Nutrition

  • Four major famines have taken place so far in 2017, which has renewed attention on the urgent need to address food security globally. However, food security involves much more than responding to famines, and it is closely linked to factors such as governance, which plays a significant role in fragile states and developing countries. FHI 360 held a Facebook Live discussion on how integrating governance, agriculture and food security can benefit food security programs. The conversation was moderated by Gregory Adams, Director of the Locus Coalition at FHI 360, with FHI 360 experts Joseph Sany, Technical Advisor, Peacebuilding and Conflict Mitigation, and Annette Brown, Director, Research and Evaluation Strategic Initiative.

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  • Understanding the relationships among food security, climate change and conflict

    Despite decades of investments to improve food security for the world’s poorest people, hunger and malnutrition are still problems for many. Indeed, a daunting food security crisis currently puts more than 20 million people at risk of starvation in just four countries: Nigeria, Somalia, South Sudan and Yemen. In sub-Saharan Africa, an estimated 42 million children under the age of 5 will be malnourished by 2050, and 10 million additional children will be malnourished if climate change impacts continue unabated.

    This crisis calls for improvements in identifying, understanding and addressing the interlinked factors that result in broadscale food security crises. The cycle of resource degradation caused by climate change that leads to food insecurity, starvation and ongoing conflicts raises the question of whether climate change itself is a “threat multiplier” that increases the potential for conflict. Evidence suggests that the interplay between these sectors is critical to the emergence or development of many humanitarian crises. However, the complexity of these relationships and the role of climate change as a threat multiplier are less understood.

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  • An interconnected approach to improving handwashing behaviors

    Each year on Global Handwashing Day, hundreds of millions of people around the world gather to celebrate the power of handwashing with soap to save lives. This day also provides an opportunity to consider the current status of the hygiene sector and catalyze further action. As we look toward the future of hygiene behavior change, we need to ensure that we are maximizing the broader topic of integrated development and fully considering its relationship to hygiene.

    Integrated development, which can be defined in many different ways, is increasingly being discussed within the international development community, and FHI 360 plays an active role in convening this conversation. I recently had the opportunity, on behalf of the Global Public–Private Partnership for Handwashing (PPPHW), to attend an event hosted by FHI 360 titled Does 1+1=3? Proving the Integration Hypothesis, which brought together expert panelists from academia, government, donors and nongovernmental organizations.

    I took away many key learnings from this event, but the one that stuck with me most is this: If we hope to move the needle on the most entrenched development challenges, we need to consider the benefits that could be offered by combining services or sectors.

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  • Pushing for progress on maternal, newborn and child health

    The numbers are shocking. Each year, 2.8 million babies die during their first 28 days of life, while almost 800 women die every day in pregnancy or childbirth.

    A vast majority of these deaths are preventable through simple interventions: providing mothers and their children with access to basic, quality health care, especially during pregnancy and childbirth; encouraging mothers to breastfeed; and treating diarrhea and pneumonia, two of the leading killers of children under 5 years of age.

    Despite the impressive progress that has been made in recent years, achieving the Millennium Development Goals (MDGs) on reproductive, maternal, newborn and child health (MDGs 4, 5 and 6) by 2015 will require an all-out global push.

    In June, the U.S. Agency for International Development (USAID) announced a major realignment of US$2.9 billion of its resources to “save up to half of a million children from preventable deaths by the end of 2015.” In addition, USAID introduced an ambitious strategy, Acting on the Call: Ending Preventable Child and Maternal Deaths, to dramatically increase progress in 24 countries that account for 70 percent of child and maternal deaths.

    This is an important policy shift — one that has the potential to have great impact on development by saving the lives of 15 million children and nearly 600,000 women by 2020. FHI 360, a member of the Advisory Group for Acting on the Call, supports USAID’s commitment. We have seen how evidence-based interventions in maternal, newborn and child health are making a difference in communities around the world.

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  • Don’t forget about dad: Six strategies for getting fathers more involved in child feeding

    Whether he’s aware of his influence or not, almost every father in every culture influences his family’s choices about how to feed the children. His everyday decisions about how many of the eggs the family’s chickens lay will be sold at market and how many will be kept at home for the family to eat can make the difference between a stunted child and one who reaches his or her full growth potential.

    The Alive & Thrive project reviewed programs from around the world that were designed to engage fathers in child feeding, identifying the strategies that seem to make these programs work. Not surprisingly, the six strategies we identified in the most innovative “dads” programs echo sound principles from behavior change and social marketing. Our review indicated that, especially when program planners apply these six strategies, fathers’ actions can lead to real improvements in nutrition.

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  • Bringing global attention to the need for reducing micronutrient malnutrition

    Good nutrition is critical in preventing child and maternal deaths. Deficiencies in micronutrients, such as iodine, iron, vitamin A and zinc, can lead to impaired physical and cognitive development, poor pregnancy outcomes (for example, a low birth weight baby), a weakened immune system, anemia, night blindness and even death. It is estimated that micronutrient malnutrition affects more than 2 billion people worldwide.

    For more than a decade, the Food and Nutritional Technical Assistance (FANTA) project, funded by USAID, has been a key contributor to the global effort to reduce micronutrient deficiencies. Our work has focused on the development of new methods to identify dietary gaps, through research on the impact of lipid-based nutrient supplements on the health status of vulnerable populations and dissemination of the most up-to-date, relevant information to a wide range of nutrition stakeholders.

    Recently, FANTA contributed to the development of software called Optifood, which can be used to identify local food combinations that can fill (or come as close as possible to filling) micronutrient gaps based on local foods and diet. Optifood results contribute to the development of cost-effective, context-specific approaches.

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  • Listen to the talking baby: Breastfeeding is a smart idea

    As children fare, so do nations. An investment in the well-being, health, and development of children today will be reflected in the health and development of their communities and nations. A smart investment in the future saves lives, saves money, and can be scaled up to reach children, wherever they are.

    Breastfeeding is a smart investment.

    Nutrition during the 1,000 days of a mother’s pregnancy until her child’s second birthday is a critical window of opportunity to give a child a healthy start at life. And beginning from birth, breastfeeding offers food security for infants and young children everywhere. Evidence shows that improving breastfeeding practices could save the lives of 800,000 children annually, and millions more would benefit from the increased immunity and nutrition breast milk provides.

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  • The Food and Nutrition Technical Assistance III (FANTA) project, funded by the U.S. Agency for International Development and managed by FHI 360, recently released Strengthening Nutrition in Ghana: A Report on FANTA Activities from 2007 to 2013.

    The report summarizes FANTA’s work in Ghana over the past six years. This work, which focused on strengthening nutrition programs and services and on integrating nutrition services into the Ghanaian health system, was carried out in collaboration with the Ghana Ministry of Health, the Ghana Health Service and other stakeholders.

    The project had three main objectives:

    1. Introduce community-based management of acute malnutrition (CMAM) and scale up integrated CMAM services within the existing Ghanaian health system
    2. Introduce nutrition assessment, counseling and support (NACS) and scale up integrated NACS services within existing HIV and tuberculosis service delivery
    3. Strengthen maternal and child health and nutrition services through advocacy, coordination and the development of a national nutrition policy

    By November 2013, 1,023 facilities were providing community-based management of acute malnutrition services, 15,025 children were treated for severe acute malnutrition and 18,688 people living with HIV received nutrition assessment and counseling — achievements that all resulted from FANTA training and programming.

    In addition to describing FANTA’s activities and achievements, the report offers a description of the challenges that the project worked to address, as well as recommendations and lessons learned on improving service nutrition delivery and eliminating malnutrition in Ghana.

    Learn more about FANTA in Ghana here.

  • Gender, economics, and ART adherence: What’s the connection?

    In a rural village in central Africa, my colleagues and I stood over a registration book for antenatal care clients with the goal of identifying clinic-level data that could be extracted for a project evaluation. As we made our way through the book, the left sides of the pages were filled with names of women, dates and HIV test results — it was clear that almost all of the women who tested HIV positive received some form of antiretroviral therapy (ART). As my eyes ran to the right across spaces for follow-up records, however, the fields became increasingly emptier, and our team began to discuss the various barriers to services, even a highly effective service like prevention of mother-to-child transmission (PMTCT).

    Access and adherence to the greater continuum of HIV care is influenced by several factors, including community-level gender norms and related behaviors. For example, HIV-positive men may avoid HIV testing and may spend a significant amount of their income attempting to address symptoms of their illness rather than confirming their HIV status. Often, these behaviors are driven by fear that knowledge of a positive HIV test result could compromise their leadership at home and cause family instability. Research has also identified instances when men undermine their wives’ access and adherence to ART, even taking their wives’ medication for themselves. Interestingly, despite such challenges, women are more likely to access and adhere to HIV-related treatment and care than men.

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  • Improving global nutrition through stronger food systems

    This year’s World Food Day focuses on sustainable food systems for food security and nutrition. What is the relationship between food systems and nutritional outcomes?

    Through various initiatives — such as the U.S. Government’s Feed the Future Initiative, the Scaling Up Nutrition (SUN) movement and the 1,000 Days Partnership — the international community has made a significant commitment to improving nutrition around the world. To meet the goals of these efforts, we need to focus not only on clinical interventions to address malnutrition, but also on safe, healthy food systems that can lead to more sustainable, scalable results.

    A focus on food systems means making investments that put the right information and resources in the hands of communities and households to prevent malnutrition in a number of areas: improved dietary quality and food consumption (especially during the 1,000 days from conception to a child’s second birthday), better child-feeding practices, increased access to and availability of higher quality water and sanitation services, and healthier and more diverse agricultural production choices. Food systems should also include equity considerations, such as offering women and other economically disadvantaged groups greater opportunities to grow and earn from the production of nutritious food.

    Most of the world’s population at risk of malnutrition either grows its own food or buys it in local markets. In the past, agricultural programs focused on increasing the amount of food available. We now understand that healthy food systems should also focus on the production and availability of diverse foods that provide the nutrients needed for adequate nutrition and health. This is particularly important in order to prevent malnutrition in populations most at risk — children under two and pregnant and lactating women. Issues about food safety, which emerge all along the value chain — from the choice of inputs to the processing of foods — are also crucial to consider if we are to protect consumers’ health and nutrition.

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