutrients of
particular concern ( identify vulnerability/at risk of dietary
deficiency - e.g lack of animal foods; no fresh
vegetables/fruits, lack of DGLV/YOV–lack of vit. C & A in
diet)
• Food record and 24 hr recall methods of choice for
estimating mean intakes; quantitative dietary intake
methods to obtain individual nutrient intakes
• Take measurements for each individual on at least 2 non-
consecutive days to obtain intra-individual variation
Module 5: Program and Policy Application, Tina Sanghvi PhD
16. Why improving food security does not
necessarily remove undernutrition
Module 5: Program and Policy Application, Tina Sanghvi PhD
17. A&T Baseline: Stunting is High Even
in Food Secure Households
Bivariate
55
53.29
50
49.88
45 46.39 47.32 47.07
44.52
40
39.28
35
PERCENT STUNTED
35.38
30
Food secure
25
Mildly food insecure
20 22.99 23.14 Moderate food insecure
19.18 Severely food insecure
15
13.88
10
5
0
Vietnam Bangladesh Ethiopia
+ p < 0.10, * p < 0.05, ** p < 0.01, *** p < 0.001
Module 5: Program and Policy Application, Tina Sanghvi PhD
Ruel; A&T Partners' Meeting, Hanoi
9/27/2011
18. Factors that determine nutritional status
Module 5: Program and Policy Application, Tina Sanghvi PhD
19. Adequate Complementary Feeding
100
90
By Wealth Quintiles By Age Groups
80
70
60
58
50
47 44 48 48
40
38 38 36
30
20 16
10
0
Lowest Second Middle Fourth Highest 6-8m 9-11m 12-17m 18-23m
BDHS 2007
20. Quality of Children’s Diets (BDHS, 2007)
Meat, Fish, Poultry and Eggs Consumed (< 24 h)
100
90
80 71 75
70 64
60 48
50
40 34
30 24
20 10
10 0 0 2
0
Age <2 m 2-3 m 4-5 m 6-7m 8-9m 10- 12- 16- 20- 24-
11m 15m 19m 23m 35m
21. Why is nutrition not improving?
• Knowledge: do people know what foods they should
consume by age, sex, occupation, physiological status?
• Do families have the resources/motivation to convert
knowledge to practice
• If food intakes (energy and nutrients) are
adequate, could there be intervening factors e.g. illness
• Pre-disposing factors: maternal undernutrition
seasonal food/income shortages, migration, illness
outbreaks, hygiene/sanitation, emergencies
• Importance of under 2’s
Module 5: Program and Policy Application, Tina Sanghvi PhD
22. Illustration of association between
dietary adequacy and anthropometry
Prevalence of % with % with Total under
under inadequate adequate or adequate
nutrition diet diet nutrition
% <-2SDs 20 10 30
% > -2SDs 0 70 70
Total sample 20 80 100
Note: 10% have adequate diets but are still undernourished due to other causes
Source : Mason, 2002 in “Measurement and Assessment of Food Deprivation and Undernutrition”, FAO
23. New focus on under 2 yr age group
• Most rapid decline in nutritional status
• Damage is largely not reversible
• Affects child growth + adult chronic diseases
• Affects brain development/learning as well as
physical development
• All national nutrition indicators focus on
young children, to improve MDG 1 have to
prevent under 2 decline in nutrition
Module 5: Program and Policy Application, Tina Sanghvi PhD
24. Goal: To reduce undernutrition, improve IYCF
Maximum decline at 3 to 15 months – period of IYCF
0.5
Length-for-age Z-score
EBF Complementary Feeding
0
------- ---------------------------
-0.5
Boys WHO Girls WHO
Growth of girls/ boys
Boys NCHS Girls NCHS
NCHS/WHO standards
-1
-1.5
-2
-2.5
1 3 5 7 9 11 13 15 17 19 21 23 25
Age (mo)
Growth data: Kuntal K. Saha et al, Food Nutr Bull. 2009; 30: 137-44
ICDDRB
Module 5: Program and Policy Application, Tina Sanghvi PhD
25. CF Provides Adequate Energy & Nutrients
Energy Required & Amount From Breastmilk & CF
1000
900
800 BF + CF
Calories per day
700 550
Exclusive BF
600
300 Compl. Food
500 200
400 Breastmilk
300
200
100
0
0-2 3-6 7-8 9-11 12-23
Age in months
½ Bati ½ Bati 1 Bati •At least 4 types
Recommended diet: 2 times 3 times 3 times •Hygienically
Daily + Daily + Daily+ prepared
Module 5: Program and Policy Application, Tina Sanghvi PhD
Bati = 250 ml
26. Indicators – Country Investment Plan
Key Indicators Baseline (‘07-’10) Final ‘15-’16)
Overall goal:
% People undernourished 27 17.5
% Child stunting 43 25
% Child underweight 41 33
Outcome/impact:
Food availability (food supplies) (rice supply & share)
Food access (income)
- Poverty rate < 2022 kcals/day 40 24
- Poverty rate < 1805 kcals/day 19.5 14
Food utilization
- Minimum acceptable 42 56
complementary feeding
(quantity & quality of CF 6-23 m)
Module 5: Program and Policy Application, Tina Sanghvi PhD
27. Minimum acceptable diet for under 2’s
• 3 conditions must be met:
– Breastfeeding
– Meal frequency as per age (2 to 3 times plus snacks)
– At least 4 different categories of food
Analysis should be used to focus BCC messages, how to
deal with HH food availability, mothers’ time
constraints etc.
Module 5: Program and Policy Application, Tina Sanghvi PhD
28. 100
Gaps in feeding
90
80
Median EBF 1.8 m 68
70
60
58
50
48 47
43 43 43
40 36
30
20 16
10
0
Breastfeeding Complementary Feeding
BDHS 2007, WHO (HKI 2006)
Module 5: Program and Policy Application, Tina Sanghvi PhD
29. Main messages
• What is needed to ensure food security &
nutrition results:
– Food availability - Food access - Food utilization
– Behavior change communications to promote
specific dietary & health habits
• Disaggregated analysis of trends, causes &
evaluations to design relevant interventions
• Equity: rational use of foods to reach the
disadvantaged & high risk ages; targeted
nutrition
Module 5: Program and Policy Application, Tina Sanghvi PhD
30. Conclusion
• Understanding what indicators & assessment
methods to use in policy & programs is key
• Food & dietary adequacy (total energy &
diversity) is a necessary, but not sufficient
condition for good nutrition
• Interpreting and presenting data in an
accurate and relevant manner is essential
• Assessments that do not lead to actions are
meaningless
Module 5: Program and Policy Application, Tina Sanghvi PhD