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Authors:Nora Hobbs, Julia Hug, Saskia de Pee Pages: S45 - S57 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S45-S57, December 2023. Background:Africa’s drylands have unique food environments and persistently high rates of wasting and stunting. This article documents findings and experiences from Fill the Nutrient Gap (FNG) processes conducted in 7 Sub-Saharan African countries that include drylands.Objective:This study advocates for a comprehensive consideration of the specific food environments of drylands using a novel analytical framework and shares findings and best practices for improving food and nutrition security in these contexts.Methods:Three analyses are combined. Analysis 1 re-analyzes cost and non-affordability of nutrient-adequate diets indicators from FNGs by reclassifying areas as drylands and non-drylands. Analysis 2 uses malnutrition estimates in drylands and non-drylands and examines associations with non-affordability of nutrient-adequate diets. Analysis 3 synthesizes evidence from FNG processes to document how those indicators were used to engage stakeholders and inform nutrition policy and practice in drylands.Results:The nutrient-adequate diet of a 5-person household was 2.60 USD (41%) more expensive in drylands. A nutrient-adequate diet was not affordable to 71% of households in drylands, compared to 55% in non-drylands. Wasting and stunting prevalence and non-affordability of nutrient-adequate diets were simultaneously high in drylands.Conclusion:The article presents new evidence that contributes to elucidate specific characteristics of the food environment of Africa’s drylands and suggests a framework to improve on those factors systematically. The FNG is innovative in combining an analytical framework with multistakeholder review and dialogue, as well as modeling of possible strategies, to build consensus on possible transformation pathways to improve diets in drylands.Plain language titleFindings of high non-affordability of diets and malnutrition enhances systems thinking for action in Africa’s drylandsPlain language summaryThe article documents findings and experiences from the World Food Programme’s Fill the Nutrient Gap (FNG) processes conducted in 7 Sub-Saharan African countries that include drylands. The objective is to advocate for a comprehensive consideration of the specific food environments of drylands using a novel analytical framework and share findings and best practices of how this can support improvements in food and nutrition security in these contexts. The FNG process relies on 2 metrics of cost of a nutrient-adequate diet and the proportion of people who cannot afford it which capture important dimensions of the local food environment. Three analyses are combined. Analysis 1 reanalyzes the indicators of cost and non-affordability by reclassifying areas as drylands and non-drylands. Analysis 2 uses malnutrition estimates in drylands and non-drylands and examines associations with non-affordability of nutrient-adequate diets. Analysis 3 synthesizes evidence from FNG processes to document how indicators of cost and non-affordability were used to engage stakeholders and inform nutrition policy and practice in the 7 countries. The nutrient-adequate diet of a 5-person household was found to be 2.60 USD (41%) more expensive in drylands. A nutrient-adequate diet was not affordable to 71% of households in drylands, compared to 55% in non-drylands. Examining the link between non-affordability of nutrient-adequate diets and different forms of malnutrition, wasting, and stunting prevalence and non-affordability of nutrient-adequate diets was simultaneously high in drylands, whereas this relationship appeared more nuanced in non-drylands. The article also synthesizes findings from FNG reports on the specific characteristics of the food environment of Africa’s drylands that can help make sense of cost, affordability, and malnutrition patterns. The FNG is innovative in combining an analytical framework with multistakeholder review and dialogue, to build consensus on the priority actions for transformative, system-wide changes toward improved diets and nutrition in drylands. Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:15Z DOI: 10.1177/03795721231178065 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Moctar Sacande, Giulia Muir Pages: S58 - S68 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S58-S68, December 2023. Background:Twenty-seven African countries have committed to restore more than 100 million hectares of degraded land by 2030 as part of the African Forest Landscape Restoration Initiative (AFR100). In addition, for the same period of time, the African-led Great Green Wall initiative seeks to restore 100 million hectares of degraded agro-sylvo-pastoral lands in the Sahel. The current UN Decade on Ecosystem Restoration (2021-2030) moreover marks an unprecedented opportunity to shape future landscapes, and forge more biodiverse and nutritious food systems. Yet most large-scale restoration actions continue to be largely isolated from socioeconomic challenges facing dryland communities, not least food security and acute malnutrition. Such isolations contribute to low restoration successes and outcomes in Africa’s drylands. At the same time, international interventions aimed at improving acute malnutrition in the drylands have not adequately considered the agriculture-nutrition linkages, particularly “pre-farm gate”—including consumption pathways which optimize the use of native plant diversity.Objectives:This article identifies priority action areas emerging from experiences over 5 years of restoration activities carried out in the Sahel through Food and Agriculture Organization’s (FAO) Action Against Desertification Programme supporting the implementation of Africa’s Great Green Wall. These actions aim to inform development and humanitarian interventions on the ground to render restoration interventions nutrition-sensitive and hence more effective in practice.Results:Recognizing the symbiotic relationship between landscapes and livelihoods, FAO developed a blueprint for large-scale restoration that combines biophysical and socioeconomic aspects for the benefit of rural communities. The approach builds climate and nutritional resilience into its restoration interventions as a preventative approach to reverse land degradation and ultimately improve livelihoods, food security, and nutrition.Conclusions:FAO’s experience demonstrated that what is planted and when has the potential to not only significantly improve biodiversity and reverse land degradation, but also positively influence nutrition outcomes. Future interventions in the drylands must involve joint efforts between nutritionists and natural resource managem prove both human and planetary health.Plain language titleRestoring Africa’s Drylands With Nutritious Native PlantsPlain language summaryThe African-led Great Green Wall (GGW) initiative seeks to restore 100 million hectares of degraded lands in the Sahel, in the context of the current UN Decade on Ecosystem Restoration by 2030, marking an unprecedented opportunity to shape future landscapes, and forge more biodiverse and nutritious food systems. At the same time, international interventions aimed at improving acute malnutrition have not adequately considered the agriculture-nutrition linkages, particularly “pre-farm gate,” including consumption pathways which optimize the use of native plant diversity. Recognizing the symbiotic relationship between landscapes and livelihoods, Food and Agriculture Organization (FAO) developed a blueprint for large-scale restoration that combines biophysical and socioeconomic aspects for the benefit of rural communities and builds climate and nutritional resilience into its restoration interventions as a preventative approach to reverse land degradation and ultimately improve livelihoods, food security, and nutrition. This article identifies priority action areas emerging from experiences over 5 years of restoration activities carried out in the Sahel through FAO’s Action Against Desertification supporting the implementation of the GGW. The results demonstrated that what is planted and when has the potential to not only significantly improve biodiversity and reverse land degradation but also positively influence nutrition outcomes. Future interventions in the drylands must involve joint efforts between nutritionists and natural resource management specialists in order to improve both human and planetary health. Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:15Z DOI: 10.1177/03795721231190779 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Aishwarya Venkat, Anastasia Marshak, Helen Young, Elena N. Naumova Pages: S94 - S108 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S94-S108, December 2023. Reduction of wasting, or low weight-for-height, is a critical target for the Zero Hunger Sustainable Development Goal, yet robust evidence establishing continuous seasonal patterns of wasting is presently lacking. The current consensus of greatest hunger during the preharvest period is based on survey designs and analytical methods, which discretize time frame into preharvest/postharvest, dry/wet, or lean/plenty seasons. We present a spatiotemporally nuanced study of acute malnutrition seasonality in African drylands using a 15-year data set of Standardized Monitoring and Assessment of Relief and Transition surveys (n = 412,370). Climatological similarity was ensured by selecting subnational survey regions with 1 rainy season and by spatially matching each survey to aridity and livelihood zones. Harmonic logit regression models indicate 2 peaks of wasting during the calendar year. Greatest wasting prevalence is estimated in April to May, coincident with the primary peak of temperature. A secondary peak of wasting is observed in August to October, coinciding with the primary peak of rainfall and secondary peak of temperature. This pattern is retained across aridity and livelihood zones and is sensitive to temperature, precipitation, and vegetation. Improved subnational estimation of acute malnutrition seasonality can thus assist decision makers and practitioners in data-sparse settings and facilitate global progress toward Zero Hunger.Plain language titleFifteen Years of Rapid Assessment Surveys Indicate Seasonal Variability in Prevalence of Acute Malnutrition Among Children Younger Than 5 Years in African DrylandsPlain language summaryWasting or low weight-for-height is a key indicator of short-term or acute malnutrition. The timing of highest wasting prevalence, particularly among children younger than 5 years, is of interest for humanitarian efforts to reduce hunger. Current knowledge about this timing derives from survey designs, which discretize continuous time into preharvest/postharvest, dry/wet, or lean/plenty seasons. Instead of this categorical approach, we utilize harmonic regressions that allow for modeling of continuous time in our analysis of 15 years of Standardized Monitoring and Assessment of Relief and Transition surveys. Surveys conducted in parts of North Africa with 1 rainy season (unimodal regions) were selected for similar climate, and survey locations were further subdivided by aridity and livelihood zones. The seasonal pattern of extreme wasting prevalence in each group was modeled using survey data for a total of 412,370 children. We identified 2 periods of highest wasting prevalence in April to May and August to October. The April to May peak occurs during highest temperatures, and the August to October peak occurs during periods of highest rainfall and warmer temperatures in the study area. These findings can inform the timing of nutrition programs in unimodal dryland regions and guide future quantitative models of acute malnutrition seasonality. Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:15Z DOI: 10.1177/03795721231178344 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Samuel M. Thumbi, Josphat Muema, Nyamai Mutono, Joseph Njuguna, Christine Jost, Erin Boyd, Daniel Tewoldeberhan, Immaculate Mutua, George Gacharamu, Francis Wambua, Rob Allport, Emmanuella Olesambu, Abdal Monium Osman, Darana Souza, Irene Kimani, Julius Oyugi, Zipporah Bukania, Harriet Oboge, Guy H. Palmer, Jonathan Yoder Pages: S119 - S123 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S119-S123, December 2023. Background:Livestock-dependent communities in Africa’s drylands disproportionately experience acute malnutrition, especially during drought seasons. We detail the design and implementation of the Livestock for Health (L4H) study aimed at determining the effect of providing livestock feed and nutritional counselling to prevent seasonal spikes of acute malnutrition.Methods:The L4H study employed a 3-arm cluster randomized controlled trial to compare households in pastoralist settings in northern Kenya receiving livestock feeds during critical dry periods, with or without nutritional counseling, with control households. Over 4 dry seasons, 2019 to 2021, the study collected data on household milk production, consumption patterns, mothers’/children’s nutritional status, household socioeconomic status, herd dynamics, and human and animal health status every 6 weeks.Results:L4H recruited 1734 households, with 639, 585, and 510 households assigned to intervention arms 1 and 2 and control arm 3, respectively. From these households, 1734 women and 1748 children younger than 3 years were recruited. In total, 19 419 household visits were completed, obtaining anthropometric measures 9 times on average for each child and mother. Eighty-one households (5%) were lost from the study due to the mother’s death, child’s death, migration, and withdrawal for other reasons.Discussion:L4H’s success in a challenging environment was possible due to strong community engagement, formative studies to inform trial design, collaboration with local authorities, and effective interdisciplinary collaboration. Subsequent manuscripts will report the study findings.Trial Registration:The study was registered October 29, 2020, and is online at ClinicalTrials.gov (ID: NCT04608656). Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:15Z DOI: 10.1177/03795721231195427 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Helen Young, Nola Jenkins, Abdal Monium Osman, Patrizia Fracassi, Anne Radday Pages: S5 - S8 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S5-S8, December 2023.
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Authors:Patrizia Fracassi, Morgane Daget, Sangmin Seo, Riccardo D’Angeli Pages: S32 - S44 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S32-S44, December 2023. Persistent child wasting is evident across the Sahel and Horn of Africa, much of which is typically dryland and dependent on agropastoralism. Two events in 2021, the United Nations (UN) Food Systems Summit and the Tokyo Nutrition for Growth Summit, represented a watershed moment for the alignment of food systems and nutrition. Against this backdrop, the costed country operational roadmaps, developed in 22 countries as part of the joint UN Global Action Plan on Child Wasting (UNICEF 2021), recognized the importance of preventing child wasting using a multisectoral approach. We use a food systems lens to assess how current governance mechanisms, policies, and programming priorities in 8 sub-Saharan countries are responsive to the food security and nutritional needs of the most vulnerable people. For governance mechanisms, we draw from a narrative review of joint annual assessments conducted by the Scaling Up Nutrition Movement’s national multistakeholder platforms since 2016. For policy frameworks, we analyze recommendations included in operational roadmaps and findings from the review of national multisectoral nutrition plans. For programming priorities, we analyze the typologies of costed interventions in the food and social protection systems. We present how nutrition and healthy diets were factored into national food systems pathways and how Government commitments to Nutrition for Growth integrate food systems and resilience. Results of this exploratory review suggest opportunities offered by the implementation of the country roadmaps should rely on a fundamental understanding of context-specific risks and vulnerabilities embedded in the systems and their dynamics.Plain language titleUsing a Food Systems Lens to Prevent Child Wasting in 8 Sub-Saharan Countries Characterized by Dryland LivelihoodsPlain language summaryChild wasting persists across the Sahel and Horn of Africa, much of which is typically dryland and dependent on agropastoralism. We use a food systems lens to assess how governance mechanisms, policies, and programming priorities in 8 sub-Saharan countries are responsive to the food security and nutritional needs of the people in greatest vulnerability. For governance mechanisms, we draw from a narrative review of joint annual assessments conducted by the Scaling Up Nutrition (SUN) Movement’s national multistakeholder platforms between 2016 and 2021. For policy frameworks, we analyze policy recommendations and national multisectoral nutrition plans. For programming priorities, we examine costed interventions within the food and social protection systems that have been included in the country’s operational roadmaps for the prevention of child wasting. As indications of high-level political dedication, we present how nutrition and healthy diets were factored into national food systems pathways developed for the 2021 UN Food Systems Summit and how food systems and resilience were integrated into Government commitments made for the 2021 Tokyo Nutrition for Growth Summit. Findings of this exploratory review point to an enabling governance, policy, and political environment for the implementation of interventions to prevent child wasting. However, results will rely on a fundamental understanding of context-specific risks and vulnerabilities embedded in the food systems and their dynamics. Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:14Z DOI: 10.1177/03795721231188767 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Anastasia Marshak, Helen Young, Elena N. Naumova Pages: S109 - S118 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S109-S118, December 2023. Background:Understanding seasonal patterns in nutritional status is critical for achieving and tracking global nutrition goals. However, the majority of nutrition seasonality research design draws on 2 or 3 within-year time points based on existing assumptions of seasonality, missing a more nuanced pattern.Objective:We aimed to identify the intra-year variability of childhood wasting, severe wasting, and weight-for-height z-scores (WHZ) in a dryland single wet-season context and illustrate an analytical approach for improving analysis of the seasonality of nutritional status.Methods:To quantify the intra-year variability in nutritional status, we use data from a 23-month panel study (May 2018 to March 2020) following 231 children (6-59 months of age) in eastern Chad. We apply a mixed-effects harmonic regression with child- and village-level fixed effects on the odds of being wasted, severely wasted, and on WHZ, testing for multiple and nonsymmetrical seasonal peaks, adjusted for child sex and age. We triangulate our findings using climate data on temperature, vegetation, and precipitation.Results:We identify 2 annual peaks of wasting and severe wasting. Wasting peaks at 14.7% (confidence interval [CI], 11.8-18.2) at the end of the dry season, while the smaller peak corresponds to the start of the harvest period at 13.4% (CI, 10.7-16.6). The odds of being wasted decline during the rainy season to 11.8% (CI, 9.4-14.7), with the lowest prevalence of 8.8% (CI, 6.9-11.1) occurring during the start of the dry season. In addition, a 1°C monthly increase in temperature is significantly associated with a 5% (CI, 1.4-8.7) and 12% (CI, 3.0-20.3) increase in the odds that a child is wasted and severely wasted, respectively.Conclusions:Intra-year variability of child wasting is far more complex and nuanced than identified by the literature, with 2 peaks, as opposed to 1, likely corresponding to different seasonal drivers, such as food insecurity, disease, water contamination, and care practices at different times of year. Better seasonality analysis can go a long way in improving the timing and content of programming with the goal of reducing child wasting.Plain language titleTwo Seasonal Peaks of Acute Malnutrition in ChadPlain language summaryUnderstanding seasonal patterns in nutrition is crucial for achieving and monitoring global nutrition goals. However, most research on nutrition seasonality relies on only a few time points within a year, which oversimplifies the true pattern. In our study conducted in Chad, a dryland environment with a single rainy season, we examined various indicators of acute malnutrition, including severe acute malnutrition. We analyzed 23 months of data from 231 children aged 6 to 59 months, considering factors such as sex, age, monthly rainfall, temperature, and vegetation. Our findings revealed 2 peaks of acute malnutrition, challenging the prevailing notion of a single peak identified in existing literature. The first, larger peak occurred at the onset of the rainy season, followed by a decline and then a second peak just before the harvest period. This pattern aligned with temperature variations rather than rainfall. The complex and nuanced seasonal patterns we observed suggest that different factors such as food insecurity, disease, water contamination, and care practices may contribute to acute malnutrition at different times of the year. Improved analysis of seasonality can significantly enhance the timing and effectiveness of interventions aimed at reducing child wasting. Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:14Z DOI: 10.1177/03795721231181715 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Gwenaelle Luc, Modibo Keita, Fata Houssoube, Edgar Wabyona, Alain Constant, Assad Bori, Kareem Sadik, Anastasia Marshak, Abdal Monium Osman Pages: S69 - S82 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S69-S82, December 2023. Background:Chad suffers from protracted hunger, facing high food insecurity (Integrated Food Security Phase Classification 3 and above), and acute malnutrition levels that surpass the emergency threshold (15% global acute malnutrition) yearly. The Food Security Sector, with European Union support, leads an inclusive effort to increase synergy between humanitarian, development, and peace-building actors to understand and address drivers of hunger.Objective:To understand the spatial distribution of child wasting and household food insecurity and systemic drivers (conflict, livelihoods, vegetation, cultural norms) as well as better understand the relationship between child wasting and household food insecurity in Kanem and Bahr el Ghazal (BeG) region, Chad, with the goal of improving nexus programming and targeting.Methods:A cross-sectional randomized cluster survey was conducted in August 2021 in Kanem and BeG across 86 villages, reaching 7002 households and 6136 children. Data were collected on child anthropometry, household food security, and livelihoods. Using mixed methods, primary data were triangulated with secondary geospatial data on vegetation index and conflicts as well as qualitative interviews with local actors. Analysis was conducted using comparison tests, linear and logistic crude, and adjusted models, as well as looking at the design effect as a measure of clustering of outcomes at the community level.Results:The geospatial distribution of hunger indicators shows child wasting and food insecurity are highly clustered. However, communities with a high prevalence of child wasting were not those with the highest levels of food insecurity, indicating different pathways. Clustering of food insecurity and child wasting is due to basic drivers of conflict, health, and seasonal access to natural resources.Conclusions:The high levels of food insecurity and child wasting are each concentrated in specific survey clusters and are not necessarily connected. They result from different causal pathways at the community level linked to the systemic drivers of the rule of access to natural resources, environmental seasonality, and livelihoods. This suggests a greater need for an integrated humanitarian, development, and peace-building interventions to address the persistent high prevalence of food insecurity and child wasting. It also suggests that these community-level and systemic drivers require greater consideration from the start in research design and data collection.Plain language titleUnderstanding Linkages Between Household Food Insecurity, Child Malnutrition, and Their Respective Clustered Drivers in ChadPlain language summaryChad experiences emergency levels of household food insecurity and child malnutrition. To address this issue, the United Nations Food and Agricultural Organization has undertaken a collaborative effort to enhance cooperation among humanitarian, development, and peace-building actors. The objective of this study was to examine how child malnutrition, food insecurity, and their drivers cluster across communities in Kanem and Bahr El Ghazal to improve response planning and targeting. The study collected data in August 2021 on malnutrition, food security, livelihoods, vegetation, and conflict and carried out interviews with local informants. In total, the research covers 86 villages, 7,002 households, and 6,136 children. The research shows that the 2 measures of hunger, child malnutrition and food insecurity, are highly clustered, affecting some communities more than others. However, villages with a high prevalence of child acute malnutrition did not have the highest levels of food insecurity, suggesting different community-level drivers. The clustering of food insecurity and malnutrition at the village level was linked to the diversity of livelihoods, the experience of conflict, health, and seasonal limitations in accessing natural resources. These findings are crucial for informing the targeting and design of integrated humanitarian, development, and peace programs. Taking a systemic approach and fostering strong coordination across interventions to address the drivers of food insecurity and malnutrition holds great potential for tackling hunger in Chad. Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:13Z DOI: 10.1177/03795721231189970 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Paul Howe, Lynnette Neufeld, Rein Paulsen, Shanda Steimer Pages: S3 - S4 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S3-S4, December 2023.
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Authors:Helen Young, Hussein Sulieman, Saverio Krätli, Abdal Monium Osman Pages: S9 - S22 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S9-S22, December 2023. Background:This article presents a new analytical approach to acute malnutrition causal analysis that is different from the orthodox approach in 2 respects. First, it engages with basic causes, that is, beyond the usual focus on individuals and households. Second, it uses a relational view in the causal analysis. The orthodox approach identifies the malnourished and their individual and household characteristics. In contrast, a relational approach explores the ways in which the relationships between people, their livelihoods, and the environment, mediated by systems and institutions, create the underlying drivers associated with acute malnutrition for some, while simultaneously creating better conditions for others.Methods:The article draws on 2 case study communities in West Darfur, Sudan, first considering the Darfur context and the inequitable policies and weakened institutions that have led to ethnic polarization, multilayered conflict, and humanitarian crises. The article explores how this context has played out differently in each community, contrasting their livelihood specializations, conflict-related losses, and livelihood diversification over time.Findings:This analysis shows how the relative vulnerability of some people versus others is strongly influenced by their social, economic, and political relationships, as reflected in their shifting power relations and uneven control over livelihood resources.Conclusions:Shifting the focus to the basic drivers, especially the institutional structures, processes, and relationships, will deepen the causal analysis of child acute malnutrition, make it more meaningful, and provide a new direction for engagement, learning, and action to address the deepening problem of child acute malnutrition.Plain language titleA Relational Approach to the Drivers of Acute MalnutritionPlain language summaryThis article introduces a new approach to understanding the causes of child acute malnutrition that differs from the traditional methods in 2 key ways. First, it goes beyond focusing solely on individuals and households by examining the underlying and basic causes. Secondly, it adopts a relational perspective in analyzing the causes. The traditional approach to studying the causes of acute malnutrition identifies malnourished individuals and examines their personal and household characteristics. In contrast, the relational approach looks at how the connections between people, their livelihoods, and the environment, influenced by systems and institutions, contribute to the development of acute malnutrition while also creating better conditions for some others. To illustrate this approach, the article presents findings from 2 communities in West Darfur, Sudan. It examines the Darfur context, including the policy and institutional context that has contributed to ethnic polarization and multiple conflicts and led to humanitarian crises. The article compares these 2 communities, focusing on their livelihood specializations, losses related to conflict, and changes in livelihood strategies over time. The article argues that by concentrating on the basic drivers of acute malnutrition, particularly the institutional structures, processes, and relationships, we can gain a deeper understanding of the issue. This approach can make the analysis of child acute malnutrition more meaningful and provide new insights for addressing this pressing problem. Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:12Z DOI: 10.1177/03795721231198968 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Susanne Jaspars Pages: S23 - S31 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S23-S31, December 2023. This article examines how systems and institutions influence the distribution of resources in society and, as such, affect livelihoods, food security, and nutrition. It draws on research on the political economy of food, and the governance effects of food aid practices, conducted in Sudan and Somalia and on the role of a social approach to nutrition in situations of famine and mass starvation. This article argues first for the importance of examining political structures as basic causes of malnutrition as they influence whether and how institutions function (in relation to land, markets, employment, aid, or justice). Second, this article illustrates how, in situations of crisis, the manipulation of institutions can create power for some and vulnerability to malnutrition in others. Third, it argues that a focus on treatment of malnutrition and behavior (hygiene and feeding practices) has drawn attention away from systems and institutions and feeds into discrimination as a basic cause. Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:12Z DOI: 10.1177/03795721231202236 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Elena N. Naumova Pages: S83 - S93 Abstract: Food and Nutrition Bulletin, Volume 44, Issue 2_suppl, Page S83-S93, December 2023. Background:Malnutrition is an umbrella term that refers to an impairment in nutrition indicative of subsequently compromised human well-being. The term covers the full spectrum of nutritional impairments from a small yet detectable departure from a “norm” to a terminal stage when severe malnutrition could result in death. This broad spectrum of nutritional departures from “the optimum” dictates the need for an ensemble of metrics to capture the complexity of involved mechanisms, risk factors, precipitating events, short-term, and long-term consequences. Ideally, these metrics should be universally applicable to vulnerable populations, settings, ages, and times when people are most susceptible to malnutrition. We should be able to characterize and intervene to minimize the risk of malnutrition, especially child acute malnutrition that could be assessed by anthropometric measurements.Objectives:The main challenge in reaching such an ambitious goal is the complexity of measuring, characterizing, explaining, predicting, and preventing malnutrition at any dimension: temporal or spatial and at any scale: a person or a group. The expansive body of literature has been accumulated on many temporal aspects of malnutrition and seasonal changes in nutritional (anthropometric) status. The research community is now shifting their attention to predictive modeling of child malnutrition and its importance for clinical and public health interventions. This communication aims to provide an overview of challenges for understanding child malnutrition from a perspective of predictive modeling focusing on well-documented seasonal variations in nutritional outcomes and exploring “the systems approach” to tackle underlining conceptual and practical complexities to forecast seasonal malnutrition in an accurate and timely manner. This generalized approach to forecasting seasonal malnutrition is then applied specifically to child acute malnutrition. Citation: Food and Nutrition Bulletin PubDate: 2023-10-18T02:20:12Z DOI: 10.1177/03795721231202238 Issue No:Vol. 44, No. 2_suppl (2023)
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Authors:Genanew Agitew Brhanu, Zewdu Berhanie Ayele, Samson Gebremedhin Gebreselassie Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Food and nutrition insecurity continues to be one of the persistent challenges in Ethiopia. The country has been responding to the challenges in various ways to foster sustainable development.Objectives:The objective of the study is to assess the national food and nutrition security policy and strategic responses.Method:A qualitative review of policies, strategies, programs, guidelines, and a government commitment, document was conducted. Interviews with experts from food and nutrition-implementing governmental and nongovernmental organizations were also employed. Thematic analysis with description was used.Results:The results of the study revealed that global initiatives stimulated Ethiopia to progressively take various strategic directions to address the ongoing food and nutrition challenges. In addition to various policy directions, the country has been implementing nutrition-specific and nutrition-sensitive programs under the multisectoral approach. The concepts and practices of food and nutrition security shifted from simply balancing the demand and supply of food to a broader and more inclusive food system approach with the involvement of multiple actors. However, more has been said than done. The policy, strategic objectives, and initiatives have not been adequately translated into practices. Actions toward ensuring food and nutrition security, on the other hand, are constrained by institutional, environmental, technological, and emerging priorities like an outbreak of a pandemic and political instability.Conclusion:The study concluded that available policy and strategic intents have sufficiently addressed food and nutrition challenges in documents and need to be fully translated into practices.Plain language titleEthiopia’s Policy and Strategies to Ensure Food and Nutrition SecurityPlain language summaryEthiopia is facing food and nutrition insecurity problems that require multidimensional action. We studied how the country is responding to the challenges through national food and nutrition security policies and strategies. We found that global initiatives stimulated Ethiopia to progressively take various strategic directions to address the ongoing food and nutrition insecurity problems. The country has devised nutrition-specific and nutrition-sensitive programs under the multisectoral approach, which incorporates policy, strategies, program, guidelines, and a political commitment document. The concepts and practices of food and nutrition security have evolved from balancing the demand and supply of food to a broader and more inclusive food system approach with the involvement of multiple actors. However, the country did not fully translate the policy response into the ground. Interventions to ensure food and nutrition security are challenged by institutional, environmental, technological, other priority agenda, and political instability. Based on the study, we conclude that the country has a fertile policy environment that needs to be translated into practices uniformly across all regions. Citation: Food and Nutrition Bulletin PubDate: 2023-10-26T07:12:27Z DOI: 10.1177/03795721231202559
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Authors:Nishmeet Singh, Samuel Scott, Neha Kumar, Gayathri Ramani, Quinn Marshall, Kate Sinclair, Saman Kalupahana, Malika Fernando, Renuka Silva, Amila Perera, Renuka Jayatissa, Deanna Olney Abstract: Food and Nutrition Bulletin, Ahead of Print. Background:Little is known about how the COVID-19 pandemic has affected food security and livelihoods in Sri Lanka.Objective:This article aims to assess food insecurity, perceived effects of COVID-19, and coping mechanisms among agriculture-based households in rural Sri Lanka.Methods:We used 2 rounds of panel data from phone surveys (n = 1057 households) conducted in 5 districts. Food insecurity (30-day recall), perceived impacts of COVID-19 (6-month recall), and coping mechanisms (6-month recall) were assessed using a household questionnaire. To assess food insecurity, we used the 8-item Food Insecurity Experience Scale. We tested for differences between T1 (baseline: December 2020-February 2021) and T2 (follow-up: July 2021-September 2021) and explored the association between food insecurity and the perceived effect of COVID-19 on income using a logistic regression model.Results:Food insecurity was highly prevalent (T1: 75%, T2: 80%) but varied across districts. Most respondents were affected by COVID-19 and/or COVID-19-associated mitigation measures (T1: 84%, T2: 89%). Among affected households, commonly reported impacts included those on income (T1: 77%, T2: 76%), food costs (T1: 84%, T2: 83%), and travel (∼90% in both rounds). Agricultural activities were also adversely affected (T1: 64%, T2: 69%). About half of COVID-19-affected households reported selling livestock or assets to meet basic needs. Households whose income was impacted by COVID-19 were more likely to be food insecure (adjusted odds ratio: 2.56, P < .001).Conclusions:Households in rural Sri Lanka experienced food insecurity and livelihood disturbances during the COVID-19 pandemic. Additional surveys are needed to assess recovery post-COVID-19 and to understand if programs that support livelihoods have been protective.Plain language titleFood Insecurity and Perceived Effects of COVID-19 on Livelihoods in Rural Sri LankaPlain language summaryBackground: Sustained levels of high food insecurity are associated with a range of negative health, nutrition, and well-being effects.The COVID-19 pandemic is expected to aggravate food insecurity and worsen the livelihood situation.Little is known about how the COVID-19 pandemic affected food security and livelihoods of agriculture-based households in rural Sri Lanka. Method: This original article used household level survey data from 2 rounds of phone surveys conducted in 5 districts of Sri Lanka.Using a household-level questionnaire, we recorded experience of food insecurity in the last 30 days, perceived impact of COVID-19, and adopted coping mechanism in the 6 months prior to the survey.We reported statistical means and tested for differences between 2 survey rounds.We also explored association between food insecurity and the perceived effect of COVID-19 on income. Results: Household-level food insecurity was highly prevalent during the pandemic.Households perceived a negative effect of the pandemic on their income and employment sources.Households whose income was impacted by the pandemic were more likely to be food insecure. Conclusion: Agriculture-based households in rural Sri Lanka experienced food insecurity and livelihood disturbances during the COVID-19 pandemic.Additional research is needed to assess recovery post COVID-19 and to understand whether livelihood support programs have been protective. Citation: Food and Nutrition Bulletin PubDate: 2023-09-13T07:27:11Z DOI: 10.1177/03795721231197249
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Authors:Anastasia Marshak, Helen Young, Elena N. Naumova Abstract: Food and Nutrition Bulletin, Ahead of Print.
Citation: Food and Nutrition Bulletin PubDate: 2023-04-06T06:53:46Z DOI: 10.1177/03795721231162429
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