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"UNICEF's 2009 report Tracking Progress on Child and Maternal Nutrition drew attention to the impact of high levels of undernutrition on child survival, growth and development and their social and economic toll on nations. It described the state of nutrition programmes worldwide and argued for improving and expanding delivery of key nutrition interventions during the critical 1,000-day window covering a woman's pregnancy and the first two years of her child's life, when rapid physical and mental development occurs. This report builds on those earlier findings by highlighting new developments and demonstrating that efforts to scale up nutrition programmes are working, benefiting children in many countries."--Page 1.
United States. Congress. House. Committee on Education and Labor. Subcommittee on Healthy Families and Communities
Author : United States. Congress. House. Committee on Education and Labor. Subcommittee on Healthy Families and Communities Publisher : Unknown Page : 88 pages File Size : 45,5 Mb Release : 2009 Category : Children ISBN : UOM:39015089027745
Improving Child Nutrition Programs to Reduce Childhood Obesity by United States. Congress. House. Committee on Education and Labor. Subcommittee on Healthy Families and Communities Pdf
Donald A. P. Bundy,Nilanthi de Silva,Susan Horton,Dean T. Jamison
Author : Donald A. P. Bundy,Nilanthi de Silva,Susan Horton,Dean T. Jamison Publisher : World Bank Publications Page : 502 pages File Size : 49,6 Mb Release : 2017-11-20 Category : Medical ISBN : 9781464804397
Disease Control Priorities, Third Edition (Volume 8) by Donald A. P. Bundy,Nilanthi de Silva,Susan Horton,Dean T. Jamison Pdf
More children born today will survive to adulthood than at any time in history. It is now time to emphasize health and development in middle childhood and adolescence--developmental phases that are critical to health in adulthood and the next generation. Child and Adolescent Health and Development explores the benefits that accrue from sustained and targeted interventions across the first two decades of life. The volume outlines the investment case for effective, costed, and scalable interventions for low-resource settings, emphasizing the cross-sectoral role of education. This evidence base can guide policy makers in prioritizing actions to promote survival, health, cognition, and physical growth throughout childhood and adolescence.
Author : World Health Organization Publisher : World Health Organization Page : 442 pages File Size : 46,9 Mb Release : 2013 Category : Medical ISBN : 9789241548373
Pocket Book of Hospital Care for Children by World Health Organization Pdf
The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.
Integrating agriculture and nutrition education for improved young child nutrition by Food and Agriculture Organization of the United Nations Pdf
The Programme Lessons build on previous guidance and incorporate the experiences and lessons learned from relevant field programmes and research initiatives, reflecting the cumulative experiences of diverse experts. They are aimed at programme planners and managers working to ensure that agricultural production will have a positive impact on young child nutrition, particularly in low-income countries.
On 20 November 2009, the global community celebrates the 20th anniversary of the adoption by the United Nations General Assembly of the Convention on the Rights of the Child, the unique document that sets international standards for the care, treatment and protection of all individuals below age 18. To celebrate this landmark, the United Nations Children's Fund is dedicating a special edition of its flagship report The State of the World's Children to examining the Convention's evolution, progress achieved on child rights, challenges remaining, and actions to be taken to ensure that its promise becomes a reality for all children.
Literature review on linkages between child nutrition and economic growth by Haile, Beliyou,Azzarri, Carlo,Ahn, Hee Eun Pdf
This document summarizes published and grey literature on conceptual framework on the link between child nutrition and economic growth, determinants of child undernutrition, types of investments to enhance maternal and child nutrition, and linkages between urbanization and child nutrition. Several in-sights emerge from the review. First, and despite progresses over the last several decades, maternal and child malnutrition is still prevalent in developing countries and the progress has been uneven. While the percentage of chronically malnourished (stunted) children declined across the developing world, the number of stunted children in Africa increased due to slower reduction in stunting prevalence and population growth. Many developing countries are experiencing the coexistence of different forms of malnutrition including undernutrition, micronutrient deficiency, and overnutrition. Second, child undernutrition, especially stunting during the first 1,000 days of life, has several short- and long-term effects on individuals and economies that include impaired cognitive and non-cognitive development, poor educational performance, low productivity and earnings, and higher healthcare costs. Third, the determinants of child undernutrition are broadly classified as the immediate determinants including dietary intake and diseases; the underlying determinants that include household food security, quality of care and household living environment, and access to healthcare; and the basic determinants that include access to productive resources, stock of capital, as well as socioeconomic, political and cultural factors. Investments to enhance child nutrition can target either the immediate determinants (known as nutrition-specific investments) or the underlying determinants (known as nutrition-sensitive investments). Fourth, the effect of urbanization on child nutrition is mostly determined by the extent to which urban settlements offer their residents with better economic opportunities (e.g., better paying jobs and markets for nutritious food) and services (e.g., healthier living environments). Fifth, given the multilayer causes of child undernutrition, a multi-sectoral approach is needed to address the various determinants of undernutrition to improve maternal nutrition, promote optimal infant and young child feeding practices, enhance household food security, as well as improve healthy living environment and access to quality health care.
Improving Child Nutrition Outcomes in India by Monica Das Gupta Pdf
"Levels of child malnutrition in India fell only slowly during the 1990s, despite significant economic growth and large public spending on the Integrated Child Development Services (ICDS) program, of which the major component is supplementary feeding for malnourished children. To unravel this puzzle, the authors assess the program's placement and its outcomes using National Family Health Survey data from 1992 and 1998. They find that program placement is clearly regressive across states. The states with the greatest need for the program - the poor northern states with high levels of child malnutrition and nearly half of India's population - have the lowest program coverage and the lowest budgetary allocations from the central government. Program placement within a state is more progressive: poorer and larger villages have a higher probability of having an ICDS center, as do those with other development programs or community associations. The authors also find little evidence of program impact on child nutrition status in villages with ICDS centers. "--World Bank web site.
The State of the World's Children 2019 by United Nations Pdf
This report examines nutrition, providing a fresh perspective on a rapidly evolving challenge. Despite progress in the past two decades, around 200 million under-fives suffer from undernutrition. Adding to this toll is rising obesity, which affects 38 million children. All these forms of malnutrition threaten childrens development, while obesity is creating a lifelong legacy of disease. At the heart of this evolving challenge is a global shift towards modern diets that do not meet childrens nutritional requirements. The report provides unique data and analysis of malnutrition in the 21st century and outlines recommendations to put childrens needs at the heart of global and national food systems.
2015 Global Hunger Index by von Grebmer, Klaus,Bernstein, Jill,de Waal, Alex,Prasai, Nilam,Yin, Sandra,Yohannes, Yisehac Pdf
The developing world has made progress in reducing hunger since 2000. The 2015 Global Hunger Index (GHI) shows that the level of hunger in developing countries as a group has fallen by 27 percent. Yet the state of hunger in the world remains serious. This marks the tenth year that IFPRI has assessed global hunger using this multidimensional measure. This report’s GHI scores are based on a new, improved formula that replaces the child underweight indicator of previous years with child stunting and child wasting. This change reflects the latest thinking on the most suitable indicators for child undernutrition, one of three dimensions of hunger reflected in the GHI formula. Across regions and countries, GHI scores vary considerably. Regionally, the highest GHI scores, and therefore the highest hunger levels, are still found in Africa south of the Sahara and South Asia. Despite achieving the largest absolute improvements since 2000, these two regions still suffer from serious levels of hunger. Levels of hunger are alarming or serious in 52 countries. Most of the eight countries with alarming GHI scores are in Africa south of the Sahara. While no countries are classified in the extremely alarming category this year, this high level of hunger could still exist. Due to insufficient data, 2015 GHI scores could not be calculated for places that recently suffered from high levels of hunger, including Burundi, Comoros, Democratic Republic of the Congo, Eritrea, Somalia, South Sudan, and Sudan. 2015 Global Hunger Index Interactive App: http://ghi.ifpri.org
Nourishing millions: Stories of change in nutrition: Synopsis by Yosef, Sivan,Pandya-Lorch, Rajul Pdf
In recent years, the world has seen unprecedented attention and political commitment to addressing malnutrition. Milestones such as the Scaling Up Nutrition (SUN) Movement, the Lancet Maternal and Child Nutrition Series, and the Second International Conference on Nutrition (ICN2) have marked the rapid rise of nutrition on the global policy and research agenda. These developments reverse years of relative neglect for nutrition. Undernutrition is a global challenge with huge social and economic costs. It kills millions of young children annually, stunts growth, erodes child development, reduces the amount of schooling children attain, and increases the likelihood of their being poor as adults, if they survive. Stunting persists through a lifetime and beyond—underweight mothers are more likely to give birth to underweight children, perpetuating undernutrition across generations. Undernutrition reduces global gross domestic product by US$1.4–$2.1 trillion a year—the size of the total economy of Africa south of the Sahara.
Disease Control Priorities, Third Edition (Volume 2) by Robert Black,Ramanan Laxminarayan,Marleen Temmerman,Neff Walker Pdf
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
Author : The World Bank Publisher : World Bank Publications Page : 168 pages File Size : 53,6 Mb Release : 2010-08-27 Category : Medical ISBN : 0821384074
What Can We Learn from Nutrition Impact Evaluations? by The World Bank Pdf
Evaluation Summary What Can We Learn from Nutrition Impact Evaluations? High levels of child malnutrition in developing countries contribute to mortality and have long-term consequences for children s cognitive development and earnings as adults. Recent impact evaluations show that many different interventions have had an impact on children s anthropometric outcomes (height, weight, and birth weight), but there is no simple answer to the question What works? to address the problem. Similar interventions have widely different results in different settings, owing to differences in local context, the causes and severity of malnutrition, and the capacity for program implementation. Impact evaluations of programs supported by the Bank, which are generally large-scale, complex inter-ventions in low-capacity settings, show equally variable results. The findings confirm that it should not be assumed that an intervention found effective in a randomized medical setting will have the same effects when implemented under field conditions. There are many robust experimental and quasi-experimental methods for assessing impact under difficult circumstances often found in field settings. The relevance and impact of nutrition impact evaluations could be enhanced by collecting data on service delivery, demand-side behavioral outcomes, and implementation processes to better understand the causal chain and what part of the chain is weak, in parallel with impact evaluations. It is also important to understand better the distribution of impacts, particularly among the poor, and to document better the costs and effectiveness of interventions. High levels of child malnutrition in developing countries are contributing to mortality and present long-term consequences for the survivors. An estimated 178 million children under age 5 in developing countries are stunted (low height for age) and 55 million are wasted (low weight for height). Malnutrition makes children more susceptible to illness and strongly affects child mortality. Beyond the mortality risk in the short run, the developmental delays caused by undernutrition affect children s cognitive outcomes and productive potential as adults. Micronutrient deficiencies vitamin A, iron, zinc, iodine, for example are also common and have significant consequences. Progress in reducing malnutrition has been slow: More than half of countries are not on track to achieve the Millennium Development Goal of halving the share of children who are malnou-rished (low weight for age) by 2015. The food price and financial crises are making achievement of this goal even more elusive. The World Bank has recently taken steps to ex-pand its support for nutrition in response to the underlying need and the increased urgency due to the crises. WHAT DO WE KNOW ABOUT REDUCING MALNUTRITION? The increased interest and resources focused on the problem of high and potentially increasing rates of undernutrition raises the question, what do we know about the causes of malnutrition and the in-terventions most likely to reduce it? The medical literature points to the need to inter-vene during gestation and the first two years of life to prevent child malnutrition and its consequences. It suggests that investments in interventions during this window of opportunity among children under 2 are likely to have the greatest benefits. Recently published meta-analyses of the impact evaluation literature point to several interventions found effective for reducing undernutrition in spe-cific settings. However, there are limitations to the generalizability of those reviews findings, particularly in the context of large-scale government programs most likely to be supported by the World Bank. The reviews tend to disproportionately draw on the findings of smaller, controlled experiments; there are few examples of evaluations of large-scale programs, over which there is less control in implementation. In reviewing a large number of studies, interventions, and outcomes, they tend to focus on average impacts. They generally do not explain the magnitude or variability of impacts across or within studies. Very few address the programmatic reasons why some interventions work or don t work, nor do they assess the cost-effectiveness of interventions. Objectives of the Review This paper reviews recent impact evaluations of interventions and programs to improve child anth-ropometric outcomes height, weight, and birth weight with an emphasis on both the findings and limitations of the literature and on understanding what might happen in a non-research setting. It further reviews in greater detail the experience and lessons from evaluations of the impact of World Bank-supported programs on nutrition outcomes. Specifically, the review addresses four questions. First, what can be said about the impact of different interventions on children s anthropometric outcomes? Second, how do these findings vary across settings and within target groups, and what accounts for this variability? Third, what is the evidence of the cost-effectiveness of these interventions? Finally, what have been the lessons from implementing impact evaluations of Bank-supported programs with anthropometric impacts? While there are different dimensions of child nutri-tion that could be explored, the report focuses on child anthropometric outcomes -- weight, height, and birth weight. These are the most common nutrition outcome indicators in the literature and the most frequently monitored by national nutrition programs supported by the World Bank. Low weight for age (underweight) is also the indicator for one of the MDGs. Methodology and Scope Forty-six nutrition impact evaluations published since 2000 were systematically reviewed. These evaluations assessed the impact of diverse interven-tions community nutrition programs, conditional and unconditional cash transfers, early child devel-opment programs, food aid, integrated health and nutrition services, and de-worming. All of the evaluations used research designs that compared the outcomes among those affected by the project to the counterfactual that is, what would have happened to a similar group of people in the absence of the intervention. About half used randomized assignment to create treatment and control groups, while the remainder used matching and various econometric techniques to construct a counterfactual. Among the 46 evaluations, twelve assessed the im-pact of World Bank-supported programs on nutri-tion outcomes in eight countries. While the broader review relies on the analysis of the published impact evaluations as the main source of data, for these twelve evaluations project documents and research outputs were reviewed and World Bank staff, country officials and the evaluators and re-searchers who conducted the studies were interviewed. Findings A wide range of interventions had a positive impact on indicators related to height, weight, wasting, and low birth weight. There were a total of 10 different outcome indica-tors for the four main anthropometric outcomes. A little more than half of the evaluations addressing a height-related indicator found program impacts on at least one group of children, and this was true for about the same share of interventions aimed at improving weight-related and wasting (low weight for height)-related indicators. About three-quarters of the 11 evaluations of interventions that aimed at improving birth weight indicators registered an impact in at least one specification, including five out of seven micronutrient interven-tions. There was no clear pattern of impacts across interventions in every intervention group there were examples of programs that did and did not have an impact on a given indicator, and with varying magnitude. Evaluations of the nutritional impact of programs supported by the World Bank, which are generally large-scale, complex, and implemented in low-capacity settings, show equally variable results. Even controlling for the specific outcome indicator, studies often targeted children of different age groups that might be more or less susceptible to the interventions. It is thus difficult to point to inter-ventions that are systematically more effective than others in reducing malnutrition across diverse set-tings and age groups. Differences in local context, variation in the age of the children studied, the length of exposure to the intervention, and differing methodologies of the studies account for much of the variability in results. Context includes factors like the level and local determinants of malnutrition, differences in the characteristics of beneficiaries (including their age), the availability of service infrastructure, and the implementation capacity of government. Outside of a research setting in the context of a large government program there are many things that can go wrong in either service delivery or the demand response that can compromise impact. Beyond this, there are social factors like the status of women or the presence of civil unrest that can affect outcomes. These findings underscore the conclusion that it should not be assumed that an intervention found effective in a randomized controlled trial in a re-search setting will have the same effects when im-plemented under field conditions in a different set-ting. They also point to the need to understand the prevailing underlying causes of malnutrition in a given setting and the age groups most likely to benefit in selecting an intervention. Further, impact evaluations need to supplement data measuring impact with data on service delivery and demand-side behavioral outcomes to demonstrate the plausibility of the findings, to understand what part of a program works, and to address weak links in the results chain to improve performance. There is scant evidence on the distribution of nutrition impacts who is benefiting and who is not or on the cost-effectiveness of interventions Just because malnutrition is more common among the poor does not mean that they will disproportio-nately benefit from an intervention, particularly if acting on new knowledge or different incentives relies on access to education or quality services. Only a third of the 46 evaluations looked at the distribution of impacts by gender, mother s education, poverty status, or availability of complementary health services. Only nine assessed the impacts on nutritional outcomes of the poor compared with the non-poor. Among the evaluations that did examine variation in results, several found that the children of more educated mothers or in better-off communities are be-nefitting the most. Bank-supported cash transfers, community nutrition, and early child development programs in six of eight countries had some impact on child anthropometric outcomes. Of the 12 impact evaluations of Bank support, all but one were of large-scale government programs with multiple interventions and a long results chain. Three-quarters found a positive impact on anthro-pometric outcomes of children in at least one age group, although the magnitude was in some cases not large or applied to a narrow age group. Most of the impact evaluations involved assessment of completely new programs and involved World Bank researchers. Most used quasi-experimental evaluation designs and two-thirds assessed impact after at most 3 years of program implementation. Only half of the evaluations documented the distribution of impacts and only a third presented information on the costs of the intervention (falling short of cost-effectiveness analysis). In two of the countries (Colombia and the Philippines) the evaluations likely had an impact on government policy or programs. Lessons A number of lessons for development practi-tioners and evaluators arose from the review of impact evaluations of World Bank nutrition support. For task managers: Impact evaluations of interventions that are clearly beyond the means of the government to sustain are of limited relevance. The complexity, costs, and fiscal sustainability of the intervention should figure into the decision as to whether an impact evaluation is warranted. Impact evaluations are often launched for the purpose of evaluating completely new pro-grams, but they may be equally or even more useful in improving the effectiveness of ongo-ing programs. There are methods for obtaining reliable impact evaluation results when randomized assignment of interventions is not possible for political, ethical, or practical reasons. For evaluators: In light of the challenges of evaluating large-scale programs with a long results chain, it is well worth the effort to assess the risks to disruption of the impact evaluation ahead of time and identify mitigation measures. The design and analysis of nutrition impact evaluations need to take into account the likely sensitivity of children of different ages to the intervention. For the purposes of correctly gauging im-pact, it is important to know exactly when delivery of an intervention took place in the field (as opposed to the official start of the program). Evaluations need to be designed to provide evidence for timely decision-making, but with sufficient elapsed time for a plausible impact to have occurred. The relevance of impact evaluations for po-licymakers would be greatly enhanced if im-pact evaluations were to document both the
Institute of Medicine,Food and Nutrition Board,Committee on International Nutrition Programs,Subcommittee on Diet, Physical Activity, and Pregnancy Outcome,Subcommittee on Nutrition and Diarrheal Diseases Control
Author : Institute of Medicine,Food and Nutrition Board,Committee on International Nutrition Programs,Subcommittee on Diet, Physical Activity, and Pregnancy Outcome,Subcommittee on Nutrition and Diarrheal Diseases Control Publisher : National Academies Press Page : 206 pages File Size : 40,6 Mb Release : 1992-02-01 Category : Medical ISBN : 9780309040921
Nutrition Issues in Developing Countries by Institute of Medicine,Food and Nutrition Board,Committee on International Nutrition Programs,Subcommittee on Diet, Physical Activity, and Pregnancy Outcome,Subcommittee on Nutrition and Diarrheal Diseases Control Pdf
This book considers two important international nutrition issues, provides a scientific evaluation, and proposes strategies for intervention at the community level. Part I, Diarrheal Diseases, considers the dietary and nutritional factors that may affect the risk of contracting diarrheal disease and presents programmatic implications of these findings. Part II, Diet and Activity During Pregnancy and Lactation, examines data on the extent to which women in the developing world are known to reduce or otherwise alter their activities and diets as a result of childbearing.