• 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.


  • 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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  • On World Food Day, breast milk for a healthy start in life

    The theme of this year’s World Food Day is Sustainable Food Systems for Food Security and Nutrition. According to the World Food Programme, poor nutrition causes nearly half of deaths in children under five — 3.1 million deaths each year.1 Breast milk provides the perfect nutrition for infants through six months of age. Unlike formula, which is expensive to purchase and may not be safe or readily available, breast milk comes from a sustainable, secure source: mothers.

    The Tiny Tales video series, produced by FHI 360’s Alive & Thrive project, provides a glimpse into the project’s efforts in Bangladesh to improve nutritional outcomes for women, infants and children through counseling on prenatal nutrition and infant and young child feeding during the first 1,000 days of an infant’s life. The episodes show how one family’s life has been improved through access to healthy food, advice on exclusive breastfeeding and proper, timely introduction of complementary foods.

    Watch the episodes individually below, or click here to watch them in full.

    Episode One

    Sultana, a 26-year-old woman, awaits the birth of her second child in a rural village in northern Bangladesh. A community health care worker talks with Sultana to ensure she is getting nutrient-rich food and taking iron supplements daily during her pregnancy. The health care worker emphasizes the importance of breastfeeding within one hour of birth.

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  • Optifood: A new tool to improve diets and prevent child malnutrition in Guatemala

    What does it REALLY take to ensure young children get the proper nutrition to grow strong and healthy? This is an especially important question in poor rural communities in Guatemala, where about half of the children under five years of age are stunted (too short for their age—a sign of long-term deficits in the quantity and/or quality of food, including the right vitamins and minerals). In some parts of western Guatemala, more than eight in ten young children are stunted.

    Now there’s a new tool to help answer the question: Optifood is a computer software program, developed by the World Health Organization (WHO) in collaboration with the London School of Hygiene and Tropical Medicine, Food and Nutrition Technical Assistance III Project (FANTA), and Blue Infinity, that provides scientific evidence on how to best improve children’s diets at the lowest possible cost using locally available foods. Optifood identifies nutrient gaps and suggests food combinations the local diet can fill—or come as close to filling. It also helps identify local foods’ limits in meeting nutrient needs and test strategies for filling remaining nutrient gaps, such as using fortified foods or micronutrient powders that mothers mix into infant or young children’s porridge.

    The Government of Guatemala is fighting stunting through its Zero Hunger Initiative, which aims to reduce stunting by 10 percent by 2015 and 24 percent by 2022 through nutrition, health, agriculture, and social safety net programs. The U.S. Government and USAID are supporting these efforts through Feed the Future and Global Health Initiatives focused on the Western Highlands. USAID/Guatemala asked the USAID-funded FANTA/FHI 360 to help find strategies to improve the nutritional quality of children’s diets in the region. The challenge was to develop realistic and affordable diets for children that both meet their needs and are firmly based on scientific evidence. FANTA worked with its local partner, the Institute of Nutrition of Central America and Panama (INCAP), to collect the diet data needed for Optifood from communities in two departments of the Western Highlands, Huehuetenango and Quiché. FANTA then used Optifood to analyze the information.

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  • In Vietnam, our Alive & Thrive project, funded by the Bill & Melinda Gates Foundation, has launched an innovative social franchise model – Mat Troi Be Tho – to provide high-quality nutrition consultation services. The franchise has been exceptionally effective in Vietnam where high malnutrition rates persist. The Mat Troi Be Tho brand signifies professional, trustworthy and high-quality services in a welcoming and child-friendly environment.

    This is the first time that social franchise principles have been applied to infant and young child feeding counseling services. Counseling focuses on recommended feeding practices to optimize child growth and development in the first 2 years of life. Nearly 800 franchises have been set up in government health facilities throughout Vietnam.

    Watch the video below to learn more about Mat Troi Be Tho and our Alive & Thrive project.

  • ROADS II: Transforming corridors of risk into pathways of prevention and hope